GI

Question 1

Mallory Weiss Tear Dx/Tx

Answer 1

V/S normal, no dx ; does NOT need to be scoped (self-limiting)

Question 2

Esophageal Varices Dx/Tx

Answer 2

V/S NOT nml; Endoscopy; Octerotide dec splenic flow

Question 3

Boerhaave’s syndrome

Answer 3

• Esophageal Rupture
• Hematemesis w. SEVERE retrosternal “tearing” pain
• Pneumomediastinum
• Emergent OR consult

Question 4

Motility dysphagia

Answer 4

Solids & Liquids, Barium Swallow
Primary: Achalasia (definitive = manometry), Esophageal spasm (F)
Secondary: Scleroderma

Question 5

Mechanical dysphagia

Answer 5

Solids, EGD

Masses (slightly progressive)

Question 6

Esophageal CA

Answer 6

50-70 yo
Squamous- smokers/ EtOH
Adeno- Barrett’s (GERD)
Endoscopy for bx and dx

Question 7

Peptic Ulcer

Gastric vs Duodenal

Answer 7

5 (D) :1 (G) 
(D): 30-55 yo
(G): 55-70 yo
RF's Gastric: EtOH, smoking
H. pylori testing 
Most need Endoscopy

Question 8

Diagnosis for H. Pylori

Answer 8

Active Infection: Stool antigen > Urea Breath Test
Serology: ELISA

ACO BID x 14 days

Question 9

Cholelithiasis

Stone type

Answer 9

Cholesterol 
4F's
Estrogen, fibric acid drugs
elevated TG
DM II

Question 10

Acute Cholecystitis vs Choledocholithiasis

Answer 10

Stone in cystic duct vs Stone in common bile duct

Elevated LFT’s (ALT & AST- hepatic duct obstruction-check lipase and amylase too)

US always prior to ERCP

Question 11

Which is more specific for pancreatitis?

Answer 11

Lipase > amylase

Question 12

Hepatitis txfr fecal-oral

Answer 12

“Vowel’s go to the bowels”
Hep A
Hep E

Question 13

Who should be screened for hep C

Answer 13

All individuals born btw ‘45-‘65

Question 14

Dx Hepatits

Answer 14

ELISA or EIA (if positive -> RIBA /viral load to confirm)
Enzyme-linked immunosorbent assay (ELISA) also known as an enzyme immunoassay (EIA), used in immunology to detect the presence of an antibody or an antigen

Question 15

Tx for Hepatitis

Answer 15

• Asymptomatic with neg viral load and nml LFT’s = none
• peglyated interferon + ribavirin
• Vaccinate against A + B

Question 16

Hemochromatosis

Answer 16

M= ~50yo
F= older (periods) 

Hepatomegaly, gray skin

Elevated Ferritin

Question 17

Tx for Dermatitis herpetiformis

Answer 17

GLUTEN free diet

-pruritic papulovesicles over extensor surfaces and the trunk/neck

Question 18

RF’s for Colon CA

Answer 18

Age
Adenomatous polyps
IBD
Fm Hx of 
A) Familial adenomatous polyposis
B) HNPCC
C) Peutz-Jeghers syndrome

Question 19

Screening for Colon CA

Answer 19

Colonoscopy q 10 yrs (best)
+50yo-Flex Sig q5 yrs + yearly FOBT
Barium enema q 5-10 yrs
+50 yo - annual FOBT

Question 20

Screening for Colon CA with special populations

Answer 20

1) 1st degree relative w/ CA +60yo–> Screen at 40
2) 1st degree relative w/ CA <60 –> Screen 10 yrs younger than dx; q 3-5 yrs
3) IBD- 8 yrs after dx
4) FAP - genetic screening after age 10- complete total colectomy

Question 21

IBD (not IBS)

Answer 21

Noctural symptoms ( a/w crohn’s or UC)