1.1 Gastroenterology

Question 1

what are the only two things that are diagnosed with biopsy in the esophagus

Answer 1

cancer barret esophagus

Question 2

🚩 progressive dysphagia to both solids and liquids at the same time

Answer 2

achalasia

Question 3

🚩 dysphagia progressing from solids to liquids

Answer 3

esophageal cancer

Question 4

endoscopy showing multiple concentric rings indicates?

Answer 4

eosinophilic esophagitis

Question 5

🚩 pain on swallowing on a person with AIDS

Answer 5

esophageal candidiasis

Question 6

dysphagia from solid food associated with schatzki ring

Answer 6

steakhouse syndrome

Question 7

Plummer-Vinson Syndrome TRIAD

Answer 7

1. dysphagia due to webs
2. iron deficiency anemia
3. glositis

Question 8

what procedures are contraindicated in patients with Zenker’s diverticulum

Answer 8

nasogastric tube

upper endoscopy

*may cause perforation

Question 9

vitamin D deficiency

Answer 9

hypocalcemia

osteoporosis

Question 10

vitamin K deficiency

Answer 10

bleeding and easy bruising

Question 11

vitamin B12 deficiency

Answer 11

anemia

hypersegmented neutrophils

neuropathy

Question 12

describe the pain of IBS

Answer 12

relieved by a bowel movement

less at night

relieved by a change in bowel habit

Question 13

antispasmodic agents that can be used in IBS

Answer 13

hyoscyamine

dicyclomine

peppermint oil

Question 14

diarrhea-predominant IBS, treatment?

Answer 14

rifaximin (antibiotic)

eluxadoline

alosetron (serotonin inhibitor)

Question 15

constipation predominant IBS, treatment?

Answer 15

fiber

polyethylene glycol (lubricant)

Question 16

screening for colon cancer with IBD

Answer 16

after 8-10 years of colonic involvement with colonoscopy every 1-2 yrs

Question 17

serologic testing for IBD:

ANCA positive?

Answer 17

ulcerative colitis

Question 18

serologic testing for IBD:

ASCA positive?

Answer 18

Chron’s disease

Question 19

🚩 left lower quadrant pain and tenderness, presenting with fever and leukocytosis?

Answer 19

diverticulitis

Question 20

what is the only indication for capsule endoscopy?

Answer 20

small bowel bleeding

bleeding that has been ruled out from an upper and lower source

Question 21

colon cancer screening:

single fam member

Answer 21

10 yrs before the age of their cancer OR 40 (younger)

every 10 yrs

under age 60: every 5 yrs

Question 22

HNPCC: syndrome + screening

Answer 22

hereditary nonpolyposis colon cancer syndrome

3 family members, 2 generations, 1 premature (<50)

start age 25, every 1-2 yrs

Question 23

FAP: syndrome + screening

Answer 23

familial adenomatous polyposis

thousands of polyps with positive APC test

sigmoidoscopy at age 12, every year

Question 24

colon cancer screening: previous adenomatous polyp

Answer 24

every 3-5 yrs

Question 25

colon cancer screening: previous history of colon cancer

Answer 25

1 yr mark 3 yr mark every 5 years

Question 26

colon cancer screening: peutz-jeghers syndrome

Answer 26

start at age 8, every 3 yrs

Question 27

colon cancer screening: gardner syndrome

Answer 27

**sigmoidoscopy** at age 12, every year

Question 28

colon cancer screening: juvenile polyposis

Answer 28

age 12, every year both **upper and lower GI**

Question 29

what patients require stress ulcer prophylaxis

Answer 29

1. mechanical ventilation 2. burns 3. head trauma 4. coagulopathy

Question 30

🚩 epigastric pain that is improved with eating?

Answer 30

duodenal ulcer

Question 31

🚩 epigastric pain that is worsened by eating?

Answer 31

gsatric ulcer

Question 32

what are the 4 methods of testing for H. pylori?

Answer 32

1. endoscopy + biopsy 2. serology (IgG) 3. urea breath testing 4. stool antigen detection

Question 33

🚩 acute epigastric pain + tenderness + vomiting?

Answer 33

pancreatitis!!!

Question 34

SAAG \<1.1 suggests?

Answer 34

* infection * cancer * nephrotic syndrome

Question 35

SAAG \>1.1 suggests?

Answer 35

* portal hypertension * CHF * hepatic vein thrombosis * constrictive pericarditis

Question 36

⚠️ variceal bleeding + ascitis

Answer 36

give SBP prophylaxis norfloxacin / TMP/SMX

Question 37

⚠️ anyone with SBP

Answer 37

life long prophylaxis for recurrence fluoroquinolone

Question 38

discriminant factor formula

Answer 38

4.6 x (patient PT - control PT) + bilirrubin \>32 = give steroids for acute alcoholic hepatitis

Question 39

in general what is the most accurate test for a patient with cirrhosis? whats the exception?

Answer 39

biopsy ## Footnote PCS

Question 40

everyone born between 19**45** - 19**65** should be tested for\_\_\_

Answer 40

hepatitis C

Question 41

treatment for genotype 1 hep C

Answer 41

ledipasvir _and_ sofosbuvir (PO)

Question 42

what causes pill esophagitis

Answer 42

doxycyclin alendronate (biphosponates) KCL

Question 43

presentation of fulminant C. diff

Answer 43

High WBC Metabolic Acidosis High Lactate High Creatinine

Question 44

best inital test for diverticulitis

Answer 44

CT SCAN ## Footnote colonoscopy and barium enema are dangerous (increase risk of perforation)

Question 45

🚩 depression + weight loss + jaundice

Answer 45

pancreatic cancer!

Question 46

🚩 recent travel to south america + dysphagia

Answer 46

chagas!!!

Question 47

charcot's triad reynold's pentad

Answer 47

triad: 1. RUQ pain 2. fever 3. jaundice pentad: 4. tachycardia 5. hypotension dx: cholangitis

Question 48

Gilbert Syndrome

Answer 48

congenital disease decrease in the amount of enzyme that conjugates bilirrubin = large amounts of **unconjugated bilirrubin**