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ABIM > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

Treatment for Diffuse esophageal spasms

A
  1. trial of PPI
  2. CCB
  3. Antispasmodics
  4. anti anxiety
  5. reassurance
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2
Q

Causes of odynophagia

A
  1. infection (candida, cmv, hsv)

2. esophagitis (meds)

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3
Q

SE PPI

A 
osteo
vitamin d
hypomag
b12
c diff
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4
Q

Management of ulcerative esophagitis

A

PPI BID

repeat EGD to assess for healing and to exclude barrels (can’ two in setting of active ulcerations)

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5
Q

management of GERD

A 
patents with atypical sx take longer to respond to tx
hoarseness (PPI BID for 3 months)
h pylori (does not cause reflux)
sucralfate (doesn't do anything )
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6
Q

EGD finding of Barrets

A

salmon colored patch

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7
Q

Pathology of Barrets

A

specialized intestinal epithelium

symptoms - usually 2ndary complications- stricture/esophagitis

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8
Q

Barrets relation to esophageal Ca

A

adenocarcinoma

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9
Q

surveillance of Barrets

A

No dysplasia: repeat EGD 3-5 years
Low grade: 6-12 months
high grade in the absence of eradication therapy; 3 months

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10
Q

Endoscopic tx of Barret high grade dysplasia

A

RFA
PDT
endoscopic mucosal resection

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11
Q

Treatment of H pylori

A 
Generally 10-14 days
1. PPI , bismuth, metro tetra
P{I, amor, clarithro (some number of ppl resistant)
PPI, metro + clarithro (if pen allergy)
PPI should be bid
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12
Q

h pylori eradication

A

testing is recommmended
no earlier than 4 weeks after completing therapy
PPI should be stopped 2 weeks prior to testing

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13
Q

Atrophic gastritis etiology

A
  1. h pylori
  2. AI (a/w pernicious anemia)
  3. EOS
  4. lymphocytic
  5. Intestinal metaplasia - a/w H pylori
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14
Q

Treatment of delayed gastric emptying

A
  1. metoclopramide 10mg before meals
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15
Q

ZE syndrome

A

Stop PPI before testing for gastrin

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16
Q

Gastrinoma labs worku

A

elevated gastrin

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17
Q

suscpitous for ZE

A

recurrent ulcers
complicated ulcers
ulcer and diarrhea

18
Q

Gastric subepithelial lessions etiology

A

lipoma, pancreatic rest, duplication cyst

also gist, lymphoma, carcinoid

19
Q

GIST

A

<1 % of all tumors
Interstitial cell of Cajal
have KIT mutation

20
Q

Gastric Carcinoid

A 
gastric neuroendocrine tumor
gastrin is usually elevated
arise from enterochromaffin cells of stomach
<1 cm polypectomy is curative
rarely causes carcinoid syndrome
21
Q

Gastric lymphoma

A

malt lymphoma

22
Q

Complicatison of gastric surgery

A 
sibo
nutritional deficiencies
dumping syndrome
staple line leak
stenosis
23
Q

Symptoms of crohns

A

abdominal pain, diarrhea, weight loss

24
Q

UC symptoms

A

bloody diarrhea, tenesmus, abdominal discomfort, incontinence

25
Q

UC findings

A

uniform, continuous inflammation (start at rectum and up)

26
Q

Crohns

A

focal, patchy, deep ulcers
granulomas
perianal abscess, fistula

27
Q

UC

A

shallow ulcers

always has rectal involvement

28
Q

IBD extraintestinal manifestations

A 
PSC
episleritis/uveitis
erythema nodosum
pyoderma gangreosum
SI
29
Q

PSC

A

intrahepatic bedding

30
Q

MC extraintestingal manifestation of IBD

A

VTE

31
Q

Suspicious h/o Lynch syndrome

A

3 family members are affected w a Lynch associated cancer

32
Q

Chronic ulcerating infections presenting with IBD like symptoms

A

CMV, entamoeba histolytica

33
Q

s/s entamoeba histolytica

A

IBD like symptoms

liver abscesses

34
Q

mixed cryo

A

hep C

35
Q

Tx of Hep C

A

Ledipasvir

sofosbuvir

36
Q

typical presentation of mixed cryo

A

asthenia, arthralgia, palpable Purpura

37
Q

path of microscopic colitis collagen type

A

lymphocytic infiltrates + sub epithelial collagen band

38
Q

management of asymptomatic hepatic adenoma

A

if <5 cm, d/c ocp w follow up imaging q 6 months for 2 years

39
Q

associations for hepatic adenoma

A

ocp
steroid use
obesity
metabolic syndrome

40
Q

malignant transformation risk of hepatic adenomas

A

10%

41
Q

management of hepatic adenoma >5cm

A

surgical resection

also if found in males

ABIM (4 decks)

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