Gi

Question 1

bile acid site reabsorption

Answer 1

ileum (same as vit b12)

Question 2

volume of fluid in ileum

Answer 2

1000-1500cc

Question 3

disorders in achalasia

Answer 3

1. impaired les relaxation 2. impaired esophageal body peristalsis

Question 4

mcc ab pain

Answer 4

ibs and functional dyspepsia

Question 5

fodmap diet

Answer 5

fermentable oligomonodisaccharides and polyols - ibs

Question 6

risk of bleeding diagnostic egd, sigmoidoscopy, colonoscopy

Answer 6

<1:1000

Question 7

risk of bleeding polypectomy, emr, esd, control of hemorrhoge and stricture dilation

Answer 7

0.5-5%

Question 8

risk of pancreatitis with ercp

Answer 8

5%; 30% if with sphincter of oddi dysfunction

Question 9

low risk for bleeding endoscoic procedures

Answer 9

egd or colonoscopy with or wothout biopsy, eus without fna, ercp with stent exchange

Question 10

high risk for bleeding endoscopic procedures

Answer 10

egd or colonoscopy with polypectomy, dilation or thermal ablation, peg, eus with fna, ercp with sphincterotomy or pseudocyst drainage

Question 11

notes

Answer 11

natural orifice transluminal endoscopic surgery

Question 12

Indication for prophylaxis? all cardiac patients for endoscopy?

Answer 12

no

Question 13

bile duct onstruction in the abscence of cholangitis for ercp with complete drainage

Answer 13

No

Question 14

Indication for prophylaxis? bile duct obstruction in the abscemce of cholangitis for ercp with incomplete drainage?

Answer 14

Yes

Question 15

sterile pancreatic fluid collection for ercp or transmural drainage?

Answer 15

Yes

Question 16

sterile pancreatic fluid collection for ercp or transmural drainage?

Answer 16

Yes

Question 17

Indication for prophylaxis? solid lesion on the upper or lower git for eus fna

Answer 17

No

Question 18

Indication for antibiotic prophylaxis? cystic lesion along the git for eus fna

Answer 18

Yes

Question 19

Indication for prophylaxis? for peg regardless of type pf px?

Answer 19

yes, ideally cefazolin or with coverage for skin org

Question 20

cirhosis with acute gi bleeding antibiotics

Answer 20

Ceftriaxone or fluoroquinolones

Question 21

Indication for prophylaxis? continous peritonealdoalysis for lower gi endoscopy?

Answer 21

Yes

Question 22

Indication for prophylaxis? vascular grafts or prosthetic joints for endoscopy?

Answer 22

No

Question 23

how long to hold blood thinners prior to high risk for bleeding endoscopic procedures: aspirin, warfarin, heparin, dabigatran, apixaban/edoxaban/rivaroxaban, clopidogrel/ticagrelor, prasugrel, ticlopidinr

Answer 23

aspirin - no need,
warfarin - 5 days (3-7days) inr should be <1.5 heparin - 4-6hrs unfractionated,
lmwh skip 1 dose
dabigatran - 2-3days gfr >50, 3-4 days gfr 30-49 apixaban/edoxaban/rivaroxaban - 2 days gfr >60, 3 days gfr 30-59, 4 days gfr <30
clopidogrel/ticagrelor - 5 days
prasugrel - 7 days
ticlopidine - 10-14 days

Question 24

%melena with ugib, and %hematochezia with lgib

Answer 24

melena with ugib 90%, hematochezia with lgib - 85%

Question 25

Risk of rebleeding ``` Ulcer with clean base Flat pigmented spot Adherent clot Fibrin plug protruding from vessel Active spurting Endoscopic therapy ```

Answer 25

Risk of bleeding ``` Ulcer with clean base - 3-5% Flat pigmented spot - 10% Adherent clot - 20% Fibrin plug protruding from vessel - 40% Active spurting - 90% Endoscopic therapy - 5-10% ```

Question 26

mc location of dieulafoys lesion

Answer 26

lesser curvature of proximal stomach