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2020 ABIM studying > GI > Flashcards

GI Flashcards

1
Q

Regurgitation of undigested food, gurgling in chess, severe halitosis. Dx?

A

Zenker diverticulum

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2
Q

Difficulty initiating swallowing, coughing, choking, nasal regurgitation of fluids. Dx?

A

Oropharyngeal dysphagia

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3
Q

Food sticking or discomfort in the retrosternal region. Dx?

A

Esophageal dysphagia

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4
Q

Progressively increasing solid food dysphagia 2 Dx?

A

Peptic stricture or carcinoma

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5
Q

Episodic solid food dysphagia for months or years. Dx?

A

Esophageal web or distal esophageal ring

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6
Q

Patient taking tetracyclines, NSAIDs, potassium, iron, alendronate who presents with severe substernal chest pain with swallowing several hours to days after taking medication. Dx?

A

Pill induced esophagitis

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7
Q

Young adult with severe dysphagia and food impaction with no relief after PPI. Dx?

A

Eosinophilic esophagitis

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8
Q

Upper endoscopy with mucosal furrowing, stacked Circular rings, white specks, Mucosal friability. Dx?

A

Eosinophilic esophagitis

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9
Q

Dyspepsia, epigastric burning, early satiety, nausea, postprandial belching or bloating dx?

A

PUD

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10
Q

Oropharyngeal dysphagia Dx test and tx?

A

Videofluoroscopy w/liquid and solid phases; Treat with Dietary adjustment and incorporation of swallowing exercises

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11
Q

Eosinophilic esophagitis Dx test and tx?

A

Upper endoscopy, budesonide or swallowed fluticasone

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12
Q

Esophageal candidiasis tx? 2

A

Fluconazole or itraconazole

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13
Q

HSV esophagitis tx? 3 FAV

A

Acyclovir, valaciclovir, famciclovir

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14
Q

CMV esophagitis tx? 2

A

Ganciclovir or foscarnet

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15
Q

Anti-smooth muscle antibodies are associated with which condition?

A

Autoimmune hepatitis

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16
Q

Ascitic fluid containing PMNs greater than this number indicates SBP?

A

Greater than 250/mm3

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17
Q

ATP7B mutation is associated with which condition?

A

Wilson’s Disease

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18
Q

Low serum ceruloplasmin, neuro symptoms,brown corneal rings. Dx?

A

Wilson disease (hepatolenticular degeneration)

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19
Q

Foamy macrophages on PAS stain on a small bowel biopsy is seen in what condition?

A

Whipple’s Disease

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20
Q

Boceprevir and Telaprevir are new hepatitis C agents that can only be used against which HCV genotype?

A

HCV genotype 1

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21
Q

If a patient with inflammatory bowel disease is found to have dysplasia on colonoscopy, what is the next step in management?

A

Proctocolectomy

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22
Q

In hemochromatosis, which condition, if developed, is irreversible?

A

Hypogonadism which can lead to infertility

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23
Q

How do you differentiate chronic hepatitis B Infection from the carrier state?

A

Check liver function tests. Increased in chronic state and normal in carrier state

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24
Q

Long term use of NSAIDS increases,decreases, or has no effect on the risk of developing colon cancer?

