GI Disorders

Question 1

physiologic reflux

Answer 1

• Occurs after eating
• Is short lived
• Rarely occurs during sleep

Question 2

pathologic reflux

Answer 2

• Associated with symptoms
• Associated with mucosal injury
• Nocturnal symptoms

Question 3

3 mechanisms of GERD

Answer 3

1. Reduction in LES tone
2. Irritation of esophageal mucosa
3. Increased gastric acid secretion

Question 4

GERD worrisome symptoms

Answer 4

New onset ≥ age 60 years
* Evidence of GI bleeding (or IDA)
* Anorexia/weight loss
* Dysphagia/odynophagia
* Vomiting (obstruction)
* GI cancer in FDR

Question 5

Risk Factors for Barrett’s Esophagus

Answer 5

Duration of GERD >5-10 years
* Age >50 years
* White, male
* Hiatal hernia
* Obesity
* Tobacco use
* Nocturnal reflux

Question 6

Antacids

Answer 6

tums
increases ph for about 20-30 min

Question 7

h2 receptor antagonists

Answer 7

cimetidine, ranitidine, famotidine
decreases acid production for 6-12 hours, relief in 60 min

Question 8

Proton pump inhibitors

Answer 8

omeprazole
reduces gastric acid secretion
relief in 1-3 days

Question 9

Acute Cholecystitis

Answer 9

• Inflammation of the gallbladder
• Right upper quadrant pain; sometimes epigastric
• Fever
• Develops in about 6-11% of patients who have gallstones

Question 10

RUQ pain diff diagnosis

Answer 10

cholecystitis
acute hepatitis

Question 11

epigastric pain diff diagnosis

Answer 11

pancreatitis
gastric etiology

Question 12

LUQ pain diff diagnosis

Answer 12

Acute MI
pancreatitis
PUD
GERD
gastritis
splenic etiology

Question 13

lower abdominal pain diff diagnosis

Answer 13

appendicitis
diverticulitis
nephrolithiasis
pyelonephritis

Question 14

right lower quadrant pain with fever

Answer 14

crohn’s dx

Question 15

left lower quadrant pain plus fever

Answer 15

diverticulitis

Question 16

Colorectal CA screening options

Answer 16

FOBT- annually
FIT- annually
FIT DNA- 1-3 yrs
colonoscopy- every 10 yrs

Question 17

small bowel diarrhea

Answer 17

watery
large volume
cramping
bloating
gas

Question 18

large bowel diarrhea

Answer 18

frequent
regular
small volume
painful
fever
bloody/mucoid

Question 19

IBS

Answer 19

• Crampy abdominal pain that varies in location and character
• Diarrhea, constipation, alternating diarrhea and constipation; normal bowel habits alternating with above
• Mucus present in stools
• Other GI symptoms: GERD symptoms, early satiety, nausea, chest pain

Question 20

Diarrhea Red Flags

Answer 20

• Rectal bleeding
• Nocturnal or progressive abdominal pain
• Weight loss
• Anemia, elevated inflammatory markers, electrolyte disturbances

Question 21

ALT/AST:

Answer 21

measure integrity of liver

Question 22

PT/albumin:

Answer 22

measure synthetic activity of liver

Question 23

Bilirubin, ALP:

Answer 23

measure excretory function of liver

Question 24

HBsAg

Answer 24

Hep B surface antigen
infected (current or past)

Question 25

anti-HBs

Answer 25

Hep B surface antibody
immune (vaccine or recovery)

Question 26

anti-HBc

Answer 26

total hep B core antibody
current or previous infection

Question 27

IgM anti-HBc

Answer 27

IgM antibody to hep B core antigen
acute hep b

Question 28

HCV antibody

Answer 28

screening test
detects antibody to HCV: prior treated

Question 29

HCV-RNA

Answer 29

confirmatory test
tests for presence of virus

Question 30

pyrosis definition

Answer 30

heartburn

Question 31

gold standard test for cholecystitis

Answer 31

abdominal US

Question 32

colorectal screening recommendation starts at age

Answer 32

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