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PANRE Review > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

Most common cause of esophagitis

A

GERD

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2
Q

Patient with odynophagia is immunocompromised. Endoscopy performed, shows large, shallow ulcers. What is the likely cause and treatment?

A

CMV

Treatment: Ganiclovir

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3
Q

Patient with severe food allergies being evaluated for dysphagia. Endoscopy likely shows?

A

Multiple corrugated rings (Eosinophillic esophagitis)

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4
Q

This condition may lead to esophageal adenocarcinoma

A

Barretts esophagus

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5
Q

Gold standard diagnosis for GERD

A

24 hour pH monitoring

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6
Q

50 y/o with difficulty swallowing solids and liquids. Esophagram shows birds beak appearance of LES. Diagnosis?

A

Achalasia

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7
Q

Gold standard for diagnosing achalasia

A

Manometry

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8
Q

Corkscrew appearance on esophagram

A

Diffuse esophageal spasm

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9
Q

Manometry shows increase LES pressure with peristalsis. Diagnosis?

A

Nutcracker esophagus

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10
Q

Patient admits to persistent vomiting and difficult swallowing. Crepitus heard on auscultation. Which test should be ordered for diagnosis?

A

CT scan (Boerhaaves syndrome): shows pneumomediastinum

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11
Q

Superficial longitudinal erosions seen on endoscopy

A

Mallory Weiss Tear

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12
Q

Test of choice for diagnosing esophageal webs

A

Barium esophagram (swallow)

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13
Q

Schatzki ring is located where?

A

Squamocolumnar junction

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14
Q

Treatment for a patient with upper GI bleeding and history of alcoholism

A

Endoscopic Ligation +/- octreotide

If not successful, surgical decompression (TIPS)

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15
Q

Treatment of choice in primary prophylaxis to prevent rebleeds in esophageal varices

A

Propanolol or nadolol

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16
Q

Treatment for hiatal hernia where GE junction remains in its anatomic location

A

“Rolling hernia” is treated with surgery

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17
Q

Patient experiencing solid food dysphagia and weight loss. Endoscopy with biopsy reveals Adenocarcinoma. Where is it likely located in the esophagus?

A

Lower 1/3rd of the esophagus

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18
Q

Most common cause of gastritis? PUD?

A

H.Pylori is most common

NSAIDs/ASA is 2nd most common

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19
Q

Treatment of H.Pylori

A

Clarithromycin
Amoxicillin (metronidazole if PCN allergic)
PPI

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20
Q

Most common cause of upper GI bleed

A

Peptic Ulcer Disease

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21
Q

30 y/o patient with dyspepsia that improves with meals, has nocturnal pain at bedtime. Endoscopy reveals which kind of ulcer and where?

A

Duodenal ulcer; most commonly found in the bulb

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22
Q

70 y/o patient with dyspepsia with meals and experiencing weight loss. Endoscopy reveals what type of ulcer and where?

A

Gastric ulcer; most common in the antrum of stomach

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23
Q

Which test for H.Pylori cannot confirm eradication?

A

Serologic antibodies

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24
Q

Most common site for gastrinoma

A

Duodenal wall

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25
Q

Patient has multiple peptic ulcers seen on endoscopy. Which test may be considered next?

A

Fasting gastrin level to rule out zollinger ellison syndrome

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26
Q

Endoscopic biopsy reveals diffuse thickening of stomach wall in a 60 y/o male with hx of H.pylori, recent weight loss and early satiety. Most likely diagnosis?

A 
Gastric carcinoma (adenocarcinoma most common)
"Linitis plastica"
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27
Q

Most common type esphogeal carcinoma worldwide

A

Squamous cell carcinoma

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28
Q

4 week old infant with vomiting, olive shaped nontender nodule right of umbilicus. Diagnosis?

A

Plyoric stenosis

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29
Q

30 y/o woman with ascites, hepatomegaly and RUQ pain. Likely condition?

A

Hepatic vein obstruction

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30
Q

Patient with fever, jaundice, RUQ pain. What test is ordered to make diagnosis?

A

ECRP

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31
Q

Common bacteria associated with acute cholecystitis?

A

E. Coli

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32
Q

When a patient has no UGT what will the labs show?

A

Elevated Indirect hyperbilirubinemia (Crigler Najjar Type 1)

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33
Q

Labs reveal mild conjuagated (direct) hyperbilirubinemia and liver is grossly black. What is the condition?

A

Dubin Johnson Syndrome

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34
Q

What type of jaundice has increase in direct and indirect bilirubin?

A

Hepatocellular (hepatitis)

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35
Q

Dark urine is a sign of what in a jaundiced patient?

A

Elevated direct hyperbilirubinemia (seen in direct and hepatocellular jaundice)

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36
Q

Elevated ALP with GGT suggests what?

A

hepatic source or biliary obstruction

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37
Q

Treatment for hepatic encephalopathy

A

Lactulose, neomycin, protein restriction

38
Q

Hepatitis associated with spiking fever

A

Hepatitis A

39
Q

Patient has Hepatitis C. What tests screen for hepatocellular carcinoma?

A

Alpha fetoprotein and ultrasound

40
Q

Which lab diagnoses hepatitis E?

A

IgM anti-HEV

41
Q

A patient being screened for hepatitis B has labs reveal the following:
HbsAg -, Anti-HBs +, Anti-HBc -

Whats your interpretation?

A

Immunity to hepatitis B

42
Q

A patient being screened for hepatitis B has labs reveal the following:
HbsAg +, Anti-HBs -, Anti-HBc IgM

Whats your interpretation?

A

Acute Hepatitis

43
Q

A patient being screened for hepatitis B has labs reveal the following:
HbsAg -, Anti-HBs +, Anti-HBc IgG

Whats your interpretation?

