Inpatient Med - GI

Question 1

pain radiating to back, guarding, feels better laying forward - dx, TOC, tx

Answer 1

acute pancreatitis
CT
fluid, bowel rest, cholecystectomy if appliable

Question 2

chronic pancreatitis - dx

Answer 2

calcified pancreas on xr

lipase/amylase NL due to calcification

Question 3

what cholesterol lab elevated w/ gallstone

Answer 3

TGs

Question 4

TOC gallstone

Answer 4

US, acoutic shadow

Question 5

RUQ radiating to shoulder

Answer 5

cholecystitis

Question 6

cholecystitis tx

Answer 6

bowel rest
ceftraizxone _ metro
holecystectomy

Question 7

where would you find eso SCC?

Answer 7

upper 1/3, tobacco/etoh/toxic expose people

Question 8

where would you find adeno eso Ca?

Answer 8

lower 1/3, fat white ppl

Question 9

ToC eso Ca

Answer 9

UGD or esophogram

Question 10

ToC eso stricture

Answer 10

esophogram, gold stnadrd manometry (showing increased pressure at LES)

Question 11

pressing on neck helps you swallow - dx and toc

Answer 11

zenker’s diverticulum, esophogram

Question 12

stabbing CP worse with hot/cold food & corkscrew eso- dx & tx

Answer 12

eso spasm

tx: nitrate, CCB, PPI

Question 13

mallory weiss tx

Answer 13

PPI, if severe bleeding epi, band ligation

Question 14

red wale markings and cherry red spots in eso

Answer 14

varices

Question 15

mallory weiss v varice tx

Answer 15

mallory weiss- supportive

varice - 2 bore IV, endo ligation, octreotide, vasopressin (lower portal venous pressure)
*ballon tamp or TIPS if refrac

Question 16

varice 2ndary ppx

Answer 16

propranalol - dec. portal venous pressure

isosorbide - decrease varice pressure

FQ or cef as well

Question 17

tx for GERD refractory to anatacid, ppi/h2 block, metaclompromide (prokinetc)

Answer 17

nissen fundiplication

Question 18

tx of H.Pylori gastritis/PUD

Answer 18

CAP

clarith, amox, PPI

Question 19

tx gastrits (-) Hpyloric/PUD

Answer 19

PPI, antacid, sulfacrate

+ misoprostol if PUD

Question 20

gnawing belly pain worse at night - food makes it better

Answer 20

gastric ulcer

if duodenal get skinny

Question 21

gastric ulcer dx

Answer 21

EGD (need to r/o malig)

Question 22

MC gastric cancer (cell type)

Answer 22

adenocarcinoma

Question 23

type of hepatitis with highest mortality in pg

Answer 23

hep E

Question 24

will a person with resolved HCV have + or - HCV RNA

Answer 24

(-)

they don’t always have the Ab either

Question 25

tests for HCC screening in hep C pt

Answer 25

AFP, and ultrasound

Question 26

If you have HBeAg are you more infective or less

Answer 26

MORE - it's the antigen | if u have the antibody, less

Question 27

If you have HBcAb what does that mean

Answer 27

acute infxn | 1st sign is HBsAg tho

Question 28

tx Hep B | tx Hep C

Answer 28

Hep C: Peg inteferon, ribavirin, Harvoni, some -virs (think C aunt peg) Hep B: alpha-interforn, lamivudine, -FOvirs (think alpha-Beta party FOvirs)

Question 29

dupuytrens contractures and palmar erythema are a/w wtith what liver condition

Answer 29

cirrhosis

Question 30

dx cirrhosis

Answer 30

US, bx, CT

Question 31

is liver Ca most often primary or due to mets

Answer 31

mets | but an ex of primary is HCC

Question 32

Celiac dx

Answer 32

anti-endomysial IgA Ab and transglutaminase Ab

Question 33

vitamins you're def in w/ Celiac

Answer 33

vit D, Ca, Fe, Folate

Question 34

IBS v IBD

Answer 34

IBD has inflammation of intestinal mucosa (PANCA and ASCA +) also a/w arthritis, episcleritis, uveitis, constitional

Question 35

IBS tx

Answer 35

imodium, lopermide, -amines for ANTI diarrhea lubiprostone for cinstipation TCA, SSRI for pain

Question 36

IBD tx

Answer 36

5-ASA, meslamine, sulfsalazine CCS for flares 6mercaptpurine, azathioprine, mtx (Immune modify)

Question 37

anal fissure tx besides WASH

Answer 37

topical nifidpine and NG (vasodilator)

Question 38

colon Ca common mets

Answer 38

liver, lungs, LN

Question 39

UC sx, Cx, and dx

Answer 39

LLQ bloody diarrhea cx PSC, megacolon, Ca dx flex sig

Question 40

Crohns sx, cx, dx

Answer 40

RLQ nonbloody diarrhea, wtloss cx: perianal stuff, Fe, B12 def dx: gi series w small bowel follow through

Question 41

if you have lynch syndrome what's your colonoscopy schedule

Answer 41

start age 20-25, colonoscropy q1-2 y

Question 42

if you have NO 1st deg relatives w Colon Ca whats your colon Ca screening schedule

Answer 42

start at 50 - annual FOBT - Cscopy q10 or flexsig q5

Question 43

if you have a 1st degree relative w Colon Ca whats your screening schedule

Answer 43

start at 50 - annual FOBT - Cscopy (q10 if >60yo, q5 if <60yo)

Question 44

MC location of divericular dz

Answer 44

sigmoid colon, LLQ

Question 45

diverculosis diet

Answer 45

high fiber

Question 46

diverticulosis refrac bleeding

Answer 46

vasopressin

Question 47

diverticulitis dx

Answer 47

NPO Cipro/batrim + metro genta +clinda

Question 48

diverticula imaging

Answer 48

CT

Question 49

internal hemmorhoid sx

Answer 49

rectal bleeding, itching, fullness

Question 50

external hemorrhoid sx

Answer 50

perianal pain w/ poop, tender palpable mass

Question 51

hemmorhoid conservative tx

Answer 51

WASH, topica CCS

Question 52

is type 1 or type 2 hernia better for pt

Answer 52

type 1 - stomach and GE junction slide into mediatnum, treat like gerd. in 2, the fundus pops up and you can have strangulation so possible surgery