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Harri 's Quick peak > GASTRO > Flashcards

GASTRO Flashcards

1
Q

Storage function, relaxes to accomodate the meal

A

Proximal stomach

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2
Q

Phasic contractions, propels food residue against the pylorus

A

Distal stomach

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3
Q

secretes intrinsic Factor for Vitamin B12 absorption

A

Stomach

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4
Q

Suited For absorption of vit B 12 and bile acids

A

Ileum

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5
Q

GI diseases with impaired digestion and Absorption

A

ZE, lactase deficiency, Biliary obstruction, other intestinal enzyme deficiencies

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6
Q

most common intestinal maldigestion syndrome involving dairy products ( lactose content)

A

L actase deficiency

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7
Q

GI diseases with altered secretion

A

Gastric acid hypersecretion: ZE, G-cell hyperplasia, retained antrum Syndrome, some with DU
Gastric acid hyposecretion: Atrophic gastritis, pernicious anemia
Inflammation and infection

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8
Q

GI diseases with altered Gut Transit

A

mechanical Obstruction

Disordered Gut motor Function: impaired propulsion/ rapidpropulsion disorders

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9
Q

GI diseases associated with immune dysregulation

A

Celiac disease, Eosinophilic gastritis, Ulcerative colitis and Chron’s disease

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10
Q

GI diseases with Impaired Gut Blood flow

A

Thromboembolic causes: arterial embolus or thrombosis, venous thrombosis
Hypoperfusion causes: dehydration, sepsis, hemorrhage or decreased CO
Radiation enterocolitis
Gastroparesis due to blockage of the celias and SMA

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11
Q

GI disease typically presenting at after age 50

A

Colorectal CA

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12
Q

may be due to chronic acid reflux or with extensive Alcohol and tobacco use

A

Esophageal cancer

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13
Q

Abdominal pain:generally midline in location and vague in character

A

visceraL pain

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14
Q

Abdominal pain that can be localized and precisely described

A

Parietal pain

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15
Q

Most common causes of abdominaL pain

A

IBS and Functional dyspepsia

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16
Q

Initial procedure to evaluate dysphagia to exclude subtle rings or strictures and assess for achalasia

A

Barium swallow

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17
Q

Performed when colonoscopy is unsuccessful or contraindicated

A

Contrast enema

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18
Q

Alternative for colonoscopy For colon cancer screening

A

CT and MR Colongraphy

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19
Q

Diagnostic modality used to exclude mesenteric ischemia and determines Spread of malignancy

A

Angiography

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20
Q

Userful in searching for Intraabdominal abscesses not visualized on CT

A

Radio labeled leukocyte scans

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21
Q

Esophageal manometry is a functional test used for patient’s suspected Of

A

Achalasia

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22
Q

GOld standard for imaging of colonic mucosa

A

Colonoscopy

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23
Q

More accurate for evaluation of diverticula and measurement of colonic strictures

A

Barium enema

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24
Q

Procedure used to visualize the rectum and a variable portion of the left colon
used for colorectal cancer screening primarily used for evaluation of diarrhea and rectal outlet bleeding

A

Flexible Sigmoidoscopy

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25
Q

Used as both diagnostic and therapeutic procedure
open sphincter of Oddi: endoscopic sphincterotomy
Retrieval of stones from the ducts
Biopsy, dilation and stenting of duct strictures, stenting of ductal leaks
Di agnosis: sphincter of Oddi dysfunction

A

ERCP

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26
Q

Most accurate pre - op local staging of Cancers

A

EUS

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27
Q

Risks of Bleeding and GI perforation

A

Low risk: Diagnostic Upper endoscopy, Colonoscopy, diagnostic Eus
Increased risk: Therapeutic procedures such as EMR and ESD, control of bleeding, or Stricture
Rare with flexible sigmoidoscopy

