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USMLE Step Two > Gastrointestinal Disorders > Flashcards

Gastrointestinal Disorders Flashcards

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USMLE® Step 1 flashcards
1
Q

food poisoning as a result of mayonnaise sitting out too long

A

staph aureus

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2
Q

rice-water stools

A

vibrio cholera

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3
Q

diarrhea transmitted from pet feces

A

yersinia enterocolitica

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4
Q

food poisoning resulting from reheated rice

A

bacillus cereus

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5
Q

most common cause of traveler’s diarrhea

A

enterotoxigenic e. coli

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6
Q

diarrhea after a course of antibiotics

A

c. diff

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7
Q

diarrhea after recent ingestion of water from a stream

A

giardia lamblia or less commonly entamoeba

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8
Q

mild intestinal infection that can become neurocysticerosis

A

taenia solium

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9
Q

food poisoning from undercooked hamburger

A

EHEC

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10
Q

diarrhea from seafood

A

vibrio cholera/vulnificus/paerahemolyticus

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11
Q

bloody diarrhea from poultry

A

campylobacter or salmonella

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12
Q

bloody diarrhea with liver abscess

A

entamoeba histolytica

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13
Q

diarrhea in an AIDS patient

A

cryptosporidium or isospora (less commonly)

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14
Q

dehydrated child with greenish diarrhea in winter months

A

rotavirus

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15
Q

treatment for hepatitis B

A

IFN-alpha

lamivudine, adefovir, entecavir, telbivudine

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16
Q

treatment for hepatitis C

A

IFN-alpha and ribavirin

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17
Q

what does a barium swallow allow you to visualize

A

esophagus, LES, and stomach

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18
Q

what does a gastric emptying study allow you to visualize

A

stomach, pyloric sphincter, duodenum

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19
Q

what does a small bowel follow through allow you to visualize

A

stomach to terminal ileum

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20
Q

what does a barium enema allow you to visualize

A

colon and appendix

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21
Q

different types of esophageal diverticulum

A

zenker: upper esophagus
traction: middle esophagus
epiphrenic: lower esophagus

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22
Q

treatment for entamoeba histolytica diarrhea

A

metronidazole

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23
Q

treatment for giardia lamblia

A

metronidazole

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24
Q

treatment for salmonella

A

none unless immunocompromised (cipro)

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25
Q

treatment for salmonella

A

none unless severe (cipro TMP-SMX)

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26
Q

treatment for campylobacter

A

erithromycin

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27
Q

Hep BsAg negative
Hep BsAB negative
Hep BcAb positive

A

window period of Hep B infection

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28
Q

Hep BsAg positive
Hep BsAb negative
Hep BcAb positive

A

chronic Hep B infection

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29
Q

Hep BsAg negative
Hep BsAB positive
Hep BcAb negative

A

Hep B vaccinated status

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30
Q

Hep BsAg negative
Hep BsAB positive
Hep BcAb positive

A

past Hep B exposure

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31
Q

next step in patient complaining of dysphagia

A

barium swallow followed by EGD

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32
Q

EGD reveals gastric cancer, what is the next step

A

CT scan to stage

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33
Q

next step in management of patient with recurrent duodenal ulcers on multiple EGDs

A

serum gastrin level to rule out ZES

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34
Q

most effective treatment for duodenal ulcers not due to ZES

A

triple therapy for h. pylori

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35
Q

chem 7 lab abnormality often elevated in patients with an upper GI bleed

A

BUN

bacteria in gut breakdown hemoglobin with is reabsorbed increasing BUN

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36
Q

tumor markers for pancreatic cancer

A

CEA and CA19-9

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37
Q

tumor marker for gastric cancer

A

CEA

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38
Q

regimen for h. pylori treatment

A

PPI + clarithromycin + amoxicillin/metronidazole

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39
Q

treatment for gastric cancer

A

distal third: subtotal gastrectomy

initial two-thirds: total gastrectomy

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40
Q

treatment for pancreatic cancer in the head of the pancreas

A

whipple if localized

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41
Q

most sensitive and specific lab test for chronic pancreatitis

A

decreased fecal elastase

42
Q

treatment for chronic pancreatitis

A

alcohol cessation, enzyme replacement

43
Q

management for patient that comes to ER with abdominal pain and AXR shows free air in abdomen

A

laparotomy

44
Q

cuban immigrant with malabsorption and megaloblastic anemia

A

tropical sprue

45
Q

time-frame for post-operative ileus resolution in the different parts of the gut

A

stomach: 24 hours
small bowel: 2-3 days
large bowel: 3-5 days

46
Q

diagnosis and management: AXR reveals two distinct but sequential portions of bowel in sigmoid colon distended

A

sigmoid volvulus, colonic decompression, resection as needed

47
Q

most common cause of small bowel obstruction

A

adhesions or secondly hernias

48
Q

classic characteristic of acute mesenteric ischemia

A

pain out of proportion to the exam

49
Q

tumors that can cause secretory diarrhea

A

VIPoma, gastrinoma, carcinoid, and medullary thyroid

50
Q

most likely cause of malabsoprtion in patient with + sudan stain and normal D-xylose test

A

pancreatic insufficiency

51
Q

treatment for whipple disease

A

antibiotics (TMP-SMX or ceftriaxone) x 12 months

52
Q

serum antibodies seen in celiac sprue

A

anti-gliadin, anti-endomysial, anti-transglutaminase

53
Q

serum lab findings distinguishing crohn’s from UC

A

crohn’s ASCA positive, UC P-ANCA positive

54
Q

next step in management of patient younger than 50 w/minimal BRBPR

A

anoscopy looking for hemorrhoids

55
Q

most likely cause of acute pain and swelling of midlien sacrococcygeal skin and subcutaneous tissues

