GI lecture 4 practice questions Flashcards
Who are you more likely to find gallstones in on an ultrasound of the RUQ?
a) A 33 year old man with a BMI of 35
b) A 45 year old woman with a BMI of 33
c) A 55 year old woman with a BMI of 30
d) A 45 year old man with a BMI of 34
b) A 45 year old woman with a BMI of 33
Which is helpful to look at the function of the gallbladder, but is not helpful in detecting gallstones?
a) MRI
b) MRCP
c) ERCP
d) HIDA
d) HIDA
90% of cases of acute cholecystitis are caused by what?
a) Gallstones in the cystic duct
b) Gallstones in the common bile duct
c) Gallstones in the gallbladder
d) Gallstones in the pancreas
a) Gallstones in the cystic duct
Which of the following is most suggestive of choledocholithiasis?
a) Hyperbilirubinemia
b) Leukocytosis
c) Severe Jaundice
d) + Murphy sign
c) Severe Jaundice
Your 45 year old patient has sudden onset RUQ and epigastric pain, vomiting, and fever. Murphy’s sign is +. You do a RUQ US and see gallstones with shadowing, GB wall thickening, pericholecystic fluid. Elevated AST, ALT & ALP are elevated to ~300 units/mL. What is the most likely Dx and Tx?
a) Acute cholecystitis; cholecystectomy
b) Gallstones; pain management
c) Choledocholithiasis; pain management
d) Acute cholecystitis; pain management
e) Cholangitis; cholecystectomy
a) Acute cholecystitis; cholecystectomy
(Choledocholithiasis will have AST, ALT, & ALP elevated to >1000)
What can be caused by a bacterial infection in patients with biliary obstruction?
a) Cholecystitis
b) Choledocholithiasis
c) Gallstones
d) Cholangitis
d) Cholangitis
Endoscopic sphincterotomy (ERCP) with stone extraction and/or stent insertion is the procedure of choice for what?
a) Cholecystitis
b) Choledocholithiasis
c) Gallstones
d) Cholangitis
d) Cholangitis
Which conduction may cause dermatitis herpetiformis, malodorous fatty stools, fetal loss, pubertal delay?
a) Crohn’s
b) Celiac
c) Lactase deficiency
d) Ulcerative colitis
e) Bacterial overgrowth
b) Celiac
What is the hydrogen breath test used for?
a) Crohn’s
b) Celiac
c) Lactase deficiency
d) Ulcerative colitis
e) Bacterial overgrowth
c) Lactase deficiency
What Rifaximin (xifaxan) 1 PO TID for 14 days the primary treatment for?
a) Crohn’s
b) Celiac
c) Lactase deficiency
d) Ulcerative colitis
e) Bacterial overgrowth
e) Bacterial overgrowth
Which are synthetic markers of hepatic function? Select three
a) PT/INR
b) GGT
c) ALT
d) AST
e) PLT
f) Albumin
a) PT/INR
e) PLT
f) Albumin
Isolated mild hyperbilirubinemia that increases with fasting is the primary sign of what?
a) Alcoholic hepatitis
b) Viral hepatitis
c) Acute liver failure
d) Gilbert’s syndrome
e) Drug-induced liver injury
d) Gilbert’s syndrome
Which is more likely to have ALT and AST >25x ULN?
a) Acute exacerbations of hepatitis A
b) Acute exacerbations of hepatitis B
c) Acute exacerbations of hepatitis C
d) Acute exacerbations of hepatitis D
b) Acute exacerbations of hepatitis B
Ischemic or drug-inducted hepatitis is most likely to have what lab value?
a) AST/ALT >1,000 U/mL
b) AST/ALT >5,000 U/mL
c) AST/ALT >10,000 U/mL
d) AST/ALT >15,000 U/mL
b) AST/ALT >5,000 U/mL
The most common precursor of cirrhosis in the U.S is what?
a) Alcoholic hepatitis
b) Viral hepatitis
c) Acute liver failure
d) Gilbert’s syndrome
e) Drug-induced liver injury
a) Alcoholic hepatitis
What is the most common cause of acute liver failure in the U.S.?
a) Alcoholic hepatitis
b) Viral hepatitis
c) Gilbert’s syndrome
d) Drug-induced liver injury
d) Drug-induced liver injury
A patient presents with DILI. Their labs show disproportionate elevation ALT & AST compared with ALP. There’s no serum bilirubin elevation. What is the most likely location of the injury?
a) Hepatocellular injury (hepatitis)
b) Cholestatic injury (cholestasis)
a) Hepatocellular injury (hepatitis)
APAP toxicity: Serum APAP concentration should be obtained _______ following the time of acute ingestion or presentation:
30 minutes
1 hour
2 hours
4 hours
6 hours
8 hours
4 hours
A patient is taken in for APAP toxicity. Serum APAP conc. is currently 13 mcg/mL, but you are unsure about when the patient took the APAP. Should you administer NAC [N-acetylcysteine]?
a) Maybe
b) No
c) Yes
c) Yes
What is the most common N-acetylcysteine dosing protocol?
a) Simplified 20-hour IV protocol
b) 20-hour IV protocol
c) 72-hour oral protocol
d) 12-hour protocol
b) 20-hour IV protocol
True or false: Cholesterol stones are the least common type of gallstone
False (most common)
True or false: Pain is almost always the first symptom of gallstones
True
True or false: MRIs are not useful in visualizing the bile & pancreatic ducts, but MRCPs are.
True
True or false: Lactase deficiency may be secondary to Celiac or Crohn’s
True