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28
Q

Recommended to Start Antibiotic prophylaxis For Endoscopic procedure

A

Bile duct obstruction (-) Cholangitis: ERCP with anticipated incomplete drainage: prevention of Cholangitis
Sterile Pancreatic fluid collection (pseudooyst, necrosis) which communicates with pancreatic duCt: ERCP: cyst infection
Sterile pancreatic Fluid collection: Transmural drainage: cyst infection
cystic lesions along GI tract: EUS- FNA: cyst infection
percutaneous Endoscopic feeding tube placement: periostomal infection
Cirrhosis with acute GI bleeding: All patients regardless of endoscopic procedure

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29
Q

LR endoscopic procedures for the management of Antithrombotic Drugs before Endoscopy

A

EGD or colonoscopy with/ without Biopsy, EUS without FNA, ERCP with stent exchange

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30
Q

HR endoscopic procedures for the management of Antithrombotic Drugs before Endoscopy

A

E G D or colonoscopy with dilation, Polypectomy or thermal ablation, PEG, Eus with FNA, ERCP with sphincterotony or psendocyst drainage

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31
Q

Antithrombotic drug that does not increase the risk of bleeding during endoscopic procedures

A

Aspirin monotherapy

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32
Q

Risk of developing Pancreatitis during ERCP

A

5% with increased risk in young anicteric patients with normal ducts

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33
Q

Most common complication in Percutaneous gastrostomy tube placement during EGD

A

Wound infection

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34
Q

Increases likelihood of rebleeding from endoscopy

A

R/R-A-C/C
Respi/Renal Failure
Age> 70 y 0.
Cirrhosis/ Coagulopathy

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35
Q

Indications for urgent endoscopy

A

Resting hypotension, repeated hematemesis, Ngt aspirate that does not clear with large volume lavage, orthostatic change in vital signs, or requirement for BT

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36
Q

PUD risk of rebleeding: clean- based ulcer

A

low risk (3-5 %)

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37
Q

PUD risk of rebleeding:
Flat red or purple spots in the ulcer base
Large adherent CLots covering the ulcer base

A

Intermediate risk

10% and 20%

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38
Q

PUD risk of rebleeding: sentinel clot ( platelet plug protruding from a vessel wall in the base of an ulcer) or visible vessel; often requires local endoscopic therapy to decrease the bleeding rate

A

High Risk: approximately 40%

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39
Q

Reduces Rebleeding rate and improves patient outcome

A

proton Pump Inhibitor

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40
Q

Indicated for primary prophylaxis from large esophageal varices when BBS are. contraindicated or not tolerated preferred last therapy For bleeding esophageal varices and eradication of varices

A

Endoscopic Variceal Ligation

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41
Q

Used as salvage therapy when EVL Fails as it has higher complication rates

A

Endoscopic variceal sclerotherapy

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42
Q

Persistent caliber artery

Large caliber arteriole that runs immediately beneath the GI mucosa and bleeds through a pinpoint mucosal erosion

A

Dieulafoy’s Lesion

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43
Q

Most common location Of the Dieulafoy’s lesion

A

Lesser curvature of the proximal stomach

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44
Q

Linear mucosal rent near or across the GE junction often associated with retching or vomiting

A

Mallory- Weiss tear

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45
Q

Watermelon stomach

A

Gastric antral Vascular Ecasias (GAVE)

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46
Q

Flat mucosal anomalies diagnosed by endoscopy

A

vascular Ectasias

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47
Q

Etiology of bleeding: nutrient arteries penatrating the muscular wall of the colon en route to the colonic mucosa
Characterized by painless and impressive hermatOchezia

A

Colonic Diverticula

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48
Q

Common Causes of G00

A

malignancy and Chronic peptic ulceration with stenosis of the by pylorus

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49
Q

Risk of cecal perforation

A

> 12 cm

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50
Q

More accurate disqustic modality for Bile buct imaging

A

Mrcp and Eus >90 % accuracy

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51
Q

Procedure of choice if a bile duct stone is highly likely and urgent treatment is required(jaundice and biliary sepsis)

A

ERCP

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52
Q

Procedure of choice if a bile duct stone is highly likely and urgent treatment is required(jaundice and biliary sepsis)

