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UWORLD Q BANK review > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

Diagnosis of achalasia

A

Barium swallow and manometry

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2
Q

Rx for achalasia

A

Pneumatic dilation, surgical sectioning/ myotomy, botox- required every 3-6 months

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3
Q

Esophadeal spasm- radiology finding, treatment

A

Corkscrew appearance
High amplitude non peristaltic contractions
Rx- CCB, TCS, nitrates, PPI at times

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4
Q

Gastritis, hypercalcemia with weight loss. Diagnosis. Management

A

Zollinger Ellison syndrome- gastrinoma. Screen for MEN syndrome as well. Do serum gastrin levels. Do secretin stimulation test. Secretin inhibits gastrin. If still increased, ZES confirmed.
Rx- high dose PPI, surgery if no mets.

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5
Q

Malabsorption, arthritis, lymphadenopathy, PAS positive lamina propria. Diagnosis? Rx?

A

Whipple disease. Long term antibiotics

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6
Q

Initial test for carcinoid tumor. Treatment

A

Urine levels of 5-HIAA. Octreotide and surgery

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7
Q

Diagnosis of SBO. Rx?

A

1st x ray, accurate- CT abdomen
Fluid resuscitation
Partial SBO- supportive, NPO, NG, etc
Complete- Explorative laparotomy

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8
Q

Causes of ileus

A

Recent surgery, medical illness, electrolyte imbalance, hypothyroidism, DM, hypokalemia,

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9
Q

Most accurate test for mesenteric ischemia

A

CT angiography. Best initial- CT abdomen

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10
Q

Tests for diverticulosis and diverticulitis

A

Diverticulosis- colonoscopy, diverticulitis- CT abdomen

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11
Q

Causes of LBO

A

MCC- colon cancer
Diverticulosis, volvulus, fecal impaction, benign tumors

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12
Q

CF Cholangitis- triad

A

Fever, jaundice, RUQ pain

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13
Q

What indicated ascites is associated with portal hypertension?

A

SAAG >1.1- splenic or portal vein thrombosis, schistosomiasis, cirrhosis, RHF, constrictive pericarditis, BCS

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14
Q

Primary sclerosing cholangitis associated with ?

A

UC, P anca and onion skinning sclerosis

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15
Q

Med slowing progression of PBC

A

Ursodeoxycholic acid, cholestyramine, liver transplant

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16
Q

Gold standard for Wilson’s disease

A

24 hr urinary copper after penicillamine

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17
Q

Chain of lakes helps in diagnosis of ?

A

Chronic pancreatitis

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18
Q

Courvoisier sign associated with which cancer?

A

Pancreatic cancer

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19
Q

C diff treated with vancomycin developed C diff again. Next step?

A

Retreat with oral vancomycin. If that too doesn’t work, switch to fidaxomicin

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20
Q

Diarrhoea with urine showing low levels of D xylose. Diagnosis?

A

Celiac disease

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21
Q

Dx and Mx of TEF

A

Dx- NG tube, x ray
Mx- surgical correction, VACTERL screening

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22
Q

Syndromes associated with congenital umbilical hernia

A

Beckwith weidemann, ehlers danlos, Down’s syndrome

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23
Q

Tx of umbilical granuloma

A

Silver nitrate

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24
Q

Complications of gastroschisis. Mx?

A

Necrotising enterocolitis, bowel obstruction, SBO, FGR, oligohydramnios
Manage with sterile saline dressing and plastic wrap

25
Q

Complications of Beckwith weidemann. Dx

A

Wilms tumor, hepatoblastoma. Monitor for hypoglycaemia
Dx- serum AFP, USG Abdomen- done from birth to age 4 yrs, USG renal - 4-8 yrs

26
Q

Double and triple bubble sign seen in ?

A

Double- duodenal atresia, triple- jejunal atresia in x ray abdomen

27
Q

Squirt sign positive on DRE in? Gold standard diag?

A

Hirschsprung disease. Rectal suction biopsy

28
Q

Micro colon diagnostic of ?

