GI

Question 1

Acute Pancreatitis

Answer 1

1. Sudden steady pain in upper abdomen radiating to back
2. Dx: LFT and Amylase and Lipase
3. Tx: supportive with pain management and fluids, Surgery only in cases where there is necrosis

Question 2

Celiac Disease

Answer 2

1. Abd pain, diarrhea, malabsorption, anema

2 Increased likelihood of T cell Lymphoma: Suspect if GI symptoms with adherence to gluten diet

Question 3

Drugs that Induce pancreatitis

Answer 3

Thiazide, Furosemide, Flagyl, tetracyclines

valproic acid

Question 4

Boerhaave’s

Answer 4

esophageal perforation (usually 2/3 esophagus) can be complicated by pleural effusion, pneumomediastinum (radiolucent band adjacent adjacent to cardiac border- may present with shoulder pain, dyspnea abdominal pain. 
Dx: esophagram

Question 5

Esophageal Varices

Answer 5

Tx: 1. Sclerotherapy, banding 2. TIPS

prevention of portal HTN via non selective beta blockers (nadolol and propanolo)

Question 6

Inflammatory bowel disease

Answer 6

Fever, abdominal pain, diarrhea, blood in stool weight loss
Uveitis, iritis, joint pain, erythema nodosum, pyoderma gangrenosum, sclerosing cholangitis

Crohns:
Masses, skip lesions( cobblestone) , involvement of upper GI, perianal disease, transmural granulomas, fistulae and fissures, hypocalcemia, creeping fat of mesentery.
Tests: endoscopy/ barium study, blood tests( ASCA positive ANCA negative)

Ulcerative colitis:
Toxic megacolon is a major risk
ASCA negative and ANCA positive

Initial tx: mesalamine