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Step II CS > GI > Flashcards

GI Flashcards

1
Q

Sudan Stain?

A

Fat in stool - pancreatic insufficiency

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2
Q

D xylose test?

A

tests for problems absorbing carbs. Abnl in sprue, whipples, bacterial overgrowth

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3
Q

How/why to confirm UC/crohns before starting tx?

A

Abd XR. Look for toxic megacolon if patient is looking toxic

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4
Q

Breast ‘non feeding’ jaundice

A

First week or so of life. Hyperbili and dehydration. Low stool and OUP. Red urate xtals in diaper. Tx - optimizing lactation and increase feeding frequency

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5
Q

Physical sign typical of acute mesenteric ischemia?

A

Pain OOP for exam

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6
Q

Fecal elastase?

A

Decreased in chronic panc

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7
Q

Elevated Cr, UNa<10 in setting of cirrhosis

A

Hepatorenal synd (renal hypoperfusion)

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8
Q

Tx of ascities

A

Lasix and spironolactone

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9
Q

Tx for SBP

A

Albumin and cefotaxime

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10
Q

Cancers with high EPO?

A 
"Potentially Really High Hct"
Pheo
RCC
HCC
Hemangioblastoma (CNS)
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11
Q

Campylobacter diarrhea tx

A

eryhtromycin

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12
Q

shigella diarrhea tx

A

bactrim

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13
Q

M-W bleeds are from what vessels?

A

submucosal ARTERY bleeds

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14
Q

Vitiligo, atrophic glossitis/thyroid dz/neuro problems

A

Pernicious anemia (Anti IF abs)

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15
Q

INH AE?

A

Other than neuropathy - can also cause liver damage similar looking to viral hepatitis

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16
Q

Rapid emptying of hypertonic gastric content into small bowel. Fluid shifts from intravascular space to lumen, increase vasoactive peptide secretions and stim autonomic reflexes. s/p gastrectomy.

A

dumping syndrome. tx with diet mods

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17
Q

Acalculous cholecystitis patient population, presentation

A

Critically ill patients. Presents like calculous cholecystitis. Imaging will show distended gallbladder with wall thick and pericholecystic fluid. Tx is I/D and cholecystectomy

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18
Q

Most worrisome complication of pneumatic dilation of esoph?

A

Esophageal rupture - which can lead to mediastinitis

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19
Q

Prevent Gallstones in gastretomy patients?

A

Ursodeoxyxholic Acid

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20
Q

PTH changes in renal failure?

A

Typically hyperplasia because of low calcium and renal failure

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21
Q

SIADH changes to urine sodium?

A

Elevated. It retains water and exchanges sodium

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22
Q

Hyperbili with pancreatic cancer. Tx?

A

Palliative - stent placement, usually

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23
Q

corkscrew shaped duodenum abnormally located in right abdomen. Seen in infants with bilious emesis

A

Midgut volvulus/malro

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24
Q

What vaccine should all patients with chronic liver disease get?

A

HAV

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25
Q

Lamivudine. Works on what hepatitis virus?

A

B

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26
Q

Extra hepatic manifestations of HCV?

A

Essential mixed cryoglobulinemia, porphiria cutanea tarda, MPGN.

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27
Q

Chronic HCV can be asx or present with nonspecific sxs like fatigue, arthralgias, etc. Can also have normal or elevated LFTs

A

Don’t let normal LFTs throw you off from HCV

28
Q

Liver abscess plus travel to endemic area. Tx?

A

Think amebic liver abscess. tx with oral metronidazole. dont aspirate

29
Q

CXR shows wide mediastinum, pleural effusion, subQ emphysema. Effusion has high level of amylase

A

Think boerhaave.

30
Q

Treatment for asymptomatic gallstones?

A

NOPE! dont.

31
Q

when do we use ursodeoxycholic acid?

A

Sx gallstones but poor surgical candidates

32
Q

When do we manage SBO conservatively vs operatively?

A

Depends on how stable patient is. If hemodynamic instability - do surgery (metabolic acid/alk, fever, leukocytosis, tachy, bp messed up)

33
Q

Sphincter of Oddi dysfunction. Treatment?

A

ERCP and sphincterotomy.

