GI

Question 1

XR findings in appy

Answer 1

sentinel loop
absence of air in RLQ
fecalith

Question 2

tx of IBS

Answer 2

peppermint
high fiber diet
antispasmodics
TCAs
probiotics
psych

Question 3

optimal composition of ORS

Answer 3

2% glucose, 90 mEq NaCl

Question 4

stool WBCs

Answer 4

more indicative of bacterial diarrhea

methylene blue

Question 5

poor sanitation, diarrhea in young children/neonates, mild diarrhea, sometimes fever and vomiting

Answer 5

EPEC

Question 6

severe nonbloody diarrhea, traveling

Answer 6

ETEC

tx: bactrim, azithro, cipro

Question 7

watery –> bloody diarrhea, mimic intussusception

Answer 7

EHEC (Shiga)

antibiotics contraindicated –> increase risk of HUS

Question 8

dx Giardiasis

Answer 8

EIA and DFA assays of stool

tx: flagyl, tinidazole, nitazoxanide

Question 9

reducing substance in stool

Answer 9

sugar malabsorption

Question 10

hydrogen breath test

Answer 10

sugar malapsortion

Question 11

serum carotene and PT

Answer 11

indirect tests for fat malabsorption (measuring A and K)

Question 12

MOA of diarrhea in neuroblastoma

Answer 12

VIP production

Question 13

tx of intussusception

Answer 13

air enema

Question 14

risk factors for complications of GERD

Answer 14

prematurity
neuro impairment
family hx of severe GERD

Question 15

lab findings in pyloric stenosis

Answer 15

hypochloremic hypokalemic metabolic alkalosis

indirect hyperbili

Question 16

US cutoffs for pyloric stenosis

Answer 16

length > 14 mm

thickness > 4 mm

Question 17

tx cyclic vomiting

Answer 17

cyproheptadine
TCAs
propranolol

Question 18

cyst on floor of mouth

Answer 18

ranula = mucocele

excision

Question 19

midline mass in mouth

Answer 19

could be ectopic thyroid, do not excise

Question 20

underdeveloped/absent teeth, lack of sweat pores

Answer 20

ectodermal hypoplasia
X linked
dx: skin biopsy

Question 21

dx H pylori

Answer 21

serology = screen
fecal antigen or urea breath test as confirmation
gold standard: endoscopic biopsy

Question 22

dz assoc with rectal prolapse

Answer 22

CF
increased abd pressure
meningomyelocele
parasites

Question 23

when are intestinal polyps not concerning

Answer 23

< 5 polyps and no fam hx

Question 24

FAP

Answer 24

benign adenomatous polyps in teens –> malignant conversion

Question 25

FAP + CNS tumors

Answer 25

Turcot syndrome

Question 26

GI polyps + extra teeth, soft tissue tumors

Answer 26

Gardner's syndome AD inheritance tx: surgery

Question 27

pigmentation of lymphs and gums, lots of polyps

Answer 27

Peutz Jeghers high cancer risk in many organs tx: colonoscopies + cancer screening

Question 28

should you do a barium enema in UC

Answer 28

no, risk of perforation

Question 29

apt test

Answer 29

test if GI blood is maternal or infant's

Question 30

false positive guaiac results

Answer 30

recent meat ingestion horseradish ferrous sulfate

Question 31

false negative guaiac results

Answer 31

vitamin C old cards improper specimen storage

Question 32

GI probs assoc with T21

Answer 32

duodenal atresia Hirschsprungs Meckel's PS

Question 33

rule of two with Meckels

Answer 33

``` age of 2 2 types of tissue 2 feet from ileocecal valce 2 inches in length 2% of population ```

Question 34

dx in direct hyperbilirubinemia

Answer 34

hepatobiliary scintigraphy

Question 35

dx in suspected biliary atresia

Answer 35

US --> HIDA --> biopsy

Question 36

most common cause of cholestatic jaundice in newborn

Answer 36

TPN

Question 37

neonatal jaundice, fever, acholic stools, RUQ pain, palpable mass

Answer 37

choledochal cyst

Question 38

teenager with jaundice when has URI or fasting

Answer 38

Gilbert | glucuronyl transferase deficiency

Question 39

flu --> comatose with elevated LFTs and ammonia

Answer 39

Reye's syndrome (2/2 aspirin)

Question 40

labs in Wilsons

Answer 40

elevated hepatic copper decreased ceruloplasmin low serum copper increased urine copper

Question 41

tx Wilsons

Answer 41

D-penicillamine chelation, low copper diet

Question 42

SE of penicillamine

Answer 42

aplastic anemia

Question 43

lung, liver, and skin problems

Answer 43

A1AT deficiency

Question 44

how long after HAV infection to return to child care/food service

Answer 44

1 week after onset

Question 45

HAV PEP

Answer 45

IG if <12 mos | HAV if >12 mos

Question 46

complications of chronic HBV

Answer 46

hepatic failure | hepatocellular carcinoma

Question 47

complications of HCV

Answer 47

liver disease cirrhosis hepatocellular carcinoma

Question 48

causes of recurrent pancreatitis

Answer 48

familial dyslipidemia | hypercalcemia