GI Qs

Question 1

When to give albumin for SBP?

Answer 1

Cr>1
Bili>4
BUN>30

Question 2

Gold standard for diagnosing PSC? Findings?

Answer 2

cholangiography

segmental bile duct fibrosis with saccular dilatation of normal intervening areas, resulting in the characteristic “beads on a string” appearance

Question 3

Asymptomatic gallbladder polyp over 1 cm. Management?

Answer 3

gallbladder polyp larger than 1 cm is an indication for cholecystectomy, even if the patient is asymptomatic.

Question 4

Treatment if Crohn’s Disease in pregnant patient?

Answer 4

TNFa

Question 5

treatment of functional dyspepsia when symptoms do not respond to proton pump inhibitor or H2-blocker therapy?

Answer 5

TCA

Question 6

When to screen a patient with UC or Crohn’s disease for colon cancer?

Answer 6

every 1 to 2 years beginning after 8 to 10 years of disease.

Question 7

When to ablate Barrett’s esophagus?

Answer 7

Only for HIGH GRADE displasia

Question 8

Serum antimitochondrial antibody is present in 90% to 95% of patients with?

Answer 8

Primary biliary cholangitis

Question 9

When should a hepatocellular adenoma be surgically resected?

Answer 9

> 5 cm or that exhibit β-catenin nuclear reactivity

Question 10

Candida esophagitis should be treated with?

Answer 10

fluconazole (Not nystatin)

Question 11

Patient with a hx of endometrial CA and family history of 2 members with colon cancer - when to begin screening colonoscopy?

Answer 11

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.

Question 12

When to treat hep B? With what?

Answer 12

elevated serum ALT level and HBV DNA level > 10,000 IU/mL

pegylated interferon or entecavir

Question 13

MELD score that warrant liver transplant evaluation?

Answer 13

15+

Question 14

Milan criteria?

Answer 14

Up to three hepatocellular carcinoma tumors ≤3 cm or one tumor ≤5 cm are best treated with liver transplantation

Question 15

sorafenib - used to treat? When to start?

Answer 15

HCC

Childs A/B
performance status,
+vascular, lymphatic, or extrahepatic spread of the tumor.

Question 16

Side effects of metoclopramide?

Answer 16

hyperprolactinemia, galactorrhea, and a variety of neurologic symptoms such as tardive dyskinesia

Question 17

Drug shown to improve transplant-free survival in non–acetaminophen-related acute liver failure in patients with grade I or II hepatic encephalopathy?

Answer 17

NAC

Question 18

classic presentation of eosinophilic esophagitis?

Answer 18

young man with solid-food dysphagia that requires endoscopy for removal.

Question 19

Pegylated interferon is contraindicated in acute hepatitis B because?

Answer 19

risk of exacerbating liver inflammation

Question 20

Management of acute hepatitis B?

Answer 20

If liver dysfunction – antivirals. If no liver dysfunction – serial LFTs

Question 21

Peutz-Jeghers syndrome (PJS) - transmission? Type of polyp?

Answer 21

autosomal dominant; hamartomatous polyposis syndrome

Question 22

Lynch syndrome - transmission? Type of polyps?

Answer 22

germline mutation in a mismatch repair gene. Adenomatous polyps.

Question 23

Familial adenomatous polyposis (FAP) - transmission? Types of polyps?

Answer 23

Autosomal dominant; is characterized by tens to thousands of adenomatous colorectal polyps.

Question 24

Types of serrated polyps?

Answer 24

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

Question 25

Patient who should have a repeat colonoscopy within 3 to 6 months?

Answer 25

polyps >20 mm or polyps removed in pieces

Question 26

Patient you should have a repeat colonoscopy in one year?

Answer 26

pt with colon cancer (not adenomas) should have their first postoperative colonoscopy examination within 1 year

Question 27

Patient who should have a repeat colonoscopy in five years?

Answer 27

one to two tubular adenomas smaller than 10 mm are considered low risk and should undergo their next colonoscopy in 5 years.

Question 28

Patient who should have a repeat colonoscopy in three years?

Answer 28

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

Question 29

juvenile polyposis syndrome (JPS) - transmission? Diagnosis?

Answer 29

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.

Question 30

Juvenile polyposis syndrome – genes involved?

Answer 30

SMAD4 and BMPR1A

Question 31

Videofluoroscopy versus barium swallow?

Answer 31

Oropharyngeal dysfunction versus lower esophageal dysfunction

Question 32

Pt with HBV - when is Treatment with antiviral agents not necessary?

Answer 32

Inactive carrier state