A

ERCP

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53
Q

Charcot ‘s triad

A

Jaundice, fever, RUQ pain

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54
Q

Reynold’s Pentad

A

Charcot ‘s triad+ confusion and shock

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55
Q

Most sensitive test for diagnosis Of GERD

A

24 H ambulatory pH monitoring

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56
Q

Indications For endoscopy in GERD

A

Resistant reflux symptoms
Recurrent dyspepsia
Reflux and dysphagia to look for a stricture or malignancy
Long standing (more than or equal to 10 years) Frequent heartburn due to 6x increase risk of Barrett’s esophagus(periodic endoscopy with biopsy) to detect dysplasia or early carcinoma

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57
Q

Most sensitive diagnostic test For Peptic ulcer

A

Endoscopy

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58
Q

Alarm symptoms for endoscopy in Peptic ulcer

A

Weight loss, Anemia, Bleeding

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59
Q

progressive dysphagia, solids then liquids

A

Esophageal strictures

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60
Q

Intermittent dysphagia For both solids and liquids

A

Motor disorders

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61
Q

Episodic dysphagia For solids, typically at the beginning of a meal

A

Schatzki’s ring

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62
Q

Difficultly initiating deglutition ( transfer dysphagia) and nasal reflux with swallowing

A

pharyngeal motor disorders

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63
Q

Nocturnal regurgitation of undigested Food

A

Achalasia

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64
Q

Best initial test if motor disorder is suspected in dysphagia

A

Esophageal radiography and or a video Swallow study

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65
Q

Procedure done For resection of early-stage malignancies limited to the superficial layers of the GI mucosa

A

EMR or ESD

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66
Q

Colorectal Cancer screening strategies:

Asymptomatic individuals more than Or equal to 50 y. 0.

A

FOBT annually
CT colonography/ Flexible sigmoidoscopy /Double contrast barium enema every 5 years
Colonoscopy every 10 years

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67
Q

Chronic diarrhea ( Duration)

A

4 weeks

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68
Q

Behavior in which recently swallowed Food is regurgitated and then re swallowed repetitively for up to an hour

A

Rumination

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69
Q

Globus sensation is attributable to What disease

A

GERD

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70
Q

Useful test for diagnosing motility disorders. achalasia, diffuse esophageal spasm

A

Esophageal manometery

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71
Q

Outpouchings Of the esophagus wall, associated with increased intraluminal pressure associated with a distal obstruction

A

Diverticula

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72
Q

Seen in natural zone of weakness in the posterior hypopharyngeal wall (Killian’s triangle) and causes halitosis and regurgitation of saliva and food that may have been consumed several days earlier

A

Zenker’s diverticulum

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73
Q

Due to traction from adjacent inflammation ( tuberculosis) or by propulsion associated with esopageal motor abnormalities

A

midesophageal diverticulum

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74
Q

Thin membranous narrowing at the squamocolumnar mucosal junction Of the esophagus, seen in 10-15% of the population usually asymptomatic

A

B-ring

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75
Q

Similar to B - ring but with a lumen diameter of 13 mm and associated with episodic solid food dysphagia

A

Schatzki’s ring

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76
Q

Steakhouse Syndrome

A

Schatzki’s ring

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77
Q

Symptomatic hypopharyngeal webs and iron- deficiency anemia in middle -aged women

A

plummer - Vinson syndrome

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78
Q

Herniation of part of the stomach into the thoracic Cavity through the esophageal hiatus in the diaphragm

A

Hiatal hernia

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79
Q

Type of hiatal hernia which is associated with GERD

A

Type I sliding hiatal hernia (95% cases)

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80
Q

Esophageal CA with predilection to the distql esophagus

A

Adenocarcinoma

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81
Q

Esophageal cancer with predilection to the proximal esophagus

A

SCC

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82
Q

Rare motor disorder of the esophageal smooth muscle in which the LES does not relax normally with swallowing and the esophageal body undergoes non-peristaltic contractions

A

Achalasia

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83
Q

Loss of ganglion cells within the esophageal myenteric plexus involving both excitatory ( Cholinergic) and inhibitory(nitric oxide) ganglionic neurons

A

Achalasia

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84
Q

ManOmeric finding of the esophageal LES in patients with Achalasia

A

Normal or elevated pressure

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85
Q

Barium swallow xray Finding of patients with Achalasia

A

Dilated esophagus with poor emptying, air fluid level, tapering at the LES beak like appearance

