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GI > Week 3 review session > Flashcards

Week 3 review session Flashcards

1
Q

Which of the following is most likely if a
patient has GERD and dysphagia to both
liquids and solids?

a. scleroderma
b. achalasia
c. cancer

A

a. scleroderma - LES weakened

Achalasia is when LES fails to relax

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2
Q

Which of the following is most likely if a
patient has dysphagia to solids only and
reports a history of chronic GERD?

a. esophageal stricture
b. Zenker’s diverticulum
c. esophageal web

A

a. esophageal stricture

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3
Q

What are the triad of symptoms for Zenker’s diverticulum?

A

Dysphagia
Halitosis
Aspiration

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4
Q

Of the following esophageal obstructive
conditions, which is most likely to present with only intermittent dysphagia?

a. stricture
b. rings
c. tumor

A

b. rings

Strictures do get bigger.
Rings typically don’t get bigger in size.

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5
Q

True or False. Stroke is the most common
cause of oropharyngeal dysphagia.

a. True
b. False

A

a. True

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6
Q

What are the 4 most common issues that cause difficulty initiating swallowing

A

Stroke
Neurologic disease
Pharyngitis
SOL of neck/throat

Separately, neck issues: cervical arthritis/DISH* or whiplash

*diffuse idiopathic skeletal hyperostosis

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7
Q

Which of the following is NOT a main symptom of uncomplicated GERD?

a. regurgitation
b. nausea
c. heartburn

A

b. nausea

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8
Q

Which of these conditions is NOT associated with globus hystericus?

a. neck mass
b. anxiety disorder
c. GERD

A

a. neck mass

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9
Q

What is the most common cause of GERD?

a. excessive LES relaxation
b. hiatal hernia
c. gastric distinction
d. disruption of esophageal peristalsis
e. gastric hypersecretion

A

a. excessive LES relaxation - up to 90% of cases

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10
Q

Your patient complains of regurgitation of food, heartburn, and dysphagia. Which of the following is the recommended next step?

a. make the diagnosis of GERD clinically based on the classic symptoms being present
b. refer to a GI specialist for an endoscopy
c. order H. pylori testing

A

b. refer to a GI specialist for an endoscopy

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11
Q

What are the atypical GERD symptoms?

A 
Chest pain
Chronic cough
Dysphagia
Chronic sore/burning throat
Hoarseness
Globes sensation
Belching
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12
Q

What is the first line medication
recommended to treat GERD?

a. H2 blockers
b. Proton Pump Inhibitors (PPIs)
c. Beta-blockers

A

b. Proton Pump Inhibitors (PPIs)

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13
Q

Which of the following fulfills the recommendations for an initial management plan using a PPI to treat GERD?

a. twice daily for 4 weeks
b. once daily 8 weeks
c. take as needed only for 12 weeks
d. once daily indefinitely

A

b. once daily 8 weeks

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14
Q

When should a PPI be given ideally?

a. before eating
b. after eating
c. it doesn’t matter

A

a. before eating - 30-60 minutes

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15
Q

Functional dyspepsia is considered a(n):

a. Organic disease
b. Non-organic condition

A

b. Non-organic condition

Non-organic or “functional” disorder = no physical abnormality found to explain the condition

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16
Q

What percentage of cases of dyspepsia are due to functional dyspepsia?

a. 10-20%
b. 30-40%
c. 50-60%
d. 70-80%

A

c. 50-60%

Most people have no physical abnormality

17
Q

How long do symptoms need to be present for
a diagnosis of functional dyspepsia?

a. no specific length of time
b. at least 3 weeks
c. less than 3 months
d. at least 3 months

A

d. at least 3 months

18
Q

What is the Rome III criteria?

A 
1. One or more of the following symptoms: 
• Epigastric abdominal pain
• Epigastric burning 
• Early satiety 
• Bothersome post-prandial fullness

AND

  1. Symptoms present for ≥ 3 months

AND

  1. No evidence of organic disease
19
Q

If a patient with dyspepsia is over 45-years-
old, has a family history of gastrointestinal
malignancy, or reports alarm symptoms, what
test should be ordered?

a. abdominal x-ray
b. abdominal ultrasound
c. EGD
d. manometry

A

c. EGD

20
Q

Which of the following is true of a peptic ulcer?

a. diameter must be greater >5mm
b. diameter must be smaller <5mm

A

a. diameter must be greater >5mm

21
Q

Which are more common, gastric or duodenal ulcers?

a. gastric
b. duodenal

A

b. duodenal

> 95% duodenal ulcers occur in the first portion of the duodenum

22
Q

Which is more common, gastric cancer or duodenal cancer?

a. gastric
b. duodenal

A

a. gastric ?????

23
Q

When a patient reports increased pain with eating, which is more likely?

a. gastric ulcer
b. duodenal ulcer

A

a. gastric ulcer

Gastric ulcers pain made worse with eating.

Duodenal ulcers frequently relieved by antacids or food. Pain occurs 1.5-3 hours after a meal and pain may wake the patient from sleep.

24
Q

If free air is found under the diaphragm on chest or abdominal x-ray, what condition does this suggest?

a. functional dyspepsia
b. peptic ulcer perforation
c. gastric cancer

A

b. peptic ulcer perforation

GI (11 decks)

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