Gastroenterology Flashcards
(115 cards)
1
Q
In melena, the blood has been in the GIT for at least how many hours?
A
14 hours
2
Q
Violaceous striae is usually seen in what case
A
Cushing’s syndrome
3
Q
Bruits with audible systolic and diastolic components heard near the midline almost midway between subxiphoid area and umbilicus may suggest
A
Renal artery stenosis
4
Q
PUD that has common risk for malignancy
A
Gastric ulcer
5
Q
PUD with increased gastric acid secretion
A
Duodenal ulcer
Gastric - normal
6
Q
PUD wherein pain awakens the patient from sleep between midnight and 3 AM
A
Duodenal ulcer
7
Q
PUD precipitated by food
A
Gastric
8
Q
PUD relieved by antacid or food
A
Duodenal
9
Q
Test of choice for documenting H. pylori eradication
A
Urea breath test
10
Q
Side effect of aluminum OH
A
Constipation
11
Q
Side effect of magnesium OH
A
Diarrhea
12
Q
Black stools, darkening of tongue and neurotoxicity are ADRs of what anti PUD drug?
A
Bismuth
13
Q
Triple therapy for H-pylori eradication
A
PPI + Clarithromycin or Metronidazole + Amoxicillin or Metronidazole (if not used as second agent)
14
Q
Most common complication of PUD
A
Gastrointestinal bleeding
15
Q
Form of perforation in which ulcer bed tunnels into adjacent organ
A
Penetration
16
Q
Least common ulcer-related complication
A
Gastric outlet obstruction
17
Q
Most common cause of UGIB
A
PUD
18
Q
Large caliber arteriole that runs immediately beneath the GI mucosa and bleeds via a pinpoint mucosal erosion; seen most commonly in the lesser curvature of the proximal stomach
A
Dieulafoy’s lesion
19
Q
Vasoactive agents given to patients with variceal hemorrhage to reduce the portal venous pressure acutely by splanchnic vasoconstriction
A
Somatostatin or octreotide
20
Q
Endoscopic therapy of choice for variceal hemorrhage
A
Ligation or banding
21
Q
Most common and most characteristic symptom of hepatic disease
A
Fatigue
22
Q
Sign of hepatic disease that result from recannulation of umbilical vein with collateral veins radiating from umbilicus
A
Caput medusa
23
Q
Golden-brown copper pigment deposited un periphery of the cornea
A
Kayser-Fleischer ring
24
Q
Kayser-Fleischer rings are seen in what cases
A
Wilson’s disease
25
Dupuytrrn contracture and parotid enlargement are seen in what liver disease
Alcoholic liver disease
26
Slate-gray pigmentation of the skin is seen in what liver disease
Hemochromatosis
27
Aminotransferase that is more specific as an indicator of liver disease
ALT
28
AST:ALT > 2 is seen in what condition
Alcoholic liver disease
29
ALP > aminotransferase is seen in what condition
Cholestatic conditions
30
Single best acute measure of hepatic synthetic function
Clotting factors
31
Only clotting factor that is not synthesized in the liver
VIII (synthesized by endothelial cells)
32
First line diagnostic method if initial blood tests suggest cholestasis
Ultrasound
33
First test ordered if suspecting Budd chiari syndrome
Doppler US
34
Hepatobiliary disease with antimitochondrial antibody and elevated IgM levels
Primary biliary cirrhosis
35
Serology in window period of hepatitis
IgM anti-HBc
36
Gold standard in diagnosis of HCV infection
HCV RNA
37
Most frequent indication of liver transplant
Chronic HCV infection
38
Most feared complication of viral hepatitis
Fulminant hepatitis
39
Fulminant hepatitis is primarily seen in what 3 hepatitis viruses
B, E, D
40
TNF inhibitor given in alcoholic liver disease
Pentoxifylline
41
4 complications that differentiates compensated from decompensated cirrhosis
Variceal hemorrhage
Ascites
Jaundice
Hepatic encephalopathy
42
Fever, altered mental status, elevated WBC, and abdominal pain or discomfort in the setting of liver cirrhosis
Spontaneous bacterial peritonitis
43
Most common organism in spontaneous bacterial peritonitis
E. coli
44
Asterixis is a sign of
Hepatic encephalopathy
45
Requirement fir diagnosis of fulminant hepatitis
Hepatic encephalopathy
46
Mainstay treatment for encephalopathy
Lactulose
47
Goal number of soft stools per day in encephalopathy
2-3
48
Classification of schistosomiasis as a cause of portal hypertension
Presinusoidal hepatic cause
49
Classification of Banti's syndrome as a cause of portal hypertension
Prehepatic (massive splenomegaly)
50
Classification of Budd-Chiari syndrome as a cause of portal hypertension
Post hepatic
51
Scoring that predicts likelihood of major complication of cirrhosis
Child Pugh Score
52
Scoring system to predict prognosis of patients with liver disease and portal hypertension
Model for End-Stage Liver Disease Score
53
Scoring for prioritizing allocation for liver transplantation
Model for End-Stage Liver Disease Score
54
Secreted by K cells in the duodenum that stimulates insulin secretion
Glucose-dependent insulinotropic peptide
55
Most common cause of acute pancreatitis
Gallstone
56
Abdominal pain that is more intense when supine and is relieved upon sitting with the trunk flexed and knees drawn up
Acute pancreatitis
57
Blue discoloration around the umbilicus; seen in what cases?
