GI

Question 1

tx achalasi

Answer 1

CCB - nifedipine
nitrates
botox
dilation

Question 2

tx mallory weiss tears

Answer 2

self-limited

possible injection of epi w/ endoscopy

Question 3

tx esophageal stricture

Answer 3

PPI
H2 blocker ("tidine")

Question 4

tx GERD

Answer 4

1) H2 blocker

2) PPI

Question 5

RF gastric adenocarcinoma

Answer 5

male
smoking
h pylori

Question 6

dx ZE syndrome

Answer 6

secretin stimulation test
fastin serum gastrin
tx: PPI or surgery

Question 7

tx H pylori

Answer 7

PPI + clarithromycin + amoxicillin

PPI + pepto + tetracyclin + metronidazole

Question 8

pyloric stenosis on barium swallow

Answer 8

string sign

railroad track sign

Question 9

tx pyloric stenosis

Answer 9

pyloromyotomy - Ramstedt’s procedure

Question 10

cholecystitis

Answer 10

infxn gallbladder

RUQ pain + N/V + fever

Question 11

RF cholecystitis

Answer 11

native american
female
obesity
diabetes
prego
crohn's

Question 12

chlonangitis sx

Answer 12

charcot + reynolds

ERCP

Question 13

prodrome - anorexia/nausea/vomit
joint ache
diarrhea
fever
jandice
mild RUQ pain

Answer 13

Hep B

anti-HBc = acute infxn

Question 14

single stranded RNA
prodrome sames as hep B
jaundice

Answer 14

PCR for HCV RNA
HCV antibody
tx: interferon alpha, pegylated interferon, ribavirin

Question 15

tx hep D

Answer 15

peginterferon

Question 16

fibrosis/scarring of liver

macrocytic anemia, increased PT

Answer 16

cirrhosis
tx: folate, iron
FFP for bleeding
fluids/Na for ascites

Question 17

80 cases assoc w/ cirrhosis
cachexia
sudden ascites
deterioration of a pt w/ cirrhosis who has been stable

Answer 17

liver CA
CT/MRI + contrast
monitor: AFP + US

Question 18

Ranson criteria

Answer 18

55 y/o
WBC > 16000
LDH > 350
AST > 250
glucose > 200

Question 19

RF pancreatitis

Answer 19

gallstones
etoh abuse
autoimmune
trauma

Question 20

test for dx pancreatis

Answer 20

CT

Question 21

pancreatic CA

Answer 21

MC adenocarcinoma
steatorrhea
whipple procedure = pancreaticoduodenectomy + gastro-jejuostomy + chlecystojejunostomy

Question 22

psoas vs obturator

Answer 22

psoas = pain w/ right hip flexion or passive extension
obturator = pain w/ flexion + internal rotation

Question 23

cramping + bloating
diarrhea/constipation
dermatitis herpetiformis

Answer 23

celiac

anti-tTG, IgA

Question 24

mild to moderate divericulitis tx

Answer 24

clear liquids

flagyl, cipro, augmentin

Question 25

colonoscopy + bx = cobblestone and skip lesions (transmural inflammation)

Answer 25

crohn's | tx: 5 ASA, steroids

Question 26

limited to mucosa/submucosa bloody diarrhea high risk colon CA

Answer 26

ulcerative colitis tx: sulfasalazine (5-ASA), steroids protocolectomy

Question 27

``` colicky abdominal pain child holding knees to chest pallor lethargy currant jelly stool ```

Answer 27

intussusception FOBT + sausage shaped mass tx: air contrast enema

Question 28

target sign US

Answer 28

intussusception

Question 29

parts of Hesselbach's triangle

Answer 29

inferior epigastric artery, inguinal canal, rectus muscle

Question 30

hypogonadism + MCP arthropathy heart failure bronze diabetes

Answer 30

high serum iron, low trasferrin transferrin saturation > 45% tx: weekly phlebotomy, deferoxamine

Question 31

complications hermochromatosis

Answer 31

cirrhosis + hepatocellular CA

Question 32

wilsons low ceruloplasmin tx?

Answer 32

penicillamine | avoid shellfish, liver, legumes

Question 33

CT "chain of lakes"

Answer 33

chronic pancreatitis

Question 34

pancreatic CA

Answer 34

``` hx smoking, chronic pancreatitis adenocarcinoma of the head CA 19-9 CT scan + contrast whipple procedure ```

Question 35

sudden, intermittent painless rectal bleeding in child < 2

Answer 35

meckel's diverticulum MC congenital abnormality of small intestine technetium 99m scan = ectopic gastric tissue tx: surgery

Question 36

meckel's rule of 2s

Answer 36

``` MC kids < 2 affect 2% population 2x more common M has 2 types tissue - pancreatic and gastric found 2 i w/in ileocecal valve ```

Question 37

failure to pass meconium w/in 48H bilious vomit, FTT explosive poops after rectal exam

Answer 37

Hirschsprung dx - barium enema = narrow distal colon w/ proximal dilation definitive dx: rectal bx tx: surgery colostomy + pull thru procedure

Question 38

rectal bx of Hirschsprung

Answer 38

lack of: myeneteric (Auerbach's plexus) submucosal (Meissner's plexus)

Question 39

1st mon life + bilious emesis blood/mucus stool AXR = bird-beak

Answer 39

volvulus + malrotation | tx: NG tube decompression, fluids, surgery

Question 40

study of choice vovulus + malrotation

Answer 40

upper GI = abnormal location ligament of Treitz

Question 41

what abnormality is Hirshsprung assoc w/

Answer 41

Down syndrome

Question 42

tumor marker colon CA

Answer 42

CEA

Question 43

MC place anal fissures

Answer 43

posterior midline

Question 44

tx hemorrhoids

Answer 44

fiber, fluids, sitz | sclerotherapy, rubber band ligation, electrocoagulation, surgery

Question 45

study choice hernia

Answer 45

CT