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PANCE Exam Review > GI > Flashcards

GI Flashcards

1
Q

Vit. B3 (Niacin) Deficiency

A

Pellagra, 3 D’s:

  • Diarrhea
  • Dementia
  • Dermatitis
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2
Q

What are 5 findings seen in Refeeding Syndrome?

A
  • Hypophosphatemia
  • Hypokalemia
  • Thiamine deficiency
  • CHF
  • Peripheral edema
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3
Q

Dx for Intussusception

A

US

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4
Q

Dx GOLD for CholeCystitis

A

HIDA

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5
Q

Biliary tract infection 2ry to obstruction (gallstones, malignancy) . Dx?

A

CholAngitis

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6
Q

Patient Hx: atherosclerosis dz.
CC: Bloody diarrhea and LQ pain.
What is the Dx?

A

Ischemic Colitis

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7
Q

Malabsorption with Lactose Intolerance occurs where:

A

Small intestine

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8
Q

Dx GOLD for Mesenteric Ischemia

A

CT angiography

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9
Q

Tx for Intussusception

A

Air/Contrast enema

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10
Q

What is the initial Dx method for Colorectal CA and what does it show?

A
  • X-ray

- Apple-core sign

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11
Q

Uncooked meat can lead to:

A

E. coli food poisoning

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12
Q

What is seen with Vit. B6 (Pyridoxine) Deficiency?

A
  • Sideroblastic anemia
  • Convulsions
  • Peripheral neuropathy
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13
Q

↑ CEA (CarcinoEmbryonic Antigen) level is seen in:

A

Colorectal** > Pancreatic CA

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14
Q

MCC of Intussusception

A

Tumor or Meckel’s diverticulum

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15
Q

Lab test needed to make a Dx of ACUTE Hepatitis B:

A

Core antibodies

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16
Q

MCC Ischemic Colitis

A

LOW blood flow in mesenteric vessels

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17
Q

Cause of Mesenteric Ischemia:

A

Thrombus or embolic occlusion

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18
Q

Intussusception presents with:

A

Vomiting and bloody stools (currant jelly)

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19
Q

What Hep B serologic marker is indicative of immunity d/t vaccination?

A

ONLY Anti-HB surface (+)

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20
Q

Tumor marker for Pancreatic CA:

A

CA 19-9

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21
Q

What medication decreases gastric acidity which leads to a decrease in calcium absorption?

A

PPIs: Omeprazole

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22
Q

Test used to determine eradication of H. pylori:

A

Urea breath test

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23
Q

PPIs increase risk for:

A

C. difficile and fractures

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24
Q

Sausage-like mass RUQ representing the actual intussusceptum and an empty space in RLQ representing the movement of the cecum out of its normal position. What is the sign called?

A

Dance’s sign

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25
Q

Which Abx can turn the eyes yellow in G6PD Deficiency?

A

-Bactrim

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26
Q

What is Ogilvie Syndrome?

A

Massive dilation of colon WITHOUT mechanical obstruction

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27
Q

Tx for small bowel obstruction:

A

NGT, surgery

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28
Q

MC occluded intestinal artery in Mesenteric Ischemia:

A

Superior

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29
Q 
Sxs: 
-Painless jaundice
-Wt. loss
-Depression
What is the Dx?
A

Pancreatic CA

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30
Q

Tx for Ogilvie Syndrome

A
  • Colonic decompression

- Neostigmine

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31
Q

1st and 2nd MCC Pancreatitis:

A

1st: Gallstones
2nd: EtOH

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32
Q

Dx GOLD for CholAngitis

A

Endoscopic Retrograde Cholangio-Pancreatography (ERCP)

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33
Q

Pancreatitis Tx

A

IV Fluids

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34
Q

Gall bladder (cystic duct) obstruction by gallstone → inflammation/infection. Dx?

A

CholeCystitis

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35
Q

What makes up Charcot triad?

