Esophagus And stomach

Question 1

What finding proves a diagnosis of GERD?

Answer 1

-EGD with prior esophagitis, peptic stricture, Barrett’s esophagus on endoscopy
-prior abnormal pH study

Question 2

What predicts response to antireflux (PPI) therapy?

Answer 2

Abnormal acid exposure on pH monitoring

Question 3

the atypical reflux symptom most likely to respond to a trial of PPI therapy?

Answer 3

Noncardiac chest pain

Question 4

Common location for pill-induced esophagitis?

Answer 4

The proximal esophagus at the level of the aortic arch (transition zone between skeletal and smooth muscle)

Question 5

Barrett’s nodule wholly resected with HGD. Next step?

Answer 5

RFA

Question 6

Barrett’s patient. After how many sessions of RFA is the patient is an RFA failure?

Next step?

Answer 6

5

Cryotherapy

Question 7

Nissen Complications
1. gastric folds are seen proximal to the wrap
2. wrap is seen around the stomach rather than the GEJ
3. passage of the scope may encounter resistance, and proximal dilation may be seen
4. initial retroflexed view does not show a visible wrap at the hiatus and closer inspection demonstrates a wrap proximal to the hiatus

Answer 7

1. Slipped
2. Malpositioned
3. Tight wrap
4. Herniated wrap

Question 8

Gastric hyperplastic polyp result from inflammatory proliferation of what cells?

Answer 8

Foveolar

Question 9

These cells secrete what?
1. Parietal
2. enterochromaffin-like (ECL)
3. chief cells secrete

Answer 9

1. Acid
2. Histamine
3. Pepsinogen

Question 10

Which is more sensitive for pernicious anemia: parietal cell antibody or intrinsic factor antibody?

Answer 10

parietal cell antibody

Question 11

Octreotide nuclear medicine test is used for?

Answer 11

Find carcinoid, pancreatic neuroendocrine tumors, and to localize sarcoidosis

Question 12

Types of gastric carcinoids? Risk of metastasis?

Answer 12

Type 1 - chronic atrophic gastritis. <5% metastasis.

Type 2 - Zollinger-Ellison syndrome and MEN-1 syndrome. They have a metastatic risk of approximately 10 percent.

Sporadic, or type 3, gastric carcinoids have the highest malignant potential with a metastatic risk greater than 50 percent.

Question 13

buspirone can be used to treat?
Mechanism?

Answer 13

Functional dyspepsia

Fundic relaxation and accommodation

Question 14

risk factors in the development of dysplasia in fundic gland polyps

Answer 14

Size, antral gastritis and familial adenomatous polyposis (FAP) syndrome

Question 15

Glasgow-Blatchford vs Rockall?

Answer 15

Admission vs mortality

Question 16

gastrin? pH? Parietal cell mass?

Of:
1) corpus predominant H pylori gastritis
2) pernicious anemia
3) GOo

Answer 16

1) High, high, low
2) high, high, low
3) elevated (due to obstruction), low

Question 17

Quadruple therapy?

Answer 17

PPI, tetracycline, metronidazole and a bismuth salt

Question 18

The only established independent risk factors for stress ulcers are:

Answer 18

1) mechanical ventilation for 48 hours or longer
2) coagulopathy (plt less than 50k or INR greater than 1.5)

Question 19

ZE workup?

Answer 19

1)gastrin level
2) basal gastric output and peak acid output (following pentagastrin administration)