GI

Question 1

What are the standard three drug regimens for H. Pylori eradication?

Answer 1

ECA — Esomeprazole, Clarithromycin, and Amoxicillin or
ECM — Esomeprazole, Clarithromycin, and Metronidazole

Question 2

What is the standard three drug regimen for H. Pylori eradication if there is penicillin allergy and no recent macrolide use?

Answer 2

ECM — Esomeprazole, Clarithromycin, and Metronidazole

Question 3

What is the standard four drug regimen for H. Pylori eradication which is especially useful if there is a penicillin allergy and recent macrolide use?

Answer 3

EBMT — Esomeprazole, Bismuth Subsalycylate, Metronidazole, and Tetracycline

Question 4

What serologies would be present in a patient with acute Hep A virus infection?

Answer 4

Anti-HAV, IgM

Question 5

What serologies would be present in a patient with acute Hep B virus infection?

Answer 5

HBsAG, HBe-AG, anti-HBc, IgM

Question 6

What serologies would be present in a patient with chronic Hep B virus infection?

Answer 6

HBsAG, anti-HBe, anti-HBc, IgM, IgG

Question 7

What serologies would be present in a patient with recovered Hep B virus?

Answer 7

Anti-HBs, anti-HBc

Question 8

What serologies would be present in a patient with acute Hep C virus infection?

Answer 8

Anti-HCV, HCV RNA

Question 9

What serologies would be present in a patient with chronic Hep C virus infection?

Answer 9

Anti-HCV, HCV RNA

Question 10

How is current HCV infection differentiated between prior exposure?


Answer 10

PCR

Question 11

What clinical scoring system is used to evaluate risk of mortality in acute pancreatitis?

Answer 11

Ranson’s criteria

Question 12

What are the components of Ranson’s criteria?

Answer 12

George — age greater than 55 (>70 for gallstones)
Washington — WBC > 16,000
Got — glucose >200
Lazy — LDH >350
After — AST >250
He — Hct drop >10
Broke — BUN elevation >5
C — calcium <8
A — arterial 02 <60
B — base deficit >4
E — estimated fluid sequestration >6L

Question 13

The presence of 5 of Ranson’s criteria is associated with what mortality rate?

Answer 13

5-6 risk factors = 40% mortality

Question 14

The presence of 5 of Ranson’s criteria is associated with what mortality rate?

Answer 14

5-6 risk factors = 40% mortality

Question 15

The presence of 8 of Ranson’s criteria is associated with what mortality rate?

Answer 15

> 7 risk factors = 100% mortality

Question 16

How many calories are required to meet basic metabolic demands?

Answer 16

25-30 kcal/kg/day nutritional support

Question 17

What are indications for stress ulcers prophylaxis?

Answer 17

Mechanical ventilation >48 hours, use of vasopressors, coagulopathy, steroid use, TBI, severe burn, sepsis, hx of PUD/GI bleeding.

Question 18

What diagnostic test is a priority for a patient presenting with diverticulitis?

Answer 18

Plain abdominal films to look for pneumoperitoneum.

Question 19

What is the gold-standard diagnostic test for cholecystitis?

Answer 19

Abdominal ultrasound

Question 20

What is the gold-standard diagnostic test for pancreatitis?

Answer 20

CT (more useful than US)

Question 21

What is the gold-standard diagnostic test for appendicitis?

Answer 21

US or CT

Question 22

What electrolyte derangements are characteristic of refeeding syndrome?

Answer 22

Hypocalcemia, hypokalemia, hypophosphatemia, hypomagnesemia, and thiamine deficiency.

Question 23

What drugs are used in the treatment of ulcerative colitis?

Answer 23

Mesalamine and hydrocortisone suppositories and/or enemas

Question 24

What drugs are used in the treatment of diverticulitis?

Answer 24

NPO, IVF, abx — cipro + flagyl or levo + flagyl