GI

Question 1

first line PBC

Answer 1

urso

Question 2

complication of CT cyst drainage in echinnococcus

Answer 2

anaphylaxis! cyst contents are very antigenic

Question 3

kernitcerus presents with:

Answer 3

hypotonia
seizures
choreoathetosis
hearing loss

Question 4

when is jaundice pathologic?

Answer 4

• on first day of life
• bilirubin rises >5mg/day
• bili > 19.5 in a term baby
• hyperbilirubinemia (>2) after 2 weeks of life

Question 5

recurrent aspiration PNA in newborn babe

Answer 5

TEF –> food traveling to lungs

Question 6

most common TEF

Answer 6

EA with dital TEF

Question 7

radiographic sign seen in pyloric steonsis?

What is the best test?

Answer 7

string sign with barium swallow

best FIRST test= US
best dx test= upper GI series

Question 8

CHARGE syndrome

Answer 8

C= coloboma of eye, CNS
H=heart defects
A= atresia (choanal)
R= retarded development
G= genital/ urinary defects, hypogonadism
E= ear anomolies, deafness

Question 9

presentation of intussusception

Answer 9

currant jelly stool
sausage mass
bilious vomiting

assoc with HSP

Question 10

norovirus incubation

Answer 10

12-48hours
fecal oral
watery diarrhea, vomiting

Question 11

dx of lactose intolerance?

Answer 11

hydrogen breath test –> will have inc hydrogen

Question 12

bowel surgery in chrons?

Answer 12

remember to do as many BOWEL SAVING procedures as possible

Question 13

extraintestinal manifestations of celiac

Answer 13

skin: dermatitis herpetiformis
neuro: peripheral neuropathy
gyn: intertility

obvs other autoimmune things

Question 14

if you suspect celiac but TTG is neg/ dec IGa, what shold you test?

Answer 14

IgG for gliadin

Question 15

fever, jaundice, pale stools, dark urine, n/v in someone who recently traveled to third world country

Answer 15

Hep A

***anicteric manifestations in children

Question 16

w/u of suspected borheave’s when hemodynamically stable vs unstable

Answer 16

stable: gastrographin
unstable: CT

Question 17

when is barium CI?

Answer 17

when you have any supicion of esophageal perf –> causes mediastinitis

Question 18

pneumotosis intestinalis

Answer 18

NEC! premature infant

if bad, will see metabolic acidosis

Question 19

manifestations of whipples?

Answer 19

diarrhea
arthralgias
neuro changes
valve insufficiency
hyperpigmentation

+PAS macs in lamino proprio

tx with IV ceftriaxone

Question 20

if you had to pick one, first line for c. diff colitis?

Answer 20

oral metro (cheaper than vanc)

Question 21

staph food poisoning incubation vs salmonella

Answer 21

1-3 hours v 1-3 days (+bloody)

Question 22

esophageal varices proph?

Answer 22

propanolol + banding q1-2 weeks

if above fails, placement of TIPS

Question 23

flushing, wheezing, R sided heart abnormalities in setting of diarrhea

Answer 23

carcinoid
dx= 5HIAA
tx= octreotide

Question 24

pyogenic liver abcess

Answer 24

bugs: e. coli, klebs most common

people with galbladder dz at risk

Question 25

oral thrush with odynphagia and dysphagia in HIV patient?

Answer 25

tx for esophagitis as well --> fluconozole

Question 26

sialidentitis

Answer 26

acute infx of parotid gland - elderly, post of patient or ICU patient - prevent with hydration and oral hygeine - bug= Staph A - tx with naf, metro, clinday

Question 27

anti core vs HbeAg

Answer 27

core ab means chronic infx, envelope means new or reactivated ***envelope actively sheds during replication of active cirus

Question 28

tx for chronic heb b

Answer 28

INF a | if patient is immunosuppressed or has autoimmune disease, use something like tenofavir

Question 29

most common lead point for children with repetitive intussception?

Answer 29

meckel's intususception will show concentric rings of bowel on tranverse section

Question 30

most common cause of diarreal illness in kids?

Answer 30

rotavirus can be detected by stool ELISA

Question 31

palpable mass on DRE/ LLQ in acute diverticulosis?

Answer 31

yes, suggests pericolonic inflammation. It's a thingk.

Question 32

diagnostic/ treatment step in GI bleed that is hemodynamically unstable, not responding to resusutative efforts and hasn't yet been localized?

Answer 32

angiography

Question 33

how do you w/u a gastrinoma?

Answer 33

first, check fasting gastrin levels ``` if high (>1000) and low pH= gastrinoma if between 100-1000, do sectretin stim (secretin --| gastrin) ``` **associated with MEN1

Question 34

treatment of MALToma

Answer 34

1st: erradicate h pylori 2nd: chemo/ rad if that fails

Question 35

acid fast oocytes in diarrhea of HIV patient

Answer 35

cryptosporidium

Question 36

how do you tx toxic megacolon?

Answer 36

conservatively bowel rest, correct lytes abx if from c diff at risk of perf.

Question 37

antismooth muscle ab

Answer 37

autoimmune hepatitis don't forget about this as a cause for cirhosis!!

Question 38

non caseating granulomas with neutrophils in the crypts in a 60 yo man

Answer 38

chrons bimodal age dist!!

Question 39

ADEK deficiency in ZES?

Answer 39

ZES decreases pH --> pan lipases require an alkaline environment to emulsify fat --> impaired absorption E defi- can manifest as gait disturbance

Question 40

melanosis coli

Answer 40

pigmentation of colonic mucosa from laxative abuse look for a patient with a psych histroy and many episdoes of watery diarrhea during the day and night . elevated Mg can be sign of abuse

Question 41

breast feeding failure jaundice

Answer 41

- first week of life - infrequent volume of feeds causes slow transit time, GI tract reabsorbs bili <10% of bili is conjugated because gut only resorbs unconjugated bili ***breast milk jaundice will present at 1-2 weeks

Question 42

psoas sign

Answer 42

pain with hip extension - usefull in PSOAS ABCESS= subacute, low grade fever - retrocecal appy