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2020 ABIM studying > GI > Flashcards

GI Flashcards

1
Q

Regurgitation of undigested food, gurgling in chess, severe halitosis. Dx?

A

Zenker diverticulum

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2
Q

Difficulty initiating swallowing, coughing, choking, nasal regurgitation of fluids. Dx?

A

Oropharyngeal dysphagia

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3
Q

Food sticking or discomfort in the retrosternal region. Dx?

A

Esophageal dysphagia

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4
Q

Progressively increasing solid food dysphagia 2 Dx?

A

Peptic stricture or carcinoma

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5
Q

Episodic solid food dysphagia for months or years. Dx?

A

Esophageal web or distal esophageal ring

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6
Q

Patient taking tetracyclines, NSAIDs, potassium, iron, alendronate who presents with severe substernal chest pain with swallowing several hours to days after taking medication. Dx?

A

Pill induced esophagitis

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7
Q

Young adult with severe dysphagia and food impaction with no relief after PPI. Dx?

A

Eosinophilic esophagitis

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8
Q

Upper endoscopy with mucosal furrowing, stacked Circular rings, white specks, Mucosal friability. Dx?

A

Eosinophilic esophagitis

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9
Q

Dyspepsia, epigastric burning, early satiety, nausea, postprandial belching or bloating dx?

A

PUD

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10
Q

Oropharyngeal dysphagia Dx test and tx?

A

Videofluoroscopy w/liquid and solid phases; Treat with Dietary adjustment and incorporation of swallowing exercises

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11
Q

Eosinophilic esophagitis Dx test and tx?

A

Upper endoscopy, budesonide or swallowed fluticasone

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12
Q

Esophageal candidiasis tx? 2

A

Fluconazole or itraconazole

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13
Q

HSV esophagitis tx? 3 FAV

A

Acyclovir, valaciclovir, famciclovir

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14
Q

CMV esophagitis tx? 2

A

Ganciclovir or foscarnet

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15
Q

Anti-smooth muscle antibodies are associated with which condition?

A

Autoimmune hepatitis

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16
Q

Ascitic fluid containing PMNs greater than this number indicates SBP?

A

Greater than 250/mm3

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17
Q

ATP7B mutation is associated with which condition?

A

Wilson’s Disease

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18
Q

Low serum ceruloplasmin, neuro symptoms,brown corneal rings. Dx?

A

Wilson disease (hepatolenticular degeneration)

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19
Q

Foamy macrophages on PAS stain on a small bowel biopsy is seen in what condition?

A

Whipple’s Disease

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20
Q

Boceprevir and Telaprevir are new hepatitis C agents that can only be used against which HCV genotype?

A

HCV genotype 1

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21
Q

If a patient with inflammatory bowel disease is found to have dysplasia on colonoscopy, what is the next step in management?

A

Proctocolectomy

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22
Q

In hemochromatosis, which condition, if developed, is irreversible?

A

Hypogonadism which can lead to infertility

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23
Q

How do you differentiate chronic hepatitis B Infection from the carrier state?

A

Check liver function tests. Increased in chronic state and normal in carrier state

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24
Q

Long term use of NSAIDS increases,decreases, or has no effect on the risk of developing colon cancer?

A

Decreases

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25
Q

Of the three major forms of hepatitis, which does not currently have a vaccine against it?

A

Hepatitis C

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26
Q

Patient is found to have positive antibodies to soluble liver antigen (SLA). What Condition does this patient likely have?

A

Autoimmune hepatitis (which also has anti-smooth muscle antibodies)

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27
Q

Post-gallbladder removal, patient has right upper abdominal pain and still has elevated LFTs. Next step in management?

A

Check manometery studies to rule out sphincter of oddi function

28
Q

What antibody can be associated in individuals who have Crohn’s Disease?

A

Anti-Saccharomyces cerevisiae antibodies (ASCA)

29
Q

What is Charcot’s triad?

A

Fever, Right upper quadrant abdominal pain, and Jaundice. Indicates cholangitis

30
Q

What are the two most common HLA markers associated with a condition that has positive antibodies to tissue transglutaminase?

A

HLA DQ-2 and HLA DQ-8

31
Q

Which hepatitis B marker indicates active replication?

A

HBeAg

32
Q

Which hepatitis C treatment medications may exacerbate autoimmune hepatitis?

A

Interferon

33
Q

Which hepatitis infection is the only type that is a DNA virus?

A

Hepatitis B

34
Q

Dysphagia (esophageal webs), glossitis, iron deficiency anemia Dx?

