Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step 3 > GI > Flashcards

GI Flashcards

1
Q

What is the next best step in management for a pt who presents with dysphagia without anemia/bleeding and dx is unknown?

A

Barium (swallow) Study

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the next best step in management of a pt with dysphagia, wt loss, heme positive stool or anemia?

A

Endoscopy

Only do barium if endoscopy is not an option

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the best initial treatment for esophageal cancer?

A

Surgical resection for non-metastatic disease

Chemo after surgery: 5-Fluorouracil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the most likely dx in a middle age woman presenting with dysphagia and iron deficiency anemia?

A

Plummer-Vinson Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a serious complication associated with Plummer Vinson Syndrome?

A

Squamous Cell Esophageal Cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the best initial treatment for Plummer-Vinson Syndrome?

A

Iron Replacement

also , on CCS, include stool softeners as iron can lead to constipation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the best initial treatment for Schatzki’s Ring and Peptic Stricture?

A

Pneumatic Dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What muscle group is affected in Zenker’s Diverticulum?

A

Posterior Pharyngeal Constrictor Muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How are Prinzmetal’s Angina and Esophageal spastic disorders distinguished?

A

Prinzmetal’s Angina will have ST elevation and abnormality with Coronary Stimulation.

No cardiac abnormalities found with Esophageal disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the treatment for Esophageal spastic disorders and Prinzmetal’s Angina?

A

Calcium Channel Blockers and Nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the next best step in management for a HIV-neg pt with odynophagia?

A

Endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is next best step in management for HIV-pos pt presenting with odynophagia and CD4 ct

A

Fluconazole

Note: perform endoscopy only if no response to fluconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most common cause of esophagitis in HIVpos pt?

A

Candida Esophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the treatment for pt with high grade esophageal dysplasia?

A

Surgical resection, ablation, or distal esophagectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the treatment for pt with Low-grade dysplasia?

A

PPI and repeat endoscopy in 3-6 mos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the treatment for pt with Barret’s esophagus?

A

PPI and repeat endoscopy q 2-3 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is next best step in management for pt >45 yo who presents with epigastric discomfort for several weeks with no other symptoms and heme-neg stool?

A

Upper Endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the indications for stress ulcer prophylaxis?

A

Head trauma
Intubation/ mechanical ventilation
Coagulopathy w/ steroid use
Burns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the indication for Helicobacter triple therapy?

A

Iff pt has positive Bx WITH gastritis or ulcer on endoscopy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the most likely dx for pt presenting with Gastrinoma and Hypercalcemia?

A

MEN I Syndrome (MEN gene mutation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What biological marker prophile is associated with Crohn’s Disease?

A 
Antineutrophil cytoplasmic Ab (ANCA)-Neg
Antisaccharomyces cervicsiae (ASCA)-Pos
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What biological marker prophile is associated with Ulcerative Colitis?

A

ANCA: Pos
ASCA: Neg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the best initial therapy to treat UC and Crohn’s Disease?

A

Mesalamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the side effects of sulfasalazine?

A

Rash
Hemolytic Anemia
Interstitial Nephritis

(thus not firstline therapy to treat IBD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the treatment for controlling sx of Fistulizing Crohn’s Disease?

A

Infliximab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What test must be done prior to starting Infliximab?

A

PPD (if positive give INH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the best treatment for management of acute sx with UC and Crohn’s Disease?

A

Budesonide (steroids)

has very little systemic side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is best treatment to manage pt with UC/Crohn’s who has severe and recurrent sx when steroids are stopped?

A

Azathioprine and 6-mercaptopurine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the best treatment for pt with perianal involvement with Crohn’s Disease?

A

Metronidazole and Ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is best initial test in a pt suspected of antibiotic -associated (c.diff) diarrhea?

A

stool Toxin assay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the causes of fat malabsorption?

A

Chronic Pancreatitis
Celiac Diesase (Non-tropical Sprue)
Tropical Sprue
Whipple Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are associated complications of fat malabsorption?

A 
Hypocalcemia (vit d def and soponification) --> osteoporosis
Oxaloacetate stones (increased absorption)
Easy bruising (factor-type bleedingd/t Vit K def)
Vit B12 def (terminal ileum damage or pancreatic damage)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the best initial test for malabsorption?

A

Stool Sudan black stain (for fat presence)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Waht is the most sensitive test for malabsorption?

can use to r/o

A

72-hr Fecal fat test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What micro/macro nutrient malabsorption can be associated with Celiac disease?

