MKSAP GI II

Question 1

When is a cholecystectomy indicated for a gallbladder polyp?

Answer 1

If polyp is > 1cm in size or any size associated with gallstones

Question 2

What are the 2 ways you can check for H pylori eradication?

Answer 2

1. fecal Ag test

2. Urea breath test

Question 3

When do you perform cholecystectomy in patients admitted with gallstone-related complications (i.e. pancreatitis)?

Answer 3

During admission (NOT after)

Question 4

Indications for ERCP in patients with primary sclerosing cholangitis (assoc with ulcerative colitis)?

Answer 4

1. bacterial cholangitis
2. increasing jaundice
3. increasing pruritus
4. dominant stricture on imaging

Question 5

What are red flag symptoms that should prompt a COLONOSCOPY regardless of patient’s age?

Answer 5

Rectal bleeding with iron deficiency anemia, abdominal pain, and weight loss

Question 6

What is Narcotic Bowel Syndrome?

Answer 6

AKA opiate-induced gastrointestinal hyperalgesia = centrally mediated disorder of GI pain characterized by paradoxical increase in abdominal pain with increasing doses of opioids

Question 7

What is Distal Intestinal Obstruction syndrome?

Answer 7

Thickened intestinal contents that completely or partially block the small intestine in patient with cystic fibrosis

Question 8

How do you diagnose irritable bowel syndrome?

Answer 8

1. recurrent abdominal pain/discomfort at least 3 days per month in the last 3 months
2. associated with two or more the following
   - relief with defecation
   - onset assoc with change in frequency of stool
   - onset assoc with change in appearance of stool

Question 9

Are celiac plexus blocks useful in chronic pancreatitis?

Answer 9

No.

Question 10

Sofosbuvir and ledipasvir is treatment for:

Answer 10

hepatitis C

Question 11

How do you treat idiopathic polyarteritis nodosa (fever, arthralgia, vasculitic rash)?

Answer 11

Cyclophosphamide and prednisone

Question 12

How do you treat polyarteritis nodosa from HBV?

Answer 12

entecavir (and if it’s from HCV you use HCV treatment)

Question 13

What kind of feeding system is preferred in patients with acute pancreatitis who are NPO for days? (IV v NG)

Answer 13

Enteral nutrition (NG/J) because it maintains healthy gut mucosal barrier to decrease translocation of bacteria

Question 14

Who qualifies for PRIMARY ppx against SBP?

Answer 14

1. ascitic fluid total protein <1.5
AND
1. sodium <130
2. Cr <1.2
3. BUN>25
4. T bili >3
5. Child-Turcotte-Pugh class B or C