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Physician Assistant Exam > GI > Flashcards

GI Flashcards

1
Q

With achalasia will the patient have dysphagia to liquids, solids or both?

A

Both

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2
Q

With a gastric ulcer are the patient’s exacerbated or relieved with food?

A

Exacerbated

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3
Q

Which NSAID has the highest rate of peptic ulceration?

A

Naproxen

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4
Q

Which is more likely to pass into the scrotum, a direct or indirect hernia?

A

Indirect

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5
Q

Which are more painful, hemorrhoids above or below the dentate line?

A

Below, internal hemorrhoids are not painful.

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6
Q

What will the bowel sounds be early on in a small bowel obstruction? What will they be later on?

A

Early they are hyperactive. Late they are absent

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7
Q

What two viral hepatitis infections are self limiting?

A

A and E

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8
Q

What two blood test can be used to diagnose celiac?

A

IgA endomysial antibody and IgA tTG antibody

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9
Q

What tumor marker may be used for liver cancer?

A

alpha-Fetoprotein

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10
Q

What tumor maker can be used to follow pancreatic cancer?

A

CA-19-9

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11
Q

What treatment should be started for asymptomatic diverticulosis?

A

None

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12
Q

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

A

Lamivudine

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13
Q

What medication is most commonly used for long term treatment of GERD?

A

PPIs - omeprazole, lansoprazole, pantoprazole

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14
Q

What medical treatment is given for a gastrinoma?

A

PPIs

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15
Q

What it is the recommended treatment for Hep C infection?

A

Pegylated interferon alpa-2a

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16
Q

What is the treatment for most Mallory-Weiss tears?

A

Self limiting, typically within 48 hours

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17
Q

What is the term for painful swallowing?

A

Odynophagia

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18
Q

What is the term for difficulty swallowing?

A

Dysphagia

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19
Q

What is the term for an abscess in the sacrococcygeal cleft?

A

Pilonidal disease

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20
Q

What is the only curative therapy for gastric adenocarcinoma?

A

Surgical resection

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21
Q

What is the most specific test for acute cholecystitis?

A

HIDA

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22
Q

What is the most common vessel blocked with intestinal ischemia?

A

Superior mesenteric artery

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23
Q

What is the most common location of colorectal cancer?

A

Cecum 38%

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24
Q

What is the most common location for an anal fissure?

A

Posterior midline

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25
Q

What is the most common location for a pancreatic tumor?

A

75% occur in the head of the pancreas

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26
Q

What is the most common cause of peptic ulcer disease?

A

H. pylori

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27
Q

What is the most common cause of lower GI bleed?

A

Diverticulosis

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28
Q

What is the most common cause of folate deficiency?

A

Alcoholism

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29
Q

What is the most common cause of acute bacterial cholangitis?

A

Choledocholitaisis

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30
Q

What is the most common anorectal problem affecting patients over 50?

A

Hemorrhoids

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31
Q

What is the medical term for feeling like there is a lump in your throat?

A

Globus

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32
Q

What is the main risk factor for esophagitis?

A

Immunocompromised patient

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33
Q

What is the leading cause of iron deficiency anemia?

A

Chronic GI bleed

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34
Q

What is the imaging modality of choice for pancreatitis?

A

CT

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35
Q

What is the gold standard for diagnosis and treatment of bile duct stones?

A

ERCP

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36
Q

What is the first step in treating GERD?

A

Lifestyle modification

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37
Q

What is the diagnostic test of choice for Zenker’s diverticulum?

A

Barium swallow will show the diverticulum

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38
Q

What is the best test to check for H. pylori?

A

Urea breath test

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39
Q

What is the best imaging study for acute appendicitis?

A

CT

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40
Q

What is the #1 cause of small bowel obstruction?

A

Postoperative adhesions

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41
Q

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

A

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

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42
Q

What is most specific diagnostic test for peptic ulcer disease?

A

Endoscopy

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43
Q

What is Charcot’s triad?

A

RUQ pain, fever, jaundice

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44
Q

What is a good beta blocker to reduce portal HTN?

A

Propranolol

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45
Q

What is a common symptom that goes along with chest pain for GERD patients?

A

Dry cough

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46
Q

What does HBsAG (Hep B surface antigen) indicate?

A

Active Hep B infection

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47
Q

What does ERCP stand for?

A

Endoscopic retrograde cholangiopancreatography

48
Q

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

A

Recovery from infection or immunization to Hep B

49
Q

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

A

Previous or ongoing infection Hep B infection

50
Q

What disease is defined as an immunologic response to gluten?

A

Celiac

51
Q

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

A

5-ASA products - sulfasalazine, mesalamine

52
Q

What causes Mallory-Weiss tears?

A

Forced vomiting or retching (Often involving alcohol)

53
Q

What are two treatments you should consider for esophageal strictures?

A

Dilation of the esophagus and long term PPIs

54
Q

What are two things that an anal fissure off midline might suggest?

A

Crohn’s, syphilis, HIV, neoplasm

55
Q

What are two common predisposing factors for esophageal varices?

A

Portal HTN and cirrhosis often caused by alcoholism

56
Q

What are the two most common causes of pancreatitis?

A

Cholelithiasis and ETOH

57
Q

What are the two main complications of cirrhosis?

A

Portal HTN & liver insufficiency

58
Q

What are the first three steps of managing pancreatitis?

A

NPO, pain control, fluids

59
Q

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

A

older than 55, WBC>16, glucose>200, LDH>350, AST>250

60
Q

Under routine circumstances when should patients begin getting screening colonoscopies?

A

Age 50

61
Q

Thumbprint sign on abdominal film should make you think of what diagnosis?

A

Intestinal ischemia

62
Q

There are vaccines for which two versions of hepatitis?

