10 USMLE Gastroenterology Quick Review Questions with Answers (Set 1)

These 10 quick USMLE review questions test the high-yield facts that show up again and again on the exam: lower GI bleeding, HIDA scan, retroperitoneal colon, enteric nervous system, pancreatic ducts, celiac disease, hepatitis B, achalasia, GERD and vomiting. Each question includes the correct answer.

Written by Dr. Ray Makar, MD, author of the Repeated USMLE Questions eBook series.

Prefer video? Watch daily USMLE case questions on MedFocus by Dr. Ray on YouTube.

How to use this page: read the question, pick your answer, then tap Show Answer and Explanation.

Questions

Question 1. Which one of the following conditions is the most likely cause of acute lower gastrointestinal bleeding in patients older than 40?

A- Colorectal cancer
B- Diverticulosis
C- Ulcerative colitis
D- Varicose veins

B- Diverticulosis
The correct answer is B

 

Question 2. Which of the following is the diagnostic test used when ultrasound is equivocal for cholecystitis?

A- Abdominal x-ray
B- CT scan
C- HIDA scan
D- Liver function tests

C- HIDA scan
The correct answer is C

 

Question 3. Which one the following parts of the large intestine is extraperitoneal?

A- Cecum
B- Descending colon
C- Sigmoid colon
D- Transverse colon

B- Descending colon
The correct answer is B

 

Question 4. Meissner’s plexus of nerves is located within which layer of the gastrointestinal tract?

A- External layer
B- Mucosa
C- Muscularis Externa
D- Submucosa

D- Submucosa
The correct answer is D

 

Question 5. Pancreatic exocrine secretions empty into the duodenum through which one of the following?

A- Accessory pancreatic duct
B- Common bile duct
C- Duct of Santorini
D- Duct of Wirsung

D- Duct of Wirsung
The correct answer is D

 

Question 6. Which of the following is/are the most likely biopsy features seen in Celiac disease?

A- Crypt abscesses with excess neutrophils
B- Flattening of villi with excess lymphocytes
C- Lack of ganglion cells
D- Lymphoid aggregates with granulomas

B- Flattening of villi with excess lymphocytes
The correct answer is B

 

Question 7. Which of the following is the earliest abnormal test after infection with hepatitis B?

A- ALT
B- Anti-hepatitis B antibodies
C- Serum bilirubin
D- Surface antigen

D- Surface antigen
The correct answer is D

 

Question 8. Which of the following tests is the most accurate one to confirm the diagnosis of achalasia?

A- Barium esophagram
B- Chest X-ray
C- Esophageal manometry
D- Upper endoscopy

C- Esophageal manometry- Esophageal manometry is the most accurate test for diagnosing achalasia because it directly measures lower esophageal sphincter relaxation and esophageal peristalsis. Barium swallow may show a “bird-beak” appearance, but it is not as definitive. Endoscopy rules out obstruction but does not confirm achalasia.
The correct answer is C

 

Question 9. Which of the following is the most appropriate next step in the management of a patient complaining of symptoms of GERD?

A- Barium swallow
B- Endoscopy
C- Omeprazole
D- Ranitidine

C- Omeprazole- For typical GERD symptoms without alarm features, the best initial management is a trial of a proton pump inhibitor such as omeprazole. Endoscopy and barium studies are not first-line unless there are concerning symptoms. Ranitidine is no longer recommended due to safety concerns and is less effective than PPIs.
The correct answer is C

 

Question 10. Prolonged vomiting results in which one of the following findings?

A- Metabolic acidosis with hypernatremia
B- Metabolic acidosis with hyperkalemia
C- Metabolic alkalosis with hyperkalemia
D- Metabolic alkalosis with hypokalemia

D- Metabolic alkalosis with hypokalemia
The correct answer is D

 

High-yield points from this set

  • Diverticulosis is the most common cause of acute lower GI bleeding.
  • HIDA scan confirms acute cholecystitis when ultrasound is unclear.
  • Manometry is the most accurate test for achalasia.
  • Prolonged vomiting causes hypokalemic metabolic alkalosis.

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