A
  • Jaundice
  • Fever
  • RUQ pain
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36
Q

With Familial Adenomatous Polyposis:

  • At what age do screenings start?
  • What screening is done?
  • How often?
A
  • Age 12
  • Sigmoidoscopy
  • Every 1-2 yrs
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37
Q

Tx for Esophagitis D/T Candida

A

Fluconazole

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38
Q

MCC PUD

A

H. pylori

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39
Q

In what Dx would we find Charcot triad?

A

Acute CholAngitis

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40
Q

RUQ or Epigastric pain that may radiate to shoulder. Dx?

A

Choledocholithiasis

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41
Q

How do we confirm GERD Dx?

A

Endoscopy

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42
Q

MC type of Pancreatic CA:

A

Adenocarcinoma

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43
Q

In Tx Ogilvie Syndrome with Neostigmine, what are two serious complications?

A
  • Bradycardia

- Asystole

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44
Q

2 skin PE findings of Pancreatitis:

A
  • Grey Turner sign: ecchymosis of left flank

- Cullen sign: umbilical ecchymosis

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45
Q

MCC of CholAngitis

A

Choledocholithiasis leading to bacterial infection, E. coli

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46
Q

What sign shows a palpable non-tender gallbladder. Dx?

A
  • Courvoisier Sign

- Pancreatic CA

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47
Q

Pancreaticoduodenectomy is AKA:

A

Whipple procedure

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48
Q

What antibody is found in Crohn’s?

A

ASCA (Anti-Saccharomyces cerevisiae antibodies)

-think “Crohn’s da asco!”

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49
Q

MC metabolic abnormality in bulimia nervosa 2ry to vomiting:

A

Hypokalemia

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50
Q

What labs are seen in PKU?

A

↓ phenylalanine hydroxylase (PAH) leads to →

  • ↓ tyrosine
  • ↑ phenylalanine
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51
Q

Dermatological condition associated with Celiac Disease:

A

Dermatitis Herpetiformis (eczematous-like rash)

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52
Q

MC infectious etiology of diarrhea in AIDS:

A

Cryptosporidium

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53
Q

What condition should be suspected in a dehydrated neonate with hyperkalemic, hyponatremic metabolic alkalosis?

A

Adrenal crisis

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54
Q

Pyloric Stenosis: non-bilious or bilious vomiting?

A

Non-bilious

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55
Q

MC type of Esophageal CA in U.S. is and d/t:

A
  • Adenocarcinoma

- Complication of GERD/Barrett’s

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56
Q

Best to confirm Achalasia:

A

Esophageal Manometry

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57
Q

Tx GOLD for CHRONIC Anal Fissures:

A

Lateral internal sphincterotomy

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58
Q

Pt. presents with severe, watery diarrhea with white mucus. Dx?

A

Cholera

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59
Q

Tx for Hepatic Encephalopathy

A

Lactulose

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60
Q

MC liver disease in U.S.

A

Nonalcoholic fatty liver

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61
Q

Common complication of acute hepatitis and when does it occur:

A
  • Aplastic anemia

- 6–12 weeks after hepatitis

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62
Q

What makes up Reynold’s Pentad?

A

Charcot Triad plus:

  • HypoTN
  • AMS
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63
Q

MC site of FB obstruction

A

Cricopharyngeus muscle, C6 level

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64
Q

Sxs: Musty, urine/body odor. Dx?

A

PKU

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65
Q

Tx for Hypokalemia

A

Potassium + Mg

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66
Q

Dx for Celiac Dz.

A

Small bowel Bx

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67
Q

MCC of SCC of Esophageal CA

A

Smoking and EtOH

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68
Q

Sxs: irritability that comes and goes, lethargy, abdo distention. Dx?

A

Intussusception

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69
Q

MCC of Appendicitis

A

Fecalith

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70
Q

Tx for PKU

A
  • Tyrosine

- AVOID Phenylalanine

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71
Q

What 2 labs are seen in Celiac Dz?

A
  • IgA anti-Endomysial (EMA)

- Anti-tissue Transglutaminase (anti-tTG) antibodies

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72
Q

Hirschsprung’s Dz. complication

A

Toxic megacolon

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73
Q

Tx for Spontaneous Bacterial Peritonitis

A

IV 3rd-gen. Cephalosporin (ASAP)

74
Q

Does Appendicitis present with Leukocytosis and fever?

