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1. PPS Board Prep_Mar > GASTRO/NUTRI > Flashcards

GASTRO/NUTRI Flashcards

1
Q

Smoking is a risk factor to _ but a protective factor to _.

UC / CD

A

Smoking is a risk factor to Crohn’s Disease but a protective factor to Ulcerative Colitis.

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2
Q

Skip lesions on histopath are more common in UC or CD?

A

Crohn’s Disease

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3
Q

Rectal bleed is more common in UC or CD?

A

UC

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4
Q

Toxic megacolon and sclerosing cholangitis is more common in UC or CD?

A

UC

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5
Q

p-ANCA more positive in UC or CD?

A

UC

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6
Q

MC cause of Lower GIT obstruction in neonates

A

Hirschsprung disease

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7
Q

Gold standard for diagnosis of Hirschsprung disease

A

Rectal biopsy
> absent ganglion cells and acetylcholinesterase positive stain

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8
Q

MC micronutrient deficiency

A

Iron

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9
Q

Micronutrient deficiency that is the most important preventable cause of mental retardation

A

Iodine deficiency

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10
Q

The major risk period for growth stunting is _

A

between 4 mos and 24mos
Chp 55

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11
Q

TRUE OR FALSE. Breastmilk is a poor source of Vitamin D

A

TRUE

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12
Q

The following are true about important principles for weaning EXCEPT:

A. begin at 6 mos old
B. Introduce 1 new food at a time
C. Give no more than 24 oz/day of cow’s milk
D. Fluids other than BM, water and formula are allowed

A

D. Fluids other than BM, water and formula are allowed
> other fluids are DISCOURAGED
Table 56.7

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13
Q

When should bottle weaning begin?

A. 12-15mos
B. 15-20mos
C. 18-24mos
D. >24mos

A

A. 12-15mos

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14
Q

The ff are specific nutrients of concern in vegetarianism except:

A. Iron
B. Zinc
C. Vitamin D and Calcium
D. Vitamin C

A

D. Vitamin C

Specific nutrients of concern:
1. iron
2. Zinc
3. Vit D and Ca
4. Fatty acids
5. Vit B12
6. Iodine

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15
Q

Bitot spots is seen in what vitamin deficiency

A

Vitamin A

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16
Q

Excess of which vitamin can cause fetal abnormalities/teratogenic?

A

Vitamin A

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17
Q

Manifestation of pellagra
What micronutrient deficiency

A

3D
Dementia
Dermatitis
> symmetric
> sun exposed areas- sunburn
> glove/stocking appearance
> casal necklace
Diarrhea

Vitamin B3 deficiency

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18
Q

Which of the ff drug is associated with Vitamin B6 deficiency?

A. Phenobarbital
B. isoniazid
C. Valproic acid
D. Olanzapine

A

B. isoniazid

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19
Q

The greatest risk of undernutrition occurs when?

A

first 1000 days, from conception to 24mos
Chp 57

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20
Q

_ stimulates appetite
_ stimulates satiety

A

Ghrelin
Leptin

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21
Q

Reduced/Elevated levels of adiponectin are asstd w reduced insulin sensitivity

A

Reduced

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22
Q

Level of adiponectin in obese patients

A

Low
> elevated levels of free fatty acids and plasma triglycerides

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23
Q

When does adiposity rebound happen?

A

Approximately 5.5yo

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24
Q

Electrolyte abnormality in refeeding syndrome

A

Low K, Ph and/or Mg

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25
Q

Scorbutic rosary is seen in what micronutrient deficiency

A

Vitamin C deficiency

26
Q

Rachitic rosary is seen in what micronutrient deficiency

A

Vitamin D deficiency

27
Q

Osteomalacia vs rickets

A

Osteomalacia
> inadequate mineralization of bone matrix in both adults and children

Rickets
> bone matrix not mineralized in growing bones, before closure of the epiphyses

28
Q

Which micronutrient deficiency is the leading cause of preventable blindness in children?

A

Vitamin A deficiency

29
Q

Criterion for obesity BMI
overweight

A

Overweight BMI 85-95p
Obesity BMI =>95p

30
Q

Clinically apparent jaundice appears when serum bilirubin are at _ levels

A

2-3mg/dL in children and adults

In neonates, can be as high up to 5mg/dL

31
Q

Most severe type of PFIC

A

PFIC 1
> Amish jews
> Byler disease
> CM: steatorrhea

PFIC 2
> Rapidly progressive cholestatic giant cell hepatitis

PFIC 3
> elevated GGT

32
Q

Abdominal UTZ finding in patients with biliary atresia

A

Triangular cord sign
> coe-shaped fibrotic mass cranial to the bifurcation of the portal vein

33
Q

Golden period for Kasai procedure

A

The success rate for establishing good bile flow after the Kasai procedure is much higher (90%) if performed before the 8th week of life

60 days.

