Gastroenterology

Question 1

Oropharyngeal vs Esophageal dysphagia: sx and dx procedures

Answer 1

Oropharyngeal: liquids > solids (aspiration)
Dx: video flouroscopy
Esophageal: solids> liquids (obstruction/motility)
Dx: barium swallow

Question 2

Corkscrew-shaped esophagus: dx and tx

Answer 2

Diffuse esophageal spasm

Tx: nitrate, Ca ch blocker, surgery

Question 3

Bird beak esophagus: dx and tx

Answer 3

Achalasia (degeneration inhib neurons auerbach plexus)

Tx: nitrate, ccp, endoscopinc inj, Heller myotomy

Question 4

Etiology curling vs cushing ulcer

Answer 4

Curling: burn injuries
Cushing: TBI

Question 5

Type A vs Type B gastritis:

Etiology, location

Answer 5

Type A: Autoantibodies to parietal cells, causes pernicious anemia, fundus
Type B: H. pylori or NSAID, antrum

Question 6

Triple therapy for H. pylori

Answer 6

Amoxicillin, clarithromycin, omeprazole

Question 7

Organisms that cause bloody diarrhea (4)

Answer 7

Salmonella, Shigella, E colie (EHEC), Campylobacter

Question 8

Chronic diarrhea in AIDS pt (2)

Answer 8

Cryptosporidium, isospora

Question 9

Campylobacter: Labs and Tx

Answer 9

Fecal RBCs and WBCs

Tx: erythromycin

Question 10

Entamoeba histolytica: presentation, labs/imaging, tx

Answer 10

Presentaton: severe abd pain, fever, hx of travel
Labs/imagining: fecal rbcs, wbcs; “flask-shaped” ulcers
Tx: metronidazole

Question 11

Causes of watery diarrhea (5)

Answer 11

V cholerae,rotavirus, e coli (ETEC), cryptosporidium, giardia

Question 12

Grouped, papulovesicular, pruritic skin

located symetrically elbows, knees, buttocs, post scalp (disease + associated dx)

Answer 12

Dermatitis herpetiformis

Celiac disease

Question 13

Diarrhea, dementia, dermatitis and death

Answer 13

pellagra

Question 14

Carcinoid syndrome: assoc deficiency + tx

Answer 14

Assoc def: pellagra (B3 def) tryptophan (precursor to niacin) used to make serotonin
Tx: octreotide

Question 15

Tx of diverticulitis

Answer 15

Bowel rest, NG tube placement, Broad spectrum abx (metronidazole + flouroqin or 2nd/3rd cephalo)

Question 16

Indirect vs direct hernia: etiology and location

Answer 16

Indirect: congenital patent processus vaginalis; lateral to in epigastric vessels
Direct: defect in transversalis fascia (Breakdown with age)
medial to epigastric vessels

Question 17

Extraintestinal manifestations of UC (4)

Answer 17

Primary sclerosing cholangitis, aphthous stomatitis, erythema nodosum, pyoderma gangrenosum

Question 18

Sx and Tx of choledocolithiasis

Answer 18

Sx: biliary colic, jaundice, fever, pancreatitis
incr alk phos, t and dbili
Tx: ERCP with sphicterotomy + cholecystectomy

Question 19

MRCP/ERCP shows “beading”: Dx and Tx

Answer 19

Dx: Primary sclerosing cholangitis
Tx: ursodiol, ERCP and stenting, liver transplant

Question 20

Primary sclerosing cholangitis: associated dx and malignancy

Answer 20

Assoc with ulcerative colitis and cholangiocarcinoma

Question 21

presents with incr unconjugated bilirubin, no other abnormalilities

Answer 21

Gilbert’s (decr activity of glucoronyl transferase)

Question 22

Drugs causing hepatitis (4)

Answer 22

Alcohol
Acetominophen
INH
methyldopa

Question 23

Hyperbilirubinemia: Causes for unconj (4) and conjugated (2)

Answer 23

Unconj: hemolytic anemia, gilbert, crigler-najjar
Conj: Dubin-Johnson, Rotor’s

Question 24

+ anti-smooth muscle antibodies

Answer 24

autoimmune hepatitis

Question 25

Hep B serology: - Acute early infxn - Immunity - + during window period - High vs low transmissibility

Answer 25

- Acute early infxn: HBsAg - Immunity: HBsAb - + during window period: HBcAb - High transmissibility: HBeAg - Low transmissibility: HBeAb

Question 26

Tx of chronic HCV and HBV

Answer 26

HCV: interferon and ribavirin HBV: Interferon and lamivudine or adefovir

Question 27

SAAG dx of ascitis

Answer 27

SAAG> 1.1: Portal hypertension | SAAG

Question 28

+ Antimitochonrdrial Ab: Dx + Tx

Answer 28

Dx: Primary biliary cirrhosis Tx: Ursodeoxycholic acid, cholestyramine, liver transplant

Question 29

Spontaneous bacterial peritonitis: Dx and Tx and ppx

Answer 29

Dx: >250 PMNs/ml Tx: 3rd gen cephalosporin, IV albumin Ppx: flouroquinolone

Question 30

Tx Wilson's disease

Answer 30

penicillamine, zinc