GI

Question 1

Familial Adenomatous Polyps

Answer 1

100% risk of colon cancer, will need annual sigmoidoscopy. May also have extra/missing or un-erupted teeth, cysts, adrenal masses, congenital hypertrophy of the RPE

Question 2

Courvoisier’s sign?

Answer 2

Enlarged, palpable gall bladder in the picture of obstructive jaundice = pancreatic cancer or cancer of the biliary tree

Question 3

Young person with large ulcers in the stomach duodenum and pancreas, non-resolving with PPI

Answer 3

Zollinger-Ellison Syndrome - gastrin secreting tumours, most sensitive testing is the secretin IV test - which should reduce the gastrin secretion if not - then positive for ZES

Question 4

Fothergills sign?

Answer 4

Palpable, firm, non-pulsatile mass that does not change with flexion of the rectus muscles and does not cross midline - rectus sheath hematoma

Question 5

Carnett’s sign

Answer 5

Pain worsens when they attempt to rise or when the muscles are strained with coughing

Question 6

Tx for proctitis

Answer 6

Surcralfate enema for analgesia, can move on to balloon dilation for obstruction or to endoscopic therapy

Question 7

Risk factors for developing gallstones

Answer 7

Diabetes, obesity, Crohn’s disease, hepatitis, cystic fibrosis

Question 8

Zenker’s Diverticulum

Answer 8

Outpouching of the pharynx - halitosis/ reflux/ globus sensation

Question 9

What can a C.jejuni infection mimic and what are possible sequela of infection

Answer 9

Appendicitis and can lead to meningitis, G-B, and reactive arthritis

Question 10

Pancreatitis in alcoholics - lipase and amylase?

Answer 10

Low amylase and high lipase

Question 11

Screening for HCC?

Answer 11

Only if pt has cirrhosis, then with US and AFP q 6 months