A

Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)

35
Q

Fat, female, forty, and fertile

A

Cholelithiasis (gallstones)

36
Q

Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands/genitalia Dx?

A

Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction, ^ cancer risk, mainly GI)

37
Q

Jaundice, palpable distended non-tender gallbladder Dx?

A

Courvoisier sign (distal malignant obstruction of biliary tree)

38
Q

Red “currant jelly” stools Dx?

A

Acute mesenteric ischemia (adults), intussusception (children)

39
Q

Weight loss, diarrhea, arthritis, fever, adenopathy Dx?

A

Whipple disease (Tropheryma whipplei)

40
Q

Pain out of proportion to exam, atherosclerosis, CKD, a fib, metabolic acidosis with elevated lactate. Diagnosis?

A

Acute mesenteric ischemia

41
Q

Acute mesenteric ischemia diagnostic test and trt?

A

CT; IR for Stent or Sx for resection/revascularization

42
Q

Rapid fire assoc:Antimitochondrial antibodies (AMAs)

A

1º biliary cirrhosis (female, cholestasis, portal hypertension); also associated with pruritis and Sjögren syndrome

43
Q

Rapid fire assoc: Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies

A

Celiac disease (diarrhea, weight loss)

44
Q

Rapid fire assoc: “Lead pipe” appearance of colon and abdominal imaging

A

Ulcerative colitis (loss of haustra)

45
Q

Rapid fire assoc: “Apple core” lesion on barium enema x-ray

A

Colorectal cancer (usually left-sided)

46
Q

Rapid fire txt: Chronic hepatitis B or C

A

IFN-α (HBV and HCV); ribavirin, simeprevir, sofosbuvir (HCV)

47
Q

Rapid fire txt: Crohn disease

A

Corticosteroids, infliximab, azathioprine

48
Q

Chronic atrophic gastritis (autoimmune) causes Predisposition to?

A

gastric carcinoma (can also cause pernicious anemia)

49
Q

Rapid fire assoc:Triglyceride accumulation in liver cell vacuoles

A

Fatty liver disease (alcoholic or metabolic syndrome)

50
Q

Rapid fire assoc:Thousands of polyps on colonoscopy

A

Familial adenomatous polyposis (autosomal dominant, mutation of APC genes)

51
Q

Multiple colon polyps, osteoma/soft tissue tumors, impacted/supernumerary teeth

A

Gardner syndrome (subtype of FAP)

52
Q

Rapid fire assoc: Eosinophilic cytoplasmic inclusion in liver cell

A

Mallory body (alcoholic liver disease)

53
Q

Severe RLQ pain with deep tenderness

A

McBurney sign (acute appendicitis)

54
Q

What is the gold standard for diagnosing small intestinal bacterial overgrowth?

A

Endoscopy with jejunal aspirate

55
Q

What is the recommendation for initial colonoscopy after inflammatory bowel disease diagnosis and follow up colonoscopies?

A

8 years after diagnosis and then every 1-2 years

56
Q

What is the name of the sign in which RLQ pain is elicited with LLQ palpation in a patient suspected of having appendicitis?

A

Positive Rovsing sign

57
Q

Abd pain, ascites, and hepatomegaly Dx?

A

Budd-Chiari syndrome (posthepatic venous thrombosis)

58
Q

In addition to Fat soluble vitamins, what else is not absorbed in patients with celiac disease?

A

Iron, vitamin B12, folate

59
Q

When is the first colonoscopy recommended in patients with FAP?

A

Age 10-12 & repeated every 1-2 y

60
Q

What test is ordered prior to the Performance of Nissen fundoplication for GERD?

A

Manometry to ensure normal motility.

61
Q

Stool Osmolar gap equation?

A

290- 2(stool Na+ stool K)

62
Q

What does a high stool Osmolar gap suggest? Low?

A

Osmotic diarrhea, Secretory

63
Q

Patients with Ileal resection and diarrhea need to be treated with what medication?

A

Cholestyramine (have bile salt malabsorption) as well as b12 and fat soluble vitamin malabsorption

64
Q

Spontaneous esophageal rupture is diagnosed with what?

A

Chest CT or esophagram with gastrografin

65
Q

Gastrin levels >1000 suggest what 2 dx? How to differentiate?

A

Zollinger Ellison and atrophic gastritis. ZE has gastric pH<5

66
Q

Colonoscopy biopsy with mononuclear lymphocytic infiltrate in the lamina propria suggests what dx? Txt?

A

Microscopic colitis. Antidiarrheals, Budesonide for active or persistent symptoms, tnf inhibitors

2020 ABIM studying (12 decks)

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