Clinical

Question 1

workup of GERD

Answer 1

empiric trial of PPI

Question 2

alarm symptoms GERD

Answer 2

dysphagia, unintentional weight loss, hematemesis or melena

Question 3

confirm diagnosis of achalasia

Answer 3

manometry

Question 4

sign barium radiography achalasia

Answer 4

bird beak

Question 5

procedure of choice for diagnosis and treatment Mallory-Weiss tear

Answer 5

esophagogastroduodenoscopy

Question 6

testing H pylori

Answer 6

serologic testing is not helpful

fecal antigen and urea breath

Question 7

diagnosis peptic ulcer disease

Answer 7

mucosal break 5mm or larger in stomach or duodenum

Question 8

gold standard diagnosis of PUD

Answer 8

upper endoscopy

Question 9

confirm diagnosis of gastric cancer

Answer 9

upper GI endoscopy

staging on imaging is required

Question 10

treatment early stage gastric cancer

Answer 10

surgery alone

Question 11

locally advanced gastric cancer

Answer 11

surgery and post op chemo

Question 12

common causes small bowel obstruction

Answer 12

previous surgery
inguinal hernia
crohn disease
intestinal malignancy
appendicitis

Question 13

non-operative treatment small bowel obstruction

Answer 13

fluid resuscitation
bowel decompression with NG tube to decompress air/fluid
analgesia (morphine)

Question 14

operative treatment small bowel obstruction-indications

Answer 14

complete SBO
documented peritonitis
evidence of strangulation
patients non-responsive to nonoperative treatment

Question 15

diagnosis celiac disease

Answer 15

positive serologic markers and small-bowel biopsy

Question 16

serologic marker celiac

Answer 16

IgA tissue transglutaminase and endomysial antibodies

perform while still on gluten diet

Question 17

imaging appendicitis

Answer 17

usually diagnosis made clinically

CT or US show dilation >6mm

Question 18

diagnosis IBS

Answer 18

abdominal pain relieved by defecation

Question 19

diagnosis crohns

Answer 19

colonoscopy with ileoscopy and tissue biopsy

Question 20

complications crohns

Answer 20

extraintestinal involvement, intestinal obstruction, abscess formation, sinuses, fistulae

Question 21

diagnosis ulcerative colitis

Answer 21

endoscopy with biopsy and negative stool culture

Question 22

complications ulcerative colitis

Answer 22

toxic megacolon with risk of perforation

adenocarcinoma

Question 23

treatment colon cancer

Answer 23

surgical resection

Question 24

imaging choice acute diverticulosis

Answer 24

CT scan

Question 25

treatment diverticulosis

Answer 25

bowel rest, ABX, surgical intervention

Question 26

complications diverticulosis

Answer 26

bleeding, segmental colitis, perforation, abscess, fistulas, obstruction

Question 27

first line therapy non-alcoholic steatosis

Answer 27

lifestyle modifications

Question 28

diagnostic imaging cholelithiasis

Answer 28

abdominal US

Question 29

treatment symptomatic cholelithiasis

Answer 29

laparoscopic cholecystectomy

Question 30

complications cholelithiasis

Answer 30

cholangitis, cholecystitis, pancreatitis

Question 31

treatment pancreatitis

Answer 31

IV fluids | correct electrolyte abnormalities, analgesia, glucose control

Question 32

hiatal hernia

Answer 32

upper GI series | shows Nissen fundoplication

Question 33

indications for medication

Answer 33

BMI>30 | BMI>27 with obestiy related risk factors or disease

Question 34

orlistat

Answer 34

pancratic and gastric lipase inhibitor | safer for patients with CV, HTN, DM

Question 35

locaserin

Answer 35

5HT2c antagonist can cause serotonin syndrome, neuroleptic malignant syndrome and valvular heart disease safer for patient with HTN and CV

Question 36

phentermine/topiramate

Answer 36

NE/GABA | not for HTN or CV

Question 37

naltrexone/bupropion

Answer 37

opioid antagonist/dopamine NE inhibitor | suicidal warning

Question 38

liraglutide

Answer 38

GLP-1 agonist | medullary thryoid tumors warning

Question 39

continue weight loss medication

Answer 39

>5% reduction of weight at 3 months

Question 40

dietary advice

Answer 40

10% weight loss goal 1-2lb per week reduce calorie 500/day

Question 41

surgical candidates

Answer 41

BMI>35 with comorbidity | BMI>40

Question 42

types of surgeries

Answer 42

lap band vertical sleeve Roux en Y (takes month to recover from dumping) biliary diversion with duodenal switch

Question 43

most effective

Answer 43

Roux en Y and vertical sleeve

Question 44

Vbloc

Answer 44

BMI 40-45 plus comorbidity

Question 45

time of workout to maintain weight

Answer 45

200-300/wk

Question 46

workout

Answer 46

30-60 on most days | >150min/wk