GI

Question 1

5 causes of painless rectal bleeding

Answer 1

painless rectal bleeding

1. diverticulitis
2. AV malformation
3. polyps
4. Cancer
5. internal hemorrhoids

Question 2

gastric prokinetic agents

Answer 2

gastric prokinetic agents

1. metoclopromide (good for pts with gastro paresis caused by diabetes)
2. erythromycin
3. propulsin (available only in canada)

Question 3

Differential Diagnosis for mild or moderately elevated LFTs

Answer 3

1. Medications
2. viral hepititis (hepatitis panel)
3. alcoholic liver disease (radoigraping imagining)
4. hemochromatosis (iron studies, TIBC)
5. NAFLD (radiographic imagining)
6. Wilson’s disease (look for keyser-fleisher rings)
7. autoimmune hepatitis (ANA ab, anti-smooth muscle ab)

Question 4

What vitamin deficiency is expected in patients with a carcinoid tumor?

Answer 4

B3/ Niacin

Carcinoid tumors present with epsodic flushing, diarrhea, and elevated levels of urine 5-HIAA

Question 5

What oral agents should you start in patients with fulminant liver failure d/t Hepatitis B infections?

Answer 5

Hepatitis B infections leading to fulminant liver failure should be given a

Reverse Transcriptase Inhibitor:

lamivudine

tenofavir

Question 6

What is the most common cause of splenic vein thrombosis

Answer 6

the most comon cause of splenic vein thrombosis is

chronic pancreatitis

Question 7

What is the chapman point for the pancreas?

Answer 7

The chapman point associated with the pancreas is

between ribs 7-8

Question 8

What type of electrolyte imbalances are seen in profuse diarrhea?

Answer 8

Profuse watery diarrhea produces a non-anion gap acidosis.

Acidosis because of the loss of bicarbonate

non-anion gap because the gut absorbs more chloride ions.

Expect labs to show hypokalemia, hyperchloremia, acidosis

Question 9

What is the most common cause of acute diarrhea?

Answer 9

Viral infections are the most common cause of viral infections

Question 10

What is the appropriate initial imaging study for pts with an acute abdomen?

Answer 10

Patients with an acute abdomen should have abdominal x-rays in both the supine and upright positions

*An acute abdomen is the sudden onset of severe abdominal pain lasting less than 24 hours. Etiologies are numerous.

Question 11

History of atherosclerosis

acute onset abdominal pain

bloody diarrhea

Answer 11

mesenteric ischemia