A

Meconium ileus

29
Q

Confirmatory diagnosis of malformation due to volvulus, tx, associated congenital anomalies?

A

Upper GI series, LADD procedure. Omphalocele, diaphragmatic hernia, heterotaxy syndrome

30
Q

X ray findings of necrotising enterocolitis

A

Pneumatosis intestinalis, pneumoperitoenum

31
Q

Pathogenesis of allergic proctocolitis

A

Non IgE mediated inflammation

32
Q

Preventive therapy of cyclic vomiting syndrome

A

Age>5 - amitriptyline, age <5 - cyproheptadine. Risk factors- migraine in family

33
Q

Risk factors of intussusception

A

Viral illness, rota vaccine
Meckels, HSP, Celiac, intestinal tumor, polyps

34
Q

USG findings of intussception

A

Target sign, crescent sign

35
Q

Diagnosis of mid gut volvulus

A

X ray, Double bird beak/ corkscrew in upper GI series, treitz on right.

36
Q

Diagnosis of sigmoid volvulus. Mx?

A

X ray- coffee bean sign
CT scan - whirl sign
Mx- endoscopic detorsion, sigmoid colectomy

37
Q

What is to be avoided in congenital diaphragmatic hernia?

A

Bag and mask ventilation, causes lung compression. Only ET to be done

38
Q

Ogilvie syndrome, Dx, Tx?

A

X-ray- Colonic dilation, non dilated small bowel.
CT- colonic dilation without anatomic obstruction
Npo, NG/ rectal tube decompression
Neostigmine if no improvement

39
Q

Diagnosis of diabetic gastroparesis

A

Nuclear gastric emptying scan

40
Q

Rx of SIBO

A

Rifaximin

41
Q

Major risk factors of CRC

A

Obesity and T2 DM

42
Q

Hyperplastic polyps, colonoscopy screening

A

Every 10 years, every 5 years if high risk history, more frequent for adenomatous polyps

43
Q

What should be initially done if a patient presents with CRC or adenomas?

A

Proctocolectomy

44
Q

Lab findings in mesenteric ischemia

A

Leucocytosis, Hemoconcentration , elevated amylase and phosphate, lactic acidosis

45
Q

Clostridium septicum or bovis increases risk of ?

A

CRC. Do colonoscopy if organisms positive

46
Q

What is used to reduce anal sphincter pressure in anal fissure

A

Topical nifedipine

47
Q

Risk factors for GI AVM

A

Vwf disease, CKD, AS

48
Q

Initial steps of Mx of IBS

A

Low FODMAP - fermentable oligosaccharides, disaccharides, monosaccharides, polyols

49
Q

When does diarrhoea episodes occur in secretory diarrhoea

A

Nocturnal , fasting diarrhoea

50
Q

Which imaging is contraindicated in acute diverticulitis

A

Sigmoidoscopy and colonoscopy

51
Q

Colonoscopy showing Melanosis coil suggests?

A

Laxative abuse, senna laxative

52
Q

Rx for biliary atresia

A

Kasai procedure- surgical hepatoenterostomy, liver transplant

53
Q

SBP prophylaxis

A

Fluoroquinolone

54
Q

Which infectious gastroenteritis presents as pseudoappendicitis

A

Campylobacter

55
Q

20M trauma to central upper abd- fever, pain, right flank pain, Xray- free air in retroperitoneum. Diag?

A

Duodenal tear- sx repair

56
Q

2F lehargy, confusion. h/o fever, nasal discharge. Hepatomegaly, elevated LFT, acidosis, ammonia. CT- diffuse cerebral edema. Cause?

A

Medication effect- Reyes syndrome.

57
Q

Risks of intrahep cholestasis of preg. mx?

A

IUD, preterm, meconium stained fluid, NRDS. Mx- ursodeoxy, anti histamine, deliver at 37 wks

58
Q

Fecal impaction causes

A

Elderly- low fiber diet, less fluids, impaired mobility, chronic constipation, decreased sensation- dementia, spinal cord inj Can be associated with urine incontinence

59
Q
A

UWORLD Q BANK review (17 decks)

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