Gastro

Question 1

Secondary causes of GERD

Answer 1

Hiatal hernia
Zollinger Ellison Syndrome(Gastrinoma)

Question 2

Exacerbating factors of GERD

Answer 2

Obesity
Lying down after sleep
Coffee
Alcohol
Smoking
Spicy food?

Question 3

Triple therapy for H pylori

Answer 3

PPI,Clarythromycin, amoxicillin or metronidazole

Question 4

Triad of SBP

Answer 4

Fever, abdominal pain and increasing ascites

Question 5

Tests for synthetic function of liver

Answer 5

1) PT/PTT most important
2) Albumin
3) Bilirubin
4) Glucose

Question 6

VAGIND acronym for common transaminitis causes

Answer 6

Viral
Alcohol
Gallstones
Ischemia
NASH
DILI(Usually paracet)

Question 7

alcoholic and ischemic pattern of transaminitis

Answer 7

AST>ALT

Question 8

Triad of liver failure

Answer 8

Coagulopathy, Jaundice and encephalopathy

Question 9

Mx of bleeding PUD

Answer 9

IV esomeprazole
Metoclopramide
OGD for clipping
Antibiotics

Question 10

Mx of bleeding esophageal varices

Answer 10

IV esomeprazole
Octreotide
Abx: IV Roc
Fluid resus
PCT if indicated
+-OGD
+-Sengstaken blakemore/minnesota tube

Question 11

RFs for bleeding PUD

Answer 11

H Pylori
NSAIDs
Anti platelet/coagulation

Question 12

Classification system for peptic ulcers

Answer 12

Forrest

Question 13

When to give IV PPI for PUD

Answer 13

Adherent clot or active bleed/ooze. Clean base can give PO instead

Question 14

Most common causes of LBGIT

Answer 14

1. Cancer
2. Diverticulitis
3. IBD
4. AVMs
5. Hemorrhoids

Question 14

Impt cause to rule out in significant hematochezia

Answer 14

Massive UBGIT

Question 14

Triad of Budd Chiari syndrome

Answer 14

Abdominal pain, ascites and heaptomegaly

Question 15

Highest cause of mortality in esophageal varices

Answer 15

Infection: MUST give ceftriaxone on top of octreotide and esomeprazole

Question 16

Investigation and appearance of achalasia

Answer 16

Video fluoroscopy showing birds beak appearance

Question 17

Investigation of choice for diffuse esophageal spasm

Answer 17

Esophageal manometry

Question 18

Appearance of diffuse esophageal spasm on barium swallow

Answer 18

Corkscrew esophagus

Question 19

max doses of spironolactone and furosemide for ascites

Answer 19

400mg and 160mg

Question 20

Triad of acute liver failure

Answer 20

Jaundice. coagulopathy and hepatic encephalopathy

Jaundice and coag alone is liver impairment

Question 21

Scoring system for hepatic encephalopathy

Answer 21

Westhaven score

Question 22

Cause of HCC without liver cirrhosis

Answer 22

Hep B

Question 23

Test for Clostridiodes Difficile associated diarrhea

Answer 23

Stool C diff toxin

Question 24

Best test as indicator of hepatic injury

Answer 24

Coagulopathy: PT/PTT

Question 25

Causes of thrombocytopenia in cirrhosis

Answer 25

1. Splenic sequestration 2. Reduced TPO

Question 26

Drug for treatment of Wilson's disease

Answer 26

Chelating agents eg penicillamine, trientine, zinc salts

Question 27

What does MELD score stand for

Answer 27

Model for End stage Liver Disease

Question 28

Gold standard for dx of esophageal cupture

Answer 28

Contrast esophagography -ideally use gastrogriffin, barium can cause mediasitinitis

Question 29

Ideal iron chelating agent for hemochromatosis

Answer 29

Deferoxamine

Question 30

Mainstay of treatment of primary hemochromatosis

Answer 30

Therapeutic phlebotomy

Question 31

What is Mackler's triad

Answer 31

Triad of Chest Pain, Vomiting and pneumomediastinum suggesting Boerhaave syndrome(esophageal rupture)

Question 32

Why Hep B causes de novo HCC

Answer 32

Integrates into human DNA as it is a DNA virus

Question 33

Indications for liver transplant

Answer 33

1. HCC 2. Acute Liver Failure( DILI vs non-DILI) 3. Acute on Chronic LF 4. End Stage Liver Disease

Question 34

Suspicious features on US Breast

Answer 34

Mass Microcalcifications - Linear and segmented distribution likely malignant - Microcalcz worse than macro Asymmetry Distortion of architecture Nipple retraction