GI 2

Question 1

acute diverticulitis bowel habits

Answer 1

up to 50% will have constipation, some will have diarrhea

Question 2

uncomplicated diverticulitis tx

Answer 2

liquid diet and oral analgesia for 2-3 days then reassess

Question 3

chronic therapy for diverticulosis
5

Answer 3

high fiber diet with supplementation w/ psyllium/Metamucil or methlycellulose/Citrucel
stop smoking
activity
reduce meat intake

Question 4

clay colored stools, dark colored urine

Answer 4

acute hepatitis

Question 5

acute hepatitis - ammonia, prothrombin time, albumin

Answer 5

elevated ammonia and prothrombin time
decreased albumin

Question 6

rapid onset and severe epigastric and LUQ pain

Answer 6

acute pancreatitis

Question 7

acute pancreatitis - elevated pancreatitis enzymes include

Answer 7

amylase
lipase
trypsin

Question 8

acute pancreatitis - calcium

Answer 8

hypocalcemia

Question 9

sensitive serum tests for pancreatic inflammation
2

Answer 9

amylase
lipase

Question 10

two testes for c diff

Answer 10

NAAT
stool assay

Question 11

c diff abx
3

Answer 11

fidaxomicin or vanco
alt is metronidazole

Question 12

c diff diet

Answer 12

early oral refeeding is encouraged, regular low residue diet; brat diet (bananas, rice, applesauce, toast) is not necessary

Question 13

most common cause of viral gastroenteritis

Answer 13

norovirus

Question 14

acute onset of high fever, blood diarrhea, severe abd pain with at least 6 stools in a 24 hour period

Answer 14

bacterial gastroenteritis

Question 15

symptoms develop within 7 days of exposure and typically last 7 or more days; usually watery diarrhea

Answer 15

protozoal gastroenteritis

Question 16

GERD can cause damange to squamous epithelium in the lower esophagus causing what

Answer 16

Barrett’s esophagus which increases risk of squamous cell cancer

Question 17

first line tx for GERD
5

Answer 17

lifestyle changes
avoid large and/or fatty meals, typically 3-4 hours before bedtime
avoid foods/meds that relax sphincter
weight loss
stop smoking

Question 19

first line treatment for mild to mod GERD or mild esophagitis

Answer 19

H2RA e.g. nizatidine, famotidine - take at bedtime

Question 20

long term use of PPIs can cause

Answer 20

osteoporosis, bone/hip fractures in post menopausal women, acute interstitial nephritis, reduced absorption of irone, c diff

Question 21

mod to severe esophagitis - first line

Answer 21

PPI

Question 22

IBS is a

Answer 22

chronic functional disorder of the colon marked by exacerbations and remissions

Question 23

bloating with flatulence, relief obtained after defecation

Answer 23

IBS

Question 24

IBS - antispasmodics for abd pain

Answer 24

dicyclomine/Bentyl
hyoscyamine

Question 25

IBS with constipation - begin a trial of

Answer 25

fiber supplements, then trial polyethylene glycol/miralax

Question 26

IBS severe constipation - prescribe

Answer 26

lubiprostone or linaclotide

Question 27

IBS w/ diarrhea - take what

Answer 27

loperamide before meals; bile acid sequestrants as second line

Question 28

NAFLD is caused by

Answer 28

triglyceride fat deposits (steatosis) in the hepatocytes of the liver

Question 29

NAFLD initial imaging

Answer 29

liver US

Question 30

NAFLD gold standard for dx

Answer 30

biopsy

Question 31

NAFLD tx plan 5

Answer 31

lose weight exercise watch diet d/c alcohol intake avoid hepatotoxic drugs

Question 32

abd pain relieved by food or antacids with recurrence shortly after a meal

Answer 32

gastric ulcer

Question 33

abd pain relieved by food or antacids with recurrence 2-4 hours after

Answer 33

duodenal ulcer

Question 34

all patients dx with PUD should be tested for

Answer 34

h. pylori infection

Question 35

urea breath test is indicative of

Answer 35

active H. pylori infection is commonly used to document eradication of H. pylori after tx

Question 36

what two tests are more sensitive for active infection h. pylori

Answer 36

urea breath test stool antigen

Question 37

gold standard test for h. pylori

Answer 37

upper endoscopy and biopsy of gastric and/or duodenal tissue

Question 38

tx for h. pylori positive ulcers

Answer 38

triple therapy - clarithromycin + amoxicillin or metronidazole + PPI

Question 39

tx for h. pylori negative ulcers 3

Answer 39

stop NSAIDs use PPI or H2RA stop smoking