GI step 3

Question 1

oral candida treatment

Answer 1

nystatin supension

Question 2

acute cholangitis - clinical presentation

Answer 2

fever, jaundice RAQ pain (charcot triad)

+/- hupotension AMS (Reynold pentad)

Question 3

acute cholangitis - treatment

Answer 3

antibiotic

biliary drainige by ERCP within 1-2 DAYS

Question 4

diverticulitis does not improve after 2-3 days of antibiotic - managment

Answer 4

repeat CT to evaluate for complications (abscess, perforation, obstruction)
(never colonoscopy)

Question 5

GI bleeding in icu?

Answer 5

stress induced ulcers –> PPI

Question 6

hypertriglyceridemia - induced acute pancreatitis - prevention

Answer 6

fibrates

Question 7

hypertriglyceridemia - induced acute pancreatitis - treatment

Answer 7

supportive

apheresis if severe (insulin if apheresis is not available)

Question 8

pancreatitis diagnosis

Answer 8

requires 2/3
1. characteristic pain
2. lipase or amylase (>3 time up)
3. imagine
if patient has the pain --> do only labs

Question 9

pancreatitis with consistent pain

Answer 9

consider infected pancreatic necrosis

- ct scan –> gas in pancreas

Question 10

dyspepsia management

Answer 10

older than 60: upper endoscopy

lower than 60: test H pylori, upper endoscopy if high risk

Question 11

untreated celiac - complications

Answer 11

enteropathy-associated T cells lymphoma (abd pain, b symptoms, GI bleeding, obstruction, perforation)

Question 12

heapatic adenoma manifestation

Answer 12

OCP depended

asymptomatic (CT with peripheral enchancement)

Question 13

heapatic adenoma treatment

Answer 13

asymptomatic or and smaller than 5 cm –> stop OCPs

symptomatic or bigger: surgery

Question 14

heapatic adenoma - complication

Answer 14

malignant transformation in 10%

rupture and hemorrh

Question 15

conditions that require higher dose of Levothyr in hypoth

Answer 15

1. malabsorption

2. drug interaction

Question 16

unresponsive cirrhotic patient vomits blood - steps

Answer 16

2 lines, intubation, octreotide, emergent endoscopy

Question 17

how to prevent future varicoses bleeding

Answer 17

non selective beta blockers

Question 18

acute mesenteric ischemia - diagnosis

Answer 18

1. no acidosis
2. marked leukocytosis
3. hemoconcentration
4. CT abd and ct angiography –> focal or segmental bowel thickening, mesenteric stranding and prot mesenteric thrombosis

Question 19

primary billiary cholangitis - diagnosis

Answer 19

elevated ALP

positive ANTIMITO antib (if negative do liver biopsy)

Question 20

primary billiary cholangitis - treatment

Answer 20

usodeoxycholic acid

liver transpl

Question 21

primary billiary cholangitis - high risk of

Answer 21

osteopenia

Question 22

Mallory weis vs Boerhaave - management

Answer 22

Mallory: acid suppression, resolves spont
Boerh: acid suppres, antib, NPO, emeregency

Question 23

Mallory weis vs Boerhaave - studies

Answer 23

Mallory: endoscopy
Boerh: chest x-ray, CT with water soluble contrast to confirm

Question 24

threshoold for blood transf in bleeding

Answer 24

if stable: less than 7
stable with stable cardiov: less than 8
stable with unstable cardiov or malign: higher

Question 25

dumping syndrome treatment

Answer 25

low carbs and high protein diet

Question 26

characteristics of high pressure ascitis

Answer 26

serum alb - ascitis fluid alb = 1.1

Question 27

evaluation of chronic diarrhea

Answer 27

history, basic serum analysis, stool analysis

Question 28

malabs syndrome with increased osm gap

Answer 28

1. lactose intol

2. celiac disease

Question 29

bile sald induced diarrhea

Answer 29

5-10 after cholecystectomy and in short bowel syndrome

- treatment cholestyramine

Question 30

barret esophagus - management

Answer 30

• no dysplasia: ppi and endoscopy in 3 y
• low grady dysplasia: ppi and endoscopy in 6-12 months or endoscopic eradication
• high grade dysplasia: endoscopic eradication

Question 31

H pylori treatment

Answer 31

Triple therapy: PPI + Clarythromycin + amoxicillin for 10-14 days
- if penicillin allergey (metronidazole

Question 32

precipitation events for ammonia elevation in cirrhosis

Answer 32

hypovelemia
hypokelamie
met alkalosis

Question 33

angiodysplasias are frequent causes of GI bleeding particulary in pts with

Answer 33

1. ESRD
2. von willebrand
3. AS

Question 34

managment of uncomplicated gallstones

Answer 34

• no symptoms: no treatment
• colic pain management, cholecystectomy, UDCA in poor candidates
• atypical symptoms: evaluation for other causes first
• biliary colic without gallostones on imaging: cholecystokin stiumulation test

Question 35

hepatic hydrothorax

Answer 35

right side transudative plearual effusion

treatemnt: sodium restriction and diuretics: if refractory: Transjugular intrahepatic portosystemic shunt

Question 36

pancreatic cyst - next step

Answer 36

endoscopic u/s

Question 37

UC patient with abd pain, bloody diarrhea etc - next step

Answer 37

x-ray (toxic megacolon)

Question 38

toxic megacolon 2ry to UC - management

Answer 38

steroids –> if not –> surgery

avoid opiods and ASA

Question 39

splenic vein thrmobosis

Answer 39

• association with pancreatitis

- variceal bleeding (gastric varices, not esophageal)

Question 40

dyspepsia in younger than 60 with no alarming symptoms

Answer 40

h pylori test

Question 41

common drugs that cause pancreatitis

Answer 41

diuretics