Physician Assistant Exam Practice Questions about the Digestive System
A lot of pathology concerns the digestive system and you can bet there will be questions about them on the Physician Assistant Exam (known as PANCE). Here are some lively questions about the GI system.
Example PANCE Questions
Which one of the following statements concerning colon cancer screening is correct??
(A) After the age of 50, a person should obtain a sigmoidoscopy every 10 years.
(B) Fecal occult blood testing (FOBT) should be done every year after the age of 35.
(C) A colonoscopy should be done every 5 years, first starting at age 60.
(D) If a person’s brother has a history of colon cancer, the sibling should obtain a colonoscopy 5 years prior to the age at which her sibling was diagnosed.
(E) After the age of 50, a colonoscopy should be done every 10 years.
Which of the following is an example of a physiologic function of the pancreas?
(A) Secretion of cholecystokinin
(B) Secretion of pepsinogen
(C) Secretion of glucagon
(D) Absorption of calcium
(E) Absorption of bicarbonate
You’re evaluating a 65-year-old man with advanced colon cancer for a possibility of recurrence. Which of the following laboratory studies would you order at this time?
(B) CA 19-9
(C) CA 125
(D) Erythrocyte sedimentation rate (ESR)
(E) Alpha-fetoprotein (AFP)
Which of the following medications has been used in the treatment of hepatitis B?
(A) Ribavirin (Rebetol)
(B) Interferon alpha (Intron-A)
(E) Lamivudine (Epivir)
Which of the following tests would you order for someone in whom you suspect celiac disease?
(A) Carcinoembryonic antigen (CEA)
(B) Anticentromere antibody
(D) Tissue transglutaminase antibody
(E) Anti-Smith antibody
Which one of the following medications would you give to treat someone with cytomegalovirus esophagitis?
(A) Acyclovir (Zovirax)
(B) Ganciclovir (Cytovene)
(C) Fluconazole (Diflucan)
(D) Interferon alpha (Intron-A)
Example PANCE Answers and Explanations
Use this answer key to score the practice digestive system questions. The answer explanations give you some insight into why the correct answer is better than the other choices.
1. E. For anyone with no significant family history of colon cancer, it’s recommended that the person obtain a colonoscopy every 10 years, starting at age 50. A sigmoidoscopy should be done every 5 years after the age of 50, and fecal occult blood testing should be done annually. If the person has a first-degree relative who was diagnosed with colon cancer, the person should have a colonoscopy 10 years before the age at which his or her sibling was diagnosed.
2. C. Understanding physiology is just as important as understanding pathology. The pancreas has an endocrine and an exocrine function. The pancreas secretes bicarbonate and glucagon. It does not absorb bicarbonate or calcium, Choices (D) and (E). The absorption of calcium takes place in the small intestine. Pepsinogen, Choice (B), is secreted by the chief cells of the stomach. Cholecystokinin, Choice (A), is secreted by the duodenum.
3. A. The CEA is elevated in colon cancer. CA-19-9, Choice (B), is elevated in pancreatic cancer, and CA 125, Choice (C), is a tumor marker elevated in ovarian cancer. The sed rate, Choice (D), is usually elevated in an inflammatory state, so it’s nonspecific. Choice (E), alpha-fetoprotein, is elevated in hepatocellular cancer.
4. E. Choices (A) and (B), ribavirin and interferon alpha, are used in the treatment of hepatitis C. Choice (C), steroids, is used in the treatment of autoimmune hepatitis, a condition you see predominantly in young women. Choice (D), plasmapheresis, is used to treat thrombotic thrombocytopenic purpura (TTP). Choice (E), lamivudine, has been used in the treatment of hepatitis B, although it’s primarily used to treat HIV.
5. D. Someone with celiac disease has a sensitivity to the protein gluten. Wheat can stimulate a gluten sensitivity in a susceptible person. The antibody tests used to diagnose celiac disease are an anti-gliadin antibody test and a tissue transglutaminase antibody, Choice (D). Choice (A), carcinoembryonic antigen, is a tumor marker used to monitor potential recurrence of colon cancer. Choice (B), anticentromere antibody, is the antibody for CREST syndrome. Choice (C), HLA-B27, is associated with seronegative spondyloarthtopathies, including inflammatory bowel disease, Reiter’s syndrome, and ankylosing spondylitis. Choice (E), anti-Smith antibody, is present in someone who has systemic lupus erythematosus.
6. B. Ganciclovir (Cytovene), Choice (B), is used in treating cytomegalovirus (CMV) esophagitis. Acyclovir, Choice (A), is used in treating herpes simplex virus (HSV) esophagitis, and fluconazole, Choice (C), is used in treating Candida esophagitis. Interferon alpha, Choice (D), is used in treating hepatitis C, and steroids, Choice (E), are used in treating autoimmune hepatitis.