GI 1

Question 1

top 3 causes of pancreatitis

Answer 1

alcohol
gallstones
hypertriglyceridemia (over 1,000)

Question 2

what liver enzyme elevated in biliary pancreatitis

Answer 2

ALT

Question 3

more than one episode of acute pancreatitis with unknown cause.. next step?

Answer 3

ERCP

Question 4

tx of IBD induced toxic megacolon

Answer 4

IVF
ATBs
IV corticosteroids

if doesn’t resolve, subtotal colectomy with end ileostomy

Question 5

GB wall thickening and pericholecystic fluid. dx?

Answer 5

acalculous cholecystitis

Question 6

subcutaneous crepitus and pneumomediastinum

Answer 6

esophageal rupture

Question 7

bloody stools and travel to endemic area (southeast asia, africa, central and south america)

Answer 7

entamoeba histolytica

Question 8

benign, unconj hyperbilirubinemia

Answer 8

Gilbert

Question 9

benign, conj hyperbilirubinemia WITHOUT pigmented granules

Answer 9

Rotor syndrome

Question 10

benign, conj hyperbilirubinemia WITH pigmented granules

Answer 10

Dubin Johnson

Question 11

bad unconj hyperbilirubinemia

- tx

Answer 11

Crigler Najjar
phototherapy and plasmapharesis in short term
liver transplant to cure

Question 12

ATB that can tx nausea secondary to gastroparesis

and mechanism

Answer 12

erythromycin

motilin receptor agonist

Question 13

FAST exam shows fluid in splenorenal angle

- next step

Answer 13

if hemodynamically stable: CT to look for grade of injury

if not hemodynamically stable: ex lap

Question 14

sxs of small bowel obstruction

management

Answer 14

abd pain, vomiting
can't pass flatus or stool
hyperactive BS
distended, tympanitic abd
distended loops of small bowel with air fluid lvls

bowel rest, NGT, IVF
surgery for signs of complications (ischemia, bowel perf)

Question 15

differential and management of dysphagia to solids and liquids

Answer 15

achalasia, pseudoachalasia (esophageal ca)

endoscopic evaluation

Question 16

imaging of ischemic colitis

Answer 16

bowel edema

air (pneumatosis) in bowel wall

Question 17

med to prevent vatical hemorrhage, and alternative

Answer 17

nonselective beta blocker (like propranolol)

endoscopic variceal ligation

Question 18

lab diagnoses of wilson’s disease

Answer 18

low serum ceruloplasmin, less than 20
increased urinary copper excretion

liver biopsy shows hepatic copper level greater than 250 dry weight

Question 19

pathology of GI problems in polymyositis

Answer 19

problems with striated muscles of upper 1/3 of esophagus

Question 20

2 options to dx achalasia, and best dx of achalasia

Answer 20

manometry (best)

barium esophagram

Question 21

air under diaphragm from perforated peptic ulcer. next step

Answer 21

surgery

Question 22

gastroschisis associated problems

Answer 22

short gut syndrome
NEC
dysmotility

Question 23

management gastroschisis

Answer 23

sterile saline dressings and plastic wrap

surgery asap

Question 24

omphalocele associated defects

Answer 24

cardiac
NTD
trisomies

Question 25

acute mesenteric ischemia labs

Answer 25

incr amylase metabolic acidosis - from incr lactate (or can see decr bicarb) incr wbc incr Hb

Question 26

what type of GI bleed gives incr BUN/Cr

Answer 26

upper GI bleed

Question 27

chronic epigastric pain worse supine and at night

Answer 27

pancreatic cancer

Question 28

signs of biliary obstruction

Answer 28

painless jaundice conj bilirubinemia incr alk phos

Question 29

common postgastrectomy syndrome sxs tx

Answer 29

dumping syndrome N/D/cramps sweat, palpitations small, frequent, high fiber and protein foods

Question 30

lactose intolerance tests

Answer 30

positive hydrogen breath test positive stool for reducing substances low stool pH high stool osmotic gap