GI 1

Question 1

classic exam findings for acute appendicitis

Answer 1

low grade fever
RLQ pain w/ rebound and guarding
McBurney’s point
psoas and obturator signs are positive

Question 2

acute cholecystitis classic presentation

Answer 2

overweight adult pt c/o severe RUQ or epigastric pain that occurs within 1 hour or more after eating a fatty meal

Question 3

acute diverticulitis class s/sx

Answer 3

high fever
anorexia
NV
LLQ pain

Question 4

signs of acute diverticulitis
3

Answer 4

positive Rosving’s sign
board like abd
CBC - leukocytosis w/ netrophilia and shift to the left

Question 5

positive Cullen’s sign

Answer 5

blue discoloration around umbilicus - acute pancreatitis

Question 6

Grey Turner’s sign

Answer 6

blue discoloration on the flanks - acute pancreatitis

Question 7

crohn’s disease

Answer 7

IBD that can affect any part of GI tract; transmural inflammation and skip areas of involvement

Question 8

IBD that can affect any part of GI tract; transmural inflammation and skip areas of involvement

Answer 8

Crohn’s disease

Question 9

form of IBD that is limited to the colon/rectum

Answer 9

UC

Question 10

blood diarrhea w/ mucus (hematochezia) is more common with what

Answer 10

UC than with CD

Question 11

severe “squeezing” cramping pain located on the left side of the abd w/ bloating and gas that is exacerbated by food

Answer 11

UC

Question 12

Zollinger-Ellison syndrome

Answer 12

gastrinoma located on the pancreas or stomach that secretes gastrin which increases acid production in the stomach that causes severe ulcers

Question 13

gastrinoma located on the pancreas or stomach that secretes gastrin which increases acid production in the stomach that causes severe ulcers

Answer 13

Zollinger-Ellison syndrome

Question 14

zollinger-ellison syndrome - screen by

Answer 14

serum fasting gastrin level

Question 15

positive signs for appendicitis

Answer 15

psoas - raise leg while applying downward pressure
obturator - internal rotation of hip causes RLQ pain

Question 16

rovsing’s sign

Answer 16

deep palpation LLQ causes referred pain to RLQ - appendicitis

Question 17

mcburney’s point

Answer 17

RLQ pain - appendicitis

Question 18

murphy’s maneuver

Answer 18

press deeply on RUQ during inspiration, pain is positive - suggests cholecystitis

Question 19

hepatitis A - acute infection, patient is contagious

Answer 19

IgM antibody (IgM Anti-HAV)

Question 20

positive IgG Anti-HAV

Answer 20

hep A virus - presence means lifelong immunity, no virus present, native hep A infection or vaccine

Question 21

HBsAG positive

Answer 21

positive when the patient is infected currently or was infected in the past with hep B

Question 22

serologic hallmark of hep B virus infection HBV

Answer 22

HBsAg

Question 23

disappearance of HBsAg is followed by

Answer 23

the presence of hepatitis B surface antibody (anti-HBs) conferring antibodies and long term immunity from reinfection

Question 24

IgM anti-HBc indicates

Answer 24

acute HBV infection - but may remain detectable up to 2 years after acute infection

Question 25

patient is anti-HCV positive - do what

Answer 25

check HCV RNA and HCV antibody - if RNA is positive, infection is there, refer to GI

Question 26

biomarkers of hepatic injury

Answer 26

AST
ALT
ALP
bilirubin

Question 27

which liver biomarker points to issues with alcohol disorder

Answer 27

AST

Question 28

ratio of what may indicated alcohol abuse AST ALT

Answer 28

2:1 or greater

Question 29

GGT elevated on its own inidicated

Answer 29

alcoholism