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86
Q

Pharmacologic therapy For patients with Achalasia

A

Nitrates or CCB before meals

Botulinum toxin

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87
Q

Manifests as episodes of dysphagia with chest pain attributable to abnormal esophageal contractions with normal deglutitive LES relaxation

A

Diffuse Esophageal Spasm

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88
Q

Corkscrew esophagus
Rosary bead esophagus
psendo diverticula or curling

A

DES

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89
Q

Treatment shown to be efficacious For DES

A

Anxiolytics

90
Q

Exacerbating Factors for GERD

A

Abd obesity, pregnancy, gastric hypersecretion states, delayed gastric emptying, disruption of esophageal peristalsis and gluttonY

91
Q

Accounts for 90% Of reflux in normal Subjects or GERD patients without hiatal hernia

A

Transient LES relaxation

92
Q

Involves proximal esophagus, Ulcerations appear punctuate and diffuse

A

Infectious esophagitis

93
Q

multiple esophageal rings, linear Furrows or white punctate exudate

A

Eosinophilic Esophagitis

94
Q

Singular and deep at points of luminal narrowing especially near the carina, distal sparing

A

pill esophagitis

95
Q

Most severe histologic consequence of GERD

A

Barrett’s metaplasia

96
Q

Dominant mechanism Of Esophagogastric junction incompetence GERD

A

Transient LES relaxation(90% Of reflux in normal subjects or GERD patients who histal hernia)
LES hypotension

97
Q

Extra - esophageal Syndromes with established association with GERD

A

Chronic cough, laryngitis, asthma, dental erosions

98
Q

Characterised by tongues of reddish mucosa extending proximally from the GEJ with specialized columnar metaplasia

A

Barrett’s metaplasia

99
Q

Gold standard treatment Of high - grade dysplasia in GERD in a healthy patient with minimal surgical risk

A

Esophagectomy

100
Q

Adverse Effect of PPI

A

Malabsorption of vit B12 and Iron, increase susceptibility to enteric infections especially C- difficile colitis, slight increase risk of bone fracture

101
Q

Diagnosis of eosinophilic esophagitis

A

Symptoms + esophageal mucosal biopsies showing squamous epithelial eosinophil predominant inflammation

102
Q

Patient presenting with atypical chest pain heartburn that is refractory to ppi with note of peripheral eosinophilia and with history of atopy

A

Eosinophilic esophagitis

103
Q

Infectious esophagitis in immunocompromised hosts is due to

A

CMV, HSV, Candida

104
Q

Infectious esophagitis is more common in AIDS patients with CD4 count of

A

<100

105
Q

Most common organisms causing infectious esophagitis in immunocompetent hosts

A

HSV, Candida

106
Q

Risk factors for candida esophagitis

A

Immunocompromised state, esophageal stasis

107
Q

Treatment for candida esophagitis

A

Oral fluconazole for 14-21 days but if refractory may give itra, vori, posaconazole

108
Q

Endoscopic finding of vesicles, small punched out ulcerations with biopsy findings of ground glass nuclei with eosinophilic cowdry type A intranuclear inclusions, giant cell formation

A

Herpetic esophagitis

109
Q

Endoscopic appearance of serpiginous ulcers that coalesce to form giant ulcers, particularly in the distal esophagus with pathognomonic large nuclear or cytoplasmic inclusion bodies on biopsy

A

CMV esophagitis

110
Q

Treatment of choice for cmv esophagitis

A

Ganciclovir iv or foscarnet iv until healing occurs (3-6wks)

111
Q

Usual site of injury with endoscopy or ngt placement

A

Hypopharynx or GEJ

112
Q

Increased intraesophageal pressure associates with forceful vomiting and retching causing spontaneous esophageal rupture

A

Boerhaave’s syndrome

113
Q

Most sensitive in detecting mediastinal air

A

Chest ct

confirmed with contrast swallow with gastrografin followed by thin barium

114
Q

Patient presenting with vomiting retching vigorous coughing with associated UGIB with note of nontransmural tear at the GEJ

