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Step 2 CK > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

infectious agent causing food poisoning as a result of mayo sitting out too long

A

s aureus

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2
Q

infectious agent causing rice water stools

A

v cholera

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3
Q

infectious agent causing diarrhea transmitted from pet feces

A

y enterocolitis

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4
Q

infectious agent causing food poisoning resulting from reheated rice

A

b cereus

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5
Q

infectious agent causing travelers’ diarrhea

A

e coli (ETEC)

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6
Q

infectious agent causing diarrhea after course of abx

A

c diff

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7
Q

infectious agent causing diarrhea and recent ingestion of water from a stream

A

giardia, e histolytica

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8
Q

infectious agent causing mild intestinal infection that can become neurocysticercosis

A

t solium

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9
Q

infectious agent causing food poisoning from undercooked hamburger

A

e coli (EHEC)

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10
Q

infectious agent causing diarrhea from seafood

A

v parahaemolyticus

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11
Q

infectious agent causing bloody diarrhea from poultry

A

salmonella

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12
Q

infectious agent causing diarrhea and pink eye

A

adenovirus

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13
Q

infectious agent causing bloody diarrhea and liver abscess

A

e histolytica

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14
Q

infectious agent causing diarrhea in AIDS patient

A

crypto

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15
Q

infectious agent causing dehydrated child with greenish diarrhea in winter months

A

rotavirus

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16
Q

treatment of e histolytica

A

metronidazole

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17
Q

treatment of giardia lamblia

A

metronidazole

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18
Q

treatment of salmonella

A

fluoroquinolones

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19
Q

treatment of shigella

A

fluoroquinolones, TMP-SMX

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20
Q

treatment of campylobacter

A

erythromycin

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21
Q

hepatitis virus confers a high risk of chronic hepatitis

A

hep C

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22
Q

hepatitis virus confers high risk of hepatocellular carcinoma

A

hep B

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23
Q

treatment of hep C

A

interferon alpha

ribavirin

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24
Q

Hep BsAg negative
HepBsAb negative
Hep BcAb positive (IgM)

A

window period

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25
Q

Hep BsAg positive
Hep BsAb negative
Hep BcAb positive (IgG)

A

chronic infection

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26
Q

Hep BsAg negative
Hep BsAb positive
Hep BcAb negative

A

vaccine

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27
Q

Hep BsAg negative
Hep BsAb positive
Hep BcAb positive (IgG)

A

past infection

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28
Q

next step after H&P for patient complaining of dysphagia

A

barium swallow

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29
Q

treatment for diffuse esophageal spasm differ from that of achalasia

A

DES - medically, nitrates and CCBs

achalasia - surgical intervention, dilation, botox, myotomy

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30
Q

esophageal disorder which involves CP; uncoordinated contractions; corkscrew pattern on barium swallow

A

diffuse esophageal spasm

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31
Q

esophageal disorder which involves inability to relax the LES; bird’s beak on barium swallow

A

achalasia

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32
Q

esophageal disorder which involves bad breath; regurgitation of food eaten days ago

A

zencker diverticulum

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33
Q

common symptoms of GERD

A

heartburn

bad taste in mouth

persistent cough

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34
Q

gastric ulcer timing and effect of eating

A

right after intake of food

worse with nausea and vomiting

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35
Q

duodenal ulcer timing and effect of eating

A

2-4 hours after food

better with food

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36
Q

effective treatment of duodenal ulcer, not from zollinger ellison syndrome

A

PPI
amox
clarithromycin

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37
Q

treatment for gastric cancer

A

distal 1/3 - subtotal gastrectomy

middle/upper - total gastrectomy

chemo/radiation as needed

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38
Q

female patient has known duodenal ulcer refractory to high dose PPI therapy. What two tests may diagnose her disease?

A

fasting gastrin

secretin stimulation test

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39
Q

oral infection has branching rods when examined microscopically

A

actinomyces

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40
Q

malabsorption in a patient with (+) sudan stain in stool sample and normal D-xylose test

A

pancreatic insufficiency

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41
Q

treatment for whipple disease

A

ceftriaxone

TMP-SMX

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42
Q

tumors causing secretory diarrhea

A

VIPomas
gastrinoma
med thyroid
carcinoid

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43
Q

two most common food borne bacterial GI tract infections in US

A

salmonella, c jejuni

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44
Q

Which form of IBD causes perianal fissures and fistulas

A

Crohn’s

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45
Q

serum lab findings might help distinguish Crohn’s from UC

A

antisaccharomyces cerevisiae - Crohn

pANCA - UC

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46
Q

most common cause of large bowel obstruction

A

neoplasm

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47
Q

treatment for Crohn’s disease

A

steroids
azathioprine
anti TNFalpha agents

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48
Q

signs and symptoms NOT associated with IBS

A

weight loss, fever, rectal bleeding, anorexia, worsening pain

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49
Q

Characteristic symptom of acute mesenteric ischemia

A

pain out of proportion to exam

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50
Q

CT scan imaging shows what for ischemic colitis

A

pneumatosis coli

bowel wall thickening

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51
Q

time frame in which post-op ileus resolves for small bowel

A

24 hours

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52
Q

time frame in which post-op ileus resolves for stomach

A
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53
Q

time frame in which post-op ileus resolves for colon

A

3-5 days

54
Q

risk factors for diverticulosis

A

low fiber, high fat diet

increased age

55
Q

treatment for mild diverticulitis

A

bowel rest

abx: cipro + metro

56
Q

treatment for diverticulitis with abscess formation

A

perc drainage

IV abx

57
Q

next step in management of patient younger than 50 with minimal bright red blood per rectum

