Gastro

Question 1

Indicators for severe DCI

Answer 1

Leukoctyosus at >=15000
Crea >= 1.5 mg/dl

Question 2

Fulminant CDI

Answer 2

Severe CDI + hypotension, shock, ileus, megalcolon

Question 3

High risk for recurrent CDI

Answer 3

Age >65 yo
Immunocompromised
Severe CDI on presentation
Prior ep of CDI in the past 6months

Question 4

Suggestive findings on CT of Appendicitis

Answer 4

> Dilatation >6 mm with wall thickening
A lumen that does not fill with enteric contrast
Fatty tissue stranding or air surrounding the appendix (inflammation)

Question 5

Ultrasounf findings suggestive of appendicitis:

Answer 5

Wall thickening
Increased appendiceal diameter
Presence of free fluid

Question 6

Etiology of travelers diarrhea associated with cruise ships

Answer 6

Norovirus

Question 7

Single most important agent in travelers diarrhea

Answer 7

ETEC

Question 8

Major cause of dysentery in travelers diarrhea

Answer 8

Shigella

Question 9

Travelers diarrhea

• etiology in hikers and campers who drinks from freshwater streams

Answer 9

Giardia lamblia

Question 10

Travelers diarrhea

Etiology resistant to chlorin

Answer 10

Cryptosporidium

Question 11

Most common cause of intestinal obstruction

Answer 11

Post op adhesions

Question 12

Most common site of volvolus

Answer 12

Sigmoid

Question 13

Xray: coffee bean shaped dilated shadow

Answer 13

Volvolus

Question 14

Risk factors for volvolus

Answer 14

Institutionalization
Neuropsychiatric conditions requiring psychotropic medication
Chronic constipation
Aging (70s or 80s)

Question 15

Ct scan findings of cecal volvlus

Answer 15

Whorl deformity
Birds beak
C looo

Surgical decompression (laparotomy/laparoscopy)

Question 16

Most common site of GI TB

Answer 16

Ileocecal

Question 17

Abdominal xray: staircasing” pattern of dilated air and fluid-filled small-bowel loops >2.5 cm in diameter with little or no air seen in the colon

Answer 17

SBO

Question 18

• Mesenteric venous gas
• Pneumatosis intestinalis
• Pneumoperitoneum

Answer 18

Late findings (presence of bowel necrosis): Intestinal ischemia

Question 19

Most specific early finding of Intestinal Ischemia

Answer 19

Altered bowel wall enhancement

Question 20

True or False

Rectum is usually spared in colonic diverticula

Answer 20

True

> most common affecting the colon is pseudodiverticula

Question 21

most common cause of hematochezia in patients >60 years

Answer 21

Diverticula

Onlr 20% will have bleeding

Factors for increased risk of bleeding:
> Hypertension
> Presence of atherosclerosis
> Patients with regular use of antithrombotic therapy
> Regular use of NSAIDS
> Obesity
• Diabetes mellitus

Question 22

• Sigmoid diverticula
• Thickened colonic wall >4 mm
• Inflammation within the pericolic fat with or without the collection of contrast material or fluid

Answer 22

CT findings of Diverticulitis (confirming colon infection + inflammation)

Mgt Bowel rest
Antibiotics if Symptomatic Uncomplicated DD no difference

Question 23

Hinchey classification of Diverticulitis
I
II
III
IV

Answer 23

Confined abscess
Distant abscess
Noncommunication
Free communication with the peritoneum

Question 24

Causes of Mesenteri. vascular Insufficiency

Chronic:
Acute
Venous
Non occlusive

Answer 24

Chronic: atherosclerotic
Acute thrombosis and embolism
Venous hypercoagulable
Non occlusive acute hemodynamic instability

Question 25

part of colon at risk for colonic ischemia)

Answer 25

descending and sigmoid colon (Sudeck’s point:

Question 26

Markers if poor prognosis in hepatitis

Answer 26

Initial presenting features such as ascites, peripheral edema, and hepatic encephalopathy

Lab features

prolonged PT
low serum albumin level
hypoglycemia, and
very high serum bilirubin