Gastero Intestinal system

Question 1

what is the Anatomical Landmark that differentiate B/w upper GI Bleed And Lower GI bleed?

Answer 1

ligament of TREITZ (duodenojejunal flexure)

Question 2

what is the source of Bleeding in Duodenal ulcer?

Answer 2

Gastero duodenal artery

Question 3

what is the source of bleeding in Gastric ulcer?

Answer 3

Left gastric artery

Question 4

what is the leading cause of Hematemesis?

Answer 4

Peptic ulcer disease

Question 5

what are the 2 types of Peptic ulcers?

Answer 5

Gastric ulcer
Duodenal ulcer

Question 6

what is the most common site of Gastric ulcer?

Answer 6

Lesser curvature

Question 7

How will the patient of peptic ulcer bleed present?

Answer 7

Crashing blood pressure

Question 8

what are the steps in managing a case of Crashing Blood pressure? (Peptic ulcer bleed)

Answer 8

Grey IV cannula insertion (orange ideally)
fluid bolus
massive Transfusion Protocol
Hemodynamic Stability achieved

upper GI Endoscopy + cautery

Question 9

what are the Drugs that causes Drug induced gastritis?

Answer 9

Cox-1inhibitors

Indomethacin, ketorolac

Question 10

what type of gastritis is seen in Drug induced gastritis?

Answer 10

Erosive gastritis

non erosive gastritis caused by H. pylori

Question 11

A patient is presented with Cheif compliant of Hematemesis and on examinationHe had splenomegaly

what is the provisional diagnosis?

Answer 11

Portal Hypertension

If patient of Pediatric age group presents with similar compliants

we must have to Think about EXTRA HEPATIC PORTAL VEIN OBSTRUCTION (EHPVO)

Question 12

what is source of Bleeding in Hematemesis due to Portal Hypertension?

Answer 12

Esophageal collaterals with gastric veins (coronary veins)

Question 13

what is the leading cause of Portal Hypertension?

Answer 13

Alcholic cirrhosis

Question 14

what is most common cause for Liver damage in patient with History of No viral markers non alcholic & Non metabolic cause?

Answer 14

Cryptogenic cirrhosis / Non-Cirrhotic Portal fibrosis

Question 15

what is drug used in managing non-bleeding esophageal varices?

Answer 15

propranlol

propranolol uses

-non bleeding oesophageal varices
- Prophalaxis of migrane
- Hypertrophic cardiomyoPathy

Question 16

what Drug is used in managing Bleeding oesophageal varices?

Answer 16

Infusion of octreotide > Terlipressin

Question 17

what is treatment of choice in Hematemesas due to Portal Hypertension?

Answer 17

upper GI Endoscopy + Sclerotherapy

Question 18

what is the most primary site of tear Mallory weiss syndrome?

Answer 18

Lower oesophageal sphincter (strats from cardio part of stomach and goes to Lower esophageal spincter)

Question 19

what types of stains are used to demonstrate Helico bacter pylori ?

Answer 19

warthin starry stain
Steiner Stain

Question 20

what type of gastritis is seen in PUD Due to Helicobacter Pylori infection?

Answer 20

Type B Gastritis

Question 21

what Triple therapy in managing PUD due to H.pylori infection?

Answer 21

Proton Pump Inhibitors for 4-6 weeks
Clarithromycin & Amoxicillin for 2 weeks

Question 22

what is quadruple therapy in PUD management Due to H- pylori infection?

Answer 22

Proto Pump Inhibitors
tetracyclines
metronidazole
Bismuth ( Reduces the acid mucosa contact time by acting as surface Protective agent & Helps in Healing of ulcers

Blaksh Discloration of tongue is seen )

Question 23

what is Hybrid therapy in managing PUD Due to Helico bacter pylori ?

Answer 23

Proton Pump Inhibitors & Amoxicillin for 7 days

Proton pump Inhibitors & Amoxicillin & clarithromycin & Nitroimidazole for 7 days

Question 24

what is Load therapy used in management of PUD Due to H-Pylori Infection?

Answer 24

Levofloxacin & omeprazole & Alina (Nitazoxanide) & Doxycycline

Question 25

True / flase : Erythromycin & Amoxicillin & PPI are used in Triple therapy against H. pylori infection

Answer 25

false ## foot note Erythromycin is not effective against H.pylori. PPI & Amoxicillin &clarithromycin are used in Triple therapy against H.Pylori

Question 26

True/false :-Helico bacter pylori cannot be eradicated As it is sporforming bacteria

Answer 26

false ## Helico batter pylori can be eradicated as it's a non-spore forming Bacteria

Question 28

what are the most common sites in which Extracelluar Helico bacter pylori is seen in the stomach?

Answer 28

Antrum and corpus ## Acid load is relatively lesser in those areas