GI

Question 1

What is the management of a porcelain gallbladder?

Answer 1

If punctate (patchy areas of calcification) - should have cholecystectomy 2/2 increased risk of cancer even if asymptomatic. If curvilinear pattern, no intervention needed (no increase risk of cancer)

Question 2

What are the biggest predictors of the severity of pancreatitis?

Answer 2

Elevated hematocrit >44% (indicates hemoconcentration and third spacing), elevated BUN, obesity, CRP, and older age.

Question 3

Who should get colonoscopies?

Answer 3

All adults 50 and older, first-degree relative age <60 with colon cancer or adenomatous polyps, >2 first-degree relatives with colon cancer or adenomatous polyps at any age.

Question 4

What are the guidelines for colon cancer screening in pt’s with a 1st degree relative with colon cancer <60 yo?

Answer 4

Colonoscopy at age 40 or 10 years before the age of cancer diagnosis in a relative (whichever comes first).
Repeat every 3-5 years

Question 5

At what age would your get an EGD with biopsy for a patient with dyspepsia (without alarm sx)?

Answer 5

> 60 yo
<60 with significant weight loss, overt gastrointestinal bleeding, or >1 alarm feature (persistent vomiting, progressive dysphagia or odynophagia, palpable mass or lymphadenopathy, unexplained iron deficiency anemia, family history of gastrointestinal malignancy).