GI

Question 1

4 cardinal signs of strangulated bowel…

Answer 1

fever
tachycardia
leukocytosis
localized abd. tenderness

Question 2

MCC of large bowel obstruction

Answer 2

CA

Question 3

KUB findings in bowel obstruction

Answer 3

dilated loops of bowel

air fluid levels

Question 4

Tx of bowel obstruction

Answer 4

NG tube

general surgery referral

Question 5

best initial test and gold standard test for cholelithiasis…

Answer 5

US –> HIDA

Question 6

Patient p/w:

esophageal varicies

Terry’s nails (white nail beds)

palmar erythema

spider angiomata

Answer 6

cirrhosis

Question 7

which labs should be monitored in cirrhosis and for how long?

Answer 7

CBC, CMP, LFTs, Coags + EGD q 3-4 mo

Question 8

_____ should be performed every 6-12 months in cirrhosis to screen for _____

Answer 8

US

hepatocellular carcinoma

Question 9

Familial adenomatous polyposis is inherited via…

Answer 9

autosomal dominant

Question 10

Familial adenomatous polyposis screening with sigmoidoscopoy should begin at ____ because it will 100% result in colorectal CA by age 30-40

Answer 10

age 12

Question 11

MC presentation of colon CA

Answer 11

Painless rectal bleeding and a change in bowel habits in a patient 50-80 years of age

Question 12

Which is more likely to be malignant?

sessile polyps or pedunculated polyps?

Answer 12

sessile

Question 13

no onset constipation in patients over 50…

Answer 13

colon CA

Question 14

diarrhea outbreak in daycare…

Answer 14

rotavirus

Question 15

diarrhea outbreak on cruise ship…

Answer 15

norovirus

Question 16

3+ unformed stools in 24 h with at least one of the following:

fever
nausea
vomiting
abdominal cramps
tenesmus
bloody stools

Answer 16

ETEC/campylobacter

Question 17

Tx for traveler’s diarrhea

Answer 17

cipro 500mg BID x 1-3 d + loperamide

Question 18

Tx for campylobacter/shigella

Answer 18

FLQ

Question 19

What cause of diarrhea comes from poultry, pork, or raw eggs?

Answer 19

salmonella

Question 20

patient presents with:

Fever
Pea soup diarrhea
HA
rose spots (papular rash)

Answer 20

enteric fever (salmonella typhi)

Question 21

Tx for enteric fever/salmonella typhi

Answer 21

ceftriaxone

Question 22

a child presents with:

Abdominal pain and inflammatory diarrhea (small volume)

frequent, mucous and bloody stool,

nausea, vomiting (less common), possible fever

Tenesmus

Answer 22

shigella

Question 23

Tx for shigella

Answer 23

TMP-SMZ

Question 24

Dx of shigella

Answer 24

(+) fecal leukocytes

Question 25

cause of EHEC e-coli

Answer 25

undercooked ground beef

Question 26

Pt. p/w: watery, voluminous non-bloody diarrhea with nausea and vomiting progressing to bloody diarrhea/dysentery no fecal leukocytes

Answer 26

EHEC

Question 27

complication of EHEC

Answer 27

hemolytic uremic syndrome

Question 28

Tx for EHEC...

Answer 28

symptomatic

Question 29

patient presents with: hx of seafood/shellfish ingestion rice water diarrhea 24-48 hours after consumption

Answer 29

cholera

Question 30

tx options for cholera...

Answer 30

doxy, azithro, bactrim, cipro

Question 31

Which type of esophagitis? large solitary ulcers or erosions on EGD - infection at other sites

Answer 31

CMV

Question 32

What type of esophagitis? shallow punched out lesions on EGD...

Answer 32

CMV

Question 33

Tx for CMV esophagitis...

Answer 33

ganciclovir x 3-6 weeks

Question 34

barium swallow shows ribbed esophagus and multiple corrugated rings...

Answer 34

eosinophilic esophagitis

Question 35

Tx for eosinophilic esophagitis

Answer 35

ICS inhaler

Question 36

3 major causes of gastritis...

Answer 36

infx (H. pylori) NSAIDs/EtOH Pernicious anemia

Question 37

patient presents with dyspepsia, bloating, and abdominal pain. They have a hx of EtOH abuse. What condition?

Answer 37

Gastritis

Question 38

3 diagnostics for pernicious anemia...

Answer 38

(+) schilling test decreased IF parietal cell Abs

Question 39

Gastritis tx

Answer 39

PPI x 4-8 weeks +/- UGI H. Pylori testing

Question 40

H. pylori triple therapy...

Answer 40

clarithromycin, amoxicillin, | PPI

Question 41

Gold standard of GERD dx...

Answer 41

pH probe

Question 42

odynophagia, GERD and dysphagia is concerning for...

Answer 42

esophageal ulcer

Question 43

hematemesis, retching, coughing is concerning for...

Answer 43

mallory-weiss tear

Question 44

jaundice, ascites, abd distension and hemorrhage is concerning for...

Answer 44

esophageal varices

Question 45

dysphagia, early satiety, weight loss, cachexia is concerning for...

Answer 45

malignancy

Question 46

odynophagia, dysphagia and retrosternal CP is concerning for...

Answer 46

severe erosive esophagitis

Question 47

bright red blood per rectum should be concerning for...