A

Yes!

75
Q

Eating improperly refrigerated rice, meats, veggies or dried fruits may lead to:

A

Bacillus cereus

76
Q

Topical mgmt midline anal fissures:

A

Nitroglycerin

77
Q

MC surgical ER in pregnant women

A

Acute appendicitis

78
Q

Dx for Pyloric Stenosis

A

US

79
Q

MCC worldwide for Esophageal CA and where is it located?

A
  • SCC

- Upper/Middle

80
Q

52 yo male with abdominal pain and elevated liver enzymes, >10,000. What is the likely diagnosis?

A

Viral Hepatitis

81
Q

What labs are seen in Spontaneous Bacterial Peritonitis?

A

Neutrophils >250

82
Q

Nocturnal pruritus ani. Dx?

A

Pinworms

83
Q

What is a finding of Yersinia?

A

Fecal WBCs and RBCs

84
Q

What is true in elderly with abdominal pain?

A

Likely requiring emergent surgery

85
Q

PKU diet

A
  • HIGH veggies, low meats

- Avoid Aspartame

86
Q

What are the sacs called in the small bowel?

A

Valvulae conniventes (plicae circulares)

87
Q

Which ID is associated with neuro Sxs or febrile seizures?

A

Shigella

88
Q

What autoantibody is seen in UC?

A

p-ANCA

89
Q

Dx for Hepatocellular CA (HCC)

A

US and ↑ alpha-fetoprotein

90
Q

PE: gynecomastia, asterixis. Esophageal varices. Labs: ↑ ammonia. Dx?

A

Cirrhosis

91
Q

What is seen with Vit. A Deficiency?

A
  • Night vision loss
  • Dry skin
  • Bitot spots on conjunctiva
92
Q

Difference between Cholangitis and Acute Cholecystitis

A

Cholangitis: ↑ serum bilirubin level (jaundice)

93
Q

Diverticulitis vs. Diverticulosis diet

A

Diverticulitis: low fiber (to allow healing)
Diverticulosis: HIGH fiber

94
Q

Tx for Rectal Prolapse

A

Manual reduction (with no vascular compromise)

95
Q

Initial and GOLD Dx for Pancreatic CA

A

Initial: CT
GOLD: fine needle bx

96
Q

What are the sacs called in the large bowel?

A

Haustra

97
Q

Tx for Giardiasis

A

Metronidazole

98
Q

What is the upper limit of normal diameter for the different segments of bowel?

A
  • 3-6-9 rule
  • Small bowel (3 cm)
  • Colon (6 cm)
  • Cecum (9 cm)
99
Q

Best initial Tx for Esophageal Stricture

A

Dilation and PPIs to prevent

100
Q

MCC upper GI bleed

A

PUD

101
Q

CT: bowel wall edema and free peritoneal fluid. Dx?

A

Ischemic Colitis

102
Q

How much Vitamin D should infants, kids, and adolescents get in a day?

A

400 IU/day

103
Q

Bone deformities, ↓ calcium, ↓ phosphate, ↑ alkaline phosphatase. Dx?

A

Rickets (low Vit. D)

104
Q

1st line Rx for constipation

A

Bulk-forming: Methylcellulose, Psyllium

105
Q

Tx for Ulcerative Colitis

A
  • Sulfasalazine

- Surgery cures

106
Q

Pt. Hx of eating fresh produce. PE: Fever, abdominal pain and bloody diarrhea. Dx?

A

Salmonellosis

107
Q

“Pseudo-appendicitis”. N/V/D/F, RLQ pain.

A

Yersinia Enterocolitica

108
Q

Dx for Toxic Megacolon

A

X-ray → colon dilated > 6cm

109
Q

Inguinal hernia that presents with mass in abdominal wall

A

Direct

110
Q

Tx for Portal HTN of Cirrhosis

A

Spironolactone

111
Q

1st steps in mgmt for Toxic Megacolon

A

IVF, bowel rest, and NG tube

112
Q

Alcoholic. Oculomotor dysfunction (MC nystagmus), cerebellar dysfunction (ataxia), AMS. Dx?

