GI

Question 1

30y female, foul smelling oily diarrhea, bloating, fatigue, weight loss. Papulovesicular lesions on extensors or arms

Answer 1

Celiac

Question 2

20yo woman diarrhea. Lost weight over past months. Recurrent abdo pain, mouth ulcers

Answer 2

Crohns

Question 3

65yo female, jaundice, weight loss, pale stool. Colicky RUQ pain. Mass in RUQ

Answer 3

Cholangiocarcinoma

Question 4

65yo male, hx chronic hep B infx, symptoms and signs of liver cirrhosis, AFP high.

Answer 4

Hepatocellular carcinoma

Question 5

Anal fissure sx

Answer 5

painful, bright red rectal bleeding

Question 6

Anal fissure tx

Answer 6

bulk-forming laxatives
dietary - increase fluids and fibre
lubricants like petroleum jelly before poop
Can use topical analgesia and anesthetics

Question 7

Hemorrhoids

Answer 7

Painless

Can use corticosteoids

Question 8

Chronic anal fissure tx

Answer 8

topical GTN

botulinum toxin injection or surgery

Question 9

Anal fissure RFs

Answer 9

constipation
IBD
STIs (HIV, syphilis, herpes)

Question 10

Ascending cholangitis tx

Answer 10

IV abx

ERCP after 24-48hr

Question 11

Complications of acute pancreatitis

Answer 11

ARDS

Question 12

Chronic pancreatitis sx

Answer 12

abdo pain after meals (15-30min)
steatorrhea
DM

Question 13

Acute pancreatitis causes

Answer 13

Alcohol
Autoimmune
Infection
Gallstones
Medications
Trauma

Question 14

Chronic pancreatitis causes

Answer 14

Alcohol
CF
Hemochromatosis
tumours
gallstones
Smoking

Question 15

Chronic pancreatitis Ix

Answer 15

Abdo xray: pancreatic calcification
CT - calcification
Fecal elastase

Question 16

Chronic panc. tx

Answer 16

pancreatic enzymes
analgesia
antioxidants?

Question 17

gastric MALT lymphoma

Answer 17

associated w H Pylori + gastric ulcers

Question 18

gastric MALT lymphoma tx

Answer 18

If low grade - eradicate infx

Omeprazole, amox, claryhtromycin/metronidazole

Question 19

Non-hodkin lymphoma tx

Answer 19

R-CHOP chemo
Rituximab
Cyclophosphamide
Doxorubicin
Vincristine
Prednisone

Question 20

Pancreatitis causes

Answer 20

Gallstones
Ethanol
Trauma
Steroids
Mumps (and coxachie B)
Autoimmune (polyarteritis nodosa), Ascaris infx
Scorpion venom
Hypertriglycridemia, Hypercholesterolemia, Hypercalcemia, Hypothermia
ERCP
Drugs (azathioprine, mesalazine, didanosine, furosemide, bendroflumethiazide, steroids, sodium valproate)

Question 21

Diverticular disease defn

Answer 21

Herniation of colonic mucosa through muscular wall of colon. Usual site between tenia coli where vessels pierce the muscle to supply the mucosa.

Question 22

Diverticular disease Sx

Answer 22

Altered bowel habit
Bleeding
Abdo pain

Question 23

Diverticular disease comps

Answer 23

Diverticulitis
Hemorrhage
Fistula
Perforation and fecal peritonitis
Perf and development of abscess
Development of diverticular phlegmon

Question 24

Diverticular dx Tx

Answer 24

Increase fibre
Antibiotics for diverticulitis attack
Drain abscess
Recurrent acute diverticulitis - segmental resection
Hinchey 4 perforation - resection and stoma.

Question 25

Imrie/Glasgow pancreatitis scale

Answer 25

``` PANCREAS PAO2 <8 Age >55 Neutrophils (WBC) >15 Ca <2 uRrea >16 (or BUN >45) EnzymesL AST >200 (or lactate >200 or 600) Albumin <32 Sugar >10 ```

Question 26

Cholecystitis signs

Answer 26

Murphys RUQ pain --> shoulder Fev/N/V/tachy

Question 27

gallstone removal

Answer 27

ERCP

Question 28

Gallstone imaging/cholangitis

Answer 28

US CT MRCP

Question 29

Opening of common bile duct into duodenum

Answer 29

Sphincter of oddi

Question 30

Pancreatitis causes major

Answer 30

Gallstones - stuck in ampulla of vater, blocks bile and panc juices from getting into duodenum, they reflux back and inflame it. Common in older and women Alcohol - toxic to pancreatic cells ERCP

Question 31

All pancreatitis causes

Answer 31

``` I GET SMASHED Idiopathic Gallstones Ethanol Trauma Steroids Mumps Autoimmune Scorpion sting Hyperlipidemia ERCP Drugs (furosemide, thiazides, azathioprine) ```

Question 32

Pancreatitis Imrie/Glasgow interpretation

Answer 32

0-1 - mild 2 - moderate >3 - severe