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Gastroenterology Flashcards

1
Q

In melena, the blood has been in the GIT for at least how many hours?

A

14 hours

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2
Q

Violaceous striae is usually seen in what case

A

Cushing’s syndrome

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3
Q

Bruits with audible systolic and diastolic components heard near the midline almost midway between subxiphoid area and umbilicus may suggest

A

Renal artery stenosis

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4
Q

PUD that has common risk for malignancy

A

Gastric ulcer

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5
Q

PUD with increased gastric acid secretion

A

Duodenal ulcer

Gastric - normal

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6
Q

PUD wherein pain awakens the patient from sleep between midnight and 3 AM

A

Duodenal ulcer

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7
Q

PUD precipitated by food

A

Gastric

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8
Q

PUD relieved by antacid or food

A

Duodenal

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9
Q

Test of choice for documenting H. pylori eradication

A

Urea breath test

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10
Q

Side effect of aluminum OH

A

Constipation

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11
Q

Side effect of magnesium OH

A

Diarrhea

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12
Q

Black stools, darkening of tongue and neurotoxicity are ADRs of what anti PUD drug?

A

Bismuth

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13
Q

Triple therapy for H-pylori eradication

A

PPI + Clarithromycin or Metronidazole + Amoxicillin or Metronidazole (if not used as second agent)

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14
Q

Most common complication of PUD

A

Gastrointestinal bleeding

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15
Q

Form of perforation in which ulcer bed tunnels into adjacent organ

A

Penetration

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16
Q

Least common ulcer-related complication

A

Gastric outlet obstruction

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17
Q

Most common cause of UGIB

A

PUD

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18
Q

Large caliber arteriole that runs immediately beneath the GI mucosa and bleeds via a pinpoint mucosal erosion; seen most commonly in the lesser curvature of the proximal stomach

A

Dieulafoy’s lesion

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19
Q

Vasoactive agents given to patients with variceal hemorrhage to reduce the portal venous pressure acutely by splanchnic vasoconstriction

A

Somatostatin or octreotide

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20
Q

Endoscopic therapy of choice for variceal hemorrhage

A

Ligation or banding

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21
Q

Most common and most characteristic symptom of hepatic disease

A

Fatigue

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22
Q

Sign of hepatic disease that result from recannulation of umbilical vein with collateral veins radiating from umbilicus

A

Caput medusa

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23
Q

Golden-brown copper pigment deposited un periphery of the cornea

A

Kayser-Fleischer ring

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24
Q

Kayser-Fleischer rings are seen in what cases

A

Wilson’s disease

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25
Q

Dupuytrrn contracture and parotid enlargement are seen in what liver disease

A

Alcoholic liver disease

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26
Q

Slate-gray pigmentation of the skin is seen in what liver disease

A

Hemochromatosis

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27
Q

Aminotransferase that is more specific as an indicator of liver disease

A

ALT

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28
Q

AST:ALT > 2 is seen in what condition

A

Alcoholic liver disease

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29
Q

ALP > aminotransferase is seen in what condition

A

Cholestatic conditions

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30
Q

Single best acute measure of hepatic synthetic function

A

Clotting factors

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31
Q

Only clotting factor that is not synthesized in the liver

A

VIII (synthesized by endothelial cells)

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32
Q

First line diagnostic method if initial blood tests suggest cholestasis

A

Ultrasound

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33
Q

First test ordered if suspecting Budd chiari syndrome

A

Doppler US

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34
Q

Hepatobiliary disease with antimitochondrial antibody and elevated IgM levels

A

Primary biliary cirrhosis

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35
Q

Serology in window period of hepatitis

A

IgM anti-HBc

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36
Q

Gold standard in diagnosis of HCV infection

A

HCV RNA

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37
Q

Most frequent indication of liver transplant

A

Chronic HCV infection

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38
Q

Most feared complication of viral hepatitis

A

Fulminant hepatitis

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39
Q

Fulminant hepatitis is primarily seen in what 3 hepatitis viruses

A

B, E, D

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40
Q

TNF inhibitor given in alcoholic liver disease

A

Pentoxifylline

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41
Q

4 complications that differentiates compensated from decompensated cirrhosis

A

Variceal hemorrhage
Ascites
Jaundice
Hepatic encephalopathy

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42
Q

Fever, altered mental status, elevated WBC, and abdominal pain or discomfort in the setting of liver cirrhosis