Answer 47

lower GI bleed

Question 48

6 common causes of lower GI bleed

Answer 48

hemorrhoids anal fissures proctitis polyps CA diverticulosis

Question 49

Tx for giardiasis

Answer 49

tinidazole

Question 50

Tx for pinworms (enterobius vermicularis)

Answer 50

mebendazole or pyrantel pamoate

Question 51

What parasitic infection? Hx of raw/undercooked meat B12 deficiency GI sxs Weight loss

Answer 51

Tapeworm

Question 52

Tx for tapeworm

Answer 52

praziquantel

Question 53

Which parasitic GI Infection? recent travel anemia cough weight loss

Answer 53

hookworm

Question 54

hookworm treatment?

Answer 54

mebendazole

Question 55

Which parasitic GI infection? most common pancreatic duct, common bile duct, or bowel obstruction vague abdominal symptoms

Answer 55

roundworm

Question 56

Roundworm tx options (3)

Answer 56

albendazole, mebendazole, pyrantel pamoate

Question 57

What parasitic GI infx? a/w liver abscess bloody diarrhea tenesmus abd. pain

Answer 57

amebiasis

Question 58

amebiasis tx?

Answer 58

iodoquinol and flagyl (if liver abscess)

Question 59

Which parasitic GI infx? rash abdominal pain bloody stool blood in urine hx of contaminated fresh water consumption

Answer 59

schistosomiasis

Question 60

schistosomiasis tx?

Answer 60

praziquantel

Question 61

Dx of parasitic GI infections?

Answer 61

stool sample examination

Question 62

Which hemorrhoid? pain/pruritis no bleeding palpable mass with purplish hue

Answer 62

external hemorrhoid

Question 63

Which hemorrhoid? BRBPR pruritis rectal discomfort

Answer 63

internal hemorrhoid

Question 64

Tx options for internal hemorrhoids

Answer 64

fiber/sitz bath --> rubber band ligation --> closed hemorrhoidectomy

Question 65

Barium enema sows a lead pipe appearance...

Answer 65

ulcerative colitis

Question 66

Which type of IBD? mucosal surface only continuous lesions

Answer 66

ulcerative colitis

Question 67

Which type of IBD? transmural skip lesions/cobblestoning fistula forming apthous ulcers

Answer 67

crohn disease

Question 68

Medical and surgical tx for ulcerative colitis?

Answer 68

Surgery: Colectomy Medicine: prednisone, mesalamine

Question 69

Tx options for crohn disease?

Answer 69

Flares: predisone/mesalamine +/- flagyl/cipro Maintinance: mesalamine

Question 70

jaundice indicates a serum bilirubin > ____

Answer 70

2 mg/dl

Question 71

Why order CT in evaluation of pancreatitis?

Answer 71

r/o necrotizing pancreatitis

Question 72

serotonin agonist used for IBS...

Answer 72

tegaserod maleate

Question 73

Abx for IBS-D

Answer 73

rifamixin

Question 74

Ransom criteria for poor prognosis of pancreatitis at admission... (5)

Answer 74

``` Age > 55 Leukocyte: >16,000 Glucose: >200 AST: >250 LDH: >350 ```

Question 75

IBS defined as recurrent abd. pain at least ____ days per week in the last ______ months with 2 of the below: defecation related change in stool frequency change in stool form/appearance

Answer 75

one day a week x 3 months (Rome IV criteria)

Question 76

The below would elevate which bili? hemolysis G6PD deficiency Hereditary spherocytosis hematoma Gilbert syndrome

Answer 76

UCB

Question 77

flank bruising in presence of pancreatitis is called...

Answer 77

Grey Turner's sign

Question 78

Bruising near umbilicus in presence of pancreatitis is called...

Answer 78

cullen's sign

Question 79

Complication of pancreatitis...

Answer 79

pancreatic pseudocyst

Question 80

What condition? Hx of pancreatitis well circumsized pancreatic mass on imaging

Answer 80

pancreatic pseudocyst

Question 81

Triad of chronic pancreatitis...

Answer 81

pancreatic calcifications on XRay steatorrhea DM

Question 82

what type of peptic ulcer is relieved with eating?

Answer 82

duodenal | duodenal = decreased pain

Question 83

what type of peptic ulcer is painful after eating?

Answer 83

gastric

Question 84

What condition? tea colored urine vague abdominal discomfort pruritis pale stools

Answer 84

viral hepatitis

Question 85

What diagnostic lab confirms HAV infection?

Answer 85

(+) IgM anti-HAV

Question 86

Which diagnostic lab indicates that someone has had/hadn't had HBV? First look lab in HBV infection...

Answer 86

Anti-HBc

Question 87

Which lab indicates immunity to HBV?

Answer 87

Anti-HBs

Question 88

A (+) HBeAg indicates what type of HBV infection?

Answer 88

highly infectious

Question 89

A (+) HBsAg indicates what type of HBV infection?

Answer 89

ongoing infection

Question 90

Which types of hepatitis increase the risk of hepatocellular carcinoma?

Answer 90

B, C

Question 91

Which hepatitis infection is most commonly caused by IVDU?

Answer 91

HCV

Question 92

Dx of HCV...

Answer 92

RNA quantitation

Question 93

This form of hepatitis only occurs when coinfected with HBV

Answer 93

HDV

Question 94

This type of hepatitis infx occurs in mothers

Answer 94

HEV

Question 95

Alcoholic hepatitis has an AST/ALT ratio of ______ or higher...

Answer 95

AST/ALT > 2:1

Question 96

Tx of acetominophen induced toxic hepatitis?

Answer 96

N-acetylcysteine w/in 8-10 hours

Question 97

Fatty liver disease should be suspected when ___ is greater than ___

Answer 97

ALT > AST

Question 98

What is seen on liver bx in fatty liver disease?

Answer 98

macrovesicular fatty infiltrates