A

Recovery from hepatitis B

44
Q

Treatment for a hepatitis B patient with elevated ALT and inflammation show on liver biopsy?

A

Alpha interferon 2b, lamivudine, adefovir

45
Q

Patient with known cirrhosis has ascites, new unexplained fever and abdominal pain. What do you suspect?

A

Bacterial peritonitis

46
Q

Model for End Stage Liver Disease looks at what 3 labs and is usefor for determining what?

A

Total bilirubin, INR, serum creatinine

3 month mortality

47
Q

Positive anti mitochondrial antibody is hallmark of which disease?

A

Primary biliary cirrhosis

48
Q

Treatment for primary biliary cirrhosis?

A

Ursodeoxycholic acid

49
Q

Primary sclerosing cholangitis is associated with which other disease?

A

Ulcerative Colitis (+ P-ANCA)

50
Q

Diagnosis of Wilsons Disease

A

Increased urinary copper excretion

Elevated ceruloplasmin

51
Q

Acinar cell injury can lead to what disease

A

Acute pancreatitis

52
Q

Abdominal x-ray findings in acute pancreatitis

A

Sentinel loop and/or colon cut off sign

53
Q

Triad of symptoms with chronic pancreatitis

A

calcifications, steatorrhea, diabetes

54
Q

Most common form of pancreatic carcinoma and location

A

Adenocarcinoma (ductal)

70% in the head of pancreas

55
Q

Elevated CA 19-9 and CEA are associated with which condition?

A

Pancreatic carcinoma

56
Q

Most common cause of small bowel obstruction?

A

Post surgical adhesions

57
Q

1 year old with vomitting, abdominal pain and currant jelly stools?

A

Intussception

58
Q

Diagnosis and treatment of Intussception?

A

Barium contrast enema

59
Q

Which labs are positive in Celiac Disease?

A

Anti-endomysial ab

Transglutaminase ab

60
Q

Positive hydrogen breath test diagnoses which condition?

A

Lactose intolerance

61
Q

Most common cause of lower GI bleeds?

A

Diverticulosis (sigmoid colon MC area)

62
Q

Obturator sign

A

RLQ pain with int/ext rotation of hip with bent knee

63
Q

Psoas sign

A

RLQ pain with right hip flexion/extension

64
Q

30 y/o female with abdominal pain for 12 weeks of past year has relief with defecation. Reports alternating diarrhea/constipation bouts. Diagnosis?

65
Q

Patient has severe abdominal pain out of proportion to exam. What test is ordered and likely diagnosis?

A

Angiogram to rule out acute mesenteric ischemia

66
Q

Patient has chronic dull abdominal pain worse after meals. Colonoscopy shows?

A

atrophy, loss of vill (chronic mesenteric ischemia)

67
Q

Colonscopy in patient that has LLQ and bloody diarrhea reveals segmental changes at splenic flexure. Diagnosis?

A

Mestenric ischemia

68
Q

Diagnosis for toxic megacolon

A

Abdominal x-ray: dilated colon >6 cm

69
Q 
Ulcerative Colitis
      Area
      Sx
     Complications
     Colonoscopy and barium
     Labs
     Acute diagnosis
A

Limited to colon (recum always involved)
LLQ pain, tenesmus, bloody diarrhea
primary sclerosing angitis, colon CA, megacolon
uniform inflammation, sandpaper appearance, stove-pipe sign
P-ANCA
Flex sigmoidoscopy

70
Q

Most common adenomateous (potentially cancerous) polyp?

71
Q

20 y/o with polyposis, hyperpigmented lips, hands, tongue. What are they at risk for?

A

Colon cancer (Peutz-Jehgers)

72
Q

Colon cancer on barium enema

A

Apple core lesion

73
Q

Which type of hernia is lateral to inferior epigastric vessels?

A

Indirect hernia

74
Q

Patient has perianal pain worse with defecation. Likely cause?

A

External hemorrhoids

75
Q

What are Bitot spots?

A

White spots on conjunctiva associated with Vitamin A deficiency

76
Q

Pellagra is associated with deficiency in?

A

Vitamin B3 (Niacin)

Diarrhea, dementia, dermatitis

77
Q

Schilling test is used for diagnosing….

A

Pernicious anemia (macrocytic anemia)

78
Q

Patient with ophthalmoplegia, ataxia and global confusion is likely deficient in?

A

Vitamin B1 (Thiamine)

Werneckes Encephalopathy

79
Q

PKU is diagnosed how?

A

Urine: musty (mousy) odor

80
Q

Most common cause of diarrhea in adults in North America

81
Q

Patient ingests fried rice and within 3 hours experiences significantly watery diarrhea, vomitting. Likely cause?

82
Q

Most common cause of travelers diarrhea?

A

Enterotoxogenic E. Coli

83
Q

Most common cause of bacterial enteritis in US?

A

Campylobacter (C. Jejuni)

84
Q

Pea-soup stools are associated with what disease?

A

Salmonella

85
Q

Patient with crampy lower abdominal pain, explosive diarrhea with blood. Likely diagnosis and treatment?

A

Shigella

Sigmoidoscopy shows punctate areas of ulceration

Tx: Bactrim

86
Q

Treatment for Yersinia?

A

Fluoroquinolones

87
Q

Frothy, greasy, foul diarrhea

88
Q

Most common cause of diarrhea in AIDS patients

A

Cryptosporidium

89
Q

Decrease in diarrhea with fasting, increase osmotic gap. Which type of diarrhea?

90
Q

Whipples disease diagnosis?

A

Duodenal biopsy: Periodic Acid-Schiff

91
Q

Side effect of saline laxatives

A

Hypermagnesemia

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