A

Mallory weiss syndrome

115
Q

Caused by ingestion of caustic agents more commonly strong alkali

A

Corrosive esophagitis

116
Q

Most common location for pill to lodge in patients with pill esophagitis

A

Mid esophagus near the crossing of the aorta or carina

117
Q

Play a central role in gastric epithelial defense/repair, regulate release of mucosal HCO3 and mucus, inhibit parietal cell secretion and maintains mucosal blood flow and epithelial cell restitution

A

Prostaglandin

118
Q

2 principal gastric secretory products capable of inducing mucosal injury

A

Hcl and pepsinogen

119
Q

Principal contributors to acid secretion

A

Cholinergic via vagus

Histaminergic via local gastric sources

120
Q

Breaks in the mucosal surface >5mm in size with depth to the submucosa

A

Ulcers

121
Q

Most common location of DU

A

1st portion of the duodenum (>95%) with ~90% located within 3cm of the pylorus

122
Q

Ulcer associated with malignancy

A

Gastric ulcer

123
Q

Majority of DU cases are associated with

A

H. Pylori or nsaid induced

124
Q

Incidence of h. Pylori causing ulcer

A

10-15% develop frank peptic ulcer
30-60% in GU
50-70% In DU

125
Q

Antral predominant gastritis

A

DU

126
Q

Corpus dominant gastritis

A

GU, gastric atrophy, gastric carcinoma

127
Q

Ulcer caused by interuption of prostaglandin synthesis impairing mucosal defense and repair

A

NSAID-induced

128
Q

Blood group associated with ulcer due to preferential binding of h pylori

A

Blood group O

129
Q

Chronic disorders with strong association with ulcer

A 
Systemic mastocytosis
Chronic pulmo disease
Chronic renal failure
Cirrhosis
Nephrolith
Alpha 1 antitrypsin deficiency
130
Q

Chronic disorders with possible association with ulcer

A

Hyperparathyroidism
CAD
PV
chronic pancreatitis

131
Q

Most discriminating symptom of DU

A

Pain that wakes patient from sleep (md-3am)

132
Q

Pain occurs 90mins to 3h after a meal, relieved by antacids or food

A

DU

133
Q

Ulcer pain that may be precipitated by meals

A

GU

134
Q

Succussion splash is seen in

A

Gastric outlet obstruction

135
Q

Most frequent finding in ulcer patients

A

Epigastric tenderness

136
Q

Most common complication in PUD

A

Gi bleeding

137
Q

Hypercalcemia, hyperphosphatemia with renal calcinosis and progression to renal insufficiency

A

Milk-alkali syndrome

138
Q

Inhibits basal and stimulated acid secretion

A

H2 receptor antagonist

139
Q

Inhibits all phases of gastric acid secretion by irreversibly inhibiting H-K-ATPase

A

PPI

140
Q

Most potent acid inhibitory agent

A

PPI

141
Q

Due to high incidence of malignancy in GU (especially body, fundus) if biopsy negative a repeat endoscopy should be done when

A

8-12wks to document healing, if still with ulcer biopsy

142
Q

GU that fails to heal after 12wks and a DU that does not heal after 8 wks of therapy

A

Refractory ulcer

143
Q

Can decrease ulcer re bleeding in patients who undergone endoscopic therapy

A

Parenteral and orally administered PPI

144
Q

Bacterial overgrowth in the afferent limb secondary to stasis causing postprandial abdominal pain, bloating, diarrhea with malabsorption of fats and vit b12

A

Afferent loop syndrome

145
Q

Series of vasomotor and GI signs and symptoms and occurs in patients who have undergone vagotomy and drainage (billroth)

A

Dumping syndrome

146
Q

Phase of dumping syndrome which is due to rapid emptying of hyperosmolar gastric contentd into the small intestine causing fluid shift into gut lumen with plasma volume contraction, acute intestinal distention, release of vasoactive GI hormones

A

Early dumping (15-30mins after meals)

147
Q

Phase of dumping syndrome secondary to hypoglycemia fron excessive insulin release

A

Late phase (90mins to 3h)

