Gastroenterology

Question 1

What conditions can you see acanthuses nigircans in?

Answer 1

DM2, obesity, GI and lung malignancies. Of the malignancies, it’s most often associated with gastric cancer.

Question 2

What do the changes of primary sclerosing cholangitis look like on MRCP?

Answer 2

string of beads

Question 3

What antibody do you see in UC and Chron’s?

Answer 3

UC = pANCA
Chrons = ASCA (antisaccharomyces antibody)

Question 4

What stool test signifies invasive diarrhea?
What antibiotic do you use for invasive diarrhea?
What about for Campylobacter?
What about for amebiasis?
What bacteria do antibiotics prolong the infection?
What antibiotic do you use to treat E. coli O157:H7?

Answer 4

Fecal leuks
Quinolones
Macrolides
Metronidazole
Salmonella
Treat symptomatically; abx are contraindicated

Question 5

If you think your patient has eosinophilic gastroenteritis, what other cause of peripheral eosinophilia do you want to rule out before starting steroids?

Answer 5

Strongyloides (giardia does not cause peripheral eosinophilia)

Question 6

What dermatological manifestation do you see with celiac disease?

Answer 6

dermatitis herpetiformis

papulovesicular rash on the thorax and extremities

Question 7

Endocarditis caused by what 2 bacteria is often associated with colon cancer?

Answer 7

1. strep bovis

2. clostridium septicum

Question 8

A patient has multiple osteomas found incidentally on an X-ray. What do you need to do next?

Answer 8

Get a colonoscopy

Question 9

What tumor markers are for 1. colon cancer 2. pancreatic cancer 3. cholangiocarcinoma 4. ovarian cancer

Answer 9

1. CEA
2. CA-19-9
3. CA 19-9
4. CA 125

Question 10

What are the AAAABCs of PBC?

Answer 10

Antimitochondrial Antibody Attack increases Alk phos and causes obstructive Biliary lesions and liver Cirrhosis

Question 11

Onset of jaundice is when for Hep A vs Hep B?

Answer 11

3 weeks for Hep A; 3 months for Hep B

Question 12

What vasculitis is associated with Hep B?

Answer 12

Polyarteritis Nodosa

Question 13

What virus are 25% of HIV patients co-infected with?

Answer 13

Hep C

Question 14

What do you think of when you see a young woman on OCP’s who has a mass in her liver?

Answer 14

Think adenoma - OCPs are associated with benign, hepatic adenomas

Question 15

A patient who recently moved here from outside of the US presents with jaundice. What might it be due to?

Answer 15

Ascariasis

Question 16

Which vitamin deficiencies develop after weeks?

Answer 16

water soluble vitamins, magnesium, zinc, essential fatty acids

Question 17

Which vitamin deficiencies develop after months?

Answer 17

Copper and vitamin K

Question 18

Which vitamin deficiencies develop after a year?

Answer 18

vitamins A, D, selenium, and chromium

Question 19

Which vitamin deficiencies develop after several years?

Answer 19

iron, cobalt

Question 20

Which vitamin deficiencies develop after many years?

Answer 20

B12

Question 21

What is the earliest symptom of Vitamin A deficiency?

Answer 21

night blindness

Question 22

What is pellagra?

Answer 22

Associated with niacin deficiency

Characterized by the 3 D’s: dermatitis, dementia, and diarrhea

Question 23

What are the first symptoms of Vitamin C deficiency?

Answer 23

petechial hemorrhages and ecchymoses

Question 24

What’s a common presentation of Vitamin D deficiency?

Answer 24

musculoskeletal pain and weakness

Question 25

What other cancers do you commonly see in women in families who have a h/o hereditary nonpolyposis colon cancer?

Answer 25

ovarian and endometrial

Question 26

A patient presents with new or worsening glucose intolerance. What might they have?

Answer 26

pancreatic cancer

Question 27

Uranium mining is associated with what type of GI cancer?

Answer 27

gastric

Question 28

True or False - gastric cancer is associated with ETOH consumption? Gastric ulcer increases the risk of gastric cancer?

Answer 28

False to both

Question 29

Which bacterial organisms cause fecal leukocytes?

Answer 29

Shigella, along with Salmonella, E. coli O157:H7, Campylobacter, and Yersinia,

Question 30

What happens if you start antibiotics in patients with E. coli O157:H7?

Answer 30

You increase the risk of it progressing to HUS

Question 31

What disease do you suspect if you notice PAS+ laden macrophages in tissue?

Answer 31

whipple dz
- Treatment is initiated with IV ceftriaxone, and then the patient is placed on trimethoprim/sulfamethoxazole for a year.