GI/NUTRI

Question 1

What is dx:
45 yr old pt w long hx of celiacs w 2 months worsening abd pain, black stools, 11 lb weight loss. Patient appears thing an pale, stool is positive for occult blood

Answer 1

Enteropathy-associated T-cell lymphoma (EATL) = T-cell lymphoma arising from the proximal jejunum

-aggressive, poor prognosis

Question 2

What serum change is expected to occur first in a child started on ferrous sulfate w orange juice for iron deficiency anemia after drinking >24 oz of cow’s milk per day.

Answer 2

Increase in reticulocyte count within 1-2 weeks

• -usually take ~month for hematocrit and hemoglobin to increase, few months to return to normal levels
• ferritin - reflects iron stores, and do not rise until after hemoglobin normalizes

Question 3

an ulcerative colitis patient with toxic megacolon flareup can benefit from which medication?

Answer 3

Glucocorticoids to decrease inflammatory response

–5-ASA, opioids should be avoided (or other meds that decrease motility)

Question 4

How do you reassess after initiating triple therapy (amoxicillin, clarithromycin, omeprazole) in a pt with H. pylori ulcers?

Answer 4

Urea breath test or

Fecal Antigen Test 4 weeks after completion of therapy

Question 5

What are the components of the MELD score?

Answer 5

Bilirubin
INR
Sodium
Creatinine

Question 6

How do you calculate corrected calcium from albumin?

Answer 6

Corrected calcium = (measured total calcium) + 0.8(4-serum albumin)