148
Q

Gastric acid hypersecretion due to a unregulated gastrin release from a non-cell endocrine tumor (gastrinoma)

A

Zollinger-Ellison syndrome

149
Q

In ZE >60% of the tumors are

A

Malignant

150
Q

Most common non pancreatic lesion (gastrinoma) occuring in 50-75% of patients with ZE

A

Duodenal tumors

151
Q

Most common clinical manifestation seen in >90% of gastrinoma patients

A

Peptic ulcer

152
Q

Ulcer features that should raise suspicion of ZES

A

Unusual location (2nd part of duodenum and beyond)
Refractory to standard med therapy
Recurrence after acid reducing surgery
Frank complications(bleeding, obstruction, perforation)
Absence of h pylori/nsaids ingestion

153
Q

Most frequent condition that can elevate fasting gastrin level

A

Gastric hypochlorhydia or achlorhydria

154
Q

Used to differentiate between causes of hypergastrinemia, useful in patients with indeterminate acid secretory studies

A

Gastrin provocative test

155
Q

Most sensitive and specific provocative test for diagnosis of gastrinoma

A

Secretin stimulation test

156
Q

Treatment of choice for ZE

A

PPI

157
Q

Elevated gastric acid secretion after head trauma causing ulcer

A

Cushings ulcer

158
Q

Ulcer associated with severe burns

A

Curlings ulcer

159
Q

Treatment of choice for stress induced ulcer prophylaxis

A

PPI

160
Q

Most common cause of acute gastritis

A

Infectious

161
Q

More common rype of chronic gastritis

A

Type B

162
Q

Type B chronic gastritis involves predominantly what site of the stomach and is associated with what infection

A

Antral predominant

H pylori

163
Q

Type A gastritis predominantly involves

A

Fundus and body, with antral sparing

164
Q

Autoimmune type of chronic gastritis, traditionally associated with PERNICIOUS ANEMIA

A

Type A

165
Q

Rare disease characterized by large, tortuous gastric mucosal folds

A

Menetriers disease

166
Q

Functional disorder characterized by altered bowel habits + abdominal pain with NO detectable structural abnormalities

A

Irritable Bowel Sundrome

167
Q

Criteria for Diagnosis of IBS

A

Recurrent abdominal pain or discomfort at least 3 days per month in the last 3 months with 2 or more of the Following
Improvement with defecation
Onset associated with a change in the frequency of stool
Onset associated with a change in the form of stool

168
Q

Prerequisite Clinical feature in IBS

A

Abdominal pain

169
Q

most consistent Clinical feature of IBS

A

Altered bowel habits

170
Q

Constipation alternating with diarrhea with one predominating which can switch in l year is seen in

A

IBS

171
Q

Initial therapy of choice for IBS_ D

A

peripherally acting opiates

172
Q

Smoking reduces the risk for developing what type of IBD

A

Ulcerative colitis

173
Q

protective effect on patients with Ulcerative Colitis

A

Appendectomy

174
Q

OCP use increases the risk Of developing what types of IBD

A

Chron’s disease

175
Q

Interventions that alter microbiota and can improve CD

A

metro, Cipro, elemental diets

Fecal diversion

176
Q

Other distinguishing Feature of CD vs UC

A

Rectal sparing
Segmental involvement with skip areas in the midst of diseased intestine
Possible involvement of liver and the pancreas

177
Q

IBD with transmural involvement

A

CD

178
Q

Cobblestone appearance

A

CD

179
Q

Pathognomonic Feature Of CD

A

nonCaseating granulomas in all layers of the bowel

180
Q

IBD Often presenting with diarrhea, rectal bleeding teneSmus, passage of mucus, crampy abdOminal pain ANCA. positive

A

uc

181
Q

most common site of inflammation in CD

A

Terminal ileum

182
Q

Circumferential inflammation and fibrosis_ String sign is seen in what type of IBD

A

CD

183
Q

First line test for evaluation of Suspected CD and its Complications

A

CT/ MR enterography

184
Q

Mainstay Of therapy For mild- moderate uc

A

sulfasalaZine and other 5- ASA agents

185
Q

Protrusion Of mucosa through the muscularis propia of the colon

A

False or pseudodiverticulum

186
Q

common location of diverticular disease

A 
sigmoid colon (5 %)
Asian population: 70 %. in the right colon and rectum
187
Q

