Gastroenterology

Question 1

Chronic Hepatitis B treatment

Answer 1

Any of:

• Adefovir
• Lamivudine
• telbivudine
• Entecavir
• Tenofovir
• Interferon

Question 2

Chornic Hepatitis C treatment
Genotype 1:
genotype 2 and 3:

Answer 2

Genotype 1:ladipasvir adn sofusbuvir

Genotype 2 and 3: sofusbuvir and rabavirin

Question 3

Prmary biliary cirrhosis antibodies

Answer 3

Antimitochondrial Ab

Question 4

Autoinmune hepatitis

Answer 4

Anti smooth muscle Ab

Question 5

Serum-ascites albumin gradient

Answer 5

> 1.1g/dL

• portal hypertention
• CHF
• Hepatic vein thrombosis

Question 6

spontaneous bacterial peritonitis
TX?
prophylacti?

Answer 6

Tx:ceftriaxone or cefotaxime
prophylactic: norfloxacin or TMP/SMX

Question 7

when and what Abx is indicated in pancreatitis

Answer 7

> 30% necrosis, add imipenem or meropenem

Question 8

Ulcerative colitis Ab

Answer 8

ANCA

Question 9

chron Ab

Answer 9

ASCA

Question 10

Alarm symptoms indication for endoscopy

Answer 10

weight loss
blood in stoll
anemia

Question 11

when to add platelets to treatment

Answer 11

active bleeding

or PTL very low( below 10,000-20,000)

Question 12

Low osmotic gap diarrhea

Answer 12

100 mOsm/kg

• celiac disease
• whipple disease
• pancreatic insufficiency
• laxative abuse

Question 13

isolated hyperbilirrubinemia DDX

Answer 13

UNCONJUGATED
-overproducton(hemolytic or anemia)
-defective conjuntation(gibert or crigler-Najjar)
CONJUGATED
-Dubin-Johnson Sx(hyperpigmentet hepatocytes)
-Rotor Sx

Question 14

gastrointestinal bleeding treatment

Answer 14

fluis,blood,platelet,plasma,PPI+ ENDOSCOPY

osctreotide->if variceal bleeding

Question 15

esophageal varices treatment

Answer 15

octreotide
bands
propanolol
TICS(transjugular intrahepatic portosystemic shunting)

Question 16

ACUTE hep C treatmen

Answer 16

interferon + ribavirina(tox:anemia)+ telapravir or boceprevir

Question 17

msot accurate test for sclerosing cholangitis

Answer 17

ERCP

Question 18

fatigue, itching, normal bilirubin with elevated alkaline phophasate, XANTELASMAS and OSTEOPOROSIS
Dx:
TX:

Answer 18

Primary biliary cirrhosis

• most accurate test: biosy
• most accurate blood test: antimitocondrial antibodies
• tx:ursodesoxicolic acid|

Question 19

plummer-vison association

Answer 19

iron deficiency anemia
esophageal webs
squamous cell cancer

Question 20

manometry is the most accurate test for the following deseases

Answer 20

• achalasia
• apasm
• scleroderma

Question 21

GERD

Answer 21

DO NOT SCOPE

-PH monitoring is the most accurate test

Question 22

most accurate test for PUD

Answer 22

upper endoscopy with BIOPSY

Question 23

best initial therapy for H.pylory

Answer 23

FIRTS LINE:clarithro and amoxi with PPI

Question 24

gastric ulcer doesnt get better after treatment

Answer 24

do a endoscopy EXCLUDE CANCER

Question 25

Duodenal ulcer doesnt get better after treatment

Answer 25

persistent H.pylori switching the Abx to metronidazol and tetracycline

Question 26

scope patients with dyspepsia

Answer 26

- patient over 55 y | - alarm symptoms(dysphagia,weight loss,anemia)

Question 27

most accurate test for Gastrinoma

Answer 27

-persistent high gastrin leves despite injecting secretin | IF HYPERCALCEMIA LOOK FOR MEN(multiple endocrine neoplasia)

Question 28

platelet transfusion indication in GI bleeding

Answer 28

platelets below 50 000 AND CURRENT BLEEDING

Question 29

treatmetn for metronidazol resistent C.diff

Answer 29

vancomycin or Fidaxomicin

Question 30

malapsorption diarrhea

Answer 30

- celiac - chronic pancreatitis - tropical sprue - whipple disease(PAS positive macropages)

Question 31

only way to distinc between chronic pancreatitis and gluten sensitive enteropathy

Answer 31

CELIA DISEASE HAS IRON DEFICIENCY

Question 32

treatment of choice for whipple disease

Answer 32

ceftriaxone followed by TMP/SMZ

Question 33

lactose intoleranse , H braath test

Answer 33

positive

Question 34

when to screen IBD

Answer 34

8-10 years of colonic involvement(YERLY)

Question 35

IBD treatment acute: chronic

Answer 35

* acute:prednisone or bodesonide - -azathioprine adn 6mercaptopurine are used to wean patients off steroids. * chronic:mesalamine

Question 36

perineal crohn

Answer 36

cipro and metronidazol

Question 37

worst prognosis criteria for acutte pancreatitis

Answer 37

low calcium

Question 38

most accurate test for hemochromatosis

Answer 38

abdominal MRI and HFE (C282y)gene testing

Question 39

most accurate test for wilsons disease

Answer 39

abnormally increase amount of copper excretion into the urine after giving penicillamine