Cullen's sign; acute pancreatitis
Hemoperitoneum
58
Blue-red-purple ir green-brown discoloration of the flanks? Seen in what cases?
Turner's sign; acute pancreatitis
Tissue catabolism of hemoglobin
59
Preferred diagnostic test for acute pancreatitis
Lipase
60
Most common gallstone (80%)
Cholesterol stone
61
Most specific and characteristic symptom of gallstone disease
Biliary colic
62
Steady epigastric or RUQ pain radiating to interscapular area, tight scapula or shoulder; aggravated by eating fatty meal
Biliary colic
63
Gallstone becomes impacted in the cystic duct or neck of the gallbladder causing compression of CBD resulting in CBD obstruction and jaundice
Mirizzi's syndrome
64
States that a palpable enlarged gallbladder suggests that the biliary obstruction is secondary to underlying malignancy rather than to a calculous disease.
Courvoisier's Law
65
Charcot's triad of Acute cholangitis
Biliary or RUQ pain
Jaundice
Spiking fevers with chills
66
Diagnostic method that provides best visualization of the distal biliary tract
ERCP
67
Diagnostic method that provides best visualization of the proximal biliary tract
Percutaneous transhepatic cholangiogram
68
Secrets HCl and IF
Parietal cell
69
Secrets pepsinogen
Chief cells
70
Secretes serotonin in the stomach
Enterochromaffin cells
71
Secretes histamine in the stomach
Enterochromaffin-like cells
72
Pacemaker cells of the GIT
Interstitial cells of Cajal
Generates slow wave
73
Store vitamin A in the liver
Ito cells
74
Recurrent abdominal pain or discomfort at leadt 3 days per month in the last 3 months associated with improvement with defecation, change in frequency or appearance in stool
Irritable bowel syndrome
75
Charcot's neurologic triad for MS
SIN
Scanning speech
Intention tremor
Nystagmus
76
Biliary pain, obstructive jaundice and melena are triad of
Hemobilia
77
Most sensitive test for diagnosis of GERD
24-hour ambulatory pH monitoring
78
Perception of a lump or fullness in the throat that is felt irrespective of swallowing
Globus hystericus
79
Characteristic symptom of infectious esophagitis
Odynophagia
80
Corkscrew or rosary bead esophagus
DES
81
Cobblestone appearance of esophagus
Crohn's disease
82
Gold standard for confirmation of Barrett's esophagus
Endoscopic biopsy
83
Most common cause of LGIB
Hemorrhoids
84
Most common cause of hematochezi in the elderly
Hemorrhage from colonic diverticulum
85
Full-thickness esophageal tear
Boerhaave syndrome
86
Most common toxicity with sucralfate
Constipation
87
Cornerstone for therapy for Dumping syndrome
Dietary modification
88
Most sensitive/specific gastrin provocative test
Secretin study
89
Most common presentation for stress-related mucosal injury of GIT
GI bleeding
90
Type of gastritis that involves primarily the fundus and body with antral sparing
Type A gastritis (autoimmune)
91
Type of gastritis with antral-predominant involvement
Type B gastritis (infectious)
Most common
92
Inflammatory bowel disease that usually involves the rectum
Ulcerative colitis
93
Inflammatory bowel disease that usually spares the rectum but can occur in any part of the GIT
Crohn's disease
94
Pathognomonic feature of crohn's disease
Granulomas
95
Most common site of inflammation in crohn's disease
Terminal ileum
96
Mainstay of therapy for mild to moderate UC and crohn's disease
Sulfasalazine and other 5-ASA agents
97
First biologic therapy approved for crohn's disease
Infliximab (TNF-alpha inhibitor)
98
Operation of choice for UC
Ileal pouch anal anastomosis (IPAA)
99
Most frequent late complication of Ileal pouch anal anastomosis (IPAA)
Pouchitis
100
Only antibiotic for irritable bowel syndrome with sustained benefit beyond therapy cessation
Refaximin
101
Air-fluid level in the LLQ on plain abrominal film
Giant diverticulum of the sigmoid colon
102
Staging system for predicting outcomes after surgery for perforated diverticulitis
Hinchey classification system
103
Safety window for barium enema or colonoscopy after an acute attack of diverticular disease
6 weeks (risk for perforation during acute attack)
104
Best management for asymptomatic diverticular disease
Diet alteration
105
First indication of portal hypertension in liver cirrhosis
Hypersplenism with thrombocytopenia
106
Presumed mechanism for development of SBP
Bacterial translocation
107
Most common antibiotic for SBP
Cefotaxime
108
Progressive impairment in renal function and significant reduction in creatinine clearance within 1-2 weeks in the setting of liver cirrhosis or acute liver failure
Type 1 hepatorenal syndrome
109
Reduction in the GFR with an elevation of serum creatinine level (but fairly stable) in the setting of cirrhosis or acute liver failure
Type 2 hepatorenal syndrome
110
Best therapy for hepatorenal syndrome
Liver transplantation
111
Phenotypr of alpha 1 antitrypsin with greatest risk for developing chronic liver disease
ZZ phenotype
112
Most potent of the HBV antivirals
Entecavir
113
Hemolytic anemia with spur cells and acanthocytes in patients with severe alcoholic liver hepatitis
Zieve's syndrome
114
Laterality of pleural effusion in pancreatitis
Left (usually)
115
Most frequently involved artery of pseudoaneurysm
Splenic artery
