Gastroenterology

Question 1

Diagnosed by esophageal manometry and pneumatic dilatation of the esophagus , disorder characterized by loss of peristalsis and constriction of the LES

Answer 1

Achalasia

Question 2

Treatment of achalasia

Answer 2

Calcium channel blockers,
Nitrates
Endoscopic dilatation with injection of botulinum toxin

Question 3

Tumor that arises from columnar epithelium in cardia or from Barrett’s, GERD is a risk factor , most occur in the distal parts of the esophagus because this area is more likely to be exposed to regurgitated acid

Answer 3

Adenocarcinoma

Question 4

Pain characterized by a deep aching recurrent midepigastrium radiating to the back often relieved by food food or antacid. Nighttime pain with nocturnal awakening Not associated with Weight loss

Answer 4

Duodenal ulcer

Question 5

Works by Binding to the proton pump of the parietal cell, inhibiting secretion of hydrogen ions into the gastric lumen

Answer 5

Omeprazole

Question 6

A prostaglandin analog that is cytoprotective agent to GI tract mucosa

Answer 6

Misopristol

Question 7

Two most common causes of peptic ulcer disease PUD

Answer 7

NSAIDS, h pylori

Question 8

Sensation of food being hindered in its passage from mouth to stomach

Answer 8

Dysphasia

Question 9

Patients have more problems with liquids than solid and may complain that liquid comes out their nose when they try to swallow

Answer 9

Oropharyngeal dysphagia

Question 10

Described as beginning shortly after swallowing, patients refer to suprasternal notch or retrosternally to localize area causing symptoms

Answer 10

Esophageal dysphagia

Question 11

Severe reflux and dysphagia are hallmarks of

Answer 11

CREST syndrome

Treat with PPI’s

Question 12

An outpouching of esophageal mucosa that is acquired and becomes symptomatic in middle age. Confirmed by barium swallow. Patient complains of regurgitating undigested food hours after eating

Answer 12

Zenkers diverticulum

Question 13

Ill defined condition characterized by recurring intermittent symptoms of epigastric discomfort and fullness and normal physical exam

Answer 13

Nonulcer dyspepsia

Treat with reassurance and lifestyle modifications

Question 14

Common side effect of PPIs

Answer 14

Diarrhea

Question 15

PPIs top 4 associated complications

Answer 15

Diarrhea, ⬆️ risk pneumonia, ⬆️risk hip fracture, ⬆️risk clostridium Difficile

Question 16

Most common cause acid reflux

Answer 16

Transient relaxation of the LES

Question 17

thrombosed hemorrhoid presenting within 72 hours of onset

Management?

Answer 17

Xthrombosed hemorrhoid presenting within 72 hours of the onset of symptoms is elliptical excision of the hemorrhoid and overlying skin under local anesthesia, such as 0.5% bupivacaine hydrochloride in 1:200,000 epinephrine, infiltrated slowly with a 27-gauge needle.