gastro

Question 1

When to screen Barrett esophagus

Answer 1

No dysplasia -> 1 year, then every 3 years.
Low-grade -> every 6 months.
High-grade -> ablation

Question 2

Treatment for H. pylori

Answer 2

Clarithromycin, amoxicillin (or metronidazole), and PPI for 10-14 days

Question 3

Thiamine deficiency signs

Answer 3

Nystagmus, ophthalmoplegia, ataxia, and confusion

Question 4

Study to predict severity of pancreatitis

Answer 4

BUN

Question 5

stool osmotic gap

Answer 5

290 - 2 x [stool Na - tool K] ->

100 is osmotic

Question 6

Celiac disease serologic test

Answer 6

tissue transglutaminase IgA

Question 7

Sign of ulcerative colitis

Answer 7

acute onset, start at rectum, continuous mucosal microulcerations

Question 8

Sign of Crohn disease

Answer 8

gradual onset, transmural disease with skip lesions

Question 9

Dermatologic signs of IBS

Answer 9

erythema nodosum and pyoderma gangrenosum

Question 10

Who gets acute mesenteric ischemia

Answer 10

older than 50 with cardiac disease

Question 11

Presentation of acute mesenteric ischemia

Answer 11

acute onset of acute pain, soft abdomen, pain out of proportion to exam

Question 12

Hereditary Nonpolyposis Colorectal Cancer

Answer 12

colorectal adenomas develop by age 20-30

Question 13

Familial Adenomatous Polyposis

Answer 13

hundreds of colorectal adenomas by age 16

Question 14

Peutz-Jeghers Syndrome

Answer 14

mucocutaneous melanocytic macules and gastrointestinal hamartomatous polyps

Question 15

Polyp, low risk screening

Answer 15

1-2 adenomas, repeat in 5-10 yrs

Question 16

Polyp, high risk screening

Answer 16

> 2 adenomas, >1cm, villous, high grade dysplasia -> repeat in 3 yrs

Question 17

Extrahepatic manifestations of hepatitis B

Answer 17

polyarteritis nodosum and membranous glomerulonephritis

Question 18

Extrahepatic manifestations of hepatitis C

Answer 18

mixed cryoglobulinemia, membranoproliferative glomerulonephritis, porphyria cutanea tarda, and non-Hodgkin lymphoma

Question 19

Signs of primary biliary cirrhosis

Answer 19

50 yo women with fatigue, dry eyes and mouth, and pruritis

Question 20

Blood tests for primary biliary cirrhosis

Answer 20

elevated alkaline phosphatase, ast, alt, normal bilirubin. often antimitochondrial antibodies

Question 21

Histology for primary biliary cirrhosis

Answer 21

focal duct obliteration with granuloma formation

Question 22

Signs of primary sclerosing cholangitis

Answer 22

40 yo, with pruritis, abdominal pain and jaundice. many with inflammatory bowel disease

Question 23

Blood tests for primary sclerosing cholangitis

Answer 23

elevated alkaline phosphatase, ast, alt.

Question 24

Imaging for primary sclerosing cholangitis

Answer 24

cholangiography shows segmental bile duct fibrosis with saccular dilatation resulting in “beads on a string”

Question 25

Histology for primary sclerosing cholangitis

Answer 25

periductal fibrosis with inflammation, bile duct proliferation, and ductopenia

Question 26

Treatment for primary biliary cirrhosis

Answer 26

ursodeoxycholic acid and transplant

Question 27

Treatment for primary sclerosing cholangitis

Answer 27

transplant

Question 28

Treatment for esophageal varices

Answer 28

non-selective beta-blockers and band ligation, TIPS

Question 29

serum - ascites albumin gradient

Answer 29

>1.1 and ascites protein 2.5 is chf

Question 30

Spontaneous bacterial peritonitis

Answer 30

ascitic culture is positive and pmn > 250

Question 31

Signs of intrahepatic cholestasis of pregnancy

Answer 31

2-3 trimester, pruritis, jaundice, elevated bile acids

Question 32

Treatment of intrahepatic cholestasis of pregnancy

Answer 32

ursodeoxycholic acid

Question 33

Signs of Hemolysis, Elevated Liver enzymes, and Low Platelets

Answer 33

3rd trimester, abdominal pain, new onset nausea, vomiting, pruritis, jaundice.

Question 34

Treatment for HELLP

Answer 34

delivery

Question 35

Budd-Chiari syndrome

Answer 35

hepatic venous outflow tract obstruction not related to cardiac failure

Question 36

Prophylactic cholecystectomy

Answer 36

gallbladder polyps >1cm, gallstones >3cm, or porcelain gallbladder

Question 37

Risk for cholangiocarcinoma

Answer 37

primary sclerosing cholangitis, biliary atresia, biliary cysts and chronic infection with liver flukes

Question 38

Dieulafoy lesions

Answer 38

submucosal arterioles that intermittently protrude through the mucosa and hemorrhage

Question 39

Cameron lesions

Answer 39

erosions found on the crest of gastric folds within a large hiatal hernia caused by mechanical trauma