GI 4

Question 1

IBS can have urinary frequency and urgency

Answer 1

oh ok

Question 2

Rome criteria for IBS?

Answer 2

Recurrent abdominal pain 3 days per month for 3 months with 2 of the following

Relief with defecation
Onset associated with change in frequency
Change in form

Need

Question 3

IBS types include constipation type, diarrhea type, and others

Answer 3

oh ok

Question 4

IBS has normal labs!

Tx options?

Answer 4

makes sense.

Tx:
Physican assurance. Validate patient.

Avoid gas porducing food. Avoid lactose and stuff

Fiber and PEG might help
Antidiarrheals might help. SSRIs (helps comorbid stuff)

Question 5

Fatigue, weight loss, abdominal pain, watery diarrhea?

Fever ,abdominal tendernesss, oral ulcers

Answer 5

Consider chrons. WILL HAVE TEST Q ON IT

left out perianal fissures and fistulas b/c too easy

Question 6

Transumural bowel inflammation? Skip lesions?

Answer 6

IT IS GUM TO BUM

Imaging shows string sign from inflammation! Skipped areas of bowel

Question 7

Crohns tx?

Answer 7

Steroids for exacerbations

Azathioprine is better than methotrexate

Anti TNF alpha agents like infliximab or adalimumab

Question 8

Crohns mnemonic

Answer 8

Crohn gives GIFTS

Granuloma
Ileum
Fistula and fissures
Transmural
Skip lesions

Question 9

Tenesmus and incontinence, bloody diarrhea with weight loss and abdominal pain, think what?

Answer 9

UC

Question 10

Aminosalicylate
Glucocorticoids
Immunosuppressive
Supplemental iron

Answer 10

oh ok

Question 11

Primary sclerosing cholangitis is associated with what?

Answer 11

IBD!

Question 12

serologic markers for IBD?

Answer 12

ASCA is crohn

pANCA with UC! (pANCA also found with that Churgg strauss)

Question 13

Most common benign small bowel cancer?

Malignant?

Answer 13

Leiomyoma

Carcinoid

Question 14

GI issue with pain out of proportion to their unimpressive exam?

Answer 14

Ischemic colitis

Question 15

WBCs on UA can happen with appendicitis how?

Answer 15

It irritates ureters. So don’t mess that up!

Question 16

Appendicitis for 5 days before coming in tx/

Answer 16

Supportive, schedule removal for 8 weeks from there

Question 17

Drugs for ileum?

Answer 17

Erythromycin for motility, neostigmine (makes sense), or metoclopramide

Question 18

Old lady with vague recurrent abdominal pain and vomiting for 5 days?

Answer 18

Galltone inlets that repeated lodges and dislodges. IT GETS CAUGHT IN THE ILEUM

Question 19

Volvulus imaging?

Answer 19

Double bubble (Air bubbles)

Question 20

Pseudotumor cerebri tx?

Answer 20

Acetazolamide, weight loss, serial lumbar puncture

Question 21

Diverticulitis outpatient tx?

Answer 21

metronidazole with fluoroquinolone (makes sense)

Question 22

When do you admit diverticulitis?

Answer 22

CANT SWALLOW MEDS, old, comorbidities, immunocompromised…

Question 23

Fistula from Crohns tx?

Answer 23

get disease to settle down with azothyopryine

Question 24

First treatment of carcinoid?

Remember right sided valvular disease can happen

Answer 24

Octreotide to shut down affect

Cyproheptadine again (used for high 5ht)

IFN alpha can be combined with octreotide

Question 25

Silicosis puts you at risk or what infection?

Answer 25

tb

Question 26

CRC is 4-5 star topic! Adenocarcinoma is it Hyperplastic is not precancerous

Answer 26

right. Villous is bad

Question 27

What is mutated in gardner syndrome?

Answer 27

Lumpy bumpy gardner (colyn polyps, OSTEOMAS, soft tissue tumors) APC gene (similar FAP)

Question 28

Turcot syndrome has what? And what mutation?

Answer 28

APC CNS tumors, Colonic adenomas So if brain cancer and colon cancer, look for it!

Question 29

Juvenile polyposis?

Answer 29

Polyps in vowels, GI bleeding. They are hamartoma

Question 30

What is Peutz Seghers?

Answer 30

Hyper pigmentation of lips. Causes hamartomas!

Question 31

Scary about HNPCC?

Answer 31

Nonpolyposis. Starts in proximal colon. Does not start as polyp

Question 32

CEA is high in what?

Answer 32

Stomach, pancreatic, colon cancer!

Question 33

Node involvment for CRC makes staging for what? What does it mean for treatment?

Answer 33

Stage III, REQUIRES CHEMO

Question 34

CRC surveillance?

Answer 34

CEA every 4 months for years CT every year for mets Colonoscopy 1, 3, and 5 years

Question 35

How do you decrease blood flow to stomach or esophagus?

Answer 35

SOMASTOSTATIN analogue like OCTREOTIDE so give it if acute bleeding!!! also give PPI

Question 36

GI bleed first step after stabilizing?

Answer 36

NG tube to see if stomach contents bloody