GI

Question 1

serology for UC

Answer 1

p ANCA

Question 2

treatment of UC

Answer 2

5- ASA (mesalamine)
steroids
immunosuppression
anti-TNFalpha

Question 3

in a patient with acute hepatitis, what type of bilirubin would you expect to be elevated?

Answer 3

direct (conjugated) bilirubin

Question 4

Colon biopsy for crohn’s disease shows?

Answer 4

transmural inflammation
non caseating granulomas
cobblestoning
skip lesions

Question 5

tx of IBS

Answer 5

behavioral

avoid gas
diet
gluten free
high fiber
exercise

Question 6

patient has elevated iron and ferritin, increased transferrin, decreased TIBC with type 2 DM and cirrhosis. Diagnosis?

Answer 6

hereditoary hemochromotisis

Question 7

diagnostic test for hereditary hemochromotosis?

Answer 7

genetic test HFE gene

Question 8

tx of hereditary hemochromatosis?

Answer 8

phlebotomy

Question 9

what stress ulcer prophylaxis tx causes c diff?

Answer 9

PPI, h2 blocker

Question 10

initial test for patient with epigastric pain, nausea, and vomiting?

Answer 10

serum lipase for pancreatitis

Question 11

what lab test on ascites fluid would confirm diagnosis of cirrhosis?

Answer 11

serum-ascites albumin gradient

(SAAG) > 1.1

Question 12

study to confirm diagnosis of achalasia?

Answer 12

barium esophagram, then esophageal manometry

Question 13

treatment of achalasia?

Answer 13

esophageal dilation
surgical myometry
botulinum toxin
medical - nifedipine, nitrates

Question 14

37 year old man with pruritus and RUQ abd pain. history of UC. Mild jaundice. ELevated direct bili and alk phosph. Dx?

Answer 14

PRIMARY sclerosing cholangitis

Question 15

labs associated with primary sclerosing cholangitis? what testing?

Answer 15

p ANCA

ERCP shows beads of biliary system

Question 16

tx for primary sclerosing cholangitis?

Answer 16

no medical tx
ERCP for dominant stricture\
liver transplant

Question 17

malignancies patient at risk for with primary sclerosing cholangitis?

Answer 17

cholangiocarcinoma, gb cancer, hepatocellular carcinoma

Question 18

56 year old man, nonsmoker, comes in with SOB, wheezing, cough. XR shows COPD/emphysema. Labs show elevated ALT/AST and signs of cirrhosis. Dx?

Answer 18

alpha 1 antitrypsin deficiency

Question 19

tx of alpha 1 antitrypsin defn?

Answer 19

infusion of alpha 1 antitrypsin

liver transplant

Question 20

middle aged female with pruritus and fatigue, autoimmune disorder, hyperpigmented skin without jaundice. Minimally elevated AST/ALT, elevated alk phosph, normal bili. Dx?

Answer 20

primary biliary cirrhosis

Question 21

dx to confirm primary biliary cirrhosis?

Answer 21

liver biopsy

Question 22

lab test that confirms primary biliary cirrhosis or suggests PBC?

Answer 22

+ AMA

Question 23

tx of primary biliary cirrhosis

Answer 23

ursodeoxycholic acid

Question 24

20 year old woman, elevated AST/ALT. No hep B/hep C. non drinker. ferritin normal. ceruloplasmin decreased. Dx?

Answer 24

wilson’s disease

Question 25

test to confirm wilson’s disease?

Answer 25

low serum copper
kayser fleischer rings
liver biopsy
genetic testing

Question 26

tx of wilson’s disease?

Answer 26

copper chelation

- penicillamine/trientein