Inflammation due to retention Of Particulate material within diverticular Sac and Formation of a fecalith

A

Diverticulitis

188
Q

Most common cause of hematochezia in patients >60 years

A

Colonic diverticulum hemorrhage

189
Q

Best diagnostic modality for localization Of massive bleeding from diverticular disease in an Otherwise stable patient

A

Angiography

190
Q

Patient presenting with fever, anorexia, LLQ Abdominal pain, Obstipation

A

Uncomplicated diverticulitis

191
Q

Diverticular disease associated with abscess or perforation or Fistula

A

complicated diverticular disease

192
Q

Best management For diverticular disease

A

Diet alteration: fiber rich ( 30g/d)

193
Q

Antibiotic therapy for patients with diverticulitis

A

co- tri or cipro + metro

addition of Ampicillin to cover for enterococci for non responders

194
Q

Circumferential/ Full- thickness profusion Of the rectal wall through the anal orifice

A

Rectal prolapse

195
Q

Most common cause of Fecal incontinence

A

Obstetric injury to the pelvic floor

196
Q

GOLD standard for treatment OF Faecal Incontinence

A

Overlapping sphincteroplasty

197
Q

Sclerotherapy is part of the management in what stage of hemorrhoidS

A

Stage I

198
Q

Banding is part of the management in What stage of Hemorrhoids?

A

stage Ill

199
Q

Operative hemorrhoidectomy

A

Stage III and IV

200
Q

Most common site of Anorectal Abscess

A

Perianal (40-50 %)

201
Q

AnOrectal Abscess have higher prevalence in What group of patients

A

Immunocompromised, Dm, hematologic disorders, IBD, HIv

202
Q

Communication of an abscess cavity with an identifiable internal opening within the anal canal

A

Fistula in Ano

203
Q

On Anal manonetry, pathognomonic for anal Fissure

A

Increased anal resting pressure and sawtooth deformity with paradoxical contractions of the sphincter muscles

204
Q

Risk Factors For AOMI

A

AF, recent AMI, VHD, recent cardiac or vascular cath

205
Q

Most often seen in the aging population affected by atherosclerotic disease
cardiogenic/ septic shock on high dose vasopressor infusions, cocaine overdose
most prevalent GI disease complicating cardiOvascular surgery

A

NOMI

206
Q

Most common locations in GI ischemia

A 
watershed areas
Splenic Flexure ( Griffith's point)
Descending/ sigmoid colon ( Sudeck's point)
207
Q

Origin of emboli in mesenteric ischemia

A

> 75% From the heart

208
Q

Gold standard for diagnosis or acute arterial occlusive disease

A

Angiography

209
Q

most common and most characteristic symptom of liver disease

A

Fatigue

210
Q

Often the presenting symptom in PBS and Sclerosing cholangitis

A

Itching

211
Q

Most reliable marker of severity

A

Jaundice

212
Q

Alcohol consumption associated with an increased risk of alcoholic liver disease

A

22-30 g/ day for women

33-45g/ daY for men

213
Q

Clinically helpful approach to diagnosis of alcohol dependence and abuse

A

CAGE questionnaire

214
Q

ANA or SMA, elevated IgG levels and compatible histology

A

Autoimmune hepatitis

215
Q

mitochondrial antibody, elevated Igm levels, and compatible histology

A

Primary biliary cirrhosis

216
Q

Decreased serum cerulo plasmin and increased urinary copper increased hepatic copper level

A

wilson’s disease

217
Q

Elevated iron Saturation and serum ferritin; genetic testing for HFE gene mutations

A

Hemochromatosis

218
Q

Elevated arterial ammonia levels have been shown to correlate with outcome in

A

Fulminant hepatic Failure

219
Q

More specific indicator Of liver injury

A

ALT

220
Q

Most common cause of acute liver Failure

A

Drug induced liver injury

Harri 's Quick peak (10 decks)

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