A

Wernicke encephalopathy

113
Q

Dx tool used for Cirrhosis and Pancreatitis

A

US

114
Q

PE: Murphy’s sign, Boas sign. Dx?

A

CholeCystitis

115
Q

Tx for C. difficile

A

PO Vanco*, PO Metro

116
Q

A patient presents with sclerosing cholangitis. What is the next step in management?

A

ERCP

117
Q

MCC intestinal obstruction <2yo

A

Intussusception

118
Q

MCC large bowel obstruction?

A

Neoplasm

119
Q

Sign indicative of a retrocecal location of appendix

A

Psoas

120
Q

Labs for Pyloric Stenosis

A

Hypochloremic, hypoK metabolic alkalosis

121
Q

MCC gastric cancer

A

H. pylori

122
Q

Mesenteric Ischemia arrhythmia RF

A

A. Fib

123
Q

What imaging test is CI in Diverticulitis?

A

Colonoscopy

124
Q

Dx for Lactose Intolerance

A

Hydrogen breath test

125
Q

Dx for Alcoholic Hepatitis

A

AST > ALT (2:1)

126
Q

Dx for Acute Hepatitis A

A

(+) Anti-HAV IgM

127
Q

MC viral cause of Intussuception

A

Adenovirus

128
Q

Loose teeth, gum bleed, and poor wound healing would be a deficiency in what vitamin?

A

C (Ascorbic Acid; Scurvy)

129
Q

What electrolyte abnormality commonly causes an ileus?

A

HypoK

130
Q

Pt. Hx of allergies. PE: stacked circular rings in esophagus. Dx?

A

Eosinophilic Esophagitis

131
Q

What vitamin deficiency presents with anemia, peripheral neuropathy, ataxia?

A

E

132
Q

Initial imaging TOC for bowel obstruction:

A

Abdominal x-ray

133
Q

MC patho of Spontaneous Bacterial Peritonitis

A

E. coli

134
Q

Tx for Traveler’s Diarrhea

A

Rehydration + Cipro (or Azithro)

135
Q

What lab values are associated with poor prognosis for pancreatitis?

A
  • Age > 55
  • WBC > 16,000
  • Blood Glu > 200 mg/dL
  • Serum lactate dehydrogenase > 350 units/L
  • Aspartate aminotransferase > 250 units/L
136
Q

What imaging tool confirms Small Bowel Obstruction?

A

Abdominal CT

137
Q

What mgmt should be avoided in Hemolytic Uremic Syndrome?

A

Antibiotics

138
Q

What is the imaging of choice for Diverticulitis?

A

CT

139
Q

What is the MCC of foodborne disease in the U.S.?

A

Salmonellosis

140
Q

MCC of Pancreatic cancer

A

Smoking

141
Q

Diarrhea and recent travel on a cruise ship. Dx?

A

Norovirus

142
Q

Tx for Wernicke Syndrome

A

Thiamine Repletion

143
Q

What test is done in a patient that has an elevated Alkaline Phosphatase?

A

ERCP

144
Q

In a pt. with a hyperplastic polyp <10mm, when would the next colonoscopy be?

A

10 years (regular)

145
Q

With no RFs, in addition to yearly hemoccult screening of the stool, how often should flexible sigmoidoscopy be performed?

A

Every 5 years

146
Q

The parents of a 16-year-old boy presents to the clinic with their son asking that you examine him. Over the past 10 mo, he has developed behavioral problems and emotional lability. PE: well-developed male, cooperative with exam but easily distracted. It is noteworthy for dysarthria, a resting tremor and the presence of gray-green pigmentation surrounding each pupil. What is the most likely diagnosis?

A

Wilson Disease (xs copper in body)

147
Q

Patient with Hx of Crohn’s disease and is allergic to NSAIDs. What is the best to prescribe?