A

Decreases

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25
Of the three major forms of hepatitis, which does not currently have a vaccine against it?
Hepatitis C
26
Patient is found to have positive antibodies to soluble liver antigen (SLA). What Condition does this patient likely have?
Autoimmune hepatitis (which also has anti-smooth muscle antibodies)
27
Post-gallbladder removal, patient has right upper abdominal pain and still has elevated LFTs. Next step in management?
Check manometery studies to rule out sphincter of oddi function
28
What antibody can be associated in individuals who have Crohn's Disease?
Anti-Saccharomyces cerevisiae antibodies (ASCA)
29
What is Charcot's triad?
Fever, Right upper quadrant abdominal pain, and Jaundice. Indicates cholangitis
30
What are the two most common HLA markers associated with a condition that has positive antibodies to tissue transglutaminase?
HLA DQ-2 and HLA DQ-8
31
Which hepatitis B marker indicates active replication?
HBeAg
32
Which hepatitis C treatment medications may exacerbate autoimmune hepatitis?
Interferon
33
Which hepatitis infection is the only type that is a DNA virus?
Hepatitis B
34
Dysphagia (esophageal webs), glossitis, iron deficiency anemia Dx?
Plummer-Vinson syndrome (may progress to esophageal squamous cell carcinoma)
35
Fat, female, forty, and fertile
Cholelithiasis (gallstones)
36
Hamartomatous GI polyps, hyperpigmentation of mouth/feet/hands/genitalia Dx?
Peutz-Jeghers syndrome (inherited, benign polyposis can cause bowel obstruction, ^ cancer risk, mainly GI)
37
Jaundice, palpable distended non-tender gallbladder Dx?
Courvoisier sign (distal malignant obstruction of biliary tree)
38
Red "currant jelly" stools Dx?
Acute mesenteric ischemia (adults), intussusception (children)
39
Weight loss, diarrhea, arthritis, fever, adenopathy Dx?
Whipple disease (Tropheryma whipplei)
40
Pain out of proportion to exam, atherosclerosis, CKD, a fib, metabolic acidosis with elevated lactate. Diagnosis?
Acute mesenteric ischemia
41
Acute mesenteric ischemia diagnostic test and trt?
CT; IR for Stent or Sx for resection/revascularization
42
Rapid fire assoc:Antimitochondrial antibodies (AMAs)
1º biliary cirrhosis (female, cholestasis, portal hypertension); also associated with pruritis and Sjögren syndrome
43
Rapid fire assoc: Anti-transglutaminase/anti-gliadin/anti-endomysial antibodies
Celiac disease (diarrhea, weight loss)
44
Rapid fire assoc: "Lead pipe" appearance of colon and abdominal imaging
Ulcerative colitis (loss of haustra)
45
Rapid fire assoc: "Apple core" lesion on barium enema x-ray
Colorectal cancer (usually left-sided)
46
Rapid fire txt: Chronic hepatitis B or C
IFN-α (HBV and HCV); ribavirin, simeprevir, sofosbuvir (HCV)
47
Rapid fire txt: Crohn disease
Corticosteroids, infliximab, azathioprine
48
Chronic atrophic gastritis (autoimmune) causes Predisposition to?
gastric carcinoma (can also cause pernicious anemia)
49
Rapid fire assoc:Triglyceride accumulation in liver cell vacuoles
Fatty liver disease (alcoholic or metabolic syndrome)
50
Rapid fire assoc:Thousands of polyps on colonoscopy
Familial adenomatous polyposis (autosomal dominant, mutation of APC genes)
51
Multiple colon polyps, osteoma/soft tissue tumors, impacted/supernumerary teeth
Gardner syndrome (subtype of FAP)
52
Rapid fire assoc: Eosinophilic cytoplasmic inclusion in liver cell
Mallory body (alcoholic liver disease)
53
Severe RLQ pain with deep tenderness
McBurney sign (acute appendicitis)
54
What is the gold standard for diagnosing small intestinal bacterial overgrowth?
Endoscopy with jejunal aspirate
55
What is the recommendation for initial colonoscopy after inflammatory bowel disease diagnosis and follow up colonoscopies?
8 years after diagnosis and then every 1-2 years
56
What is the name of the sign in which RLQ pain is elicited with LLQ palpation in a patient suspected of having appendicitis?
Positive Rovsing sign
57
Abd pain, ascites, and hepatomegaly Dx?
Budd-Chiari syndrome (posthepatic venous thrombosis)
58
In addition to Fat soluble vitamins, what else is not absorbed in patients with celiac disease?
Iron, vitamin B12, folate
59
When is the first colonoscopy recommended in patients with FAP?
Age 10-12 & repeated every 1-2 y
60
What test is ordered prior to the Performance of Nissen fundoplication for GERD?
Manometry to ensure normal motility.
61
Stool Osmolar gap equation?
290- 2(stool Na+ stool K)
62
What does a high stool Osmolar gap suggest? Low?
Osmotic diarrhea, Secretory
63
Patients with Ileal resection and diarrhea need to be treated with what medication?
Cholestyramine (have bile salt malabsorption) as well as b12 and fat soluble vitamin malabsorption
64
Spontaneous esophageal rupture is diagnosed with what?
Chest CT or esophagram with gastrografin
65
Gastrin levels >1000 suggest what 2 dx? How to differentiate?
Zollinger Ellison and atrophic gastritis. ZE has gastric pH<5
66
Colonoscopy biopsy with mononuclear lymphocytic infiltrate in the lamina propria suggests what dx? Txt?
Microscopic colitis. Antidiarrheals, Budesonide for active or persistent symptoms, tnf inhibitors

2020 ABIM studying (12 decks)

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