A

Fat malabsorption
Iron (terminal ileum destruction)–> microcytic anemia
Folate (vili damage-blunted microvili)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the best initial test in pt suspected of Celiac Disease?

A

Anti-gliadin Ab
Anti-endomysial Ab
Anti-tissue transglutaminase Ab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the most accurate test for dx’ing Celiac Disease?

A

Small Bowel Bx (always do this test to dx and r/o lymphoma of small bowel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the standard treatment for tropical Sprue?

A

Doxycycline or TMP/SMX for 3-6 months

39
Q

What is the treatment for pt presenting with foul smelling stools that float, B12 deficiency, neurological findings, ocular sx, joint pain, and diarrhea?

A

Tetracycline or TMP/SMX for 12 months

Whipple Disease treatment

40
Q

What is the order of treatment for IBS?

A

Initial: Fiber
FIber no help: Add Dicyclomine/Hyoscyamine (anichol/antispasmodic)
Antichol/antispas no help: Add TCA (Amitriptyline)

41
Q

What medications can cause acute pancreatitis?

A

Thiazides (Diuretic)
Didanosine(NRTI)
Stavudine(NRTI)
Azathiprine (Crohn’s to wean off steroids)

42
Q

What is the best initial test to dx acute pancreatitis?

A

Serum Amylase/Lipase

43
Q

What is the most accurate test to dx acute pancreatitis?

A

Abdominal CT

44
Q

What are some other useful tests in managing acute pancreatitis?

A

MRCP (if CT unclear)
Urine Trypsinogen Peptide (to measure severity)
ERCP (if dilates hepatic ducts w/o pancreatic head mass)

Note: ERCP is diagnostic and therapeutic so use when it seems possible that it can also treat something!

45
Q

If CT scan of pt with acute pancreatitis shows >30% necrosis, what is next step in management?

A

Start Antibiotics
Imipenem (gram negative/anaerobic coverage)
CT-guided biopsy (if infected/necrotic pancreas on bx–> debridement)

46
Q

What are the general presenting features of acute Hepatitis?

A

Jaundice
Fatigue
Weight Loss
Dark Urine (elevated direct bilirubin)

47
Q

What symptoms are associated with Serum-sickness phenomenon and Hepatitis B and C?

A

Joint Pain
Fever
Urticaria

48
Q

Which type of hepatitis is most severe in pregnancy?

A

Hepatitis E

49
Q

For which type of acute Hepatitis infection is there treatment?

A

Acute Hepatitis C only

50
Q

What is the treatment for acute/chronic Hepatitis C?

A

Interferon/Ribavirin and Oral Protease Inhibitor (Ledipasvir, Simeprevir, Sofosbuvir)

Note: Ledipasvir with Interferon is best combo for Genotype 1 Hepatitis C.

51
Q

Which pt is the best candidate for chronic Hep B treatment?

A 
Pt with:
 HbsAg 
 elevated Hep B PCR for DNA 
 DNA polymerase
 HbeAg
52
Q

What are the single agent treatment options for chronic Hep B?

A 
Lamivudine
Adefovir
Entecavir
Telbivudine
Tenofovir
Interferon
53
Q

What are the side effects of Interferon?

A 
Fatigue 
Flu-like sx 
Arthralgias
Myalgias
Depression
Thrombocytopenia
54
Q

What is the most common side effect of ribavirin?

A

Anemia

55
Q

What is the best initial test for dx’ing Acute Hep C?

A

Hep C Antibody (cannot tell viral activity)

56
Q

What is the most accurate test for Acute Hep C?

A

Hep C PCR (RNA)

This tells best, the viral activity, and response to treatment.

57
Q

What is the best test to determine Hep C severity?

A

Liver Bx

58
Q

What are the criteria for Hep A and B vaccination?

A 
Chronic liver disease
Household contacts w/ Hep A or Hep B
Chronic recipient of Blood products
Men who have sex with men
IV drug users
59
Q

What are the indications for Hep B vaccination alone?

A

Health Care workers
Dialysis pts
Diabetes

60
Q

What are the common features of a pt with Cirrhosis?

A 
Edema (low serum albumin)
Gynecomastia
Palmar erythema
Splenomegaly
Thrombocytopenia (splenic sequestration)
Ascites (tx with Spironolactone)
Encaphalopathy (tx with lactulose)
Esophageal Varices (banding if they bleed, Propranolol to prevent bleeding)
61
Q

What test should be included in the management of pt recently diagnosed with liver cirrhosis?

A

Endoscopy (to detect esophageal varices)

62
Q

When should a paracentesis be done for pt with ascites?