A

Spontaneous bacterial peritonitis

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43
Q

Most common organism in spontaneous bacterial peritonitis

A

E. coli

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44
Q

Asterixis is a sign of

A

Hepatic encephalopathy

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45
Q

Requirement fir diagnosis of fulminant hepatitis

A

Hepatic encephalopathy

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46
Q

Mainstay treatment for encephalopathy

A

Lactulose

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47
Q

Goal number of soft stools per day in encephalopathy

48
Q

Classification of schistosomiasis as a cause of portal hypertension

A

Presinusoidal hepatic cause

49
Q

Classification of Banti’s syndrome as a cause of portal hypertension

A

Prehepatic (massive splenomegaly)

50
Q

Classification of Budd-Chiari syndrome as a cause of portal hypertension

A

Post hepatic

51
Q

Scoring that predicts likelihood of major complication of cirrhosis

A

Child Pugh Score

52
Q

Scoring system to predict prognosis of patients with liver disease and portal hypertension

A

Model for End-Stage Liver Disease Score

53
Q

Scoring for prioritizing allocation for liver transplantation

A

Model for End-Stage Liver Disease Score

54
Q

Secreted by K cells in the duodenum that stimulates insulin secretion

A

Glucose-dependent insulinotropic peptide

55
Q

Most common cause of acute pancreatitis

56
Q

Abdominal pain that is more intense when supine and is relieved upon sitting with the trunk flexed and knees drawn up

A

Acute pancreatitis

57
Q

Blue discoloration around the umbilicus; seen in what cases?

A

Cullen’s sign; acute pancreatitis

Hemoperitoneum

58
Q

Blue-red-purple ir green-brown discoloration of the flanks? Seen in what cases?

A

Turner’s sign; acute pancreatitis

Tissue catabolism of hemoglobin

59
Q

Preferred diagnostic test for acute pancreatitis

60
Q

Most common gallstone (80%)

A

Cholesterol stone

61
Q

Most specific and characteristic symptom of gallstone disease

A

Biliary colic

62
Q

Steady epigastric or RUQ pain radiating to interscapular area, tight scapula or shoulder; aggravated by eating fatty meal

A

Biliary colic

63
Q

Gallstone becomes impacted in the cystic duct or neck of the gallbladder causing compression of CBD resulting in CBD obstruction and jaundice

A

Mirizzi’s syndrome

64
Q

States that a palpable enlarged gallbladder suggests that the biliary obstruction is secondary to underlying malignancy rather than to a calculous disease.

A

Courvoisier’s Law

65
Q

Charcot’s triad of Acute cholangitis

A

Biliary or RUQ pain
Jaundice
Spiking fevers with chills

66
Q

Diagnostic method that provides best visualization of the distal biliary tract

67
Q

Diagnostic method that provides best visualization of the proximal biliary tract

A

Percutaneous transhepatic cholangiogram

68
Q

Secrets HCl and IF

A

Parietal cell

69
Q

Secrets pepsinogen

A

Chief cells

70
Q

Secretes serotonin in the stomach

A

Enterochromaffin cells

71
Q

Secretes histamine in the stomach

A

Enterochromaffin-like cells

72
Q

Pacemaker cells of the GIT

A

Interstitial cells of Cajal

Generates slow wave

73
Q

Store vitamin A in the liver

74
Q

Recurrent abdominal pain or discomfort at leadt 3 days per month in the last 3 months associated with improvement with defecation, change in frequency or appearance in stool

