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USMLE Step 3 > GASTRO > Flashcards

GASTRO Flashcards

1
Q

Difference between acid stricture and plummer vinson

A

plummer = proximal, acid = distal

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2
Q

Treatment of non-infectious esophagitis (drugs: doxy, KCl, eosinophilic)

A

Steroid inhaler (swallow), PPI

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3
Q

Most accurate test for achalasia ________

A

Mannometry : huge pressures at GE junction

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4
Q

Indications for Scoping for Barrett’s Surveillance Among GERD patients

A

1) Alarm symptoms: Anemia, weight loss, FOBT +
2) Reflux symptoms for 5 - 10 years
3) Previous endoscopy positive: q2-3 years surveillance

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5
Q

_______ is usually beneficial to treat when there is ulcerative disease or gastric inflammation

A

H Pylori

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6
Q

Risk of PPI

A

Ca2+/Mg2+ malabsorption, bacterial invasion, interstitial nephritis

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7
Q

Indication for stress ulcer prophylaxis (PPI)

A

1) Head Trauma/Burns
2) Intubated
3) Sepsis
3) Coagulopathy
4) Steroid Use

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8
Q

Zollinger Ellison ulcers are usually present _______

Most accurate test _____

A

distal duodenum

Secretin suppression, but usually you get a hint with the serum gastrin level

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9
Q

_____ kidney stones are common among IBD patients

A

calcium oxalate (oxalate re-absorption failure)

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10
Q

Markers for Crohns _____, _____

A

ASCA, c-ANCA

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11
Q

When to start TNF in Crohns_____

A

Fistulized disease (Infliximab, Adalimumab)

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12
Q

Treatment Paradigm

Mesalamine—> AZT/6MP –> ______

A

Vedolizumab (Integrin a4b7 inhibitor, gut specific anti-inflammatory)

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13
Q

Salvage therapy for EHEC HUS ________

A

Eculizumab (complement inhibitor, hemolysis stop)

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14
Q

True/False : Drain amoeba liver abscess ______

A

False

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15
Q

______ GI infection is associated with Reiters syndrome

A

Shigella

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16
Q

diarrhea, wheezing after eating fish _______

A

Scramboid; Tx: Antihistamine

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17
Q

Bezlotoxumab is a salvage therapy for _____

A

C.diff (following dose escalated Vanc, fidaxomixin)

You can re-use vancomycin if it worked the first time, for re-infection

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18
Q

_____ is a hallmark of lactose intolerance

A

increased stool osmolarity

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19
Q

____ is a GI tumor, characterized by episodes of hypotension, wheezing, flushing, diarrhea. Treatment is _____

A

Carcinoid , Octreotide

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20
Q

D xylose test is used to assess _____

A

Celiac disease, malabsorption indicated by low serum/urine D xylose

21
Q

______ is an idiopathic malabsorption condition suspected to be due to infectious disease, results in villi flattening and nutritional deficiencies (folate, ADEK). Treatment ________

A

Tropical Sprue

Metronidazole 3 - 6 months

22
Q

PAS + stain organism, classic for _____

A

Whipple Disease (Male, Age 50, arthralgia)

23
Q

_____ test helps diagnose chronic pancreatitis

A

Secretin challenge (like in Zollinger Ellison), high fecal bicarb

24
Q

When antibiotics during pancreatitis_____

A

necrotizing, needs surgery

25
Q

____ and ___ markers indicate PBC (primary billiard cirrhosis), this antibody helps in diagnosis ____

A

IgM, ALP (isolated), Anti-mitochondrial

26
Q

Treatment of Wilsons_____

A

Penicilamine, Trientine

27
Q

Bronze diabetes is pathopnemonic for _____. Treated with ____

A

Hemachromatosis , Deforoxamine

Hint: high iron, low TIBC

28
Q

_____ is a marker for auto-immune hepatitis

A

anti-smooth muscle

29
Q

Shigella, Campylobacter, ________ EHEC, Salmonella are examples of bloody diarrhea

A

Entaemeba histolytica

30
Q

Common cause of chronic diarrhea in children _______

A

Fruit Juice

31
Q

_______ is a stain used to test feces for fat malabsorption

A

Sudan Black, most accurate = 72hr fecal fat

32
Q

Best initial test for pyloric stenosis ______

A

US Abdomen

33
Q

Best initial test for mal-rotation, volvulus _____

A

US Abdomen with Doppler

34
Q

Best initial test for esophageal atresia _____

A

Gastrograffin esophogram, choking when eating due to TE fistulization

35
Q

CHARGE association

A 
C : Coloboma/CNS
H: Heart defect
A: Choanal Atresia 
R: retarded growth 
G: GU (hypogonadism)
E: Ear (Deaf)
36
Q

Window Period

A

This patient has acute hepatitis B. The “window period” refers to that period in infection when neither hepatitis B surface antigen (HBsAg) nor its antibody (HBsAb) can be detected in the serum of the patient. It is an immunologically mediated phenomenon caused by the precipitation of antigen-antibody complexes in their zone of equivalent concentrations and, thereby, their removal from the circulation.

Because of this, the first thing that will happen in the window period is that the serum will become negative for the surface antigen (HBsAg) as that antigen is precipitated out of the serum by developing levels of its specific antibody (HBsAb). Serologic tests conducted during the window period will be positive for HBcAb and HBeAb.

37
Q

hemachromatosis characterized by High serum iron/ferritin , _____TIBC (inverse of iron deficiency)

A

Low, pretend like anemia of chronic disease

38
Q

45+ with epigastric pain ______

A

Automatic endoscopy EGD consult

39
Q

Zollinger Ellison wit hypercalcemia ____

A

MEN syndrome

40
Q

Zollinger Ellison Diagnosis ____

A

Secretin suppression test

Somatostatin Scan

EUS

41
Q

Indication for antibiotics in Crohns____

A

Perianal Crohns

42
Q

How to treat Cryptosporidium GI infection____

A

HAART,

43
Q

Hepatitis A post-exposure prophylaxis

1) Age<12 months_____
2) Age> 12 months_____

A

Ig

Vaccine

Give both if immunocompromised

44
Q

Hep B post exposure prophylaxis

1) Naive vaccine_____
2) Child_____
3) Vaccinated_____

A

Ig + Vaccine

Ig + Vaccine

Check serology, then vaccinate

45
Q

Cirrhotics should get ultrasound q_____ for HCC screening

A

6 months

46
Q

Treatment of PBC

1) Ursodeoxycholic acid
2) _____

Common complication____

A

Obeticholic acid

Osteoporosis

47
Q

____ _disease is characterized by pseudogout, bronze diabetes, panhypo-pit (infiltration), cirrhosis

Dx_______

A

Hemachromatosis

Iron panel: High Iron/Ferritin low TIBC, high iron Sat —> MRI/HFe gene mutation

48
Q

_____ associated with young woman with auto-immune disease (ITP, thyroiditis, hemolytic anemia), ANA + , Anti smooth muscle + , SPEP; Hypergamma

A

Autoimmune hepatitis

USMLE Step 3 (19 decks)

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