Geri 1

Question 1

Choking while drinking liquids, tongue deviation, asymmetrical palate, thick speech. Good test:

Answer 1

Swallow Evaluation

Question 2

85 y/o, recurrent pneumonia: good test, evaluate for:

Answer 2

Swallow study for silent aspiration

Question 3

Belching and chest discomfort, part of stomach above diaphragm. Diagnosis:

Answer 3

Hiatal hernia

Question 4

75 y/o difficulty swallowing liquids and solids, manometry shows diffuse dysmotility. Underlying condition:

Answer 4

Diabetes Mellitus

Question 5

Smoking and alcohol use, cancer of distal esophagus:

Answer 5

adenocarcinoma

Question 6

79 y/o, trouble initiating swallow, hesitance, feels food move slowly. Denies choking, vomiting, reflux, weight loss. Likely associated diagnosis:

Answer 6

Parkinson’s Disease

Question 7

Physical finding on tongue in atrophic glossitis:

Answer 7

Shiny, red, bald

Question 8

Most common cause for salivary dysfunction in elderly

Answer 8

iatrogenic

Question 9

Major risk factors for oral cancer

Answer 9

alcohol and tobacco

Question 10

80 y/o, choking while drinking liquids, no problems chewing or swallowing. Likely diagnosis:

Answer 10

Oropharyngeal dyspagia

Question 11

Gender affects this complication of GERD:

Answer 11

Barrett’s Esophagus

Question 12

Important factors in the development of erosive esophagus:

Answer 12

Lower esophageal sphincter pressure
Esophageal clearance rate
Mucosal Resistance
Composition of refluxate

Question 13

This food increases esophageal reflux by slowing gastric emptying:

Answer 13

fatty foods

Question 14

Diabetic with gastroparesis, labs include TSH 12, A1c 7.1. First step:

Answer 14

Recheck TSH and treat hypothyroid as needed

Question 15

Best test for post H. pylori treatment efficacy

Answer 15

H. pylori stool antigen

Question 16

45 y/o male, hx heartburn, pressure in chest without N/V or radiation, first test:

Answer 16

EKG

Question 17

45 y/o male, hx heartburn, worsening with pressure in chest, EKG normal, what next:

Answer 17

esophagogastroduodenoscopy

Question 18

92 y/o demented, constipation and bilious vomit, doesn’t eat but chews on bathrobe. Concern?

Answer 18

bezoar

Question 19

What happens in a Nissen fundoplication?

Answer 19

wrapping proximal stomach around distal esophagus

Question 20

45 y/o male, chronic allergy, recent onset of hoarse voice, no fevers, no other complaints. First steps:

Answer 20

Treat allergies then reassess laryngitis

Question 21

Old livers tend to be ______ er than young livers because of ________

Answer 21

Small, multifactorial causes

Question 22

How does one get Hep A?

Answer 22

Food, fecal-oral

Question 23

Proper term for common bile duct obstructed by gallstone

Answer 23

choledocolithiasis

Question 24

What is Charcot’s triad?

Answer 24

Fever
Jaundice
RUQ pain

Question 25

80% of gallstones are made of this, also urosdial is effective in these kinds of gallstones

Answer 25

Cholesterol

Question 26

81 y/o diabetic with pancreatitis. What is the most likely etiology?

Answer 26

pancreatic malignancy

Question 27

Big unexpected change in A1c in 81 y/o diabetic, what should you work up?

Answer 27

Pancreas

Question 28

Blood test to identify recent heavy alcohol use

Answer 28

Carbohydrate-deficient transferrin

Question 29

Define SIBO

Answer 29

Small intestinal bacterial overgrowth, colonic bacteria invade proximally into ileum and jejunum

Question 30

positive gliadin anibody, TTG negative. Is it celiac or Crohn’s?

Answer 30

Neither

Question 31

This lab test is helpful to track treatment of colon cancer, but is not particularly helpful in diagnosis

Answer 31

carcinoembryonic antigen (CEA)

Question 32

Big difference between ulcerative colitis and Crohn’s?

Answer 32

depth of mucosal lesion (Crohn’s is deeper)

Question 33

Disease characteristic unique to IBS:

Answer 33

functional disruption of enteric nerves

Question 34

Abx for C. diff that might avoid development of resistant C. diff?

Answer 34

metronidazole

Question 35

frequent etiology of abx associated diarrhea?

Answer 35

abx induced changes in colonic fermentation of carbohydrates

Question 36

what portion of people have diverticulOSIS by 80?

Answer 36

2/3

Question 37

Melena and increased BUN, how might we find the bleed?

Answer 37

upper GI endoscopy

Question 38

one effect of cytokines in chronic inflammatory disease

Answer 38

increase in hepcidin synthesis by liver

Question 39

what portion of bowel is most likely to have diverticulOSIS in Western populations?

Answer 39

sigmoid colon

Question 40

Tumor found in rectum, GI will next:

Answer 40

endoscopic ultrasound