Gastrointestinal

Question 1

Are younger patients more likely to have gastric or duodenal ulcers?

Answer 1

Duodenal

Question 2

In what type of ulcer is pain relieved after eating?

Answer 2

Duodenal

Question 3

In what type of ulcer is pain worse after eating?

Answer 3

Gastric

Question 4

Coffee ground emesis suggests what type of ulcer?

Answer 4

Duodenal

Question 5

If you suspect PUD, what class of med should you start with?

Answer 5

PPI

Question 6

Sulcrafate is associated with what?

Answer 6

Decreases in nosocomial PNA

Question 7

What is the general tx for H. pylori eradication?

Answer 7

2 antibiotics + PPI with or without bismuth for 10-14 days

Question 8

What is a classic sign of GERD in the elderly population?

Answer 8

Dysphagia

Question 9

How long should a pt have GERD sx before doing an EGD to r/o Barrett’s esophagus, CA, etc?

Answer 9

5-10 years

Question 10

Barrett’s esophagus can lead to what?

Answer 10

Esophageal CA

Question 11

How is hepatitis B transmitted?

Answer 11

Via all body fluids

Question 12

How is hepatitis A transmitted?

Answer 12

Oral-fecal route as well as blood and stool during infectious period

Question 13

Which hepatitis is related to injection drug use?

Answer 13

Hepatitis C

Question 14

What will ALT/AST be in hepatitis?

Answer 14

500-2000

Question 15

Anti-HAV antibody with IgM indicates what?

Answer 15

Acute Hep A

Question 16

Anti-Hav antibody with IgG indicates what?

Answer 16

Recovered Hep A

Question 17

What is the antigen for Hep B?

Answer 17

HBsAg

Question 18

What is the serology for active Hep B?

Answer 18

HBsAg, HBeAg, anti-HBc, IgM

Question 19

What is the serology for chronic Hep B?

Answer 19

HBsAg, Anti-HBc, Anti-HBe, IgM, IgG

Question 20

What is the serology for recovered Hep B?

Answer 20

Anti-HBc, anti-HBs

Question 21

How to distinguish acute from chronic Hep C?

Answer 21

Via PCR

Question 22

Diverticulitis is more common in pts with what kind of diet?

Answer 22

Low in fiber

Question 23

Why is an xray done on pts with suspected diverticulitis?

Answer 23

To look for pneumoperitoneum (free air under the diaphragm)

Question 24

What diet should an inpatient w/diverticulitis be on?

Answer 24

NPO

Question 25

Murphy's sign is seen in what?

Answer 25

Cholecystitis

Question 26

What is the most common complication of an ERCP?

Answer 26

Pancreatitis

Question 27

What is the number one cause of pancreatitis?

Answer 27

Heavy ETOH use

Question 28

What is the number two cause of pancreatitis?

Answer 28

Gallbladder disease

Question 29

What makes pain worse in pancreatitis?

Answer 29

Walking and lying supine

Question 30

What makes pain better in pancreatitis?

Answer 30

Sitting and leaning forward

Question 31

What are two signs of hemorrhagic pancreatitis?

Answer 31

Grey Turner's sign and Cullen's sign

Question 32

What do you see in Grey Turner's sign?

Answer 32

Flank discoloration

Question 33

What do you see in Cullen's sign?

Answer 33

Umbilical discoloration

Question 34

What two values will be elevated in 90% of pancreatitis cases?

Answer 34

Amylase and lipase

Question 35

How is pancreatitis diagnosed?

Answer 35

CT scan

Question 36

What are the Ranson's criteria for pancreatitis at admission?

Answer 36

Greater than 55 years of age, WBCs > 16k, glucose > 200, LDH > 350, AST > 250

Question 37

Vomiting at onset of pain suggests what type of bowel obstruction?

Answer 37

Proximal

Question 38

Vomiting a couple hours after the development of pain suggests what type of bowel obstruction?

Answer 38

Distal

Question 39

More distended abd suggests what type of bowel obstruction?

Answer 39

Distal

Question 40

What kind of bowel sounds are there in bowel obstruction?

Answer 40

High pitched, tinkling

Question 41

What is seen on xray in bowel obstruction?

Answer 41

Dilated loops of bowel and air fluid levels

Question 42

Does ulcerative colitis or Crohn's disease involve the rectum?

Answer 42

Ulcerative colitis

Question 43

What two types of suppositories are used in the management of ulcerative colitis?

Answer 43

Mesalamine and hydrocortisone

Question 44

What is psoas sign and what does it suggest?

Answer 44

Pain w/right thigh extension - appendicitis

Question 45

What is obturator sign and what does it suggest?

Answer 45

Pain w/internal rotation of flexed right thigh - appendicitis

Question 46

What is Rovsing's sign and what does it suggest?

Answer 46

RLQ when pressure applied to LLQ - appendicitis