GI 3

Question 1

Why more likely to surgical repair paraesophageal hiatal than sliding hiatal hernia?

Answer 1

B/c risk of incarceration/strangulation

Question 2

Type A gastritis is what?

Answer 2

AUTOIMMUNE against parietal cells, NEED TO GIVE B12

Question 3

Type B gastritis tx?

Answer 3

PPI, clarithro with amoxi for H pylori

Question 4

Duodenal ulcer almost diagnostic of what?

Answer 4

H PYLORI

Question 5

Gastric ulcer hurts when?

Answer 5

shortly after eating

Question 6

Gastric ulcer kinds? Think if burn or intracranial?

So what is common in burn unit?

Answer 6

Curling (hot iron burn)
Cushing (pressure is crushing)

Give ulcer prophylaxis! Basically give them if people in stressful hospitilaztion

Question 7

What do you do if no response to antacid treatment?

Answer 7

DO SERUM GASTRIN INVESTIGATION

Question 8

What is zollinger ellison syndrome?

H and P?

Answer 8

from GASTRIN producing tumor

Located in duodenum or pancreas

Ulcers not responding

Lab:
Fasting gastrin level
Secretin stimulation test

Question 9

What is secretin stimulation test?

Answer 9

For ZE syndrome

CAUSES INCREASE IN GASTRIN RELEASE IN ZOLLINGER ELLISON

Question 10

ZE tx?

Answer 10

PPI h2 blocker, octreotide if PPI needs help

NEEDS RESECTION
Look out for MEN1

Question 11

GAstric cancer, always biopsy around ulcer!

Answer 11

Oh ok

Question 12

What is Virchow’s node? What is sister mary joseph node?

KNOW THIS

Answer 12

Virchow is L supraclavicular

Periumbilical node is sister mary joseph

For gastric cancers!!

Question 13

Gastric cancer marker?

Answer 13

CEA

Question 14

Stomach cancer surgerY?

Answer 14

If lower third, partial gastrectomy.

If first 2/3, remove the entire thing

Question 15

Branching rods are what?

Answer 15

Actinomyces

Question 16

Antiendosomysial?

Answer 16

Antibodies in celiac (along with antiTGA)

Question 17

Tx of refractory celiac?

Answer 17

Steroids

Question 18

Tropical sprue can present years after leaving tropics.

History? Labs? Tx?

Answer 18

It looks like celiacs but no antibodies

Has megaloblastic anemia

Tx: folic acid (think get rid of megaloblastic anemia and improve it)

Tetracycline helps it too for some reason or sulfas

Question 19

Whipple disesase dx and tx?

Answer 19

History of white person with diarrhea, wasting, STEATORRHEA (OF COURSE FATTY B/c IT IS FOAMY MACROPHAGE), arthrtalgia…

Biopsy of jejunum is foamy macrophage

Ceftriaxone and BACTRIM for longt ime

Question 20

D xylose?

Answer 20

test carb absorption (pancreatic insufficiency won’t effect)

Question 21

Sedan stain?

Answer 21

For fat in stool

Question 22

Tests of shit for pancreatic insufficiency?

Answer 22

abnormal sedan (fat)
Normal d xylose (sugar absorbed normally)

Question 23

Bloody bacteria or fever or lasting five days?

Answer 23

CONSIDER bacteria or protozoan or parasite

Question 24

Inflam diarrhea think what?

Answer 24

IBD

Question 25

Osmotic diarrhea, think what?

Answer 25

Celiac or tropical sprue and much more or things not obsorbed

Question 26

Fatty diarrhea think what?

Answer 26

Pancreatic insufficiency or whipple disease

Question 27

Osmotic gap of diarrhea: if less than 50 it is what? If more than 125 it is what? Formula? KNOW!!!

Answer 27

Secretory less than 50, osmotic more than 125 is osmotic (duh) 290 - 2(Na+K)

Question 28

Secretory diarrhea causes?

Answer 28

Lots of them, but consider infection, IBS, laxative