Liver & GI

Question 1

Portal HTN is a gradient of more than ____ becoming clinically significant in excess of ____

Answer 1

6 mmHg; 10 mmHg

Question 2

What can be used as a test of the synthetic function of the liver?

Answer 2

INR

Question 3

Signs and symptoms of acute cholecystitis:

Answer 3

abdominal pain w/ RUQ tenderness, N/V, & fever

Question 4

Mode of transmission for Hep A

Answer 4

fecal-oral, sewage-contaminated shellfish

Question 5

Mode of transmission for Hep B

Answer 5

Percutaneous & sexual

Question 6

Mode of transmission for Hep C

Answer 6

Percutaneous

Question 7

Patients with _____ are at a high risk of developing spontaneous bacterial peritonitis. this has a very high ________

Answer 7

Ascites; morbidity & mortality

Question 8

a procedure performed in interventional radiology in which a shunt is placed b/w the hepatic & portal veins

Answer 8

TIPS (transjugular intrahepatic portosystemic shunt)

Question 9

a symptom described as burning or discomfort behind the sternum, possibly radiating to the neck

Answer 9

Heartburn

Question 10

the effortless return of gastric contents into the pharynx w/o the nausea or retching that would be experienced w/ vomiting

Answer 10

Regurgitation

Question 11

How can the diagnosis of achalasia be made? what is the classic appearance?

Answer 11

Esophagram; “bird’s beak”

Question 12

what type of induction for. achalasia?

Answer 12

RSI

Question 13

Esophagram shows a “corkscrew esophagus” or a “rosary bead esophagus”

Answer 13

Distal Esophageal Spasm (DES)

Question 14

What should you do with Zenker’s diverticulum

Answer 14

head of bed up for induction without cricoid pressure and no NG tube

Question 15

Therapy for GERD:

Answer 15

lifestyle modifications (avoid foods that reduce LES tone);
pharmacologic measures (inhibit gastric acid secretions PPI & H2 antagonists);
Surgical options (lap Nissen fundoplication)

Question 16

burning epigastric pain exacerbated by fasting and improved with meal consumption

Answer 16

peptic ulcer disease

Question 17

Tx for H. pylori

Answer 17

H2 receptor antagonist and abxs for 4-6 weeks

Question 18

Tx for ulcerative colitis

Answer 18

5-ASA is mainstay for mild to mod, can add glucocorticoids

Question 19

2 most common signs and symptoms of carcinoid syndrome

Answer 19

flushing and diarrhea (w/ associated dehydration and electrolyte abnormalities)

Question 20

What drugs should be avoided with carcinoid syndrome?

Answer 20

Succinylcholine, Epi, NorEpi, & Dopamine

Question 21

What drug should be given in carcinoid syndrome to prevent crisis?

Answer 21

Octreotide 24-48 hrs before surgery