gastroentropathy

Question 1

predictor for pancreatitis,

Answer 1

old age CRP , HCT, BUN >20

Question 2

colon cancer screening

Answer 2

sstart 45: clonoscopy 10
fobt or FIT every year
fidt- DNA 1-3 years
ct clonography every 5 ye
flexible sigmoidoscopy every 5 or feat FIT every 10

HIgh risk ( family): at 40 or 10 years before whichever comes first < repeat every 5 years , every 10 if diagnosed 60 or above,

UC, start 8-10 after the diagnosis, every 1-3 years

Question 3

if gamma-glutamyl transpeptidase is up

Answer 3

ALP is from bones not the bile

Question 4

Hepatic veno occulsive disease

Answer 4

Occulsion of terminal hepatic venules and causes postsinusoidal portal hypertention, bone marraow transplant patients with hepatomegaly jaundice and ascites

Question 5

choledocholithiasis treatment

Answer 5

ERCP and after non emergancy cholecystectomy to prevent future complications

If emphysematous or perforated => cholecystectomy

Question 6

ERCP therapeutic for:

Answer 6

choledocholithiasis, dilated common bile duct. cholangitis, acute biliary pancratitis

Question 6

terlipressin

Answer 6

is like octreotide

Question 7

albumin in liver cirrhosis

Answer 7

when tachycardia with fluid or sign of kidney malfunction

Question 8

variceal hemorrhage

Answer 8

IV, octreotide, AB
then if nofurther ; initiate prophylaxis BB non selective + endoscopic band igation 1-2 week

if continued; balloon tamponade then TIPS

early rebleding repeat the endoscopic therapy if recurrent then TIPS

Question 9

radiation proctitis

Answer 9

excluding other causes, lesion of pallor, mucosal hemorrhage,and telangiectasis , friability,

treatment fluids and antidiarrheal drung , if not + enemas od glucocorticoids or sucralfate

Question 10

IBS treatment

Answer 10

if pain: antispasmodics hyoscyamine and TCA
id diarrhea: soluble fiber loperamide , second line; bile acid sequestrants , serotonin 3 receptors antagonists alosetran

constipation ; soluble fiber osmotic laxatives peg
second line ; lubiprostone, guanylate cyclase agonists(linaclotide) sodium hydrogen exchanger 3 inhibitor( tenapanor)

Question 11

labs for IBS

Answer 11

if diarrhea prominant : CBC Stool culture celiac serologics CRP but if constipation : CBC

Question 12

drugs that can cause pancreatitis

Answer 12

analgesics: acetaminophen, NSAID, Mesalamine sulfasalazine, opates

AB; Isoniazid, tetracycline, metronidazole, TMZ,SUL

antepileptices; valproic acid, carbamazepine,

antihtpertensive, thiazides , fursomide, enalapril, losartan

antivirals; lamivudine. didanosine,

Immunosupressive, azathioporine, mercaptopurine. corticostreiods

others; asparaginase, estrogens

Question 13

intervals for follow up colonoscopy after polypectomy

Answer 13

no polyp and <10mm = 10 years

hyperplastic more than 10 mm ; 3-5 years

1-2 tubular adenmas<10 mm 7 years
3-4 tubular; 3-5 years

5-10 tubular or more than 10 mm or villous or tubulovillous adenomas or adenoma with high-grade dysplasia ;3

more than 10 adenomas ; 1 years

large adenomas removed by picemeal excision or 20 mm : 6 mounths

Question 14

eosinophilic esophagitis, foods

Answer 14

eggs , milk, wheaat, soy, fish, peanut treenut

Question 15

protein induced allergic proctocolitis , if not respond to changes

Answer 15

colonoscopy and if mucosal inflammation and eosinophilic infiltration confined to the distal colon and rectum