GI small Group 1 and 2

Question 1

Name the acute and chronic treatments for esophageal varicose?

Answer 1

acute: resuscitation, band ligation, endoscopic sclerosis agents, glue (rarely) octreotide

long-term: TIPS, beta blocker, additional band ligation as needed, assessment for liver transplant

Question 2

What is octreotide and what is its MOA?

Answer 2

mimics somatostatin and is admin in esophageal varicose to cause (transient) decrease in portal hypertension

Question 3

What do you add to Charcot’s triad to get Reynold’s pentad?

Answer 3

(Charcot’s: RUQ pain, fever, jaundice) + confusion and HTN

Question 4

What is the prognosis for a patient with pancreatic cancer discovered due to its compression of the common bile duct?

Answer 4

with a whipple and chemo 13mo, without treatment 3-4mo, generally poor prognosis and high likelihood of recurrence; important to connect patient with palliative care

Question 5

Name 5 PE findings that, in general that would suggest chronic liver disease and possible cirrhosis.

Answer 5

scleral icterus
hepatosplenomegaly
palmar erythema
caput medusa
peripheral edema

Question 6

Elevation in anti-mitrochondiral antibodies, elevated IgM are suggestive of what dx in a women in her 60’s?

Answer 6

primary biliary cirrhosis

Question 7

What are the histological hallmarks of PBC?

Answer 7

destruction of intrahepatic bile ducts along with macrophage and lymphocytic aggregations centered around the bile ducts

Question 8

What lab result would you look for in someone who has been immunized or been able to clear HBV infection?

Answer 8

Hepatitis Bs Ab positive is the neutralizing``

Question 9

What are other diseases that mimic achalasia?

Answer 9

gastric adenocarcinoma of the funds, esophageal adenocarcinoma, Chaga’s disease and adhesions

Question 10

Contrast treatments that are best for elderly vs. young people with achalasia.

Answer 10

young: surgical myotome
elderly: botulinum toxin (balloon dilation would be risky)

Question 11

What are the 2 general types of dysphagia?

Answer 11

oropharyngeal dysphagia and esophageal dysphagia

Question 12

What are common causes of oral pharyngeal dysphagia?

Answer 12

stroke, radiation, Parkinson’s disease, ALS, myasthenia gravis

Question 13

Intense epigastric pain is most likely what?

Answer 13

acute pancreatitis

Question 14

What are possible causes of acute pancreatitis?

Answer 14

alcohol, gallstones, hypertriglyceridemia, hypercalcemia, smoking, medications, traumatic, ischemia, scorpion bite