Gastro

Question 1

chances of cancer with Barret

Answer 1

0.5%

Question 2

Chances of cancer in gastric ulcer

Answer 2

4%

Question 3

Multiple gastric ulcers upon PPI and been off NSAIDs with neg testing for H.pylory

Answer 3

rule out Zollinger Ellison syndrome

Question 4

ZES confirmation test

Answer 4

Secretin suppression test

Elevated Gastrin despite secretin

Question 5

High Calcium + Gastrinoma

Answer 5

Look for MEN

Why

Question 6

First test for Gastrinoma

Answer 6

Gastrin level off PPI

Question 7

Gastrinoma staging test

Answer 7

EUS

Nuclear somatostatin scan

Question 8

What test distinguishes between anemia of chronic disease and malabsorption
with both iron and vitamin B12/folate deficiency?

Answer 8

Red cell blood distribution width (RDW)

Question 9

Ulcerative colitis AB

Answer 9

UC is ANCA positive/ASCA negative.

Question 10

best initial test for the presence of fat in stool?

Answer 10

Sudan black stain

Question 11

site of absorption of all divalent cations such as calcium, magnesium, and iron.

Answer 11

Duodenum

Question 12

+ Ab in Celiacs Disease

Answer 12

Antitissue transglutaminase
Antiendomysial antibodies
Antigliadin antibodies

Question 13

Joint pain in hemochromatosis

Answer 13

calcium pyrophosphate deposition of pseudogout

Question 14

Causes of death in people with hemochromatosis

Answer 14

Cirrhosis: 60%
Hepatoma: 20%
Cardiac failure: 15%

Question 15

most common cause of deaths from pancreatitis

Answer 15

inadequate fluid resuscitation.

Question 16

More than 30% Necrosis of Pancreas

Answer 16

Antibiotics and Needle Biopsy Infected Necrotic

Question 17

Endoscopy indications on GERD

Answer 17

• More than 5 years with symptoms
• Weight loss
• Anemia
• Positive FOB

Question 18

Epigastric pain in adults >45

Answer 18

Do endoscopy

Question 19

When do we treat H.pylori?

Answer 19

-Only when associated with Gastritis,MALt or Ulcer. There is no benefit in treating Helicobacter for GERD.

Question 20

Indications to check Gastrin level

Answer 20

• Large ulcer(>1 cm)
• Multiple Ulcers
• Distal location neat eh ligament of Treitz
• Recurrent or persistent dispite helicobacter treatment

Question 21

Crohn´s Disease Serology

Answer 21

+ ASCA

Antisaccharomyces cerevisiae

Question 22

Ulcerative colitis serology

Answer 22

+ANCA

Question 23

Best initial treatment for IBD

Answer 23

Mesalamine

Question 24

Perianal CD treatment

Answer 24

Metronidazole and Cipro

Question 25

Causes of infectious bloody diarrhea

Answer 25

``` CAMPYLOBACTER Salmonella Vibrio parahaemolyticus E.coli (o157:H7 HUS) Vibrio vulnificus Yersinia Amebic ```

Question 26

Best initial test for infectious diarrhea

Answer 26

-Fecal leukocytes

Question 27

Most accurate test for infectious diarrhea

Answer 27

-Stool Culture

Question 28

Antibiotic indication in infectious diarrhea in bloody diarrhea

Answer 28

- Blood - Fever - Abdominal pain - Hypotension and tachycardia

Question 29

best initial test for C.Diff

Answer 29

Stool toxin assay

Question 30

Most accurate test for C.Diff

Answer 30

Stool for PCR

Question 31

fat malabsorption diarrhea

Answer 31

- Hypocalcemia - Oxalate overabsorption(oxalate stones) - Easy bruising and elevated PT-INR - Vitamin D malabsorption

Question 32

best initial test for malabsorption diarrhea

Answer 32

- Sudan black stain of stool. | - Most acurate is 72 hours fecal fat

Question 33

Best initial test for Celiac´s

Answer 33

- Antigliadin,antiendomysial and antitissue tranglutaminase. | - Most accurate its biopsy

Question 34

Tropical sprue treatment

Answer 34

-Doxycycline -TMP for 3 to 6 months

Question 35

whipple disease treatment

Answer 35

-Tetracycline or TMP for 12 months.

Question 36

secretin stimulation and secretin Secretion test

Answer 36

secretin stimulation is for pancratitis | Secretin supression is for gastrinoma

Question 37

best initial test for Pancreatitis

Answer 37

-CT Abdoment Most accurate is Secretin stimulation test.

Question 38

Best treatment for IBS

Answer 38

FIBER, FIBER, FIBER

Question 39

How do we screen for colon cancer in : Gardner´s syndrome FAP Peutz-Jeghers syndrome

Answer 39

Sigmoidoscopy yearly starting at age 12.

Question 40

Most common cause of death in GI bleeding

Answer 40

-Myocardial ischemia

Question 41

when do we transfuse

Answer 41

Hematocrit below 30

Question 42

When do we transfuse fresh frozen plasma

Answer 42

Elevated PT-INR

Question 43

When do we transfuse platelets

Answer 43

Patient is bleeding or surgery, when PTL<50 ,00

Question 44

Causes of upper GI bleeding

Answer 44

- Ulcer - Esophagitis,gastritis,duodenitis - Varices - Cancer

Question 45

Causes of Lowe GI bleeding

Answer 45

- Angiodysplasia - Diverticular disease - Polyps - Ischemic colitis - Inflammatory bowel disease - Cancer

Question 46

Most accurate test for Ischemic Mesenteric ischemia

Answer 46

Angiography

Question 47

Abdominal pain out of propostion to physical exam

Answer 47

-Ischemic mesenteric ischemia | SURGERY!!!

Question 48

what to do if CT shows >30% of pancreas necrosis

Answer 48

-Do CT-Guided necrosis , if infected or necrotic DO SURGICAL DEBRIDMENT.

Question 49

Treatment for hepatitis B

Answer 49

Tenofovir(gives bone demineralization)

Question 50

Indications for hepatitis B vaccine

Answer 50

- Liver Disease - Health workers - Patient on dialysis - Diabetes

Question 51

SAAG>1.1

Answer 51

Portal Hypertension.

Question 52

Best initial test for Wilsons disease

Answer 52

Slit lamp

Question 53

Best initial test in hemochromatosis

Answer 53

Iron studies

Question 54

Best intial test in AIH

Answer 54

ASMA and ANA, LKM Ab.

Question 55

lynch syndrome SCOPE yearly since age 25

Answer 55

3 relatives 2 generations 1 premature(<50)

Question 56

best diagnostic test for diverticulosis

Answer 56

Barium enema

Question 57

Best diagnostic test for Diverticulitis

Answer 57

Abdominal and pelvic CT scan