Gastro

Question 1

Indications of cholecystectomy in Gallbladder polyps

Answer 1

1. Gallstones or biliary colic
2. Size >/= 1 cm
3. Size > 8 mm + PSG
4. If increased in size as following:

• size =/< 5 mm and repeated U/S in 12 months
• size 6-9 mm repeated U/S in 6 month

Question 2

SBP is diagnosed by

Answer 2

Ascitic fluid neutrophils >= 250

Question 3

SBP long term prophylaxis

Answer 3

Fluoroquinolone

Question 4

SBP treatment

Answer 4

3rd Generation cephalosporin
With
IV albumin ( 1.5 g/kg at day 1 & 1 g /kg at day 3 ) )

Question 5

Confirm diagnosis of Hepatopulmonary syndrome by

Answer 5

Agitated saline administration during ECHO

Question 6

Treatment of hepatopulmonary syndrome

Answer 6

1. O2
2. Liver transplantation

Question 7

Hepatorenal syndrome treatment

Answer 7

1. Treatment of precipitating conditions
2. DC diuretics
3. Volume expansion with iv albumin
4. Iv terlipressin or norepinephrine or
   Trial of oral midodrine and octreotide
5. Urgent liver transplantation evaluation
6. Hemodialysis if kidney function not improved

Question 8

Treatment of Hepatic encephalopathy

Answer 8

1. Precipitating cause
2. Lactulose with goal of ~ 3 bowel movement per day.

Question 9

Only Anti HBVs +

Answer 9

Immunization

Question 10

HBVs Ag
Anti HBVc ( IgM)
HBVe Ag

Answer 10

Acute infection

Question 11

Anti HBVs
Anti HBVc IgG
Anti HBVe (+/-)

Answer 11

Resolved infection

Question 12

HBVs Ag
Anti HBVc IgG
HBVe Ag

Answer 12

Immune tolerant

Question 13

HBVs Ag
Anti HBVc IgG
HBVe Ag

& high LFT

Answer 13

Immune active

Question 14

HBVs Ag
Anti HBVc IgG
Anti HBVe

Answer 14

Immune control

Question 15

Indications of treatment for HBV

Answer 15

1. Acute liver failure
2. Immune active
3. Reactivation
4. Cirrhosis
5. Immunosuppressed patients

Question 16

Treatment of peptic ulcer disease and low risk for rebleeding (clean-based ulcer, ulcers with pigmented spots)

Answer 16

1. can start oral feeding within 24 hours of endoscopy.
2. once-daily oral PPI
3. discharged from the hospital.

Question 17

In Gastric varices which imaging should be performed to determine the best treatment.

Answer 17

Abdominal CT with contrast

Question 18

Timing of next colonoscopy after removal of adenoma =/ > 10 mm

Answer 18

3 years

Question 19

Timing of next colonoscopy after removal of 3-4 adenomas < 10 mm

Answer 19

3-5 years

Question 20

CRC CHEMOPREVENTION RECOMMENDATION

Answer 20

Low dose ASA in those aged 50-59 years at increased risk for CVD

Question 21

Age to initiate screening for gastric ca in Lynch syndrome

Answer 21

30 - 35 years

Question 22

Recommended surveillance in serrated polyposis syndrome

Answer 22

Colonoscopy every 1-3 years, removal of polyps > 5 mm

Question 23

FAP genetic testing

Answer 23

APC gene testing

Question 24

Age to initiate colonoscopy in Lynch syndrome

Answer 24

Age 20-25 years or 10 years before earliest age of family CRC diagnosis

Question 25

Nonimmune person exposed to HAV
Should receive

Answer 25

Post exposure prophylaxis with HAV vaccine as soon as possible

Question 26

Post exposure prophylaxis with HAV vaccine & immune globulin
May be considered for

Answer 26

Nonimmune patients older > 40

Question 27

Treatment of SBP

Answer 27

3rd Gen. Cephalosporins

Albumin infusion in the presence of kidney or Hepatic dysfunction (bil > 4 ((68.4)) ).

Question 28

Fecal osmotic gap is calculated as

Answer 28

290 - ( 2 x ( stool Na + stool K ) )

If > 100 suggests osmotic diarrhea

Question 29

Glucose breath test

Answer 29

Diagnose small intestinal bacterial overgrowth

Question 30

Hepatic abscess >= 3

Answer 30

Percutaneous needle aspiration

Question 31

Sessile serrated polyps
Colonoscopy surveillance

Answer 31

1-2 polyps < 10 mm {5-10 years}

3-4 polyps < 10 mm {3-5 years }

5-10 polyps < 10 mm { 3 years }

Polyp > 10 mm { 3 years }

Question 32

Serous cystadenoma treatment

Answer 32

It’s not malignant
No intervention

Question 33

Fundic gland polyps
F/u endoscopy?

Answer 33

No f/u
It’s benign