A

If it is New Ascites and/or Pain, Fever, Tenderness present

63
Q

What test should be included in work up of ascites?

A

Albumin (serum and ascites)–> use to calculate SAAG

SAAG>1.1: Portal Hypertension or CHF
SAAG check cell count (> 250 neutrophils)

64
Q

What is the treatmetn for Spontaneous Bacterial Peritonitis (SBP)?

A

Cefotaxime

65
Q

What is the best initial test for a middle-aged woman with a h/o autoimmune disease presenting with itching w/w/o Xanthelesmas?

A 
Alk Phos (elevated)
Bilirubin (normal)

To dx Primary Biliary Cirrhosis

66
Q

What is the treament for pt with PBC and PSC?

A

Ursodeoxycholic Acid

67
Q

What is the most accurate test to dx PBC?

A

Antimitochondrial Ab (AMA) and Liver Bx

can hv elevated IgM level also

68
Q

What is the most likely dx in a pt with h/o IBD, presenting with itching and found to have elevated alk phos and bilirubin?

A

Primary Sclerosing Cholangitis (PSC)

69
Q

What are the most accurate tests to dx PSC?

A

ERCP (beaded biliary system)
ANCA positive
Anti-smooth muscle Ab (ASMA)

70
Q

What is the most likely diagnosis of a pt presenting with liver disease/cirrhosis, choreiform movement, neuropsychiatric abnormalities w/w/o hemolysis?

A

Wilson’s Disease (copper metabolism disorder- low ceruloplasmin)

71
Q

What is the best initial test to dx Wilson’s Disease?

A

Slit Lamp ocular exam: Kayser Fleischer rings

Note (for CCS order slit lamp and ceruloplasmin level even though cerloplasmin is less sensitive and less specific)

72
Q

What is most accurate test for dx’ing WIlson’s disease?

A

Liver Bx

73
Q

What is the treatment of choice for Wilson’s disease?

A

Penicillamine or Trientine

74
Q

What is the most likely diagnosis for a pt who has the following test results: High Serum Fe, High Ferritin, Low TIBC?

A

Hemochromatosis

75
Q

What is the most common underlying cause of Hemochromatosis?

A

HFe gene mutation

76
Q

What organs are typically affected in Hemochromatosis?

A 
Liver (Cirrhosis and Hepatoma)
Pancreas (Bronze Diabetes)
Heart (Restricted Cardiomyopathy)
Gonads (Infertility)
Skin (Hyperpigmentation) 
Joint (pseudogout/Calcium Pyrophosphate deposition)
Pituitary (panhypopituitarism)
77
Q

What is the beat initial test in dx’ing Hemochromatosis?

A

Iron studies

78
Q

What is the most accurate test for dx’ing Hemochromatosis?

A

Liver Bx or

MRI w/genetic testing

79
Q

What is the most common cause of death in Hemochromatosis?

A

Cirrhosis

80
Q

What is the treatment for Hemochromatosis?

A

Phlebotomy

81
Q

What are the best initial tests to dx Autoimmune Hepatitis?

A

ANA and SPEP (hypergammaglobulinemia)

82
Q

What is the most accurate test in pt with Autoimmune Hepatitis?

A

Liver Bx

83
Q

What autoantibodies are associated with Autoimmune hepatitis?

A

ANA

ASMA

84
Q

What is the best treatment for managing Autoimmune Hepatitis?

A

Prednisone (can use azathioprine to wean off steroids)

85
Q

What conditions are most strongly associated with Non-alcoholic Steatohepatitis (NASH)?

A

Obesity
Diabetes
Hyperlipidemia

86
Q

What physical finding is commonly present in pt with NASH?

A

Hepatomegaly

87
Q

What is the best initial test to dx NASH?

A

Liver enzymes (ALT> AST)

88
Q

What is the most accurate test to dx NASH?

A

Liver Bx: fatty infiltrate (like alcoholic liver)

89
Q

What hepatic serology is associated with Acute Hepatitis B infection?

A

HbsAg
HbeAg
HbcAb

90
Q

What serology is associated with the Window period in Hepatitis B infection (recovering)?

A

HbcAb

91
Q

What stage of Hep B infection is associated with a positive HbcAb and HbsAb

A

Resolved infection, Past Hep B infection

92
Q

What serology indicated chronic Hep B infection?

A

HbsAg present >6 months
HbeAg
HbcAb

93
Q

What tests indicate active viral replication in HepB?

A

HbeAg, HepB DNA pol, HepB DNA PCR

Step 3 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions