GASTRO AMC

Question 1

Screening recommendations for members of families with HNPCC

Answer 1

Annual or biennial colonoscopy from the age of 25

Question 2

Screening recommendations for members of families with FAP

Answer 2

Annual sigmoidoscopy from age 10 then every 3 years from age 35

Question 3

focal swelling of the tongue base or the upper pharnx along the course of the thyroglossal duct cyst

Answer 3

Lingual ectopic thyroid

Question 4

Old patient + food regurgitation

Answer 4

Pharyngeal pouch

Question 5

Lump in throat + absence of physical abnormality

Answer 5

globus phanryngeus syndrome

Question 6

Shoulder dystocia nerve injury

Answer 6

C5-C6/ porters tip/ Erbs palsy

Question 7

Klumpke paralysis/ complete claw deformity

Answer 7

C8-T1

Question 8

Manifestation of Erbs palsy

Answer 8

arm hangs limp in adduction, rotated inetrnally at the shoulder, extended and pronated at the elbow and flexed at the wrist

Question 9

Rinne positive

Answer 9

AC>BC ; normal

Question 10

Cocaine intoxication differentiating feature

Answer 10

Fever

Question 11

IDS: bloody diarrhea + abdominal cramps + systemic symptoms, long incubation; contaminated food (particularly fresh fruits and vegetables washed with contaminated water); dysentery

Answer 11

Ameobiasis/Entamoeba histolytica

Question 12

watery diarrhea

Answer 12

Enterotoxigenic Escherichia coli (ETEC)

Question 13

bloody diarrhea, but the incubation period is usually shorter (1-3 days)

Answer 13

Shigella

Question 14

“Undercooked beef” or “contaminated vegetables”
“Hemolytic uremic syndrome (HUS)”: acute renal failure, thrombocytopenia, microangiopathic hemolytic anemia
“No antibiotics” (due to increased risk of HUS)

Answer 14

EHEC

Question 15

Salmonella

Answer 15

“Poultry, eggs, reptiles”
“Watery diarrhea”, can be “bloody”
“Typhoid fever” (for Salmonella Typhi): fever, “rose spots” on abdomen, hepatosplenomegaly
Non-typhoidal strains: “gastroenteritis”
Common in immunocompromised and Sickle cell patients (risk for osteomyelitis)

Question 16

Giardia

Answer 16

“Foul-smelling, greasy stools”
“Steatorrhea”
“Fatty diarrhea” with “bloating” and flatulence
Associated with “drinking contaminated water”, often from streams or wilderness travel (e.g., hikers)
“Cysts in stool” on microscopy
“Chronic diarrhea” in immunocompromised individuals
“Pear-shaped trophozoites” seen on stool examination

Question 17

Chemoprophylaxis for malaria

Answer 17

Summary of Usage by Region:
Chloroquine-sensitive areas: Use chloroquine or mefloquine.
Chloroquine-resistant areas: Use atovaquone-proguanil, doxycycline, or mefloquine.
P. vivax or P. ovale endemic areas: Use primaquine or tafenoquine (with G6PD testing).

Special Populations:
Pregnant women: Chloroquine and mefloquine are considered safe, while atovaquone-proguanil, doxycycline, and primaquine are not recommended.
Children: Doxycycline is contraindicated in children under 8 years, but mefloquine and atovaquone-proguanil can be used with caution.

Question 18

Dosing schedule for shingles vaccination

Answer 18

After 50, 0 and then 2-6 monts after

Question 19

Vaccination schedule for Varicella

Answer 19

Children:
1st dose at 12-15 months.
2nd dose at 4-6 years.
Unvaccinated adolescents/adults:
1st dose at any time.
2nd dose 4-8 weeks later.

Question 20

Tetanus rules

Answer 20

If you have a dirty wound with incomplete or unknown vaccination OR immunocompromised -> give TIG
If you have completed vaccines + less than 5 years form last dose -> no need to give anything regardless of the type of wound
If you have completed vaccines with last dose 5-10 years prior and a dirty wound –> give vaccine
If completed and more than 10 years, regardless of type of wound –> give vaccine