A

Hep A and Hep B

63
Q

Steatorrhea should make you think of what diagnosis?

A

Pancreatitis

64
Q

Should diverticulitis always be admitted?

A

No mild cases can be treated as outpatients with rest and clear fluids.

65
Q

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

A

Intestinal ischemia

66
Q

Salivary amylase breaks down what macronutrient?

A

Carbohydrates

67
Q

Projectile vomiting should make you think of what diagnosis?

A

Pyloric stenosis

68
Q

Pica is often related to what type of anemia?

A

Iron deficiency anemia

69
Q

Patient complains of RUQ pain 20 minutes after a meal. What diagnosis should you be thinking of?

A

Cholecystitis

70
Q

Patient complains of regurgitating undigested food several hours after a meal. What diagnosis should you be thinking of?

A

Zenker’s diverticulum

71
Q

Patient complains of periumbilical pain which has now moved over McBurney’s point. What diagnosis should you be thinking of?

A

Appendicitis

72
Q

Painless bright red blood per rectum should make you think of what diagnosis?

A

Hemorrhoids

73
Q

Onion ring fibrosis from a bile duct biopsy should make you think of what diagnosis?

A

Primary sclerosing cholangitis

74
Q

One half of all adult hernias are direct or indirect?

A

Indirect inguinal hernias makeup 50% of all adult hernias

75
Q

Name the sign. Patient is supine and attempts to raise right leg against resistance.

A

Psoas sign

76
Q

Name the sign. Patient is supine and attempts to flex and internally rotate right hip

A

Obturator sign

77
Q

Most gallstones are made of what substance?

A

Cholesterol

78
Q

LLQ pain and tenderness should make you think of what diagnosis?

A

Diverticulitis

79
Q

List two common offending agents for pill induced esophagitis?

A

NSAIDS, KCL, iron, Abx

80
Q

Is surgery curative for Crohn’s or ulcerative colitis?

A

Ulcerative colitis

81
Q

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

A

Duodenum

82
Q

Inhibited inspiration with pressure over the RUQ is called what? What diagnosis does it suggest?

A

Murphy’s sign, Cholecystitis

83
Q

In order to contract Hep D what must you already have?

A

Hep B

84
Q

If you have heartburn that does not improve with medication what diagnosis should you be thinking about?

A

Gastrinoma

85
Q

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

A

Every 5 years looking for signs of gastric carcinoma

86
Q

How much fiber should you get in a day?

A

30 grams

87
Q

How is celiac most commonly diagnosed?

A

Endoscopic biopsy

88
Q

How do you treat an H. pylori infection?

A

PPI + 2 Abx, commonly omeprazole + clarithromycin and amoxicillin or PPI +metronidazole + tetracycline

89
Q

How do you treat achalasia?

A

Loosen up the muscle - botox, dilation or surgery

90
Q

First line of treatment for an anal fissure?

A

Fluid and fiber

91
Q

Fasting gastrin will be above what level with gastrinoma?

A

> 150 pg/ml

92
Q

Epigastric abdominal pain which radiates to the back should make you think of what diagnosis?

A

Pancreatitis

93
Q

Describe Grey-Turner’s sign.

A

Flank ecchymosis often related to pancreatitis

94
Q

Describe Cullen’s sign

A

Umbilical ecchymosis often related to pancreatitis

95
Q

Describe Courvoisier’s sign

A

Nontender, palpable gall bladder may indicate pancreatic neoplasm

96
Q

Define pellagra?

A

Niacin (B3) deficiency

97
Q

Currant jelly stool should make you think of what diagnosis?

A

Intussusception

98
Q

Crohn’s is found where in the GI tract?

A

It can be from esophagus to anus

99
Q

Colorectal cancer patients are almost all older than what age?

A

90% of patients are older than 50

100
Q

Birds beak esophagus on barium swallow should make you think of what diagnosis?

A

Achalasia

101
Q

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

A

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

102
Q

An epigastric olive shaped mass should make you think of what diagnosis?

A

Pyloric stenosis

103
Q

An endoscopy for presumed esophagitis shows several solitary deep ulcers. What diagnosis should you be thinking of?

A

CMV

104
Q

An endoscopy for presumed esophagitis shows multiple shallow ulcers. What diagnosis should you be thinking of?

A

Herpes simplex virus

105
Q

An elevated serum amylase and lipase should make you think of what diagnosis?

A

Pancreatitis

106
Q

An abdominal exam with pain out of proportion to the exam should make you think of what diagnosis?

A

Intestinal ischemia

107
Q

Air fluid levels on abdominal x-ray should make you think of what diagnosis?

A

Bowel obstruction

108
Q

A string sign on barium swallow should make you think of what diagnosis?

A

Pyloric stenosis

109
Q

A patient presents with unproductive retching, acute localized epigastric distention and inability to pass a nasogastric tube. What diagnosis should you be thinking of?

A

Gastric volvulus

110
Q

A patient on sulfasalazine for an inflammatory bowel disease should be supplemented with what vitamin?

A

Folate

111
Q

A patient has had GERD for years. Over the past year he has noticed an increase in difficulty swallowing his food. This should make you think of what diagnosis?

A

Esophageal strictures

112
Q

A gastrinoma is also known as what syndrome?

A

Zollinger-Ellison syndrome

113
Q

A corkscrew appearance on barium study should make you think of what diagnosis?

A

Esophageal spasms

114
Q

A colonoscopy that shows cobblestone or skip lesions should make you think of what diagnosis?

A

Crohn’s disease

115
Q

30 year old African American woman presents with dysphagia. You notice she also has thickened skin. A barium swallow demonstrates the absence of peristalsis. What diagnosis should you be thinking of?

A

Scleroderma

Physician Assistant Exam (14 decks)

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