Practice Tests Flashcards
Pouchitis vs ischemic pouchitis appearance
Pouchitis is diffuse erythema, ischemic pouchitis is asymmetric with sharp demarkation
How to treat jackhammer esophagus?
Poem if unresponsive to ca channel blockers?
How can pantoprazole cause diarrhea?
Can cause lymphocytic colitis
Pancreatic solid pseudopapillary neoplasm features
Mixed solid and cystic spaces, seen in young women, in head of pancreas, ultimately need to be removed given malignant potential
Mucinous cystic neoplasm features
Can be seen in younger women, usually in tail, cystic with thick wall, unilocular
Mycophenolate GI side effect?
Colitis and diarrhea
Risk for resecting type 1 carcinoids/
Perforation given thin gastric wall 2/2 atrophic gastritis
Remember the appearance of anal warts on retroflexion
Treat with cryotherapy
What is the time course for acute pancreatic fluid collection or necrosis vs pseudocyst/walled off necrosis?
<4 weeks is acute
How to tell difference between pseudocyst and walled off necrosis?
Walled off necrosis has a discrete wall — has solid necrosis and fluid
Difference between EGJOO and achalasia? Workup?
EGJOO has normal peristalsis but increased IRP. EGJOO with EUS to make sure no malignant obstruction
Varices in upper esophagus in patient with ? lung cancer?
Possible SVC syndrome
How to treat psoriasis 2/2 TNF inhibitor?
Switch agent
How to treat budesonide-refractory microscopic colitis?
Infliximab
EUS appearance of lipoma
Third layer, bright! (GIST, etc are dark)
Appearance of SCA and tx?
Microcystic (honeycomb) with central scar with calcifications. Just needs observation
Cowden syndrome highest cancer risk?
Breast
Serious side effect of tofacitinib?
GI perforation, cardiac issues
TNF inhibitor contraindication?
Heart failure, increases risk of death. TB, untreated HBV
Mutation that is a specific marker for mucinous cysts of the pancreas?
KRAS
Management and surveillance of Barrett’s without dysplasia?
EGD q3y and PPI daily
With low grade or high grade dysplasia, need ablative therapy
Sign of vitamin E deficiency?
Ataxia, falls, hyporeflexia
Sign of vitamin C deficiency?
Petechiae, bleeding gums, impaired wound healing
Sign of Selenium deficiency?
Cardiomyopathy
Critical medication after extensive small bowel resection?
PPI for acid suppression to prevent ulceration with increased gastric acid after resection
Difference between SOD1 (biliary sphincter of oddi stenosis) and SOD2 (functional biliary SOD), how to distinguish, how to treat?
SOD1 = biliary sphincter of oddi stenosis has biliary pain, dilated CBD AND periodically abnormal LFTs.
Treat with biliary sphincterotomy (ensure PD stent is placed and indomethacin given)
SOD2 = functional biliary SOD
May have dilated duct OR periodically abnormal LFTs. If one or the other, then do SO manometry. If <40, then functional pain, if >40 =biliary SO stenosis and go to ERCP.
What causes AIDS cholangiopathy? How does it look on biliary tree? How to treat the abdominal pain?
Caused by organisms like cryptosporidium. Intrahepatic and extra hepatic bile duct strictures and CBD dilation due to papillary stenosis (which distinguishes it from PSC). Treat abdominal pain with sphincterotomy, but mostly just needs HAART
Severe pain after ERCP with precut papillotomy or large sphincterotomy with normal lipase? How to diagnose
Possibly retroperitoneal perforation. Need CT to diagnose (too small to see on XR). Conservative management.
Can be normal after ERCP if no pain.
Severe pain and free air after shortening duodenoscope to short position? Risk factors?
Lateral wall perforation – needs closure and often surgical consult. Risk factors are bilroth II and duodenal stricture
Cardiovascular or neurologic collapse during ERCP without free air on Fluoro?
Suspect air embolism and put patient into trendelenberg.
Large pancreatic tumor with severely elevated lipase and erythema nodosum?
Acinar cell carcinoma of the pancreas.
How to treat metastatic HCC in healthy(ish) patient?
Atezolizumab or bevacizumab is better than sorafenib
