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USMLE Step 3 > Gastro > Flashcards

Gastro Flashcards

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USMLE® Step 1 flashcards
1
Q

chances of cancer with Barret

A

0.5%

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2
Q

Chances of cancer in gastric ulcer

A

4%

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3
Q

Multiple gastric ulcers upon PPI and been off NSAIDs with neg testing for H.pylory

A

rule out Zollinger Ellison syndrome

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4
Q

ZES confirmation test

A

Secretin suppression test

Elevated Gastrin despite secretin

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5
Q

High Calcium + Gastrinoma

A

Look for MEN

Why

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6
Q

First test for Gastrinoma

A

Gastrin level off PPI

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7
Q

Gastrinoma staging test

A

EUS

Nuclear somatostatin scan

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8
Q

What test distinguishes between anemia of chronic disease and malabsorption
with both iron and vitamin B12/folate deficiency?

A

Red cell blood distribution width (RDW)

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9
Q

Ulcerative colitis AB

A

UC is ANCA positive/ASCA negative.

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10
Q

best initial test for the presence of fat in stool?

A

Sudan black stain

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11
Q

site of absorption of all divalent cations such as calcium, magnesium, and iron.

A

Duodenum

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12
Q

+ Ab in Celiacs Disease

A

Antitissue transglutaminase
Antiendomysial antibodies
Antigliadin antibodies

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13
Q

Joint pain in hemochromatosis

A

calcium pyrophosphate deposition of pseudogout

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14
Q

Causes of death in people with hemochromatosis

A

Cirrhosis: 60%
Hepatoma: 20%
Cardiac failure: 15%

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15
Q

most common cause of deaths from pancreatitis

A

inadequate fluid resuscitation.

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16
Q

More than 30% Necrosis of Pancreas

A

Antibiotics and Needle Biopsy Infected Necrotic

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17
Q

Endoscopy indications on GERD

A
  • More than 5 years with symptoms
  • Weight loss
  • Anemia
  • Positive FOB
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18
Q

Epigastric pain in adults >45

A

Do endoscopy

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19
Q

When do we treat H.pylori?

A

-Only when associated with Gastritis,MALt or Ulcer. There is no benefit in treating Helicobacter for GERD.

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20
Q

Indications to check Gastrin level

A
  • Large ulcer(>1 cm)
  • Multiple Ulcers
  • Distal location neat eh ligament of Treitz
  • Recurrent or persistent dispite helicobacter treatment
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21
Q

Crohn´s Disease Serology

A

+ ASCA

Antisaccharomyces cerevisiae

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22
Q

Ulcerative colitis serology

A

+ANCA

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23
Q

Best initial treatment for IBD

A

Mesalamine

24
Q

Perianal CD treatment

A

Metronidazole and Cipro

25
Q

Causes of infectious bloody diarrhea

A 
CAMPYLOBACTER
Salmonella
Vibrio parahaemolyticus
E.coli (o157:H7 HUS)
Vibrio vulnificus
Yersinia
Amebic
26
Q

Best initial test for infectious diarrhea

A

-Fecal leukocytes

27
Q

Most accurate test for infectious diarrhea

A

-Stool Culture

28
Q

Antibiotic indication in infectious diarrhea in bloody diarrhea

A
  • Blood
  • Fever
  • Abdominal pain
  • Hypotension and tachycardia
29
Q

best initial test for C.Diff

A

Stool toxin assay

30
Q

Most accurate test for C.Diff

A

Stool for PCR

31
Q

fat malabsorption diarrhea

A
  • Hypocalcemia
  • Oxalate overabsorption(oxalate stones)
  • Easy bruising and elevated PT-INR
  • Vitamin D malabsorption
32
Q

best initial test for malabsorption diarrhea

A
  • Sudan black stain of stool.

- Most acurate is 72 hours fecal fat

33
Q

Best initial test for Celiac´s

A
  • Antigliadin,antiendomysial and antitissue tranglutaminase.

- Most accurate its biopsy

34
Q

Tropical sprue treatment

A

-Doxycycline
-TMP
for 3 to 6 months

35
Q

whipple disease treatment

A

-Tetracycline or TMP for 12 months.

36
Q

secretin stimulation and secretin Secretion test

A

secretin stimulation is for pancratitis

Secretin supression is for gastrinoma

37
Q

best initial test for Pancreatitis

A

-CT Abdoment

Most accurate is Secretin stimulation test.

38
Q

Best treatment for IBS

A

FIBER, FIBER, FIBER

39
Q

How do we screen for colon cancer in :
Gardner´s syndrome
FAP
Peutz-Jeghers syndrome

A

Sigmoidoscopy yearly starting at age 12.

40
Q

Most common cause of death in GI bleeding

A

-Myocardial ischemia

41
Q

when do we transfuse

A

Hematocrit below 30

42
Q

When do we transfuse fresh frozen plasma

A

Elevated PT-INR

43
Q

When do we transfuse platelets

A

Patient is bleeding or surgery, when PTL<50 ,00

44
Q

Causes of upper GI bleeding

A
  • Ulcer
  • Esophagitis,gastritis,duodenitis
  • Varices
  • Cancer
45
Q

Causes of Lowe GI bleeding

A
  • Angiodysplasia
  • Diverticular disease
  • Polyps
  • Ischemic colitis
  • Inflammatory bowel disease
  • Cancer
46
Q

Most accurate test for Ischemic Mesenteric ischemia

A

Angiography

47
Q

Abdominal pain out of propostion to physical exam

A

-Ischemic mesenteric ischemia

SURGERY!!!

48
Q

what to do if CT shows >30% of pancreas necrosis

A

-Do CT-Guided necrosis , if infected or necrotic DO SURGICAL DEBRIDMENT.

49
Q

Treatment for hepatitis B

A

Tenofovir(gives bone demineralization)

50
Q

Indications for hepatitis B vaccine

A
  • Liver Disease
  • Health workers
  • Patient on dialysis
  • Diabetes
51
Q

SAAG>1.1

A

Portal Hypertension.

52
Q

Best initial test for Wilsons disease

A

Slit lamp

53
Q

Best initial test in hemochromatosis

A

Iron studies

54
Q

Best intial test in AIH

A

ASMA and ANA, LKM Ab.

55
Q

lynch syndrome SCOPE yearly since age 25

A

3 relatives
2 generations
1 premature(<50)

56
Q

best diagnostic test for diverticulosis

A

Barium enema

57
Q

Best diagnostic test for Diverticulitis

A

Abdominal and pelvic CT scan

USMLE Step 3 (19 decks)

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