GIT quiz Flashcards
A 25-year-old man presents to the clinic with a 12-week history of cramping abdominal pain, fever, fatigue, and 3 - 4 bloody stools per day. A colonoscopy reveals patchy inflammation in the colon and terminal ileum consistent with moderately active CD. Vital signs include fever, HR 100 bpm, and BP 118/68 mm Hg. Which therapeutic choice is best?
infliximab IV and AZT orally Mesalamine orally Methylprednisolone IV Adalimumab IV and methotrexate
infliximab IV and AZT orally
AY. is a 32-year-old white male who presents with bloody diarrhea (6 stools per day) for 2 days. CBC and ESR are normal. Physical exam normal. Colonoscopy reveals colitis involving the rectum. Which of the following is the best choice for initial therapy for Y.?
• Sulfasalazine orally Prednisolone orally
• Mesalamine orally Mesalamine rectally
• Methylprednisolone IV
Prednisolone orally
A. Y. is a 32-year-old white male who presents with bloody diarrhea (4 stools per day) for 2 days. CBC and ESR and Physical exam normal .Colonoscopy reveals colitis involving the rectum. Which of the following is the best choice for initial therapy for Y.?
Prednisolone orally
A 34-year-old woman presents with an 8-week history of new-onset cramping abdominal pain together with 2 - 4 bloody stools day. Colonoscopy reveals diffuse superficial colonic inflammation consistent with ulcerative colitis. The inflammation is continuous and exthends flexure. The drug and route that is best for this patient is
oral mesalamine
A 35-year-old man presents with newly diagnosed mild-moderately active UC affecting his descending colon and rectum (left- sided disease). He takes loratadine 10 mg/day for seasonal allergies. Which drug regimen is best?
mesalamine enema
A 35-year-old man presents with newly diagnosed mild-moderately active UC affecting his descending colon and rectum (left- sided disease). He takes loratadine 10 mg/day for seasonal allergies. He has no known drug allergies. The drug and route that is best for this patient is
mesalamine enema
A 44-year-old woman complains of 6 months of epigastric pain and heartburn between meals and relieved by antiacids. She the clinic after noting her stools darkening. Her stools are heme positive. She undergoes endoscopy that showed a 2-cm duodenal ulcer positive for H.pylori. Which of the following is recommended initial therapy given these findings?
• pantoprazole + clarithromycin + amoxicillin for 14 days
• Pantoprazole + clarithromycin for 14 days Pantoprazole +amoxicillin for 21days Bismuth + tetracycline+ metronidazole for 14 days
pantoprazole + clarithromycin + amoxicillin for 14 days
A B. is a 45-year-old white female with a past medical history significant only for epilepsy. She has experienced heartburn after meals intermittently for the past 2 weeks. It becomes worse when she is reclining at bedtime. Her medications include phenytoin 300 mg hs. After 2weeks of OTC treatment With famotidine and lifestyle modifications, A. B.’s symptoms are not relieved and they are becoming ‘troublesome” .Which of the following iS the best choice for her now?
Discontinue current therapy and initiate therapy with omeprazole 20 mg daily.
A 68-year old women visits clinic with upper abdominal pain with anemia and heme +ve stools. She has a history of hypertension & type 2 diabetes. She takes metformin, aspirin & lisinopril. She is using diclofenac daily for the past 2 months secondary to uncontrolled pain. A rapid urease test is negative. Which treatment that is best for this patients ulcer ?
