ch3-GI

Question 1

at what age does colorectal screening begin

Answer 1

50

Question 2

what is the most common site of spread of colorectal cancer

Answer 2

liver

Question 3

what are some common characteristics of Gardner’s syndrome

Answer 3

polyps plus osteomas, dental abnormalities, benign soft tissue tumors, demoed tumors, sebaceous cysts

Question 4

what is the most common cause of large bowel obstruction in adults

Answer 4

colorectal cancer

Question 5

what type of adenomatous polyp has the greatest risk of malignancy

Answer 5

adenomatous polyps

Question 6

what is the most common site of diverticulosis

Answer 6

sigmoid colon

Question 7

what is the test of choice for diverticulosis

Answer 7

barium enema

Question 8

what is the diagnostic test of choice for diverticulitis

Answer 8

CT scan

Question 9

what are some common signs of intestinal infarction

Answer 9

hypotension, tachypnea, lactic acidosis, fever and AMS

Question 10

what is the classic presentation of acute mesenteric ischemia

Answer 10

acute onset of severe abdominal pain disproportionate to physical findings

Question 11

what is the definitive diagnostic test for acute mesenteric ischemia

Answer 11

mesenteric angiography

Question 12

what are the clinical features of hepatorenal syndrome

Answer 12

azotemia, oliguria, hyponatremia, hypotension, low urine sodium

Question 13

what is the most common etiologic agent that causes spontaneous bacterial peritonitis

Answer 13

E.coli

Question 14

what is the common medication treatment or Wilsons disease

Answer 14

D-penicillamine

Question 15

what is the most common benign liver tumor

Answer 15

Cavernous hemangiomas

Question 16

what is the liver disease caused by occlusion of hepatic venous outflow, which leads to hepatic congestion and subsequent microvascular ischemia

Answer 16

budd-chiari syndrome

Question 17

what are the clinical features associated with budd-chiari syndrome

Answer 17

hepatomegaly, ascites, abdominal pain (RUQ), jaundice, variceal bleeding

Question 18

how do you diagnose budd-chiari syndrome

Answer 18

hepatic venography; serum ascites albumin gradient > 1.1 g/dL

Question 19

what are 3 major causes of jaundice

Answer 19

hemolysis liver disease, biliary obstruction

Question 20

what type of hyperbilirubinemia should be suspected with dark urine and pale stools

Answer 20

conjugated

Question 21

what lab is often used to confirm that the ALK-P elevation is hepatic in origin

Answer 21

GGT

Question 22

what are common scenarios where albumin is decreased

Answer 22

chronic liver disease, nephrotic syndrome, malnutrition, and inflammatory states

Question 23

what is the gold standard test for choledocholithiasis

Answer 23

ERCP

Question 24

what is charcots triad and what is it associated with

Answer 24

cholangitis; RUQ pain, jaundice and fever

Question 25

what should you think of in someone with liver disease who is also pruritic

Answer 25

primary biliary cirrhosis

Question 26

what is the best noninvasive test for choledochal cysts and what is the best definitive for diagnosis

Answer 26

US for non-invasive; ERCP for definitive

Question 27

how is biliary dyskinesia diagnosed

Answer 27

HIDA scan

Question 28

what is the most common site for carcinoid tumors

Answer 28

appendix

Question 29

what is the hypocalcemia seen in acute pancreatitis due to

Answer 29

fat saponification (fat necrosis binds calcium)

Question 30

what pain medications are preferred with acute pancreatitis

Answer 30

fentanyl or meperidine

Question 31

what is the most sensitive test for pancreatic cancer

Answer 31

ERCP

Question 32

what should you always ask patients with GI bleeding

Answer 32

if they take any NSAIDS/aspirin, clopidogrel, or anticoagulants

Question 33

where is the bleeding likely coming from if they have bright red blood in stool

Answer 33

lower GI source (left colon or rectum)

Question 34

what is the diagnostic test that should be ordered for evaluation of upper GI bleed

Answer 34

upper endoscopy

Question 35

what is the most common symptom of esophageal cancer

Answer 35

dysphagia

Question 36

what is the absolute criteria for diagnosis of achalasia

Answer 36

incomplete relaxation of LES, peristalsis of esophagus

Question 37

how is diffuse esophageal spasm diagnosed

Answer 37

esophageal manometry

Question 38

what are clinical features associated with esophageal diverticula

Answer 38

dysphagia, regurgitation, halitosis, weight loss, chronic cough

Question 39

what will be sign on imaging with perforation due to PUD

Answer 39

free air under diaphragm in upright Chest Xray

Question 40

what is the clinical presentation of small bowel obstruction (proximal)

Answer 40

frequent vomiting, severe pain, minimal abdominal distention

Question 41

what is the clinical presentation of small bowel obstruction (distal)

Answer 41

less frequent vomiting and significant abdominal distention

Question 42

what is the most common extra intestinal manifestation of IBD

Answer 42

arthritis

Question 43

does ulcerative colitis or crohns disease have skip lesions

Answer 43

crohns disease