GI & Pancreatic

Question 1

Gastric acid secretion INC in ______

Answer 1

Zollnger-Ellison syndrome

Hypersecretion of gastrin by antral G-cells

Question 2

Gastric acid secretion DEC in ____

Answer 2

Pernicious anemia

Post vagotomy

Question 3

Gastric acid secretion is variable in _____

Answer 3

chronic renal failure

Question 4

H. Pylori biopsy detects _____ activity and monitors change in ____

Answer 4

Urease enzyme activity

change in pH

Question 5

C-breath test uses 13C labeled ____ and pt is monitored for ____

Answer 5

urea

13-labeled CO2

Question 6

The issue with the IgG antibody immunoassay is that it ____

Answer 6

may remain positive for several years even after successful treatment

Question 7

Characteristics of general malapsorption:

Answer 7

Amylorrhea
Steatorrhea
Creatorrhea

Question 8

Which values normally are decreased in malabsorption?

Answer 8

Ca2+
SUN
CE/lipids
glucose absorption

Question 9

Which values are normally increased with malabsorption?

Answer 9

Alk. Phosphatase

Prothrombin time

Question 10

Tests for carb malabsorption

Answer 10

D-xylose absorption (dec)
Disaccharidase test (dec
Breath H+ test (inc)

Question 11

Test for fat malabsorption

Answer 11

Fecal fat determination (inc)

14C-triolein breath test (dec)

Question 12

Test for bacterial overgrowth

Answer 12

14C-Xylose test (inc)

Question 13

Random tests for malabsorption

Answer 13

Schilling (dec)
Sweat test (cystic fibrosis)

Question 14

90% of Celiac’s pts have HLA-DQ_ and 10% have HLA-DQ_

Answer 14

90%: HLA-DQ2

10%: HLA-DQ8

Question 15

Celiac’s can be triggered by: (4)

Answer 15

post-surgery
pregnancy
emotional stress
viral infection

Question 16

Initial Celiac’s test

Answer 16

detection of IgA EMA against tissue transglutaminase

Question 17

Follow up Celiac’s test

Answer 17

Small bowel biopsies

Question 18

2% of Celiac’s patients are ____ deficient

Answer 18

IgA

Question 19

B12 deficiency is caused by ___ and ____

Answer 19

Dec intrinsic factor

Dec absorption

Question 20

Schilling test is for ____

Answer 20

B12 deficiency

<7% of dose excreted in pts with pernicious anemia

Question 21

Cystic fibrosis has elevated ___ and ___

Answer 21

Chloride and sodium (overlaps with normal)

Question 22

Factors that can increase GI blood loss (6)

Answer 22

Salicylates
Steroids
Reserpine
Indomethacine
Colchicine
Iron

Question 23

Fecal occult blood tests can have false positives caused by _____

Answer 23

horseradish

Question 24

False negatives in a fecal occult blood test can be caused by ___

Answer 24

ascorbic acid

Question 25

Acute pancreatitis is often associated with an increase in: (4)

Answer 25

Serum Methemalbumin Plasma glucose Serum bilirubin TG

Question 26

Acute pancreatitis is often associated with a decrease in

Answer 26

serum calcium

Question 27

How do serum amylase levels change over the course of acute pancreatitis?

Answer 27

Become elevated a few hours after onset but return to normal within 2-3 days

Question 28

Specificity of serum amylase test is _____ unless you are looking only at

Answer 28

low | P-isoenzyme

Question 29

Macroamylasemia may lead to _____

Answer 29

misinterpretations of a differential diagnosis of abdominal distress

Question 30

Elevated serum lipase & amylase are strong evidence for _____, but only when _____

Answer 30

a pancreatic process | only when lipase is high

Question 31

Increases of serum lipase are seen in: (7)

Answer 31

``` Acute pancreatitis Carcinoma of the head of the pancreas Alcoholic cirrhosis Severe azotemia Trauma to adipose Fat embolism Hyperalimentation therapy ```

Question 32

Serum levels of amylase may be ______ while urinary amylase may be _____

Answer 32

borderline | Elevated

Question 33

Pancreatitis amylase/creatinine clearance

Answer 33

5% to 20+%

Question 34

Non-pancreatic disorders with increases in amylase clearance/ratio of amylase:CrCl : (4)

Answer 34

Burns Myeloma Duodenal perforations Extraperitoneal surgical procedures

Question 35

Hypocalcemia in pancreatitis is caused by ____

Answer 35

hypoalbuminemia

Question 36

Hypocalcemia in pancreatitis does not occur with ___

Answer 36

acute pancreatitis of hyperparathyroidism

Question 37

_____ may be markedly elevated in acute pancreatitis, and a cause of pancreatitis can be ______

Answer 37

TG | Hyperlipidemia

Question 38

Glucose intolerance may be seen in acute pancreatitis, with ______ ____

Answer 38

transient hyperglycemia