GI

Question 1

Most common environmental factor assoc with pancreatic cancer?

Answer 1

Smoking

Question 2

Courvoisier Sign

D/t?

Answer 2

Obstruction causing the gallbladder to become palpable

Often malignant neoplasm obstructing CBD

Question 3

Pathogen responsible for most hepatic abscess

Answer 3

Klebsiella pneumoniae. (Also associate with infections of biliary tract, fatty liver disease, and DM pts.)

Question 4

Gastritis

Answer 4

gnawing epigastric pain, anemia, extremity paresthesia

Question 5

GERD

Answer 5

persistent hoarseness, dry cough, dysphagia

Question 6

Gastric ulcer

Answer 6

Left sided chest pain and anorexia

Question 7

Esophagitis

Answer 7

Severe chest pain, nausea, bitter “water brash”

Question 8

Duodenal ulcer

Answer 8

Abdominal pain, dyspepsia, weight gain

Question 9

Glycogen Storage Disorder I (Von Gierke’s disease)

Answer 9

Auto Rec deficiency in Glucose 6 Phosphatase
Doll Like Face
hypoglycemia when fasting –> lactic acidosis and Kussmaul resps

Tx: cornstarch feedings

Question 10

What is the best test to evaluate biliary dilatation without gallstones on US?

Answer 10

CT of abd with contrast

Question 11

What electrolyte abnormality is the hallmark of Refeeding syndrome?

Answer 11

HyPOPhosphatemia

Question 12

Most effective treatment for Non-Alcoholic Steatohepatitis

Answer 12

Weight loss

Question 13

Zenker’s diverticulum is due to what?

Answer 13

motor dysfunction of cricopharyngeus allowing for herniation between its muscle fibers

Question 14

What are the surgical indications for diverticulitis?

Tx?

Answer 14

Presence of a fistula
perforation
2+ attacks in the same region

Tx: Partial colectomy

Question 15

What is a common cause of GI blood loss (manifesting as iron deficiency anemia) in elderly patients who have no other obvious source of bleeding?

Answer 15

Angiodysplasia

Question 16

What should you always do for a new onset dysphagia?

Answer 16

Upper endoscopy

Question 17

Booerhaave v. Mallory Weiss

Answer 17

Boerhaave is esophageal perforation after excessive vomiting/bulimia

Mallory Weiss is superficial mucosal tear seen in a weekend warrior

Question 18

Dx. Boerhaave syndrome?

Answer 18

Gastrograffin swallow then Barium then EGD

Question 19

Dx. Mallory Weiss?

Answer 19

EGD

Question 20

Tx. Diffuse esophageal spasm?

Answer 20

CCB, Nitrates

Question 21

Dx. for achalsia and zenker’s diverticulum?

Answer 21

barium swallow

Question 22

Schatski’s ring keywords

Answer 22

steakhouse dysphagia
barium swallow
surgery to lyse ring

Question 23

Gold standard for confirming reflux?

Answer 23

24 hr esophageal pH monitoring

Question 24

Barret’s Esophagus has a risk of developing what ca?

Answer 24

Adenocarcinoma

Question 25

Ulcer types Curling v. Cushing

Answer 25

"burn from curling iron" | "cushion the brain"

Question 26

Gastric ca. keywords

Answer 26

Mucosal cell metaplasia Signet ring cells Virchow's (left supraclavicular) node

Question 27

Most common location of a VIPoma? Keywords?

Answer 27

@ pancreatic tail tea-colored watery diarrhea hypOkalemia, hypochlorhydria

Question 28

Right sided colon ca. keywords

Answer 28

Bleed --> Iron Def. anemia | + Melena

Question 29

Left sided colon ca. keywords

Answer 29

Apple core Obstructing Pencil stool Hematochezia

Question 30

Angiodysplasia of colon is associated with?

Answer 30

Aortic Stenosis | Heyde's syndrome

Question 31

If there's Upper GI Bleed, what's the next dx. step?

Answer 31

EGD if stable | NG tube and lavage

Question 32

If there's Lower GI Bleed with no bleeding, what's the next dx. step?

Answer 32

Colonoscopy

Question 33

If there's Lower GI Bleed with medium amount of bleeding, what's the next dx. step?

Answer 33

Tagged RBC scan

Question 34

If there's Lower GI Bleed with high bleeding, what's the next dx. step?

Answer 34

Arteriogram

Question 35

Labs in Biliary Tract obstruction

Answer 35

Increased ALKPHOS, GGT, Conjugated Bili | Jaundice, pruritus, clay stool, dark urine

Question 36

Ulcerative Colitis keywords

Answer 36

``` Bloody diarrhea Colon ca. (do annual colonoscopy after 8 yrs of disease) Crypt Abscesses Erythema nodosum Lead Pipe Mucosa and submucosa inflamm. Primary Sclerosing cholangitis (pANCA, ANA) Pseudopolyps @ Rectum Toxic Megacolon ``` Tx: 5ASA, Steroids

Question 37

Crohns keywords

Answer 37

``` Anti-Saccharomyces-Cervisiae Abs (ASCA) Cobblestone Fistulas Non-caseating granulomas Perianal fissures Skip lesions Transmural Watery diarrhea Nephrolithiasis (IBD causes impaired fat absorption) ``` Tx: 5ASA, Corticosteroids, Infliximab IV (TNFa Ab), No NSAIDS.

Question 38

Primary Sclerosing Cholangitis (PSC) keywords

Answer 38

``` HLA-DR52A pANCA Males with Ulcerative Colitis Cholangiocarcinoma risk Onion Skinning ``` Tx: Ursodiol, ERCP, Liver transplant

Question 39

Most common type of colonic polyps?

Answer 39

Adenomatous. Have malignant potential.

Question 40

Primary Biliary Cirrhosis (PBC) --> cholestasis S&S Dx Tx

Answer 40

middle age woman pruritus, skin hyperpigmentation, hepatomegaly, fatigue, xanthelasma, steatorrhea Increased ALKPHOS + Anti-mitochondrial Ab (AMA) Tx: Ursodeoxycholic Acid

Question 41

Esophageal Varices Ppx?

Answer 41

Propranolol, Nadolol (non-selective BBs)