Gastroenterology Board Exam Started: Jul 12, 2026 22:47 Page 54 of 58 Attempt #1262 Overall: 0 / 286 questions answered Question 266 / 286 Not answered In an outpatient specialty clinic: a 81-year-old man has hematemesis with melena with risk profile of gallstones. After initial stabilization and assessment, what is the most appropriate management step? A. Urgent ERCP for biliary obstruction with sepsis B. IBD induction therapy per severity C. Lactulose for overt hepatic encephalopathy D. Aggressive IV fluid resuscitation in pancreatitis E. Proton pump inhibitor-based therapy Show Answer & Explanation Correct Answer: C Explanation: Lactulose for overt hepatic encephalopathy is preferred because it aligns with guideline-based care priorities, reduces avoidable complications, and supports safe outcomes in Gastroenterology. Reference: ECCO Guidelines for Inflammatory Bowel Disease Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 267 / 286 Not answered In an emergency department assessment: a 46-year-old man is evaluated for ascites with confusion in the context of chronic viral hepatitis. Which is the most appropriate next investigation? A. Colonoscopy with biopsy B. Abdominal ultrasound C. Serum lipase measurement D. MRCP when indicated E. Diagnostic paracentesis Show Answer & Explanation Correct Answer: D Explanation: MRCP when indicated is the most appropriate next test because it directly clarifies the leading diagnosis and guides immediate management in Gastroenterology. Reference: AASLD Guidance for Cirrhosis Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 268 / 286 Not answered In an emergency department assessment: a 60-year-old man presents with right upper quadrant pain with jaundice. Relevant risk context includes chronic viral hepatitis. What is the most likely diagnosis? A. Crohn disease B. Acute pancreatitis C. Decompensated cirrhosis D. Peptic ulcer disease E. Acute cholangitis Show Answer & Explanation Correct Answer: E Explanation: The pattern of right upper quadrant pain with jaundice with risk factors such as chronic viral hepatitis is most consistent with Acute cholangitis. This answer best matches the expected diagnostic framework for Gastroenterology. Reference: Tokyo Guidelines for Cholangitis Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 269 / 286 Not answered In an emergency department assessment: a 44-year-old man presents with ascites with confusion. Relevant risk context includes family history of IBD. What is the most likely diagnosis? A. Decompensated cirrhosis B. Acute cholangitis C. Peptic ulcer disease D. Acute pancreatitis E. Crohn disease Show Answer & Explanation Correct Answer: A Explanation: The pattern of ascites with confusion with risk factors such as family history of IBD is most consistent with Decompensated cirrhosis. This answer best matches the expected diagnostic framework for Gastroenterology. Reference: ECCO Guidelines for Inflammatory Bowel Disease Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Question 270 / 286 Not answered During ward handover: a 66-year-old woman presents with epigastric pain radiating to back. Relevant risk context includes family history of IBD. What is the most likely diagnosis? A. Acute cholangitis B. Peptic ulcer disease C. Ulcerative colitis D. Crohn disease E. Acute pancreatitis Show Answer & Explanation Correct Answer: A Explanation: The pattern of epigastric pain radiating to back with risk factors such as family history of IBD is most consistent with Acute cholangitis. This answer best matches the expected diagnostic framework for Gastroenterology. Reference: Tokyo Guidelines for Cholangitis Comments & Discussion No comments yet. Be the first to comment! Your Name * Your Comment * (Max 200 chars) 200 characters remaining Post Comment Comments remaining this hour: 10/10 Cancel « ← Previous Page 54 of 58 Next → »