Question 1

A 35-year-old woman presents with recurrent abdominal pain at least 3 days per month for the past 3 months. The pain is relieved by defecation and is associated with a change in stool frequency and form. Which of the following is the most likely diagnosis based on the Rome IV criteria?

Accepted Answer

Irritable Bowel Syndrome (IBS)

Question 2

Which of the following best differentiates secretory diarrhea from osmotic diarrhea during a period of fasting?

Accepted Answer

Secretory diarrhea persists during fasting, while osmotic diarrhea improves or resolves.

Question 3

A patient with chronic diarrhea is found to have excessive loss of potassium and metabolic acidosis. Which of the following is the most likely underlying mechanism?

Accepted Answer

Excessive intestinal fluid secretion leading to electrolyte loss

Question 4

Which of the following is NOT considered an alarm symptom in the clinical presentation of constipation?

Accepted Answer

Straining during defecation

Question 5

A 28-year-old woman with IBS-D is prescribed alosetron. What is the mechanism of action of this medication?

Accepted Answer

Serotonin (5-HT3) antagonist

Question 6

Which of the following is a common cause of acute, non-inflammatory diarrhea?

Accepted Answer

Bacterial toxin-mediated fluid secretion

Question 7

A patient with constipation is found to have normal GI motility and frequency but passes hard stools. Which type of primary constipation does this represent?

Accepted Answer

Normal transit constipation

Question 8

Which of the following medications is most appropriate for treating constipation by increasing water secretion into the GI lumen?

Accepted Answer

Lubiprostone

Question 9

A 45-year-old man presents with frequent, loose stools for 5 weeks. He has a history of Crohn disease. Which type of chronic diarrhea is most likely in this patient?

Accepted Answer

Inflammatory diarrhea

Question 10

Which of the following best describes the pathophysiology of IBS according to the central hypothesis?

Accepted Answer

Dysfunction of the brain-gut axis involving the central and enteric nervous systems

Question 11

A patient with diarrhea is found to have a stool osmotic gap of 120 mOsm/kg. Which type of diarrhea does this most likely indicate?

Accepted Answer

Osmotic diarrhea

Question 12

Which of the following is a recommended first-line lifestyle modification for the treatment of constipation?

Accepted Answer

Increase dietary fiber intake to 20-35 g/day

Question 13

A patient with IBS-C is prescribed tegaserod. What is the mechanism of action of this drug?

Accepted Answer

Serotonin (5-HT4) agonist

Question 14

Which of the following is a potential complication of untreated chronic diarrhea?

Accepted Answer

Metabolic acidosis

Question 15

A 50-year-old woman presents with constipation, anemia, and unintended weight loss. What is the most appropriate next step?

Accepted Answer

Evaluate for possible colorectal malignancy

Question 16

Which of the following best explains why loperamide is used in the treatment of diarrhea?

Accepted Answer

It decreases intestinal motility by acting on opioid receptors in the gut

Question 17

A patient with IBS-D is prescribed rifamycin. What is the rationale for this therapy?

Accepted Answer

It is an oral antibacterial agent targeting gut microbiota

Question 18

Which of the following is a key factor in the pathophysiology of IBS involving the immune system?

Accepted Answer

Low-grade inflammation and increased intestinal permeability

Question 19

A patient with chronic constipation is found to have pelvic floor muscle dysfunction. Which type of primary constipation does this represent?

Accepted Answer

Disorders of defecation

Question 20

Which of the following is the most appropriate initial management for a patient with acute infectious diarrhea?

Accepted Answer

Rehydration and electrolyte replacement

Alterations in Gastrointestinal (GI) Motility and Related Disorders: Diarrhea, Constipation, and Irritable Bowel Syndrome (IBS)

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