NVD

Question 1

How is diarrhea defined?

Answer 1

• 3+ loose or watery stools per 24 hours

Question 2

What is the difference between acute vs chronic?

Answer 2

• acute = 14 days or less

- chronic = >30 days

Question 3

What is the most commonly diagnosed gastrointestinal condition?

Answer 3

• Irritable Bowel Syndrome (IBS)

Question 4

How is IBS characterized?

Answer 4

• chronic abdominal pain with altered bowel habits

Question 5

What are the 3 causes of constipation?

Answer 5

• Antacids
• Opioids
• Iron

Question 6

What are the 4 causes of diarrhea?

Answer 6

• Alcohol
• Augmentin
• Antibiotics
• Lactulose

Question 7

What dietary modifications is recommended in IBS?

Answer 7

• low FODMAPs diet

Question 8

What agent is used as first line therapy for diarrhea?

Answer 8

• Loperamide

Question 9

What is the second line therapy for diarrhea?

Answer 9

• Cholestyramine

Question 10

What is the first line therapy for constipation?

Answer 10

• psyllium (metamucil)

Question 11

What is the second line therapy for constipation?

Answer 11

• osmotic laxatives

* PEG, lactulose, milk of magnesia

Question 12

What are the 4 alarming symptoms that warrant referral for colonoscopy?

Answer 12

• weight loss
• nocturnal symptoms
• unexplained iron deficiency anemia
• family history of selected organic diseases

Question 13

What serum antibody assays are related to Celiac Disease? (2)

Answer 13

• IgA EMA

- IgA/IgG tTG

Question 14

What 2 genes are related to Celiac Disease?

Answer 14

• HLA-DQ2

- HLA-DQ8

Question 15

What is the difference in the diagnostic approach of celiac disease if the patient is gluten free or not?

Answer 15

• consuming gluten = look for IgA tTG + total IgA

- gluten free= perform gluten challenge then look for the assays

Question 16

Prevalence of lactose malabsorption and intolerance is lowest n what population?

Answer 16

• Europeans + White Americans

Question 17

What 4 symptoms are common after ingestion of lactose in a lactose intolerant patient?

Answer 17

• abdominal pain
• bloating
• flatulence
• borborygmi

Question 18

What is the most common test for lactose intolerance?

Answer 18

• Lactose breat hhydrogen test

Question 19

What are the big “pit falls” that needs to be ruled out in a patient that is vomiting?

Answer 19

• SBO

- Pregnancy

Question 20

What anti-emetic increases the risk of tardive dyskinesia?

a. serotonin receptor antagonists (Ondansetron)
b. phenothiazines (prochlorperazine)
c. dopamine antagonist (metoclopramide)

Answer 20

c. dopamine antagonist (metoclopramide)

Question 21

What are the 2 major ions that is lost with vomiting?

Answer 21

• Sodum

- Chloride

Question 22

What are the 2 major ions that is lost with diarrhea?

Answer 22

• Sodium

- Potassium

Question 23

What is the pathophysiology of cannabinoid hyperemesis?

Answer 23

prolonged exposure to cannabinoids inactivates the TRPV1 receptor which results in nausea and emesis

Question 24

What drug therapy is used for cannabinoid hypermesis?

Answer 24

• butyrophenones (haloperidol)

* benzos are second choice

Question 25

What scale is a useful too to evaluate bowel habits in a patient with IBS?

Answer 25

• Bristol stool form scale

Question 26

What drug therapy is indicated for abdominal pain and bloating?

Answer 26

• antispasmodic agents