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Tina's Deck of Knowledge 😅 > IM Plat- Gastroenterology > Flashcards

IM Plat- Gastroenterology Flashcards

1
Q

A patient complaining of dysphagia underwent barium swallow which revealed a “corkscrew esophagus” with tertiary contractions. What is the most likely diagnosis?

A

Diffuse esophageal spasm

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2
Q

What hormone is secreted by the K cells in the duodenum and stimulates insulin secretion by the pancreas?

A

GIP

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3
Q

What is the gold standard for the diagnosis of colonic mucosal disease?

A

Colonoscopy

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4
Q

Using the Child Pugh Score stratification, the cut-off that indicates decompensated cirrhosis is set at?

A

> or = 7

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5
Q

Duodenal ulcers tend to penetrate this structure when it starts to perforate.

A

Pancreas

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6
Q

Gastric ulcers tend to penetrate this structure when it starts to perforate.

A

Left hepatic lobe

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7
Q

What is the diagnostic test of choice for documenting eradication of H. pylori in patients with PUD?

A

Urea breath test

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8
Q

Give 3 non-invasive tests for the detection of H. pylori in patients with PUD.

A

Serology
Urea breath test
Stool antigen

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9
Q

A large caliber arteriole that runs immediately beneath the GI mucosa and bleeds through a pinpoint mucosal erosion.

A

Dieulafoy’s lesion (Persistent Caliber Artery)

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10
Q

What is the most common cause of UGIB?

A

Bleeding PUD

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11
Q

What is the most common cause of hematochezia in patients >60 years old?

A

Bleeding colonic diverticulum

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12
Q

What is the most common cause of rectal bleeding in infancy?

A

Anal fissure

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13
Q

What 3 variables are used to calculate the MELD score for prognosticating patients with liver disease and portal hypertension?

A

BIC: serum bilirubin, INR and serum Creatinine

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14
Q

What is the most common and most characteristic symptom of liver disease?

A

Fatigue

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15
Q

A sign of liver disease that results from recannulation of the umbilical vein resulting in collateral veins radiating from the umbilicus.

A

Caput medusa

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16
Q

What is the best acute measure of hepatic synthetic function?

A

Clotting factors

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17
Q

Which clotting factor is not synthesized in the liver?

A

Factor VIII

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18
Q

It is the qualitative marker of HBV replication and relative infectivity.

A

HBeAg

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19
Q

What is the first antibody to rise in Hepa B infection and is readily demonstrable in the serum within the 1st 1-2 weeks after the appearance of HBsAG?

A

Anti-HBc

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20
Q

What hormone is secreted by the enterochromaffin cells in the stomach? by the enterochromaffin-like cells?

A

Serotonin by the EC cells

Histamine by the ECL cells

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20
Q

What is the most sensitive indicator of HCV infection?

A

HCV RNA

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21
Q

Give the pharmacologic standard of management of chronic Hepatitis C.

A

Pegylated IFN + Ribavirin

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22
Q

More sensitive serologic indicator of HBV replication than HBEag and is considered a quantitative marker of Hepa B infection.

A

HBV DNA

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23
Q

What is the most common adverse effect of ribavirin therapy?

A

Hemolysis

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24
Q

Stores Vitamin A in the liver.

A

Ito cells

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24
Q

What is the initial and most common histologic response to hepatotoxic stimuli?

A

Fatty liver

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26
Q

Asterixis and hypoactive reflexes are first manifested at what grade of hepatic encephalopathy?

A

Grade 2

27
Q

A CLD patient was noted to have excessive sleepiness but is still arousable. On MSE, he was slightly aggressive and is disoriented to time and place. Neuro PE showed hyperactive reflexes, muscle rigidity and a (+) Babinski sign. Give the grading of hepatic encephalopathy.

A

Grade 3

28
Q

Intestinal enzyme that triggers the conversion of pancreatic trypsinogen to trypsin.

A

Enterokinase

29
Q

Single best acute measure of hepatic synthetic function and helpful in both the diagnosis and assessing prognosis of acute parenchymal liver disease.

A

Coagulation factors

30
Q

Give the 2 antibiotic adjuncts in the management of hepatic encephalopathy.

A

Neomycin

Metronidazole

31
Q

Blue-red purple discoloration of the flanks that reflects tissue catabolism of hemoglobin seen in patients with pancreatitis.

A

Turner’s sign

32
Q

What is the most reliable marker if severity and also considered the hallmark of liver disease?