A

anoscopy

58
Q

cause of acute pain and swelling of midline sacrococcygeal skin and subq tissues

A

pilonidal cyst

59
Q

gene responsible for familial adenomatous polyposis

A

APC

60
Q

Common etiologies of upper GI bleeds

A 
ulcer
esophageal varices
AVM
tumors
erosions
mallory-weiss tears
61
Q

common etiologies of lower GI bleeds

A 
diverticulitis
neoplasms
ischemia
hemorrhoids
rectal fissures
62
Q

volume status assessment in patient with GI bleed

A

vital signs

HR, BP, urine output

63
Q

difference between mallory-weiss tear and boerhaave tear

A

mallory-weiss tear - laceration superficial in esophageal mucosa

boerhaave - perforation/tear, full thickness

64
Q

ranson criteria for acute pancreatitis on admission

A

GA LAW

glucose > 200
AST > 250
LDH > 350
age > 55
WBC > 16,000
65
Q

ranson criteria for acute pancreatitis in first 48 hours

A

CALvin and HOBBeS

calcium 10
pO2 4
BUN > 5
sequestration of fluid > 6

66
Q

treatment for chronic pancreatitis

A

stop alc/smoking
pancreatic enzymes
fix nutrition
surgical repair

67
Q

two most common cause of acute pancreatitis in US

A

gallstones

alcohol

68
Q

procedure to treat cancerous tumor in head of pancrease

A

whipple procedure

69
Q

signs and symptoms suggestive of pancreatic adenocarcinoma

A

painless jaundice, anorexia, wt loss, nausea, vomiting, palpable nontender GB

70
Q

medication used to stop insulin production in patient with insulin producing pancreatic tumor

A

octreotide

71
Q

symptom is the most common presentation of a patient with VIPoma

A

watery diarrhea

72
Q

patient presents with dysphagia and the barium swallow shows a corkscrew pattern of esophagus. Dx?

A

diffuse esophageal spasm

73
Q

patient presents with dysphagia and barium swallow shows bird’s beak sign in distal esophagus. Dx?

A

achalasia

74
Q

type of patient at risk for acalculous cholecystitis?

A

TPN

critically ill

75
Q

What is charcot’s triad? What is reynold’s pentad?

A

Charcot: RUQ pain, jaundice, fever

Reynold’s: RUQ pain, jaundice, fever, AMS, hypotension

76
Q

treatment of cholecystitis

A

cholecystectomy

77
Q

treatment of cholangitis

A

drain bile ducts, fluids and IV abx, wait for cholecystectomy

78
Q

most common cause of travelers diarrhea

A

e coli (ETEC)

79
Q

medical treatment for ulcerative colitis

A

5 ASA (mesalamine, sulfasalazine)

acute: steroids

80
Q

what distinguishes primary biliary cirrhosis from primary sclerosing cholangitis?

A

PBC: women, autoimmune with RA, Sjogrens, CREST, intrahepatic bile duct, treatment ursodeoxylic acid, labs AMA, ANA

PSC: men, associated with UC, intra/extrahaptic bile duct, treatment liver transplant, labs pANCA, associated with cholangiocarcinoma, ERCP shows beads on a string

81
Q

treatment for primary biliary cirrhosis

A

ursodeoxycholic acid, liver transplant

82
Q

Sign and disease with deep palpation of RUQ, arrest of inspiration due to pain

A

murphy sign

cholecystitis

83
Q

Sign and disease with charcot’s triad, hypotension, AMS

A

reynold’s pentad

cholangitis

84
Q

Sign and disease with RLQ pain on passive extension of hip

A

psoas sign

appendicitis

85
Q

Sign and disease with RLQ pain on passive internal rotaiton of flexed hip

A

obturator sign

appendicitis

86
Q

Sign and disease with LUQ and referred left shoulder pain

A

Kehr’s sign

splenic rupture

87
Q

Sign and disease with ecchymosis of skin overlying flank

A

gray turner sign

pancreatitis

88
Q

Sign and disease with ecchymosis of skin overlying periumbilical area

A

cullen’s sign

pancreatitis

89
Q

treatment for hepatic encephalopathy

A

lactulose, rifaximin

90
Q

antibiotics used to treat spontaneous bacterial peritonitis

A

cefotaxime, ceftriaxone

91
Q

two diuretics used in conjunction for the treatment of ascites/portal HTN

A

furosemide and spironolactone

92
Q

symptoms of budd-chiari?

