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Internal Medicine > GI/Hepatology > Flashcards

GI/Hepatology Flashcards

1
Q

Initial treatment for type 1 autoimmune pancreatitis

A

High-dose PO prednisone

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2
Q

Treatment for severe alcoholic hepatitis, defined as Maddrey score > 32 or the presence of hepatic encephalopathy

A

Prednisolone

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3
Q

Appropriate colon cancer surveillance with colonoscopy for patients with 1 or 2 sessile serrated polyps < 10 mm without dysplasia

A

Every 5 to 10 years

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4
Q

Diagnostic study for Budd-Chiari syndrome

A

US with doppler

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5
Q

Post exposure prophylaxis for hepatitis A virus in nonimmune person

A

Hepatitis A virus vaccine

+ HAV immune globulin if > 40 y/o

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6
Q

Diagnosis associated with insulinoma in patients <40 years old

A

MEN type 1

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7
Q

Management for localized Ulcerative proctitis

A

Topical/suppository 5-ASA

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8
Q

Elevated serum ferritin level and transferring saturation

A

Hereditary hemochromatosis

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9
Q

Study of choice for active lower GI bleeding with associated hemodynamic instability

A

CT angiography

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10
Q

Treatment of choice for familiar adenomatous polyposis

A

Colectomy

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11
Q

Recommend surveillance for cervical cancer screening in patients with IBD receiving immuno suppressive therapy

A

Pap testing annually

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12
Q

Dysphasia and food bolus obstruction usually found in younger men with a topic conditions

A

Eosinophilic esophagitis

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13
Q

Recommend surveillance for patients with cirrhosis who have undergone virologic cure for Hepatitis C virus infection

A

US every 6 months for evaluation of HCC

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14
Q

Recommended imaging modality for the diagnosis of acute mesenteric ischemia

A

CT angiography

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15
Q

Equation for fecal osmotic gap

A

290 - (2 x [stool Na + stool K])

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16
Q

Evaluation for suspected oropharyngeal dysphasia

A

Videofluoscopy with liquid and solid phases

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17
Q

Degeneration of the myenteric plexus with failure of the lower esophageal sphincter to relax in response to swallowing and absent peristalsis

A

Achalasia

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18
Q

Diagnostic evaluation for Achalasia in the following order

A

1) barium swallow
2) Esophageal manometry
3) Upper endoscopy

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19
Q

First line therapies for achalasia

A

Laparoscopic surgical myotomy of the LES and endoscopic pneumatic dilation of the esophagus

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20
Q

Appropriate evaluation for GERD refractory to empiric therapy with PPI

A

Upper endoscopy

If normal, ambulatory esophageal pH monitoring or impedance pH testing

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21
Q

Surveillance for Barret esophagus and no dysplasia

A

Every 3 to 5 years

22
Q

Surveillance for Barret esophagus with low-grade dysplasia in those that do not choose endoscopic ablation

A

Every 6 to 12 months

23
Q

Evaluation for eosinophilic esophagitis

A

8 week trial of PPI

If symptoms refractory, this confirms diagnosis

If symptoms resolved, this indicates GERD-associate eosinophilia

24
Q

Timing of follow-up H. pylori testing After completion of therapy

A

4 weeks

25
Q

First line therapy for dumping syndrome

A

Smaller, more frequent meals

26
Q

Most common cause of recurrent celiac disease symptoms

A

Gluten exposure

27
Q

Management for esophageal hypomotility disorder

A

Lifestyle changes + PPI

28
Q

Painless obstructive jaundice with cross-sectional imaging revealing sausage-shaped pancreatic enlargement with and without elevated IgG4 levels

A

Type 1 Autoimmune pancreatitis (elevated IgG4)

Type 2 AIP (normal IgG4)

29
Q

1) Osmotic gap > 100 mOsm/kg H2O

2) Osmotic gap < 50 mOsm/kg H2O

A

1) osmotic diarrhea

2) secretory diarrhea

30
Q

Appropriate surveillance for patients with larger adenomas (>10 mm), 5-10 tubular adenomas <10 mm, Adenomas with tubulovillous histology, or other adenomas with high-grade dysplasia

A

Colonoscopy every 3 years

31
Q

Diagnosis of Puetz Jeghers syndrome requires 2 of the following 3 criteria:

A

1) >2 PJS-type hamartomatous polyps in the G.I. tract
2) Multiple melanogic macules in the mouth, bucc mucosa, nose, Eyes, fingers, genitalia
3) Family history of PJS

32
Q

Age at which patients with Lynch syndrome should be screened for colon and stomach/small bowel cancer

A

Colon: colonoscopy beginning at ages 20 to 25 years (or 2-5 years before the earliest cancer diagnosis in family)

Stomach/small bowel: Upper endoscopy beginning at age 30 to 35 years

33
Q

Surveillance for ulcerative pancolitis or Crohn disease

A

Colonoscopy beginning 8 years after diagnosis then performed every 1 to 2 years after

Proctocolectomy if dysplasia is found

34
Q

Poorly localized severe abdominal pain, often out of proportion to physical findings; peritoneal signs signify infarction

Diagnostic evaluation

Treatment

A

Acute mesenteric ischemia

CTA or selective mesenteric angiography

Peritoneal: urgent laparotomy
Not peritoneal: angiography

35
Q

Postprandial abdominal pain, Fear of eating, and weight loss; often signs and symptoms of atherosclerosis in other vascular beds

Diagnostic evaluation

Treatment

A

Chronic mesenteric ischemia

CTA, selective angiography, or MRA

Surgical reconstruction or angioplasty with stenting

36
Q

LLQ abdominal pain and self-limited bloody diarrhea

Diagnostic evaluation

Treatment

A

Ischemic colitis

Colonoscopy: patchy segmental ulcerations

Supportive care with IV fluids and bowel rest

37
Q

Management for gallbladder polyps > 1cm

A

Cholecystectomy

38
Q

Treatment for functional dyspepsia refractory to PPI

A

Tricyclic antidepressant

39
Q

Management for Canada esophagitis

A

PO fluconazole

40
Q

Appropriate management for dermatitis herpetiformis after resolution of celiac symptoms

A

Testing for G6PD deficiency prior to initiating dapsone

41
Q

Hepatitis A prophylaxis in

1) healthy persons <40 years old
2) Older adults and those who are immune compromised or half chronic liver disease

A

1) hepatitis A vaccine

2) Vaccine + immunoglobulin

42
Q

Hepatitis B prevention for postexposure prophylaxis after needlestick injury and for sexual and household contacts of patients with HBV

A

Hepatitis B vaccine + HBIG

43
Q

Recommended indications for treatment in patients with hepatitis B infection

A

1) acute liver failure or cirrhosis
2) Infection in the immune active phase
3) Infection in the reactivation phase (immune escape)
4) Immunosuppression or planned immunosuppression

44
Q

Treatment for hepatitis B virus

A

entecavir or tenofovir

45
Q

Indications for US Surveillance every 6 months in patients with HBC anD increased risk for HCC

A

1) cirrhosis
2) Asian men > 40 years and Asian women >50 years
3) Black patients > 20 years
4) Elevated ALT level and HBV DNA levels > 10,000 U/mL
5) Family history of HCC

46
Q

Initial diagnostic study for hepatitis C infection

A

Anti-HCV antibody

If positive, test for HCV RNA

47
Q

Patients with HCV who are candidates for liver transplantation

A

HCV + decompensated disease

Localized HCC

48
Q

HCC Ultrasound surveillance for patients with HCV cirrhosis

A

Every 6 months

49
Q

Indication for initiation and discontinuation of prednisolone in alcoholic hepatitis

A

Inititation: MDF > 32, MELD > 18, or encephalopathy and ascites

Discontinuation: If bilirubin level does not improve by day 7

50
Q

Most appropriate screening test for Hemochromatosis

A

Fasting serum transferrin saturation

51
Q

Diagnostic studies of Hemochromatosis

A

C282Y homozygous or C282Y/H63D compoubd heterozygous

52
Q

The diagnosis of Peutz-Jeghers syndrome is based on the presence of 2 of the following 3 criteria:

A

1) 2 or more PJS type hamartomatous polyps in G.I. tract
2) Multiple melanotic macules in the mouth, buccal mucosa, nose, eyes, genitalia, or fingers
3) Family history of PJS

Internal Medicine (12 decks)

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