1. A 54-year-old male presents with melena, hematemesis, and a history of alcohol abuse. Which of the following is the most likely diagnosis? A. Peptic ulcer disease B. Acute pancreatitis C. Esophageal varices D. Gastric cancer Answer: C. Esophageal varices Rationale: The presence of melena and hematemesis in a patient with a history of alcohol abuse suggests esophageal varices due to portal hypertension. 2. A patient is diagnosed with celiac disease. Which of the following dietary changes is most appropriate? A. Gluten-free diet B. Low-residue diet C. High-fiber diet D. Lactose-free diet Answer: A. Gluten-free diet Rationale: Celiac disease is an autoimmune disorder where ingestion of gluten leads to damage in the small intestine. 3. Which laboratory finding is typically observed in a patient with acute pancreatitis? A. Decreased amylase B. Elevated bilirubin C. Elevated lipase D. Decreased C-reactive protein Answer: C. Elevated lipase Rationale: Elevated serum lipase is more specific to the pancreas and remains elevated longer than amylase in acute pancreatitis. 1. Which of the following is a risk factor for developing peptic ulcers? A. Chronic stress B. Low dietary fiber intake