Kevin's GI

Question 1

Toxic megacolon

Answer 1

megacolon plus 3 of: 
fever 
↑ HR 
↑ WBC
anemia 

Caused by severe inflammation

Question 2

Risks for megacolon

Answer 2

Chagas
UC
hirschsprung

Question 3

Rx for megacolon

Answer 3

fluids
steroids
correct any electrolyte abnormalities

+ stool sample to rule out infection

Question 4

Most common site of crohn’s involvement

Answer 4

ileocecal

B12 absorption here

Question 5

UC treatment

Answer 5

• 5-aminosalicylic preparations- mesalamine
• 6-mercaptopurine
• infliximab
• colectomy.

Question 6

crohn’s treatment

Answer 6

Corticosteroids
-azathioprine
-antibiotics (eg,
ciprofloxacin metronidazole)
-infliximab
-adalimumab

Question 7

Loss of haustra –> “lead

pipe” appearance on imaging is buzzword for

Answer 7

Ulcerative colitis

Question 8

The Ranson criteria

Answer 8

used to determine prognosis in acute pancreatitis.

Factors that ↓ survival:
 age > 55 years
WBC> 16,000/µm
glucose > 200 mg/dL
 LDH >  400 IU
AST >  250 IU/L.

Question 9

Crohns kidney stone composition

Answer 9

1- calcium oxalate

2- urate

Question 10

Ulcers and pain with food

Answer 10

Gastric ulcer - PAIN Can be Greater with meals—weight loss

Duodenal ulcer- Decreases with meals—weight gain

Question 11

H-Pylori triple therapy

Answer 11

Omeprazole 20 mg BID
amoxicillin 1000 mg BID
clarithromycin 500 mg BID

14 days

Question 12

Granulomas may be from these diseases

Answer 12

Sarcoid
TB
Wegners
Crohns

Question 13

String sign on KUB is buzz word for

Answer 13

crohns

Question 14

Indications for surgery in UC

Answer 14

toxic megacolon

Question 15

A serum albumin minus ascitic fluid albumin greater than 1.1 suggests ___________ as a cause for ascites.

Answer 15

portal hypertension alone

Tuberculosis, pancreatitis, and malignancy would cause inflammation and increased capillary permeability, causing protein to leak into the ascitic fluid. This would result in a gradient
between the serum and ascitic fluid of less than 1.1

Question 16

Characteristics of primary sclerosing cholangitis

Answer 16

Classically in middle-aged men with IBD.
Associated with ulcerative colitis.

p-ANCA ⊕.

beads on a string appearance

Question 17

Primary biliary cirrhosis

Answer 17

Classically in middle-aged women.

Anti-mitochondrial antibody ⊕, ↑ IgM

Associated with other autoimmune conditions

Autoimmune reaction–> lymphocytic infiltrate + granulomas –> destruction
of intralobular bile ducts.

Question 18

SIDEROBLASTIC ANEMIA

Answer 18

Anemia due to defective protoporphyrin synthesis

Question 19

________ is a blood cell protein that contains iron and can be an acute inflammatory disorder

Answer 19

Ferritin

↓ ferritin = ↑ TIBC

Question 20

characterized by a large tortuous arteriole most commonly in the stomach wall (submucosal) that erodes and bleeds.

Answer 20

Dieulafoy’s lesion

usually in lesser curvature

Question 21

IV PPI in upper GI bleed

Answer 21

prevents further bleeding (rebleeding or during endoscopy)