GIT

Question 1

Acute LGIB w/ hemodynamic instability: after initial resuscitation, what is the next diagnostic step?

Answer 1

Upper endoscopy

Question 2

UGIB: Change in hemoglobin may not be evident up to ____ hours after bleeding event

Answer 2

72 hours

Question 3

Most frequent PE finding of GU or DU

Answer 3

Epigastric tenderness

Question 4

First step in a patient with new onset dyspepsia <40 y/o and without alarm symptoms

Answer 4

Non-invasive H. pylori testing

Question 5

Melena is blood that has been in the GIT for at least _____ hours

Answer 5

14 hours

Question 6

Gold standard of H. pylori testing

Answer 6

Histologic evaluation of endoscopic biopsy

Question 7

Scleral icterus means bilirubin is >___ mg/dL

Answer 7

3

Question 8

Best way to initially assess GIB

Answer 8

BP and HR

Question 9

Most reliable marker of severity of liver disease and it’s hallmark symptom

Answer 9

Jaundice

Question 10

Single most common risk factor for hep C infection:

Answer 10

Injection drug use

Question 11

Often the only clinical finding in alcholic liver disease

Answer 11

Hepatomegaly

Question 12

Treatment of ALD with severe hepatitis, discriminant function >32 or MELD >20

Answer 12

Steroids (Prednisolone)

Question 13

Components of MELD

Answer 13

Bilriubin, INR, Creatinine

Question 14

Medical management for portal hypertension

Answer 14

Nonselective beta blockers
Splanchnic vasoconstrictors (Somatostatin, octreotide)

Question 15

Chylous ascites indicates a TG level of

Answer 15

> 200 mg/dL

Question 16

Remains the gold standard of determining cause of ascites

Answer 16

Laparotomy/laparoscopy with peritoneal biopsy

Question 17

Patients with small amounts of ascites can be initially managed by:

Answer 17

Sodium restriction

Question 18

Moderate amounts of ascites are managed with:

Answer 18

Diuretics (initially spironolactone)

Question 19

Management for refractory ascites

Answer 19

Repeated large volume paracentesis and TIPS

Question 20

In colonic adenoCA, obstruction here leads to hematochezia, narrowing of stool caliber, tenesmus

Answer 20

Rectosigmoid area

Question 21

Colon CA: Best predictor of long-term prognosis

Answer 21

Pathologic stage at diagnosis

Question 22

Urgent endoscopy is recommended in cirrhotics with UGIB within how many hours?

Answer 22

12 hours

Question 23

Single best acute measure of hepatic synthetic function

Answer 23

Coagulation studies

Question 24

Earliest radiologic change in ulcerative colitis

Answer 24

Fine granular changes

Question 25

Earliest macroscopic finding in Crohn's disease

Answer 25

Aphthous ulcers

Question 26

Defining lesions of UC

Answer 26

Crypt abscesses and ulcers

Question 27

Treatment of SBP

Answer 27

Cefotaxime/Ofloxacin/Ciprofloxacin + IV Albumin

Question 28

Cornerstone of therapy in dumping syndrome

Answer 28

Dietary modificiation

Question 29

Treatment of choice for stress prophylaxis

Answer 29

PPIs

Question 30

The two principal gastric secretory products that induce mucosal injury

Answer 30

HCl and Pepsinogen

Question 31

In pancreatitis, lipase stays elevated for _____ days

Answer 31

7-14 days

Question 32

Most important clinical finding in regard to severity of the acute pancreatitis episode

Answer 32

Persistent organ failure >48h

Question 33

Initial imaging modality of choice for acute pancreatitis

Answer 33

Abdominal ultrasound

Question 34

Patients with gallstone pancreatitis with signs of acute cholangitis should undergo _____ within 24-48 hrs

Answer 34

ERCP

Question 35

Most common cause of chronic pancreatitis in the USA

Answer 35

Alcoholism

Question 36

Test with the best sensitivity and specificity for chronic pancreatitis

Answer 36

Secretin test | Becomes abnormal when 60% or more of the exocrine pancreas has been lost

Question 37

Diffuse calcifications noted on plain film the of the abdomen are pathognomonic for:

Answer 37

Chronic pancreatitis

Question 38

Cornerstone of therapy in chronic pancreatitis

Answer 38

Pancreatic enzyme replacement

Question 39

Most common congenital anatomical variant of the human pancreas

Answer 39

Pancreas divisum

Question 40

Most common histologic response to hepatotoxic stimuli

Answer 40

Fatty liver

Question 41

Cornerstone of treatment of alcoholic liver disease

Answer 41

Complete abstinence

Question 42

Most common cause of ascites

Answer 42

Portal hypertension

Question 43

Nutritional vitamin D deficiency is best assessed by obtaining serum ________

Answer 43

Serum 25-hydroxyvitamin D

Question 44

Most common site of inflammation in Crohn’s disease

Answer 44

Ileum

Question 45

Most common gastrointestinal cause of hypernatremia

Answer 45

Diarrhea

Question 46

Pneumococcal vaccine should be administered 2 weeks [before/after] splenectomy

Answer 46

2 weeks before splenectomy

Question 47

Usually the first indicator of portal hypertension

Answer 47

Hypersplenism

Question 48

Perhaps the most reliable physical finding in the liver examination

Answer 48

Hepatic tenderness

Question 49

Most common symptoms in Hep C

Answer 49

Fatigue

Question 50

Most important factor in progression of Hep B into cirrhosis and HCCA

Answer 50

Level of HBV replication

Question 51

Best therapy for hepatorenal syndrome

Answer 51

Liver transplant

Question 52

Acetaminophen dose associated with fatal fulminant liver disease

Answer 52

25g and above

Question 53

Most distinguishing serologic feature of chronic hep D

Answer 53

Anti-LKM3

Question 54

Best prognostic factor in chronic Hep C

Answer 54

Liver histology

Question 55

Mainstay of treatment of autoimmune hepatitis

Answer 55

Glucocorticoids