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PANRE Review > Gastroenterology > Flashcards

Gastroenterology Flashcards

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1
Q

Most common cause of esophagitis

A

GERD

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2
Q

Patient with odynophagia is immunocompromised. Endoscopy performed, shows large, shallow ulcers. What is the likely cause and treatment?

A

CMV

Treatment: Ganiclovir

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3
Q

Patient with severe food allergies being evaluated for dysphagia. Endoscopy likely shows?

A

Multiple corrugated rings (Eosinophillic esophagitis)

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4
Q

This condition may lead to esophageal adenocarcinoma

A

Barretts esophagus

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5
Q

Gold standard diagnosis for GERD

A

24 hour pH monitoring

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6
Q

50 y/o with difficulty swallowing solids and liquids. Esophagram shows birds beak appearance of LES. Diagnosis?

A

Achalasia

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7
Q

Gold standard for diagnosing achalasia

A

Manometry

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8
Q

Corkscrew appearance on esophagram

A

Diffuse esophageal spasm

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9
Q

Manometry shows increase LES pressure with peristalsis. Diagnosis?

A

Nutcracker esophagus

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10
Q

Patient admits to persistent vomiting and difficult swallowing. Crepitus heard on auscultation. Which test should be ordered for diagnosis?

A

CT scan (Boerhaaves syndrome): shows pneumomediastinum

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11
Q

Superficial longitudinal erosions seen on endoscopy

A

Mallory Weiss Tear

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12
Q

Test of choice for diagnosing esophageal webs

A

Barium esophagram (swallow)

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13
Q

Schatzki ring is located where?

A

Squamocolumnar junction

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14
Q

Treatment for a patient with upper GI bleeding and history of alcoholism

A

Endoscopic Ligation +/- octreotide

If not successful, surgical decompression (TIPS)

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15
Q

Treatment of choice in primary prophylaxis to prevent rebleeds in esophageal varices

A

Propanolol or nadolol

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16
Q

Treatment for hiatal hernia where GE junction remains in its anatomic location

A

“Rolling hernia” is treated with surgery

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17
Q

Patient experiencing solid food dysphagia and weight loss. Endoscopy with biopsy reveals Adenocarcinoma. Where is it likely located in the esophagus?

A

Lower 1/3rd of the esophagus

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18
Q

Most common cause of gastritis? PUD?

A

H.Pylori is most common

NSAIDs/ASA is 2nd most common

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19
Q

Treatment of H.Pylori

A

Clarithromycin
Amoxicillin (metronidazole if PCN allergic)
PPI

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20
Q

Most common cause of upper GI bleed

A

Peptic Ulcer Disease

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21
Q

30 y/o patient with dyspepsia that improves with meals, has nocturnal pain at bedtime. Endoscopy reveals which kind of ulcer and where?

A

Duodenal ulcer; most commonly found in the bulb

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22
Q

70 y/o patient with dyspepsia with meals and experiencing weight loss. Endoscopy reveals what type of ulcer and where?

A

Gastric ulcer; most common in the antrum of stomach

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23
Q

Which test for H.Pylori cannot confirm eradication?

