JB GI

Question 1

Achalasia tx

Answer 1

botulinum toxin injection
nitrates
CCB

Question 2

Acute Hepatitis B labs

Answer 2

+ HBsAg
- anti-HBs
anti-HBc IgM

Question 3

Ascites management

Answer 3

Na restriction
spironolactone
TIPS procedure

Question 4

Boerhaave syndrome Sx

Answer 4

Retrosternal chest pain worse w/ deep breath and swallowing
Hematemesis
Crepitus due to pseudomediastinum

Question 5

Budd-Chiari syndrome

Answer 5

Obstruction of hepatic outflow: hepatomegaly, ascites, RUQ pain
Rapid development of acute liver dz (jaundice, hepatosplenomegaly)

Question 6

Cholelithiasis risk factors

Answer 6

5 Fs: Fat, fair, female, forty, fertile

Question 7

Cirrhosis tx

Answer 7

Lactulose - encephalopathy
Na restriction/spironolactone - ascites
cholestyramine - pruritus

Question 8

Diverticular disease dx

Answer 8

CT scan TOC

Question 9

Diverticulitis tx

Answer 9

NPO and IV abx (ciprofloxacin or bactrim + metronidazole)

Question 10

Esophageal cancer dx

Answer 10

Upper endoscopy w/ bx
hypercalcemia - SCC

Question 11

Esophageal ring dx

Answer 11

Barium esophagram TOC

Question 12

Esophageal varices tx

Answer 12

BB- decrease portal HTN
Octreotide and balloon tamponade –> cyanoacrylate injection
TIPS or surgery

Question 13

G6PD deficiency sx

Answer 13

Oxidative stress (infection, fava beans, sulfa drugs)
back/abdominal pain, jaundice, dark urine, splenomegaly

Question 14

Giardiasis tx

Answer 14

Metronidazole/ tinidazole and nitazoxamide
albendazole or mebendazole

Question 15

Hemorrhoid tx

Answer 15

rubber band ligation, sclerotherapy, infrared coagulation
hemorrhoidectomy

Question 16

Chronic HCV labs

Answer 16

+ HCV RNA
+ anti HCV

Question 17

Acute HCV labs

Answer 17

+ HCV RNA
+/- anti-HCV

Question 18

Resolved HCV labs

Answer 18

• HCV RNA
  +/- anti-HCV

Question 19

Hirschsprung disease dx

Answer 19

anorectal manometry (BIT)
Rectal bx definitive

Question 20

Hypercalcemia tx

Answer 20

IV saline –> furosemide 1st line
Severe: calcitonin, bisphosphonates (IV pamidronate)

Question 21

Noninvasive infectious diarrhea

Answer 21

S. aureus
Bacillus cereus
Vibrio cholera
Enterotoxigenic E. coli
C. diff

Question 22

Invasive infectious diarrhea

Answer 22

Campylobactor
Shigella
Salmonella
Yersinia
Enterohemorrhagic E. coli

Question 23

IBD tx

Answer 23

Amino salicylates (sulfasalazine, mesalamine) –> CS (acute flares) –> immune modifying agents –> anti TNF agents

Question 24

IBS tx

Answer 24

Diarrhea: anticholinergics/spasm (Dicyclomine), antidiarrheal (loperamide)
Constipation: Prokinetic, bulk forming laxatives, saline/osmotic laxative, lubiprostone
Pain: TCA/SSRI

Question 25

Liver cirrhosis sx

Answer 25

ascites, hepatosplenomegaly, gynecomastia, spider angioma, caput medusa, jaundice, muscle wasting, hepatic encephalopathy, asterixis, esophageal varices, spontaneous bacterial peritonitis

Question 26

Liver cirrhosis MCC

Answer 26

ETOH (in US), chronic viral hepatitis (HCV), NAFLD, hemochromatosis

Question 27

Malnutrition tx

Answer 27

Anorexia: hospital if <75% expected body weight or medical complications
CBT, supervised meals, weight monitoring
Depression: SSRI, atypical antipsychotics

Question 28

Neuroleptic malignant syndrome MCC and tx

Answer 28

MCC: drug (resperdil)
supportive care
DA agonist: bromocriptine, amantadine

Question 29

OD ethylene glycol (antifreeze) tx

Answer 29

ethanol or fomepizole

Question 30

Pneumoperitonium dx

Answer 30

Something perforated
Most sensitive test: free air under diaphragm

Question 31

Pseudomembranous colitis sx

Answer 31

copious watery stools after recent abx use.
low grade fever, N, anorexia

Question 32

Pseudomembranous colitis tx

Answer 32

mild: metronidazole (first line), PO vanco
Severe: PO Vanco

Question 33

SBO dx

Answer 33

Abd xray: air fluid levels in step ladder pattern, dilated bowel loops

Question 34

SBO tx

Answer 34

IV fluids, NG suction and NPO
Strangulation: surgical

Question 35

Ulcerative colitis dx

Answer 35

TOC: flex signmoidoscopy in acute dz
Curative: surgery

Question 36

Riboflavin deficiency sx

Answer 36

oral-ocular-genital syndrome
oral: mouth lesions, magenta tongue, angular chelitis, pharyngitis
Ocular: photophobia, corneal lesions
Genital: scrotal dermatitis

Question 37

Vitamin K deficiency labs

Answer 37

Prolonged PT, normal fibrinogen, normal plt

Question 38

wilson’s dz labs

Answer 38

low ceruloplasmin, increased urinary copper excretion

Question 39

Zollinger Ellison syndrom labs

Answer 39

high fasting gastrin level (best screening)
+ secretin
increased chromogranin A