A

ascites
hepatomegaly
jaundice
RUQ pain

93
Q

25 year old man with abdominal pain, watery diarrhea after meals. Exam shows fistulas between bowel and skin as well as nodular lesions on tibias. Dx?

A

Crohns

94
Q

most widely used screening test for hemochromatosis

A

ferritin (increased)

95
Q

what copper related lab value would you order with someone with wilson disease?

A

serum ceruloplasmin (low)

96
Q

treatment for hemochromatosis?

A

phlebotomy, avoid excess alcohol, deferoxamine

97
Q

location of zenker diverticulum, epiphrenic diverticulum, traction diverticulum

A

zenker: above UES
epiphrenic: above LES
traction: mid esophagus

98
Q

most common type of TE fistula

A

upper esophagus ends in blind pouch

lower esophagus attached to trachea

99
Q

classic presenting scernario for NEC

A

poor feeding, abd distention, bloody stools, pneumatosis intestinalis

100
Q

physiologic jaundice - age, t bili, cause, tx

A

2-3 d,

101
Q

breastfeeding - age, t bili, cause, tx

A
102
Q

breast milk - age, t bili, cause, tx

A

> 1 week, > 5.5, unknown factor in milk, resolves on own

103
Q

tx for a rectal fistula

A

fistulotomy

104
Q

patient with cirrhosis presents to the ER to have his recurrent ascites drained. Analysis of the ascites fluid reveals an absolute neutrophil count > 250. What is the diagnosis?

A

SBP

105
Q

What is light’s criteria? What is it for?

A

exudative effusion

pleural fluid protein: serum protein > 0.5
pleural fluid LDH: serum LDH > 0.6
protein > 3 g

106
Q

tumor marker used in colon cancer

A

CEA

107
Q

which type of esophageal cancer is most prevalent in the US?

A

adenocarcinoma

108
Q

Next step in diagnosis of cholecystitis when the ultrasound is equivocal?

A

HIDA

109
Q

45 year old obese woman with pruritus, clay colored stools and dark urine has an elevated alk phosph and elevated bili. What is the most likely cause?

A

biliary obstruction

110
Q

24 year old woman with elevated BP. Good BMI, good diet, exercises, and does not smoke or use BC. What might be the cause of her HTN? What might be seen on radiological imaging?

A

fibromuscular dysplasia

beads on a string

111
Q

tumor marker most useful in diagnosis of pancreatic cancer

A

CA 19-9

112
Q

which form of IBD would you see a “lead pipe” appearance on barium enema?

A

UC

113
Q

Ranson criteria for pancreatitis on admission

A

GA LAW

glucose
AST
LDH
age
WBC count
114
Q

Ranson criteria for pancreatitis

A

CALvin and HOBBeS

calcium
Hct
O2
BUN
base deficit
sequestration of fluid
115
Q

2 disorders should come to mind when a neonate has meconium ileus

A

CF

hirschsprung

116
Q

tx for entamoeba histolytica

A

metronidazole

117
Q

tx for giardia lamblia

A

metronidazole

118
Q

tx for salmonella

A

quinolone or TMP-SMX

119
Q

tx for shigella

A

quinolone or TMP-SMX

120
Q

tx for campylobacter

A

erythromycin

121
Q

what is charcot’s triad in cases of cholangitis?

A

fever, RUQ pain, jaundice

122
Q

Patient suspected of having gastric cancer. During the physical exam you palpate in two places for enlarged lymph nodes associated with this disease. Where will you palpate and what are the names of the enlarged nodes?

A

virchow’s node - left supraclavicular

sister mary joseph - periumbilical

123
Q

2 year old boy presents with painless rectal bleeding. What diagnosis do you suspect and what study would you order to confirm the diagnosis?

A

meckel’s diverticulum

meckel’s scan

124
Q

what is the treatment for mild unconj hyperbilirubinemia in a neonate? Sever unconj hyperbilirubinemia in a neonate?

A

phototherapy

phototherapy or exchange transfusion

125
Q

3 year old girl presents with abdominal mass, hematuria, HTN. What is the most likely diagnosis?

A

wilms tumor

126
Q

cuban immigrant presents with symptoms of malabsorption is found to have megaloblastic anemia. Dx and tx?

A

tropical strue

treatment: folate, tetracycline

127
Q

Elderly woman with a history of cholelithiasis presents with a 5 day history of vague intermittent abdominal pain and vomiting. Dx?

A

gallstone ileus

128
Q

Treatment for whipple disease?

A

TMP-SMX for 1 year, ceftriaxone

129
Q

Medications are used in the treatment of ileus?

A

metoclopromide, erythromycin, neostigmine

130
Q

What is the most sensitive and specific lab test for the diagnosis of chronic pancreatitis?

A

low fecal elastase

131
Q

Antibiotic combinations used in outpatient treatment of diverticulitis?

A

cipro/metro

bactrim + metro

amox-clav

132
Q

Elevated lab in patients with an upper GI bleed?

A

BUN

Step 2 CK (16 decks)

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