MKSAP GI I

Question 1

Do you need to hold secondary ppx ASA for a colonoscopy?

Answer 1

No

Question 2

Achalasia vs pseudeoachalasia

Answer 2

Achalasia- issue with nerves, insidious, symptoms progressing over long time

Pseudoachalasia- looks like achalasia but is due to underlying malignancy, symptoms are much more acute (~3 months)

Question 3

What type of diet do you recommend for IBS?

Answer 3

Low FODMAP diet

Fermentable, Oligo-, Di-, Mono-saccharides And Polyols AKA carbs

Question 4

What is esophageal manometry used to diagnose?

Answer 4

Motility disorder (like achalasia)

These usually present as dysphagia to both liquids and solids.

Question 5

What is ambulatory 24-hour pH testing used to diagnose?

Answer 5

GERD that has not responded to medical therapy

Question 6

Symptoms of Zenker diverticulum?

Answer 6

Halitosis, aspiration, burgling in chest, SOLID food dysphagia, regurgitation of undigested food

You diagnose this with barium esophagram.

Question 7

What is hepatopulmonary syndrome?

Answer 7

In people with liver cirrhosis, some patients develop dilation of pulm vasculature at the base of the lungs causing desaturations occur when patient stands

(Diagnosed with ECHO, people normally have unremarkable imaging)

Question 8

Treatment for acalculous cholecystitis

Answer 8

Surgery (cholecystectomy or cholecystostomy tube)

Question 9

What are the three types of colon polyps?

Answer 9

1. hyperplastic (nonneoplastic with no clinical significance)
2. sessile serrated polyps
3. traditional serrated adenomas

Question 10

Who qualifies for 1-year surveillance for colonoscopy?

Answer 10

1. More than 10 adenomas
2. Polyposis syndrome
3. Lynch syndrome

Question 11

Who qualifies for 3-year surveillance for colonoscopy?

Answer 11

1. 3 or more adenomas/sessile polyps
2. one adenoma larger than 10mm size
3. one adenoma with any degree of villous or high-grade dysplasia

Question 12

Who qualifies for 5-year surveillance for colonoscopy?

Answer 12

1. two or few adenomas/sessile polyps

2. 1st degree relative with colon cancer at age <60

Question 13

“Sausage-shaped” pancreas is associated with:

Answer 13

Type 1 autoimmune pancreatitis (frequent manifestation of IgG4 disease)

Treatment: prednisone

Question 14

In patients with end-stage liver disease and portal hypertension, hepatorenal syndrome is characterized by what three things?

Answer 14

1. oliguric kidney failure

2. bland urine sediment, 3. marked sodium retention (edema, ascites, low urinary sodium)

Question 15

Indications for liver transplant

Answer 15

MELD 15 or decompensated cirrhosis