A

Irritable bowel syndrome

75
Q

Charcot’s neurologic triad for MS

A

SIN

Scanning speech
Intention tremor
Nystagmus

76
Q

Biliary pain, obstructive jaundice and melena are triad of

77
Q

Most sensitive test for diagnosis of GERD

A

24-hour ambulatory pH monitoring

78
Q

Perception of a lump or fullness in the throat that is felt irrespective of swallowing

A

Globus hystericus

79
Q

Characteristic symptom of infectious esophagitis

A

Odynophagia

80
Q

Corkscrew or rosary bead esophagus

81
Q

Cobblestone appearance of esophagus

A

Crohn’s disease

82
Q

Gold standard for confirmation of Barrett’s esophagus

A

Endoscopic biopsy

83
Q

Most common cause of LGIB

A

Hemorrhoids

84
Q

Most common cause of hematochezi in the elderly

A

Hemorrhage from colonic diverticulum

85
Q

Full-thickness esophageal tear

A

Boerhaave syndrome

86
Q

Most common toxicity with sucralfate

A

Constipation

87
Q

Cornerstone for therapy for Dumping syndrome

A

Dietary modification

88
Q

Most sensitive/specific gastrin provocative test

A

Secretin study

89
Q

Most common presentation for stress-related mucosal injury of GIT

A

GI bleeding

90
Q

Type of gastritis that involves primarily the fundus and body with antral sparing

A

Type A gastritis (autoimmune)

91
Q

Type of gastritis with antral-predominant involvement

A

Type B gastritis (infectious)

Most common

92
Q

Inflammatory bowel disease that usually involves the rectum

A

Ulcerative colitis

93
Q

Inflammatory bowel disease that usually spares the rectum but can occur in any part of the GIT

A

Crohn’s disease

94
Q

Pathognomonic feature of crohn’s disease

A

Granulomas

95
Q

Most common site of inflammation in crohn’s disease

A

Terminal ileum

96
Q

Mainstay of therapy for mild to moderate UC and crohn’s disease

A

Sulfasalazine and other 5-ASA agents

97
Q

First biologic therapy approved for crohn’s disease

A

Infliximab (TNF-alpha inhibitor)

98
Q

Operation of choice for UC

A

Ileal pouch anal anastomosis (IPAA)

99
Q

Most frequent late complication of Ileal pouch anal anastomosis (IPAA)

100
Q

Only antibiotic for irritable bowel syndrome with sustained benefit beyond therapy cessation

101
Q

Air-fluid level in the LLQ on plain abrominal film

A

Giant diverticulum of the sigmoid colon

102
Q

Staging system for predicting outcomes after surgery for perforated diverticulitis

A

Hinchey classification system

103
Q

Safety window for barium enema or colonoscopy after an acute attack of diverticular disease

A

6 weeks (risk for perforation during acute attack)

104
Q

Best management for asymptomatic diverticular disease

A

Diet alteration

105
Q

First indication of portal hypertension in liver cirrhosis

A

Hypersplenism with thrombocytopenia

106
Q

Presumed mechanism for development of SBP

A

Bacterial translocation

107
Q

Most common antibiotic for SBP

A

Cefotaxime

108
Q

Progressive impairment in renal function and significant reduction in creatinine clearance within 1-2 weeks in the setting of liver cirrhosis or acute liver failure

A

Type 1 hepatorenal syndrome

109
Q

Reduction in the GFR with an elevation of serum creatinine level (but fairly stable) in the setting of cirrhosis or acute liver failure

A

Type 2 hepatorenal syndrome

110
Q

Best therapy for hepatorenal syndrome

A

Liver transplantation

111
Q

Phenotypr of alpha 1 antitrypsin with greatest risk for developing chronic liver disease

A

ZZ phenotype

112
Q

Most potent of the HBV antivirals

113
Q

Hemolytic anemia with spur cells and acanthocytes in patients with severe alcoholic liver hepatitis

A

Zieve’s syndrome

114
Q

Laterality of pleural effusion in pancreatitis

A

Left (usually)

115
Q

Most frequently involved artery of pseudoaneurysm

A

Splenic artery

Internal Medicine (8 decks)

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