A

Jaundice

33
Q

Which serum enzyme is more specific in diagnosing Acute Pancreatitis?
A. Amylase
B. Lipase

A

B. Lipase

33
Q

What is the cornerstone of chronic pancreatitis therapy?

A

Pancreatic enzyme replacement

34
Q

What is the diagnostic test of choice in those with suspected pancreatitis but serum lipase/amylase are not markedly increased to accepted values to accurately diagnose the condition?

A

CT Scan

35
Q

Give the 3 mainstays in the management of Acute Pancreatitis.

A
  1. Pain relief (IV Meperidine)
  2. Hydration (IV fluids and colloids)
  3. Bowel rest
35
Q

What is the most frequently involved vessel in pancreatic pseudoaneurysm?

A

Splenic artery

36
Q

What is the procedure of choice for the diagnosis of cholelithiasis?

A

GB Ultrasound

36
Q

What is the most common location if pancreatic pseudocysts?

A

Body or Tail (85%)

37
Q

Which part of the GI tract is spared in Crohn’s disease?

A

Rectum

38
Q

This condition is seen in severe attacks of UC wherein the transverse colon is dilated to more than 6 cm with loss of haustrations.

A

Toxic megacolon

40
Q

Antibody seen in most patients with Ulcerative colitis? Crohn’s disease?

A

pANCA in UC; Anti-Saccharomyces cerevisiae antibody (ASCA) in CD

41
Q

The staging used for perforated diverticular disease?

A

Hinchey classification system

42
Q

The type of diverticulum that involves the mucosa through the muscularis propria.

A

Psedodiverticulum or False diverticulum

43
Q

Using the Goodsall’s rule, what is the track of an anterior fistula lying more than 3 cm. from the anal verge?

A

Curved track (similar to posterior fistulas) that opens into the posterior midline of the anal canal

44
Q

A common complication of cholecystitis in elderly men and patients with DM.

A

Emphysematous cholecystitis

45
Q

What is the most commonly used third-gen cephalosphorin used in the treatment of SBP?

A

Cefotaxime

46
Q

What are the most frequently cultured organisms in Emphysematous cholecystitis?

A

Clostridium welchii and Clostridium perfringens

Escherichia coli

47
Q

Triads: Choledochal cyst

A

PaJaMa: Abdominal Pain, Jaundice, Abdominal Mass

48
Q

What is the most feared outcome of porcelain gallbladder thus, requiring prophylactic and/or immediate cholecystectomy?

A

Carcinoma of the gallbladder

49
Q

Triads: Cholecystitis

A

Fever, RUQ pain, Leukocytosis

50
Q

Triads: Cholangitis

A

FPJ: Fever, RUQ pain, Jaundice

51
Q

What is the initial test of choice for massive obscure bleeding?

A

Angiography

52
Q

Appendectomy is protective against which inflammatory bowel disease?

A

Ulcerative colitis

54
Q

What is the earliest radiologic change of ulcerative colitis seen on single contrast barium enema?

A

Fine mucosa granularity

56
Q

What pharmacologic drug was the first biologic therapy approved for Crohn’s disease?

A

Infliximab: anti-TNF-a

57
Q

Using the Park’s classification, what is the most common type of fistula-in-ano?

A

Intersphincteric (at the dentate line where the anal glands enter the anal canal)

58
Q

Portal hypertension is defined as the elevation of hepatic venous pressure gradient by ____.

A

> 5 mmHg

59
Q

What is the fatal dose of acetaminophen causing fulminant liver disease?

A

> or = 25 g

60
Q

What is the initial test of choice in patients suspected of having Budd-Chiari syndrome?

A

UTZ with Doppler Imaging

61
Q

What is the gold standard for the diagnosis and management of acute arterial occlusive disease?

A

Laparotomy

62
Q

A 40-year old female, s/p appendectomy came in due to a 5-day history of diffuse abdominal pain and distention. Abdominal xray done showed fluid- and gas-filled loops of small intestine arranged in a “stepladder pattern” with air-fluid levels and absence of gas in the colon. What is the most probable diagnosis?

A

SBO probably secondary to intestinal adhesions

65
Q

In pregnant patients, appendicitis commonly occurs during what trimester?

A

Second trimester

66
Q

What is the most common cause of appendiceal luminal obstruction?

A

Fecalith

Tina's Deck of Knowledge 😅 (14 decks)

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