GI Qs Flashcards
When to give albumin for SBP?
Cr>1
Bili>4
BUN>30
Gold standard for diagnosing PSC? Findings?
cholangiography
segmental bile duct fibrosis with saccular dilatation of normal intervening areas, resulting in the characteristic “beads on a string” appearance
Asymptomatic gallbladder polyp over 1 cm. Management?
gallbladder polyp larger than 1 cm is an indication for cholecystectomy, even if the patient is asymptomatic.
Treatment if Crohn’s Disease in pregnant patient?
TNFa
treatment of functional dyspepsia when symptoms do not respond to proton pump inhibitor or H2-blocker therapy?
TCA
When to screen a patient with UC or Crohn’s disease for colon cancer?
every 1 to 2 years beginning after 8 to 10 years of disease.
When to ablate Barrett’s esophagus?
Only for HIGH GRADE displasia
Serum antimitochondrial antibody is present in 90% to 95% of patients with?
Primary biliary cholangitis
When should a hepatocellular adenoma be surgically resected?
> 5 cm or that exhibit β-catenin nuclear reactivity
Candida esophagitis should be treated with?
fluconazole (Not nystatin)
Patient with a hx of endometrial CA and family history of 2 members with colon cancer - when to begin screening colonoscopy?
at risk for Lynch syndrome so:
every 1 to 2 years beginning at age 25 years, or 2 to 5 years earlier than the youngest age at diagnosis of colorectal cancer if the affected relative was younger than 25 years old.
When to treat hep B? With what?
elevated serum ALT level and HBV DNA level > 10,000 IU/mL
pegylated interferon or entecavir
MELD score that warrant liver transplant evaluation?
15+
Milan criteria?
Up to three hepatocellular carcinoma tumors ≤3 cm or one tumor ≤5 cm are best treated with liver transplantation
sorafenib - used to treat? When to start?
HCC
Childs A/B
performance status,
+vascular, lymphatic, or extrahepatic spread of the tumor.
Side effects of metoclopramide?
hyperprolactinemia, galactorrhea, and a variety of neurologic symptoms such as tardive dyskinesia
Drug shown to improve transplant-free survival in non–acetaminophen-related acute liver failure in patients with grade I or II hepatic encephalopathy?
NAC
classic presentation of eosinophilic esophagitis?
young man with solid-food dysphagia that requires endoscopy for removal.
Pegylated interferon is contraindicated in acute hepatitis B because?
risk of exacerbating liver inflammation
Management of acute hepatitis B?
If liver dysfunction – antivirals. If no liver dysfunction – serial LFTs
Peutz-Jeghers syndrome (PJS) - transmission? Type of polyp?
autosomal dominant; hamartomatous polyposis syndrome
Lynch syndrome - transmission? Type of polyps?
germline mutation in a mismatch repair gene. Adenomatous polyps.
Familial adenomatous polyposis (FAP) - transmission? Types of polyps?
Autosomal dominant; is characterized by tens to thousands of adenomatous colorectal polyps.
Types of serrated polyps?
hyperplastic polyps (when small and located in the rectosigmoid colon, are believed to impart no risk to the patient) Sessile serrated polyps and traditional serrated adenomas, are precancerous lesions
Patient who should have a repeat colonoscopy within 3 to 6 months?
polyps >20 mm or polyps removed in pieces
Patient you should have a repeat colonoscopy in one year?
pt with colon cancer (not adenomas) should have their first postoperative colonoscopy examination within 1 year
Patient who should have a repeat colonoscopy in five years?
one to two tubular adenomas smaller than 10 mm are considered low risk and should undergo their next colonoscopy in 5 years.
Patient who should have a repeat colonoscopy in three years?
Patients with (1) an adenoma 10 mm or larger, (2) three to ten adenomas, (3) an adenoma with a villous component (such as a tubulovillous or villous adenoma), or (4) an adenoma with high-grade dysplasia
juvenile polyposis syndrome (JPS) - transmission? Diagnosis?
Autosomal dominant. The clinical criteria for diagnosis of JPS include
(1) more than three juvenile polyps of the colon,
(2) juvenile polyps throughout the gastrointestinal tract, or
(3) one or more juvenile polyps combined with a family history of JPS.
Juvenile polyposis syndrome – genes involved?
SMAD4 and BMPR1A
Videofluoroscopy versus barium swallow?
Oropharyngeal dysfunction versus lower esophageal dysfunction
Pt with HBV - when is Treatment with antiviral agents not necessary?
Inactive carrier state