A

Steroids and TNF blockers (-mab)

148
Q

Tx for Chronic Pancreatitis

A

Steroids > Colchicine

149
Q

A 3-week-old presents with mom who states baby has continuous bilious vomiting. What is the likely Dx?

A

Volvulus (twisting)

150
Q

Next step for GALLSTONES (Cholecystitis) with inconclusive ultrasound

A

HIDA scan

151
Q

What is the next step if ultrasound came back negative for gallstones?

A

ERCP

152
Q

Celiac Dz vs. Lactose Intolerance

A

CD: failure to thrive

153
Q

MC type of inguinal hernia

A

Indirect

154
Q

Pt. presents with his 3rd anorectal abscess. What do you suspect?

A

Crohn’s

155
Q

Tx for Ascities

A
  • Spironolactone

- Na+ restriction

156
Q

Tx for Diverticulitis

A

Cipro (or Bactrim) + Metro

157
Q

Pseudomembranous Colitis AKA:

A

C. diff

158
Q

What is ileus and what can cause this?

A
  • ↓ peristalsis WITHOUT structural obstruction

- Post surgery, opiates, hypoK

159
Q

Initial Dx for Hirschsprung disease

A

Anorectal manometry

160
Q

Tx for Abdominal Hernia

A

Kids:

  • Observe: close by 2 yo
  • Surgery: if >5 yo
161
Q

Pt. presents after ingesting an unknown medication. She has anorexia, N/V, RUQ pain and jaundice. Labs show abnormal coag studies. She has hepatic necrosis. Dx?

A

Acetaminophen Toxicity

162
Q

Acetaminophen Toxicity Workup

A
  • APAP levels, then Nomogram
  • LFTs
  • PT, PTT, INR
  • UA, ECG
163
Q

Tx for Esophagitis D/T CMV (CD4 <200)

A

Ganciclovir

164
Q

What is a hallmark sign of Zollinger-Ellison Syndrome (ZES)?

A

Acid diarrhea

165
Q

Pt. presents with a horizontal anal fissure. What do you suspect?

A

HIV or Crohn’s

166
Q

Dx for Ischemic Colitis

A

Colonoscopy

167
Q

MC type of Colorectal CA

A

Adenocarcinoma

168
Q

What is the best Tx for Esophageal Varices?

A

Band ligation

-Then sclerotherapy > Octreotide > BB > PPI

169
Q

What is the best way to Dx H. pylori?

A

Endoscopy with bx or Fecal antigen

170
Q

What is a common sign of gastric ulcers vs. duodenal?

A

GU: get wt. loss

171
Q

What meds are CI in a patient with GERD?

A

CCB and Nitroglycerin

172
Q

Tx for Wilson Disease

A

D-Penicillamine

173
Q

Pt. presents with IBS. She complains of abdominal cramps. How would you like to treat this patient?

A

-Antispasmodics: Atropine
OR
-Anticholinergics: Dicyclomine

174
Q

Pt. reports that a family member in the house was recently diagnosed with Hep. A. What is your management?

A

Give immunoglobin (within 2 wks)

175
Q

What will be elevated in hepatitis?

A
  • Indirect bilirubin

- Conversion can’t happen D/T liver damage in hepatitis → jaundice

176
Q

Which test would show as positive for a chronic hepatitis B patient?

A

Surface antigen

177
Q

GOLD Dx for Hirschsprung Disease

A

Rectal Bx

178
Q

57 yo presents with cogwheel rigidity and elevated liver enzymes. What is the likely Dx?

A

Wilson’s Disease

179
Q

49 yo female presents with abdominal pain, ascites, hepatomegaly and elevated liver enzymes. What would an US help diagnose?

A

Budd Chiari DVT (Hepatic Vein Obstruction)

180
Q

What GI Dx’s use US?

A
  • Cirrhosis
  • Pancreatitis
  • Intussusception
  • Hepatocellular CA
  • Pyloric Stenosis
181
Q

What GI Dx’s use CT?

A
  • Diverticulitis
  • Small Bowel Obstruction
  • Initial for: Pancreatic CA

PANCE Exam Review (32 decks)

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