A

pilonidal cyst

56
Q

most likely cause of recurrent LLQ abdominal pain improving after defecation

A

diverticulosis

57
Q

patient at risk for acalculous cholecystitis

A

ICU patient or patient on TPN

58
Q

charcot’s triad

A

fever, RUQ pain, and jaundice

59
Q

reynold’s pentad

A

fever, RUQ pain, jaundice, altered mental status, hypotension

60
Q

next step for patient found to have calcified gallbladder

A

biopsy

61
Q

treatment of cholecystitis v. cholangitis

A

cholecystitis go right to cholecystectomy

cholangitis perform endoscopic drainage followed by delayed cholecystectomy

62
Q

patient with colon cancer has local lymph node involvement without distant mets

A

stage III

will require chemotherapy

63
Q

patient undergoes colonoscopy and is found to have 3 small tubular adenomas, when should he undergo his next colonscopy

A

5 years

64
Q

man tells you his father was diagnosed with colon cancer at age 55, when should his first colonoscopy be

A

45

65
Q

antibiotic combination to treat diverticulitis as an outpatient

A

metronidazole + TMP-SMX/augmentin/fluoroquinolone

66
Q

how are anal fissures managed

A

stool softeners, topical nitroglycerin, anti-spasmotics

refractory cases may receive partial sphincterotomy (risk of incontinence)

67
Q

most common causes of upper GI bleeds

A

peptic ulcer disease, esophagitis, variceal bleeds, gastritis, mallory-wise tears

68
Q

most common causes of lower GI bleeds

A

upper GI bleeds, diverticulosis, AV malformations, colorectal cancer, mesenteric ischemia, meckel’s diverticulum

69
Q

how is volume status assessed in patient with GI bleed

A

blood pressure, heart rate, urine output

70
Q

antibiotic contraindicated in neonates with hyperbilirubinemia

A

ceftriaxone

71
Q

deep palpation of RUQ causes arrest of inspiration and pain

A

murphy’s sign, cholecystitis

72
Q

RLQ pain on passive extension of hip

A

psoas sign, appendicitis

73
Q

RLQ pain on passive internal rotation of the flexed hip

A

obturator sign, appendicitis

74
Q

LUQ pain and referred left shoulder pain

A

kehr’s sign, splenic rupture

75
Q

ecchymosis of the skin overlying the flank

A

grey-turner sign, pancreatitis

76
Q

ecchymosis of the skin overlying the periumbilical area

A

cullen’s sign, pancreatitis

77
Q

treatment for hepatic encephalopathy

A

lactulose and rifaximin (or neomycin)

protein restriction

78
Q

symptoms of budd-chiari syndrome

A

ascites, hepatomegaly, jaundice

79
Q

most widely used screening test for hemochromatosis

A

serum ferritin

80
Q

treatment for hemochromatosis

A

phlebotomy and deferoxamine

81
Q

primary biliary cirrhosis v. primary sclerosing cholangitis

A

PBC: female, intrahepatic ducts only, anti-mitochondrial antibodies, anti-ANA
PSC: male, intrahepatic and extrahepatic ducts, P-ANCA, ERCP shows beads on a string

82
Q

treatment for primary biliary cirrhosis

A

urodeoxycholic acid +/- colchicine

eventual liver transplant

83
Q

most common type of TE fistula

A

blind upper esophageal pouch, lower esophagus is connected to the trachea

84
Q

hepatitis virus types

A 
A: picornavirus, single-stranded RNA
B: hepadnavirus, double-stranded DNA
C: flavivirus, single-stranded RNA
D: delta agent, incomplete single-stranded RNA
E: calicivirus, single-stranded RNA
85
Q

statistics for progression to chronic hepatitis

A

5% adults progress to chronic hepatitis B
90% children progress to chronic hepatitis B
80% adults progress to chronic hepatitis C

86
Q

increased LES pressure, incomplete LES relaxation, decreased peristalsis

A

achalasia

see “birds beak” sign on CXR

87
Q

management of a duodenal hematoma

A

most resolve in 1-2 weeks

treat conservatively with NG tube and TPN

88
Q

polyps that are not pre-malignant

A

peutz-jaghers, hyperplastic, inflammatory, and juvenile

89
Q

treatment for acute diverticulitis

A

NPO, IV fluids, antibitoics

elective surgery for those who have had > 2 attacks

90
Q

treatment for sigmoid volvulus

A

proctosigmoidoscopic exam, leave rectal tube in

elective sigmoid resection

91
Q

treatment for pyogenic liver abscess

A

diagnose with U/S or CT scan

percutaneous drainage required

92
Q

treatment for amebic liver abscess

A

seldom require drainage, metronidazole will suffice

93
Q

large, thin, distended gallbladder with obstructive jaundice picture

A

likely malignancy causing obstruction

94
Q

malignant obstructive jaundice, anemia, blood in stools

A

cancer of the ampulla bleeding into the lumen

95
Q

severe peptic ulcers, watery diarrhea

A

zollinger-ellison syndrome (gastrinoma)

treatment: measure serum gastrin, surgically resect

96
Q

devastating hypoglycemia in newborns that results in 95% pancreatectomy

A

nesidioblastosis

97
Q

mild diabetes, anemia, glossitis, stomatitis, and severe migratory necrolytic dermatitis

A

glucagonoma

treatment: surgically resect, somatostatin or streptozocin for metastatic disease

98
Q

diagnostic method for meconium ileus

A

gastrografin enema (also therapeutic)

99
Q

management of pyloric stenosis

A

correct metabolic abnormalities and follow with surgery

100
Q

management of intussusception

A

barium enema is both diagnostic and therapeutic

USMLE Step Two (17 decks)

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