lansoprazole
A 52-year-old woman complains of 6 months of epigastric pain & heartburn worst between meals and relieved by antacids. She comes to the clinic after noting her stools darkening. Her stools are heme positive. She undergoes endoscopy that showed a 2-cm duodenal ulcer positive for H.pylori. The recommended initial therapy for this patient is’
omeprazole + clarithromycin + amoxicillin
A 56-year-old man with history of cirrhosis is admitted with confusion, disorientation. and reduced oral intake since 2 days. . The patient is afebrile. with abdominal tenderness, reduced reflexes, and dry mucous membranes. Paracensis is negative for infection. which recommendation is best for treating this patient? • Initiate rifaximin orally • Initiate polyethylene glycol orally • Initiate ceftriaxone intravenously • initiate lactulose orally
• initiate lactulose orally
A 69-year-old man with a history of cirrhosis is admitted with confusion, disorientation. and reduced oral intake since 2 days. The patient is afebrile. with abdominal tenderness, reduced reflexes, and dry mucous membranes. Paracensis is negative for infection. The drug treatment recommended for treating this patient is
lactulose
H. B. is a 59-year-old black male recently diagnosed with PUD on endoscopy. Tissue biopsy is positive for H. pylori. H. B. has no known drug allergies. Which of the following is the ideal therapeutic regimen for H. pylori-related PUD in H. B. who is allergic to penicillin?
Omeprazole+ metronidazole clarithromycin+ metronidazole+ tetracycline
PPI+ clarithromycin+ amoxicillin clarithromycin+ metronidazole+ furazolidone
PPI, bismuth, metronidazole. Tetracycline
PPI, bismuth, metronidazole. Tetracycline
A 65 year-old man with a history of hypothyroidism, heart failure, and MI is admitted to ICU with severe community- acquired pneumonia. Six hours after admission, he develops acute respiratory failure and septic shock. Mechanical ventilation & NG tube were placed. He currently takes ramipril , metoprolol, levothyroxine, and aspirin. Which approach is most appropriate for preventing stress-related mucosal disease in this patient? • Cimetidine intravenous infusion • Magnesium hydroxide by NG tube • Sucralfate by NG tube • Pantoprazole Intravenously once daily
Pantoprazole Intravenously once daily
A 59-year-old man with a history of hypothyroidism, heart failure, and MI is admitted to ICU with severe bacterial meningitis. Six hours after admission. he develops acute respiratory failure and septic shock. Mechanical ventilatidn & NG tube were placed. He currently takes ramiprilm , metoprolol, levothyroxine, and aspirin. Which approach is most appropriate for preventing stress-related mucosal disease in this patient?
Pantoprazole IV.
A 67-year-old man With 3 years history of liver cirrhosis is admitted to the hospital for management of ascites using paracentesis. Few days after admission, he collapsed with type 1 hepatorenal syndrome. The following could be used management of this patient condition:
albumin + midodrine + octreotide
Although immunosuppressant, the following drug is not useful for induction or maintenance of remission of ulcerative colitis:
methotrexate
Which of the following is true for moderate to severe CD?
• Topical aminosalicylates are appropriate maintenance
therapy
• Budesonide is appropriate maintenance therapy.
• Methotrexate has no role in CD therapy.
• Azathioprine is the drug of choice for initial therapy.
• Oral corticosteroids are the drugs of choice for initial
therapy.
• Oral corticosteroids are the drugs of choice for initial
therapy.
Which of the following can be used for empirical treatment of a cirrhotic patient who is suspected to have spontaneous bacterial peritonitis? • Piperacillin + tazobactam • Aztreonam • Amoxicillin+ clavulanic acid • Imepenem +cliastatin Piperacillin + tazobactam
Piperacillin + tazobactam
Which of the following is true for Crohn’s Disease?
Budesonide can be used as initial therapy for CD of the terminal
ileum or ascending colon
The following drug would be appropriate for a patient with Crohn’s disease managed with sulfasalazine and prednisolone Amikacin Dexamethasone Infliximab Mesalazin
Infliximab
Which of the following is the most likely reason for the use of sulfasalazine by a patient having ulcerative colitis
maintenance of remission of the disease
The most likely reason for the use of sulfasalazine by a patient having ulcerative colitis is:
• Maintenance of remission of the disease
• Prevention of progression of the disease from stage 1 to
stage 2
• Prevention of the side effects of corticosteroids used for
induction in IBD
• Gastric H.pylori infection which might be encountered by IBD
patients
• Maintenance of remission of the disease
In patients with hepatic coma, or portal-systemic encephalopathy, decreasing the production and absorption of ammonia from the GIT is believed to be beneficial. Which of the following is the antibiotic of choice in this situation? Neomycin Chloramphenicol Cephalothin
Tetracycline Penicillin G
Neomycin
