Gastrointestinal

Question 0

What is Charcot’s triad

Answer 0

RUQ pain, fever, jaundice

Question 1

Which inflammatory bowel disease invariably involves the rectum?

Answer 1

Ulcerative colitis- may extend proximally in a continuous fashion to involve part or all of the colon only. Crohn disease is characterized by patchy transmutation inflammation (skip lesions) involving any segment of the GI tract from the mouth to the anus.

Question 2

What is Reynold’s pentad and why does it matter?

Answer 2

Charcot’s triad + hypotension + altered mental status. It indicates high risk of sepsis.

Question 3

What disease is defined as an immunologic response to the gluten?

Answer 3

Celiac

Question 4

Is peptic ulcer disease more common in the duodenum or the stomach?

Answer 4

Duodenum

Question 5

What are the 5 points of Ranson’s criteria on admission?

Answer 5

Age > 55, WBC>16, glucose>200, AST>250, LDH>350 (acute pancreatitis)

Question 6

Steatorrhea should make you think of what diagnosis?

Answer 6

Pancreatitis

Question 7

Describe Courvoisier’s sign.

Answer 7

Nontender, palpable gallbladder which may indicate pancreatic neoplasm.

Question 8

What tumor marker can be used to follow pancreatic cancer?

Answer 8

CA-19-9

Question 9

What medication used in hepatitis B infection helps prevent the need for liver transplant?

Answer 9

Lamivudine

Question 10

What is the recommended treatment for hepatitis C infection?

Answer 10

Pegylated interferon alpha-2

Question 11

What is the most common cause of folate deficiency?

Answer 11

Alcoholism

Question 12

Describe how to perform the psoas sign.

Answer 12

The patient is supine and attempts to raise right leg against resistance.

Question 13

Describe how to perform the obturator sign

Answer 13

The patient is supine and attempts to flex and internally rotate right hip.

Question 14

What two blood test can be used to diagnose celiac?

Answer 14

IgA endomysial antibody and IgA tTG antibody.

Question 15

What class medication is first line to treat inflammatory bowel disease in the maintenance phase?

Answer 15

5-ASA products - sulfasalazine, mesalamine.

Question 16

Currant jelly stool should make you think of what diagnosis?

Answer 16

Intussusception

Question 17

Severe abdominal pain 30 minutes after a meal should make you think of what diagnosis?

Answer 17

Intestinal ischemia

Question 18

What is the most common cause of lower GI bleed?

Answer 18

Diverticulosis

Question 19

If you have heartburn that does not improve with medication what is the most likely diagnosis?

Answer 19

Gastrinoma

Question 20

What tumor marker may be used for liver cancer?

Answer 20

alpha fetoprotein

Question 21

Describe Cullen’s sign.

Answer 21

Umbilical ecchymosis secondary to retroperitoneal bleeding. (pancreatitis or ruptured ectopic pregnancy)

Question 22

What is the leading cause of iron deficiency anemia?

Answer 22

Chronic GI bleed

Question 23

At what age and how often should fecal occult blood test be performed as a screening tool?

Answer 23

Beginning at age 50 and they should be done every year.

Question 24

Define Pellagra?

Answer 24

Niacin (B3) deficiency

Question 25

How often should patients with pernicious anemia have a screening endoscopy performed?

Answer 25

Every 5 years looking for signs of gastric carcinoma.

Question 26

What does Anti-HBs (hep B surface antibody) indicate?

Answer 26

Recovery from infection (or immunized)

Question 27

A 15 year old boy presents complaining of night pain in the pelvis. The x-ray report comes back with the description of a mass with an "onion skin appearance". What is the most likely diagnosis?

Answer 27

Ewing sarcoma (2nd MC cancer of bone in children and adolescents)

Question 28

Describe Turner's sign

Answer 28

Blue-black discoloration around the flanks, e.g. in acute hemorrhagic pancreatitis and other causes of retroperitoneal hemorrhage.

Question 29

A patient complains of regurgitating undigested food several hours after a meal. What is the most likely diagnosis?

Answer 29

Zenker's diverticulum

Question 30

What does an Anti-HBc (hep B core antibody) indicate?

Answer 30

Previous or ongoing infection

Question 31

What are the two most common causes of pancreatitis?

Answer 31

Cholelithiasis and ETOH

Question 32

An endoscopy for presumed esophagitis shows multiple shallow ulcers. What is the most likely diagnosis?

Answer 32

Herpes simplex virus

Question 33

An endoscopy for presumed esophagitis shows several solitary deep ulcers. What is the most likely diagnosis?

Answer 33

Cytomegalovirus