second-MKSAP Flashcards
First-line treatment for esophageal hypomotility disorder
Lifestyle changes, eating upright, consuming liquid/Semiliquid >solid diet
+
PPI
meds/conditions that could be the causes of esophageal hypomotility disorder
Anticholinergics
Smooth muscle relaxants
Estrogen/progesterone/Pregnancy
Scleroderma
___Disease suspicion is a good time to do barium esophagram
If suspecting motility issue or proximal lesion likely Zenker diverticulum
Dysphagia occurs with food solid-Only, suggests___Disorder
Mechanical Obstruction
Dysphagia that occurs with liquids alone or liquids and solids, suggests___Disorder
Motility disorder
Esophageal motility study should be done if you see clinical signs of___and are suspicious of___disorder
Dysphagia with solids and liquids
Motility Disorder suspected
Patient has a history of GERD, has some issues with dysphagia, some red flag signs exist like weight loss or anemia, what is the next diagnostic step?
EGD with biopsy
Patient who has some bleed after getting a colonoscopy polyp removal, is on Eliquis, in addition to holding Eliquis what should you do next?
Vitals are stable, hemoglobin 9
Nothing further, just monitor
Do not give Andexxat alfa or PCC
3-year follow-up colonoscopy is warranted for these kinds of polyps
- > 10 mm adenoma
- 5-10 mm tubular adenomas <10 mm
- Any adenoma with tubulovillous or villous histology Or high-grade dysplasia
7 to 10-year Colonoscopy follow-up is warranted for these kinds of polyps
1-2 small <10 mm tubular adenomas
What are the symptoms of chronic mesenteric ischemia?
Epigastric abdominal pain 30 minutes after food ingestion
Repeat upper endoscopy for a gastric ulcer should be done for___type of ulcer or in situation such as ____ symptom
Suspicious of malignant ulcer-Otherwise routine upper endoscopy for gastric ulcer is not recommended
Continuation of symptoms despite PPI or other therapy
- What is the treatment for autoimmune hepatitis? And what is the duration?
treatment with immunosuppression combined with prednisone and immunomodulator-azathioprine
Duration of 2 to 3 years because it has a high rate of relapse
- ___Is most likely diagnosis if you have symptoms of abrupt onset lower abdominal discomfort/cramping, followed by hematochezia within 24 hours
Colonic ischemia
- Acute diverticulitis present with rectal bleed?
No according to MKSAP
- Colicky lower abdominal pain, think___diagnosis
Acute diverticulitis
- Patient comes with abdominal pain, there is thickening of “watershed” areas of the colon, think___diagnosis
Ischemic colitis/colonic ischemia
- When the histological finding of colon shows crypt architectural distortion, think___diagnosis
Ulcerative colitis
- This medication___is a good option for mild to moderate ulcerative colitis whereas___medication is better for moderate to severe ulcerative colitis
5-amino salicylate
Glucocorticoid for severe
- Patient has a mild UC flareup, and it is mostly located near the rectum/descending colon area, should you give them p.o. or topical/suppository 5-aminosalicylate?
Give them the topical suppository unless patient refuses then give p.o.
