GI 3

Question 1

suspect pancreatic adenocarcinoma. workup?

Answer 1

if jaundice, do US (b/c at head)

if no jaundice, do CT (b/c at tail)

Question 2

multiple liver lesions. next step?

Answer 2

colonoscopy

Question 3

biggest modifiable risk factor for pancreatic cancer

Answer 3

smoking

Question 4

alcoholic hepatitis labs other than AST and ALT

Answer 4

incr GGT
incr bilirubin
incr INR

Question 5

features of PBC

Answer 5

pos AMA
jaundice
hepatomegaly
steatorrhea
hyperlipidemia 
thyroid disease

Question 6

anti smooth muscle Ab

Answer 6

autoimmune hepatitis

Question 7

dx and tx of carcinoid

Answer 7

5-HIAA

octreotide, surgery for liver mets

Question 8

indications for TIPS

Answer 8

portal hypertension (variceal hemorrhage, ascites)
hepatorenal syndrome

Question 9

management of hepatic encephalopathy

Answer 9

tx volume depletion and electrolyte abnormalities (like hypokalemia)
lactulose, lactitol
rifaximin

Question 10

small intestinal bacterial overgrowth

• sxs
• associations

Answer 10

flatulence
bloating
diarrhea

anatomical abnormalities (surgery, strictures)
motility disorders (DM, scleroderma)

Question 11

causes of positive urine bilirubin

Answer 11

hepatic dysfunction
biliary obstruction
defective hepatic bilirubin secretion

(buildup of conjugated bilirubin leaks into urine)

Question 12

causes of positive urine urobilinogen

Answer 12

excess hemolysis

normally urobilinogen in feces, and 1% in urine.. but excess hemolysis overcomes that ability

Question 13

ursodeoxycholic acid used to treat

Answer 13

cholesterol gallstones in people not surgical candidates

PBC and PSC