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Internal Medicine Board Exam > GI Disease > Flashcards

GI Disease Flashcards

1
Q

Female, elevated LFTs, positive ANA, and smooth muscle antibody, and elevated IgG, and liver histology?

A

Autoimmune hepatitis, treatment is prednisone and azathiprine

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2
Q

What three things does the MELD score make up? Besides Dialysis

A

Dialysis
Creatinine, Bilirubin, and Na

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3
Q

What is the MDF score?
What does it use?

A

Maddrey Discriminant Function
Prothrombin and Bilirbuin

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4
Q

MELD score over 20 and MDF over 32 can be given what?

A

Prednisolone

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5
Q

Augmentin, Valproic Acid, and phenytoin can cause what damage?

A

Liver Damage

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6
Q

If more than 5L of fluid removed via paracentesis, what should be given?

A

Albumin

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7
Q

MELD score greater than what should be referred for transplant?

A

Greater than 15

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8
Q

New onset Liver Cirrhosis, unknown cause, what should be evaluated?

A

Heart, get an echo

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9
Q

Celiac’s disease with IgA deficiency, what should be evaluated?

A

IgG Anti-Gliadin and IgA antibody measurement

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10
Q

Salvage therapy for H. Pylori is what for 14 days?

A

Bismuth, tetracycline, metronidazole, and PPI 14 days

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11
Q

What is the therapy for H. Pylori, initial therapy?

A

Clarithyomycin, Amoxicillin, and Omeprazole 10 days

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12
Q

Metastatic Pancreatic Cancer, should a patient be treated for HCV?

A

No further treatment

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13
Q

If a patient has hepatic decompensation with Liver failure, what should be done? Even if the MELD-Na score is less than 15

A

Liver transplant

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14
Q

Oral thrush, what should be given, even with a low CD4 count?

A

Think about Fluconazole, hold off on acyclovir right away, particularly if no biopsy

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15
Q

Esophageal Hypmotility Disorder is assoicated with poor peristalsis, what is the correct treatment?

A

Lifestyle Changes and PPI

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16
Q

Primary Sclerosing Cholangitis occurred what is another test that should be done?

A

Think about colonoscopy

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17
Q

GI bleed on AC, held AC, when can a person restart?

A

After waiting 7 days, maybe restarted

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18
Q

If there is concern for gastroparesis, what test should be done?

A

4 hour gastric scintigraphy

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19
Q

Mild travel’s diarrhea, what should be given?

A

Loperamide

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20
Q

A patient with a well-defined 1.5cm lesion in the left lower lobe, HCC concern, what should be done?

A

Hepatic Liver Mass resection

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21
Q

If a patient is taking aspirin for stroke prevention only, has a high ASCVD score, and he has a GI bleed, what should be done with his ASA?

A

Hold his ASA

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22
Q

Functional Dyspepsia, does not respond to a PPI, what is the next best step?

A

Nortriptyline

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23
Q

Maddrey Discriminant Function Score of 32 or greater or the presence of hepatic encephalopathy, is what treatment?

A

Prednisolone

24
Q

Patient with portal hypertension and cirrhosis of liver, what medication should be stopped?

A

Lisinopril, this will decrease blood flow to kidney, want to maintain adequate blood flow

25
Q

Patient has intestinal metaplasia, they should have what medical therapy?

A

The patient should have surveillance endoscopy performed

26
Q

Autoimmune Pancreatitis that shows type 1 autoimmune pancreatitis, what is a good treatment for this?

A

Prednisone

27
Q

Chronic Constipation, weight loss history, 52 year old male, what should be done?

A

Colonoscopy

28
Q

Hepatic adenoma, 4cm in a man, what should be done?

A

Should be removed

29
Q

Hepatic adneoma, 5cm in a woman, what should be done?

A

Surgery, unless adenoma shrank with d/c of OCPs

30
Q

Best chronic pancreatitis recommendation for treatment?

A

Tobacco Cessation/Alcohol Cessation

31
Q

Dysphagia with solids to liquids, iron deficiency anemia, and weight loss. What is the first test that should be ordered?

A

Endoscopy with biopsy

32
Q

Cirrhosis and Portal hypertension patient, they have an AKI, what should be done?

A

D/C diuretics
Beta Blockers can decrease renal perfusion, worsening the situation, hold them

33
Q

5 month history of diarrhea, characterized as bowel movements containing oil droplets, needing multiple flushes, consistent with steatorrhea, how can this be confirmed?

A

Glucose breath test, small bowel overgrowth

34
Q

Woman with inflammatory bowel disease receiving immunosuppressive therapy should undergo what testing annualy?

A

Pap Smear

35
Q

Adenoma x 1 greater than 10mm, should have a repeat colonoscopy when?

A

3 years ago

36
Q

Severe Crohn’s disease requires what?

A

Infliximab

37
Q

Old gentleman wants to go back on NSAID after ulcer, what should be done?

A

PPI and Celecoxib

38
Q

Cefotaxime and albumin should be used in what scenario?

A

SBP

39
Q

PBC is diagnosed with what lab test?

A

Anti-mitochondrial antibody

40
Q

Dermatitis Herpetiformis on physical exam, can be treated with dapsone, what testing should be done for then?

A

G6PD testing

41
Q

Autoimmune hepatitis treatment has a high rate of relapse, how long should treatment continue before drug cessation?

A

2-3 years before cessation

42
Q

Hereditary Hemochromatosis will be suggested by what two lab values?

A

Elevated Ferritin and Transferrin Saturation

43
Q

What is a condition commonly associated with dysphagia and food bolus obstruction? Usually found in younger men with atopic conditions

A

Eosinophilic Esophagitis

44
Q

Moderate to Severe Relapse Ulcerative Colitis, what is the recommended treatment?

A

Azathioprine and Infliximab

45
Q

If a patient has a pancreatic cyst collection of 12cm, what is the best recommendation for treatment?

A

Observation

46
Q

Gastric Polyps are found and removed. When should a follow up endoscopy be performed?

A

No follow up needed

47
Q

Gallbladder polyp greater than 1.0 should have what done?

A

Gallbladder removal

48
Q

Cirrhosis should be evaluated for if the patient does or does not have what?

A

Portal Hypertension

49
Q

Patients with Varices should have what done yearly?

A

Endoscopy screening and platelets, think about Coreg (non-selective beta blocker)

50
Q

Upper GI bleed, what two drugs should be given?

A

Octreotide and PPI

51
Q

Ceftriaxone 1g q24hr can be given for what type of GI bleed?

A

Upper GI bleed

52
Q

What is one IV medication that could help with an EGD?

A

IV Reglan

53
Q

When a patient has cirrhosis, what two medications can be given to help?

A

Lasix 20: Aldactone 50, should be in a 2:5 ratio

54
Q

What does colestipol and cholestyramine do?

Why are these medications added?

A

Help slow down diarrhea

Patient had their terminal illeum removed via surgery

55
Q

What criteria need to be met to discuss a potential liver transplant?

A

Think about Milan Criteria

56
Q
A

Internal Medicine Board Exam (18 decks)

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