A

Serologic antibodies

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24
Q

Most common site for gastrinoma

A

Duodenal wall

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25
Patient has multiple peptic ulcers seen on endoscopy. Which test may be considered next?
Fasting gastrin level to rule out zollinger ellison syndrome
26
Endoscopic biopsy reveals diffuse thickening of stomach wall in a 60 y/o male with hx of H.pylori, recent weight loss and early satiety. Most likely diagnosis?
``` Gastric carcinoma (adenocarcinoma most common) "Linitis plastica" ```
27
Most common type esphogeal carcinoma worldwide
Squamous cell carcinoma
28
4 week old infant with vomiting, olive shaped nontender nodule right of umbilicus. Diagnosis?
Plyoric stenosis
29
30 y/o woman with ascites, hepatomegaly and RUQ pain. Likely condition?
Hepatic vein obstruction
30
Patient with fever, jaundice, RUQ pain. What test is ordered to make diagnosis?
ECRP
31
Common bacteria associated with acute cholecystitis?
E. Coli
32
When a patient has no UGT what will the labs show?
Elevated Indirect hyperbilirubinemia (Crigler Najjar Type 1)
33
Labs reveal mild conjuagated (direct) hyperbilirubinemia and liver is grossly black. What is the condition?
Dubin Johnson Syndrome
34
What type of jaundice has increase in direct and indirect bilirubin?
Hepatocellular (hepatitis)
35
Dark urine is a sign of what in a jaundiced patient?
Elevated direct hyperbilirubinemia (seen in direct and hepatocellular jaundice)
36
Elevated ALP with GGT suggests what?
hepatic source or biliary obstruction
37
Treatment for hepatic encephalopathy
Lactulose, neomycin, protein restriction
38
Hepatitis associated with spiking fever
Hepatitis A
39
Patient has Hepatitis C. What tests screen for hepatocellular carcinoma?
Alpha fetoprotein and ultrasound
40
Which lab diagnoses hepatitis E?
IgM anti-HEV
41
A patient being screened for hepatitis B has labs reveal the following: HbsAg -, Anti-HBs +, Anti-HBc - Whats your interpretation?
Immunity to hepatitis B
42
A patient being screened for hepatitis B has labs reveal the following: HbsAg +, Anti-HBs -, Anti-HBc IgM Whats your interpretation?
Acute Hepatitis
43
A patient being screened for hepatitis B has labs reveal the following: HbsAg -, Anti-HBs +, Anti-HBc IgG Whats your interpretation?
Recovery from hepatitis B
44
Treatment for a hepatitis B patient with elevated ALT and inflammation show on liver biopsy?
Alpha interferon 2b, lamivudine, adefovir
45
Patient with known cirrhosis has ascites, new unexplained fever and abdominal pain. What do you suspect?
Bacterial peritonitis
46
Model for End Stage Liver Disease looks at what 3 labs and is usefor for determining what?
Total bilirubin, INR, serum creatinine 3 month mortality
47
Positive anti mitochondrial antibody is hallmark of which disease?
Primary biliary cirrhosis
48
Treatment for primary biliary cirrhosis?
Ursodeoxycholic acid
49
Primary sclerosing cholangitis is associated with which other disease?
Ulcerative Colitis (+ P-ANCA)
50
Diagnosis of Wilsons Disease
Increased urinary copper excretion | Elevated ceruloplasmin
51
Acinar cell injury can lead to what disease
Acute pancreatitis
52
Abdominal x-ray findings in acute pancreatitis
Sentinel loop and/or colon cut off sign
53
Triad of symptoms with chronic pancreatitis
calcifications, steatorrhea, diabetes
54
Most common form of pancreatic carcinoma and location
Adenocarcinoma (ductal) | 70% in the head of pancreas
55
Elevated CA 19-9 and CEA are associated with which condition?
Pancreatic carcinoma
56
Most common cause of small bowel obstruction?
Post surgical adhesions
57
1 year old with vomitting, abdominal pain and currant jelly stools?
Intussception
58
Diagnosis and treatment of Intussception?
Barium contrast enema
59
Which labs are positive in Celiac Disease?
Anti-endomysial ab | Transglutaminase ab
60
Positive hydrogen breath test diagnoses which condition?
Lactose intolerance
61
Most common cause of lower GI bleeds?
Diverticulosis (sigmoid colon MC area)
62
Obturator sign
RLQ pain with int/ext rotation of hip with bent knee
63
Psoas sign
RLQ pain with right hip flexion/extension
64
30 y/o female with abdominal pain for 12 weeks of past year has relief with defecation. Reports alternating diarrhea/constipation bouts. Diagnosis?
IBS
65
Patient has severe abdominal pain out of proportion to exam. What test is ordered and likely diagnosis?
Angiogram to rule out acute mesenteric ischemia
66
Patient has chronic dull abdominal pain worse after meals. Colonoscopy shows?
atrophy, loss of vill (chronic mesenteric ischemia)
67
Colonscopy in patient that has LLQ and bloody diarrhea reveals segmental changes at splenic flexure. Diagnosis?
Mestenric ischemia
68
Diagnosis for toxic megacolon
Abdominal x-ray: dilated colon >6 cm
69
``` Ulcerative Colitis Area Sx Complications Colonoscopy and barium Labs Acute diagnosis ```
Limited to colon (recum always involved) LLQ pain, tenesmus, bloody diarrhea primary sclerosing angitis, colon CA, megacolon uniform inflammation, sandpaper appearance, stove-pipe sign P-ANCA Flex sigmoidoscopy
70
Most common adenomateous (potentially cancerous) polyp?
Tubulous
71
20 y/o with polyposis, hyperpigmented lips, hands, tongue. What are they at risk for?
Colon cancer (Peutz-Jehgers)
72
Colon cancer on barium enema
Apple core lesion
73
Which type of hernia is lateral to inferior epigastric vessels?
Indirect hernia
74
Patient has perianal pain worse with defecation. Likely cause?
External hemorrhoids
75
What are Bitot spots?
White spots on conjunctiva associated with Vitamin A deficiency
76
Pellagra is associated with deficiency in?
Vitamin B3 (Niacin) Diarrhea, dementia, dermatitis
77
Schilling test is used for diagnosing....
Pernicious anemia (macrocytic anemia)
78
Patient with ophthalmoplegia, ataxia and global confusion is likely deficient in?
Vitamin B1 (Thiamine) Werneckes Encephalopathy
79
PKU is diagnosed how?
Urine: musty (mousy) odor
80
Most common cause of diarrhea in adults in North America
Norovirus
81
Patient ingests fried rice and within 3 hours experiences significantly watery diarrhea, vomitting. Likely cause?
B. Cereus
82
Most common cause of travelers diarrhea?
Enterotoxogenic E. Coli
83
Most common cause of bacterial enteritis in US?
Campylobacter (C. Jejuni)
84
Pea-soup stools are associated with what disease?
Salmonella
85
Patient with crampy lower abdominal pain, explosive diarrhea with blood. Likely diagnosis and treatment?
Shigella Sigmoidoscopy shows punctate areas of ulceration Tx: Bactrim
86
Treatment for Yersinia?
Fluoroquinolones
87
Frothy, greasy, foul diarrhea
Giardia
88
Most common cause of diarrhea in AIDS patients
Cryptosporidium
89
Decrease in diarrhea with fasting, increase osmotic gap. Which type of diarrhea?
Osmotic
90
Whipples disease diagnosis?
Duodenal biopsy: Periodic Acid-Schiff
91
Side effect of saline laxatives
Hypermagnesemia

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