Potpourri of Common GI Diseases

Question 1

6 Common risk factors for PUD

Answer 1

H pylori infection
NSAID use
Other drugs (cocaine, meth, glucocorticoids, etc)
Smoking
Alcohol
Stress

Question 2

3 tests for H pylori

Answer 2

Blood test (test for IgG antibodies - but only tells you if you have ever been infected)
Breath test (for urea)
Stool test

Question 3

When is imaging helpful in PUD?

Answer 3

When patients present with complications such as a massive UGI bleed or perforation
Not helpful for epigastric pain/discomfort (you need a scope)

Question 4

What is the first line imaging modality used when there is suspected non-traumatic intra-abdominal pathology

Answer 4

X-ray
Looking for free air from a perforation
Then CT to identify the site of perforation

Question 5

MISO for types of diarrhea

Answer 5

Metabolic (malabsorption, medication)
Infectious (immune, ischemia)
Secretory (structural)
Osmotic

Question 6

4 signs of celiac on histology

Answer 6

Severe villous atrophy
Crypt hyperplasia
Enterocyte disarray
Intense inflammation of the lamina propria and epithelial cell layer

Question 7

What main micronutrient is absorbed in the

1. Duodenum
2. Jejunum
3. Ileum

Answer 7

1. Iron
2. Folate
3. B12

Question 8

Best tool to diagnose celiac

Answer 8

Biopsy
Imaging is not required and may not be helpful
CT can be useful to investigate complications

Question 9

2 examples of complications in celiac

Answer 9

Lymphoma

Intussusception

Question 10

6 characteristics of a high risk phenotype of crohns

Answer 10

Young
Extensive disease
Non-inflammatory
Extra-intestinal manifestation
Active smoker
Steroid use

Question 11

2 pros and 2 cons of imaging for Crohn’s

Answer 11

Pros: characterizing disease (small bowel involvement can distinguish Crohns from UC), identifying complications (obstruction, fistulas)
Cons: not needed for diagnosis, radiation

Question 12

How do you distinguish dilated small bowel from large bowel on X-rays?

Answer 12

Large bowel: haustra (bands stop halfway)

Small bowel: valvulae conniventes (bands go all the way across)

Question 13

Normal diameter of the

1. Small intestine
2. Large intestine
3. Cecum

Answer 13

1. 3 cm
2. 6 cm
3. 9 cm

Question 14

In Crohn’s, CT can identify what 2 things?

Answer 14

Transmural inflammation (predisposes to strictures, fistulas, sinus tracts
Complications (obstruction, abscesses)

Question 15

For fistulizing Crohn’s what 2 medications do you use for

1. Induction of remission
2. Maintenance of remission

Answer 15

1. Steroids and biologics

2. Biologics and immunomodulators (AZA/6MP, MTX)

Question 16

Toxic megacolon

Answer 16

Clinical term for an acute toxic colitis with dilatation of the colon (also called toxic colitis)
Colonic dilatation and signs of systemic toxicity
Fever, tachycardia, leukocytosis, anemia (3 of them)
Any 1 of dehydration, altered mental status, electrolyte abnormality, hypotension

Question 17

Best imaging test for toxic megacolon

Answer 17

CT