34
Q

The first step in the management of patients with ascites is:

A. Paracentesis
B. Abdominal UTZ
C. rule out SBP and restrict Na intake

A

C. rule out SBP and restrict Na intake

Na intake to 0.5g (1-2meqs/kg/day)

35
Q

MC hereditary hyperbilirubinemia

A

Gilbert syndrome
> unconjugated hyperbilirubinemia
> occurs after puberty, therefore no chronic liver disease
> no treatment required
> mild elevations in total serum bili with NO evidence of liver damage

36
Q

Crigler Najjar vs Gilbert vs Dubin Johnson vs Rotor

A

Crigler Najjar & Gilbert
> UNCONUGATED hyperbil

Criggler:
> early-onset: as early as 3rd DOL
> extreme hyperbil
Type 1: jaundice, acholic stools
Type 2: no acholic stools, PARTIAL gluoronyl transferase deficiecnt

Dubin Johnson
> CONJUGATED hyperbil
> asx, mild jaundice
> diagnosed in adol or early adulthood
> total urine coproporphyrin normal levels
> Liver histo: black pigment similar to melanin

Rotor syndrome
> CONJUGATED hyperbil
> asx, mild jaundice
> diagnosed in adol or early adulthood
> total urine coproporphyrin ELEVATED levels
> Liver histo: NO black pigment

37
Q

Kayser-Fleischer rings seen in _

A

Wilson Disease
> hepatolenticular degeneration

38
Q

Most important marker of liver injury

A. Bilirubin levels
B. Synthetic liver functions
C. Aminotransferase levels
D. Coagulation factor levels

A

B. Synthetic liver functions

Altered synthetic function is the most important marker of liver injury.

Synthetic dysfunction is reflected by a combination of abnormal protein synthesis (prolonged PT, high international normalized ratio [INR], low serum albumin levels), metabolic disturbances (hypoglycemia, lactic acidosis, hyperammonemia), poor clearance of medications dependent on liver function, and altered sensorium with increased deep tendon
reflexes (hepatic encephalopathy).

> Abnormal liver synthetic function is a marker of liver failure and is an indication for prompt referral to a transplant center

39
Q

Most prevalent form of Hepatitis

A

Hepa A

40
Q

Fulminant types of Hepatitis

A

B D and E
Table 385.1

41
Q

Fecal-oral spread of Hepatitis

A

A and E
Table 385.1

42
Q

Pre-exposure prophylaxis for those with chronic liver disease, which of the ff is recommended?

A. Ig only
B. HAV only
C. None if fully immunized
D. Both Ig and HAV

A

D. Both Ig and HAV

If travel is planned in < 2 wk, older patients, immunocompromised hosts, and those with chronic liver disease or other medical conditions should receive both Ig and the HAV vaccine.

43
Q

Persistence of HBsAg over _ defines chronic infection state

A

6 months

44
Q

(+) anti HBs
(+) anti HBc

A. resolved infection
B. immunized w Hepa B vaccine
C. Both
D. NOTA

A

A. resolved infection

(+) anti HBs ONLY = immunized

45
Q

Marker of Hepa B infectivity

A

HBe Ag

46
Q

HBIG should be given to infants of HBsAg positive mothers within _.

A

12 hrs
ASAP but not later than 7 days
Table 385.9

47
Q

MC cause of chronic liver disease in children

A

Non alcoholic fatty liver disease

48
Q

MC HBD associated with IBD

A

sclerosing cholangitis

49
Q

Stage of Hepatic Encephalopathy:
Stupor, but arousable, confused with asterixis and rigidity. EEG show markedly abnormal triphasic waves

A. Stage I
B. II
C. III
D. IV

A

C. III
Table 391.1

50
Q

Choledochal cyst that is a diverticula of the CBD

A. Type I
B. IA
C. II
D. III

A

TYPE II

MC is Type I - cyst (saccular or fusiform) dilation on the CBD

51
Q

MC cause of extrahepatic portal hypertension

A

Portal vein thrombosis

52
Q

MC cause of portal hypertension in children

A

Liver cirrhosis

53
Q

MC presentation of portal HTN

A

Bleeding
> MC rupture of esophageal varices

54
Q

Can cause chronic hepatitis infection

A

B C D

55
Q

The only serum marker present during the window phase (4-6mos)

A

Anti HBc IgM

56
Q

The only marker for Hep B not detected in serum

A

HBc Ag
> only found in liver tissue

57
Q

All primary teeth erupt by _ yo
All permanent teeth are completed by _ yo

A

3yo
13yo

58
Q

MC congenital anomaly of the esophagus

A

Esophageal atresia

59
Q

Persistent vomiting in caused by pyloric stenosis can lead to _

A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis

A

B. Metabolic alkalosis
> Progressive loss of fluid, hydrogen ion, and chloride leads to hypochloremic metabolic alkalosis

60
Q
A

1. PPS Board Prep_Mar (16 decks)

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