Western Internal Medicine Test #2

Question 1

Main risk factor for gastritis

Answer 1

HP bacteria

Question 2

What medication do you add if a patient has gastritis and anemia?

Answer 2

Vitamin B 12

Question 3

4 types of stomach cancer

Answer 3

Tubular gland cancer
Mucosa gland cancer
Pulpiform cancer
Diffuse cancer

Question 4

What are the two organs spread to from stomach cancer?

Answer 4

Liver and lung

Question 5

Paracancer syndromes?

Answer 5

Periphlebitis, dyspigmentation under axilla, skin color change

Question 6

How is stomach cancer diagnosed?

Answer 6

Gastroscopy, biopsy

Question 7

Main treatment for chronic gastritis

Answer 7

If because of HP bacteria: colloidal bismuth and emoprazole, lansoprazole

If not because of HP bacteria: stop NSAIDS, if bile reflux take hydrotalcite, aluminum hydroxide

Stop drinking alcohol and smoking. Eat fresh vegetables and fruits, less smoked meat and preserved foods.

Question 8

Main cause of cirrhosis in Asia and US?

Answer 8

Asia - hepatitis

US - alcoholism

Question 9

3 signs of portal hypertension

Answer 9

1. Spleen enlargement
2. Collateral circulation build up
3. Ascites

Question 10

Common complication of cirrhosis

Answer 10

HEPATIC COMA

also upper gastric bleeding, infection, hepatorenal syndrome

Question 11

What is the main complication of cirrhosis that causes death

Answer 11

Hepatic coma

Question 12

Hepatitis A transmission

Answer 12

fecal - oral, contaminated food, water, shellfish

Question 13

Hepatitis B transmission

Answer 13

Percutaneous, sexual, perinatal

Question 14

Hepatitis C transmission

Answer 14

Percutaneous, sexual

Question 15

Hepatitis D transmission

Answer 15

Percutaneous, sexual, requires Hep b transmission

Question 16

Hepatitis E transmission

Answer 16

Fecal - oral

Question 17

Which hepatitis types are acute

Answer 17

Hep A, Hep B, Hep C, Hep D, Hep E

Question 18

Which hepatitis types are chronic

Answer 18

Hep B, Hep C

Question 19

Hep A serology

Answer 19

Acute: Anti HAVIgM

Post exposure: Anti-HAVIgG

Question 20

Hep B serology

Answer 20

HBsAG+

Question 21

Hep C serology

Answer 21

HCV RNA

Question 22

Hep D serology

Answer 22

Anti HDV

Question 23

Hep E serology

Answer 23

Anti-HEVIgM

Question 24

Hep A vaccination

Answer 24

Yes

Question 25

Hep B vaccination

Answer 25

Yes

Question 26

Hep C vaccination

Answer 26

No

Question 27

Hep D vaccination

Answer 27

immunize against Hep B

Question 28

Hep E vaccination

Answer 28

No

Question 29

Typical body sign of cirrhosis

Answer 29

The liver is hard and large upon palpation

Question 30

What kind of medication can cause stomach cancer/ulcer?

Answer 30

NSAIDS

Question 31

What is the routine test for stomach cancer/ulcer?

Answer 31

HP bacteria

Question 32

Lab test to diagnose Duodenal ulcer

Answer 32

Stool is mucussy and bloody, colonoscopy | More pain after eating

Question 33

Main risk factor of HCC (liver cancer)?

Answer 33

Cirrhosis (hep B infection, aflatoxin)

Question 34

Which organs spread to by liver cancer?

Answer 34

Lung

Question 35

Reliable features of angina

Answer 35

left chest sharp and fixed pain that radiates

Question 36

Reliable features of gastric pain

Answer 36

Dull constant upper abdominal pain

Question 37

Reliable features of liver pain

Answer 37

Right lower abdominal pain

Question 38

Reliable features of kidney pain

Answer 38

Severe waxing and waning pain radiating from the back to the front

Question 39

Reliable features of gallbladder pain

Answer 39

Murphy's syndrome

Question 40

Reliable features of pancreatic pain

Answer 40

belt like pain

Question 41

Reliable features of appendix pain

Answer 41

McBurney's syndrome

Question 42

Which abdominal pain is relieved with vomiting?

Answer 42

Gastric obstruction

Question 43

Which abdominal pain is not relieved with vomiting?

Answer 43

Angina?

Question 44

Case study gastric pain/gastritis

Answer 44

Upper abdomen irregular distending pain for 3 years, usually happens after improper diet, sometimes with acid reflux, belching, ECG is negative. Diagnosis: gastroscope, biopsy, HP breath test Treatment: stop NSAIDS, no alcohol or smoking

Question 45

Case study stomach cancer

Answer 45

Upper abdomen discomfort, no appetite, weight loss for one month Lab test: gastroscope Treatment: surgery, chemotherapy

Question 46

Case study duodenal ulcer

Answer 46

Recurrent upper abdominal pain, gets worse when hungry, relieved after food, the pain gets worse after food then vomits, distending pain reduced. Mild dehydration, upper abdomen water sound DU with pyloric obstruct Lab tests: stool test, colonoscopy Diagnosis: colonoscopy Differentiation: can find bacteria in the stool, chron's disease does not have blood in the stool, IBS has no blood in the stool

Question 47

Case study HCC/liver cancer

Answer 47

Right upper abdomen distending pain getting worse and worse, spider agonise on the face, right upper abdomen pressing pain, emaciation, the liver feels large and hard to touch Lab test: AFP, ultrasound, CT scan, x ray Differentiate: cirrhosis, liver disease/hepatitis, liver abscess Treatment: surgery, chemo, radiation

Question 48

Symptoms of cirrhosis decomposition

Answer 48

``` Liver function decline Jaundice Anemia/bleeding Female hormones increase, male decreasee Liver pain Spider angioma Spleen enlargement ```