GI Rosh

Question 1

what helps distinguish c diff from from other benign antibiotic-associated diarrhea

Answer 1

fecal leukocytes (C diff)

Question 2

tx Cdiff

Answer 2

oral vancomycin or oral fidaxomicin

Question 3

primary treatment for Giardia infection

Answer 3

Tinidazole 2 grams orally as a single dose
avoid lactose containing foods

Question 4

dx sigmoid volvulus

Answer 4

XR - bent inner tube, coffee bean sign
Abdominal CT scan
Contrast enema

Question 5

tx sigmoid volvulus

Answer 5

sigmoidoscopy
surgery

Question 6

tx hepatic encephalopathy

Answer 6

lactulose and rifaximin

Question 7

What is the recommended protein intake in a patient with hepatic encephalopathy?

Answer 7

1–1.5 g/kg/day.

Question 8

in what dz is Dermatitis herpetiformis commonly seen

Answer 8

celiac

Question 9

what is Dermatitis herpetiformis

Answer 9

vesicobullous, pruritic lesions on the elbows, knees, and buttocks

Question 10

MCC SBO

Answer 10

adhesions from prior abdominal surgery

Question 11

dx SBO

Answer 11

XR
CT

Question 12

tx SBO

Answer 12

NG tube decompression

Question 13

What type of hernia is most commonly associated with small bowel obstruction?

Answer 13

inguinal hernia

Question 14

Mallory-Weiss syndrome is characterized by

Answer 14

longitudinal mucosal lacerations in the distal esophagus and proximal stomach, commonly associated with violent or repeated vomiting

Question 15

sx mallory-weiss

Answer 15

dysphagia, odynophagia, and upper GI bleeding (mild)

Question 16

dx mallory weiss

Answer 16

upper endoscopy

Question 17

tx mallory weiss

Answer 17

All patients with Mallory-Weiss syndrome should be treated with proton pump inhibitors for acid suppression and antiemetics

if active bleeding - thermal coagulation, hemoclips, or endoscopic band ligation

Question 18

what is Boerhaave syndrome

Answer 18

full-thickness esophageal perforation and a surgical emergency

Question 19

how to patients with Boerhaave syndrome present

Answer 19

severe chest pain that begins acutely after vomiting

Question 20

The most common cause of upper gastrointestinal (GI) bleeding

Answer 20

duodenal ulcer – usually due to H pylori

Question 21

The second most common cause of peptic ulcer formation

Answer 21

NSAID use

Question 22

classic sx for gastric vs duodenal ulcers

Answer 22

gastric ulcers cause pain immediately after meals, whereas food relieves the pain caused by duodenal ulcers

Question 23

tx H pylori infection

Answer 23

quadruple therapy: 14 days of PPI, bismuth, tetracycline, metronidazole

Question 24

where do anal fissures MC occur

Answer 24

posterior midline

Question 25

tx anal fissure

Answer 25

high fiber diet, softening stool to prevent recurrent trauma, and normalization of bowel movement if no response --> topical nitroglycerin or topical diltiazem In cases that do not respond to conservative treatment, topical nitroglycerin or diltiazem ointment

Question 26

what lab can aid in the diagnosis of acute mesenteric ischemia

Answer 26

serum lactate

Question 27

incarcerated vs strangulated hernia

Answer 27

incarcerated - Firm and painful, nonreducible by direct manual pressure strangulated - Painful due to impaired blood flow, ischemia, and necrosis, overlying skin changes

Question 28

Any patient with an exam indicative of a strangulated hernia should receive

Answer 28

cefoxitin intravenously and emergent surgical consultation

Question 29

tx for thrombosed hemorrhoids

Answer 29

anesthetizing the lesion and evacuating with an elliptical incision

Question 30

CT findings for cholecystitis

Answer 30

thickened gallbladder wall (> 4–5 mm), pericholecystic fluid, or dilated intra- or extrahepatic biliary ducts

Question 31

Which form of IBD is more likely to develop a malignancy

Answer 31

UC