Oral Exam

Question 1

Radiographic features of Crohn’s disease

Answer 1

Thumb printing due to presence of skip lesions

String sign due to thickening of intestinal wall

Ulcers,fistulas, fissures

Question 2

Indications for surgery in Crohn’s

Answer 2

Intestinal obstruction

Symptomatic fistulas

Disabling perianal disease

GI perforation

GI abscess

Intestinal hemorrhage

Intestinal carcinoma

Question 3

Radiographic features of ulcerative colitis

Answer 3

Loss of Haustra/ lead pipe

Pseudopolyposis

Question 4

Indications for surgery in ulcerative colitis

Answer 4

Toxic megacolon

Intestinal obstruction

Hemorrhage

Perforation

Colorectal carcinoma

Question 5

Pancreatitis etiology

Answer 5

Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting
Hyperlipidemia, HYPERCALCEMIA
Idiopathic
Drugs

Question 6

Ranson’s criteria

Answer 6

At admission:

Age > 55

WBC > 16,000

️Glucose > 200 mg/100ml

LDH > 350

SGOT > 250

48 hours after admission:

Hcrt > 10 point decrease

BUN > 5mg/100ml increase

Calcium < 8

pO2 < 60 mmHg on room air

Base excess > 4 meq/l

Estimated fluid sequestration > 6 L

Question 7

Complications from pancreatitis

Answer 7

Pseudo yet

Pancreatic ascites

Hemorrhage

Necrosis

Abscess

ARDS

Splenic vein thrombosis

GI tract obstruction

Question 8

Etiologies of bowel obstruction

Answer 8

Adhesions

Hernia

Carcinoma

Volvulusp

Question 9

Poor prognostic factors on physical exam for Breast cancer

Answer 9

Edema of skin a Breast

Skin ulceration

Tumor fixed to chest wall

Massive axillary lymph node enlargement

Supraclavicular lymph node

Satellite skin nodules

Arm edema

Inflammatory carcinoma

Size

Color change

Question 10

MCCo Breast cancer

Answer 10

Ductal carcinoma in situ

Tx: Lumpectomy with radiation or simple mastectomy

⭐️DO NOT WORRY ABOUT AXILLARY NODES

Question 11

DD of epigastric pain

Answer 11

PUD

GERD

Gastritis

Cholelithiasis

Ischemic heart disease

Pancreatitis

Question 12

Diagnostic procedure to determine if blood is proximal to ligament of Treitz

Answer 12

Ng tube can show reflux of blood

Also scoping

Question 13

Duodenal ulcer complications

Answer 13

️Bleeding

Perforation

Outlet obstruction

Intractability

Question 14

Preop evals

Answer 14

Cardiac: Past mi, meds, chest pain, ARF, arrhythmia, CHF, murmur, HTN

Pulm: Smoking, asthma, obesity, COPD, cough, occupational lung probs, exertion all dyspnea

Endocrine: DM, thyroid disease, liver dysfnxn, adrenal insufficiency, malnutrition

Renal: HTN, edema, stones, DM

️Bleeding: Anticoags, alcohol use, malnutrition

Question 15

Lab abnormalities with bowel obstruction

Answer 15

Leukocytosis

Hemoconcentration

Hyponatremia

Hypokalemia

Increased BuN, creatinine, and urine SG

Question 16

Radiographic studies with bowel obstruction

Answer 16

Abdominal CT and CXR

Question 17

Patient with sudden and severe abdominal pain and absent bowel sounds

Answer 17

Think a perforation, possible of an ulcer

Question 18

Barium enema findings in Crohn’s disease

Answer 18

Thickened ️terminal ileum with reflux

Question 19

Causes of upper GI bleed

Answer 19

Gastritis

Duodenal ulcers

Gastric ulcers

Mallory Weiss

Hemophilia

Esophagitis

Varices

Tumor

Question 20

Signs of perforated peptic ulcer

Answer 20

Sudden onset of severe abdominal pain

Abdominal rigidity

Absent bowel sounds

Question 21

Treatments for epigastric pain

Answer 21

PPIs, H2 blockers,Sucralfate, antacids, lifestyle modifications