34
Q

BRBPR if less than 50 y and no rf’s

A

can monitor with anoscopy/sigmoidoscopy

35
Q

Persistent abd pain/dyspepsia s/p chole.

A

postchole syndrome/ get ercp

36
Q

Watery, frequent diarrhea. Bx of colon shows brown discoloration of colon with lymph follicles shining thru as pale patches. melanosis coli

A

LAxative abuse

37
Q

What metabolic abnormality can iron tox give you?

A

Met acidosis

38
Q

liver with fatty vacuolization, diffuse mitochondrial injury.

A

Reyes syndrom. tx ffp, glucose and mannitol

39
Q

When d o you start UC colon CA surveillance?

A

8 yrs s/p dx - then do cscope every 1-2 years

40
Q

How do you treat non bleeding esoph varicies?

A

BBLOX. no sclerotherapy

41
Q

Noncaseating granulomas are seen with which IBD?

A

Chrons

42
Q

what antibodies do you look for UC? Chrons?

A

PANCA for UC. Anti Saccharomyces cerevisiae for chrons

43
Q

what sex abnormalities do we see in chronic liver dz?

A

test atrophy, gynecomastia, hypogonadism

44
Q

Mild DM, necrolytic migratory erythema, wt loss, diarrhea. dx?

A

Think glucagonoma

45
Q

Ductopenia is seen with?

A

PBC, liver failure, tplant (called vanishing bile duct synd)

46
Q

How can systemic sclerosis cause malapsorption?

A

Low gi motility leads to bact overgrowth

47
Q

suspected achalasia. What else do you need to rule out?

A

Malignancy obvs/. so do endoscopy

48
Q

What raises your suspicion for angiodyplasia over diverticulosis?

A

Aortic stenosis or ESRD

49
Q

What meds can we use to treat HBV?

A

even though none actually cures dz - INFa along with a bunch of HIV drugs, like lamivudine (Epivir), adefovir (Hepsera), tenofovir (Viread), telbivudine (Tyzeka) and entecavir

50
Q

Alopecia, abnormal taste, bullous/pustules on orifices, poor wound healing. Seen in TPN and IBD

A

Zinc def

51
Q

Best imaging for diverticulitis?

A

Abd CT

52
Q

How does severe acute panc lead to severe hypotension?

A

systemic vascular injury and permeability

53
Q

How does bowel ischemia lead to met acidosis?

A

because increase lactate

54
Q

Corn based diets are deficient in?

A

Niacin - pellagra

55
Q

If urine dipstick is positive for bili, what type (UCB, CB) of hyperbili are we thinking?

A

Conjugated

56
Q

Pathophys of rotors?

A

benign. defect in hepatic storage of bili. Conj bili leaks to plasma

57
Q

Why can antiTTG sometimes be negative in celiac?

A

Because celiac is also assoc with concurrent IgA def.

58
Q

Most common complication of PUD?

A

Hemorrhage > Perforation

59
Q

Mechanism of NASH?

A

insulin resistance leads to hepatic uptake of fatty acids

60
Q

PAtient with HCV. What should you do prior to starting antiviral tx?

A

Do liver bx - best indicator of clinical disease progression.

61
Q

Patient looks like he has pancreatitis. What test should you get to evaluate underlying cause of patient’s condition?

A

RUQ US. Even if it doesn’t look like he has gall stones. ETOH and stones account for 75% of cases.

62
Q

Elevated liver enzymes with tremor, rigidity, abnormal gait?

A

Wilson’s dz. COpper can affect basal ganglia. SLit lamp tests. decreased serum ceruloplasmin

63
Q

periorbital edema, eosinophilia, and myositis. splinter hemorrhages/conjunctival or retinal hemorrhages. dx?

A

trichinella infection

64
Q

ARF in HCV patient. Does not respond to bolus, no urinary retention. DX? Tx?

A

This patient has hepatorenal syndrome prolly. Only way to tx is with liver tplant. Very quick mortality.

65
Q

Suspected esoph perforation. How do you diagnose?

A

Barium swallow

66
Q

Jet black liver?

A

Dubin Johnson. Not Rotor. Johnson = Jet Black

Step II CS (17 decks)

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