Gastroenterology ABIM Exam Question Bank

35 CME & MOC Points


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Gastroenterology Sample Questions:

Question 1

What is the most clinically expeditious method to differentiate hypergastrinemia due to gastrinoma from gastrin elevation due to PPI therapy?

A) Basal and maximal acid output
B) Secretin stimulation
C) Gastric pH
D) Serum chromogranin A

Answer
C) Gastric pH


Explanation
Correct: (C) Gastric pH. Explanation: pH testing of gastric secretions is the most expeditious method of ruling out gastrinoma. Gastric pH will be acid (low) if hypergastrinemia is due to gastrinoma; however, causes of elevated gastrin due to hypochlorhydria (PPI use, atrophic gastritis) will reveal a relatively neutral pH. Secretin stimulation and acid output testing are useful to confirm the diagnosis of gastrinoma but require specialized equipment not as readily available as pH paper. Serum chromogranin A is a diagnostic test for gastrinoma but is not as expeditious as simply checking the gastric acidity.

Reference
Yamada's Handbook of Gastroenterology, 3rd Edition


Question 2

On CT scan, a 45-year-old man was incidentally found to have a well-circumscribed, round, 3 cm mass that appeared to arise from the wall of the stomach. What is the next appropriate step in evaluation?

A) Esophagogastroduodenoscopy
B) Upper GI series with barium
C) Follow-up CT scan in 6 months to assess for interval growth
D) EUS FNA
E) Non-contrast CT chest

Answer
D) EUS FNA


Explanation
Correct: (D) EUS FNA. Explanation: The mass described in the CT scan is likely to represent a subepithelial mass that will require EUS to image and also to perform EUS-guided FNA of the lesion for a tissue diagnosis. EGD and upper GI series are unlikely to provide any additional information and endoscopic imaging of the lesion can be performed at the time of EUS.

Reference
Yamada's Handbook of Gastroenterology, 3rd Edition

Questions taken from the BoardVitals Gastroenterology ABIM Exam Question Bank.

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