GI Review

Question 1

Drugs that can cause leg swelling

Answer 1

Ca Channel blockers

Also: NSAIDS and steroids

Question 2

Two main causes of acute pancreatitis

Answer 2

alcohol or gallstones

Question 3

pancreatic calcifications on abdominal imaging

Answer 3

chronic pancreatitis

Question 4

Less common causes of acute pancreatitis

Answer 4

idiopathic
Metabolic (hypertriglyceridemia, hypercalcemia)
Meds: (GLP-analogues, valproic acid, HCTZ)

Question 5

fever
RUQ pain
Palpable gallbladder

Answer 5

cholangitis- stone in common bile duct

Question 6

What hormone causes gallbladder contraction?

Answer 6

CCK

Question 7

Tumor marker for pancreatic cancer

Answer 7

CA 19-9

Question 8

Tumor maker in carcinoid tumor

Answer 8

5-HIAA (in urine)

Question 9

Boerhaave syndrome

Answer 9

esophageal rupture from vomiting.

Leads to mediastinitis and respiratory failrue

Question 10

Palmar erythema is a sign of

Answer 10

high estrogen levels-> cirrhosis and pregnancy

Question 11

Zollinger Ellison Syndrome

Answer 11

gastrinoma

Causes jejunal ulcers and chronic diarrhea

Question 12

severe pain out of proportion to exam

in older person with CAD

Answer 12

Mesenteric ischemia

Question 13

Older person, debilitated
abdominal distension
massive colon on x-ray

Answer 13

volvulus

Question 14

Older person
left lower quadrant pain
fever

Answer 14

diverticulitis

Question 15

1-2 year old

intermittent jelly like stools

Answer 15

Intussusception

Question 16

Most common cause of Traveller’s diarrhea

Answer 16

E. coli

Question 17

Diarrhea
no fever
5 hours after exposure

Answer 17

S. aureus

Question 18

shellfish
water still
after travel
low K

Answer 18

vibrio cholera

Question 19

HIV chronic diarrhea

Answer 19

cryptosporidium

Also: giardia, Isospora, Cyclospora, CMV

Question 20

Chronic steatorreha

duodenal biopsy with villous atrophy

Answer 20

Celiac’s

Question 21

Outdoor exposure
diarrhea
high eosinophils

Answer 21

Strongdyloides

Question 22

Diarrhea after antiboitic exposure

Answer 22

Colstridium difficule

Question 23

High indirect bilirubin after stress

No other symptoms

Answer 23

Gilbert’s

Question 24

5 week old
clay stools
jaundice
HSM
increase in direct bilirubin

Answer 24

obstruction of the biliary system

Question 25

Mild jaundice elevated LDH high reticulocyte count peripheral smear findings

Answer 25

hemolytic anemia

Question 26

40ish woman itching liver disease high alk phos

Answer 26

primary biliary cirrhosis (Anti-mitochondrial)

Question 27

Liver disease Altered mental status young person

Answer 27

Wilson's disease

Question 28

Lab finding in Wilson's disease

Answer 28

Low ceruloplasm

Question 29

Diabetes CHF liver disease skin or testicular findings

Answer 29

Hemochromatosis

Question 30

Test for hemochromatosis

Answer 30

HFE genotype

Question 31

40ish woman jaundice very high transaminases

Answer 31

Autoimmune hepatitis | Anti-smooth muscle antibodies

Question 32

HBsAg negative anti-HBc negative anti-HBs positive

Answer 32

Immune due to hepatitis B vaccination

Question 33

HBsAg positive anti-HBc positive IgM anti-HBc positive anti-HBs negative

Answer 33

Acutely infected

Question 34

HBsAg positive anti-HBc positive IgM anti-HBc negative anti-HBs negative

Answer 34

Chronically infected

Question 35

HBsAg negative anti-HBc positive anti-HBs negative IgG positive

Answer 35

Resolved infection (most common)

Question 36

AST/ALT ratio >2

Answer 36

alcoholic hepatitis

Question 37

mechanism of Gilbert's

Answer 37

deficiency of glucuronyl transferase

Question 38

Treatment of biliary atresia

Answer 38

liver transplant

Question 39

Vitamin deficiency in breast milk fed baby

Answer 39

Vitamin D

Question 40

Transmural inflammation skip lesions fitulas noncaseating granulomas

Answer 40

Crohn's

Question 41

Bloody diarrhea toxic megacolon continuous lesion surface inflammation

Answer 41

Ulcerative colitis

Question 42

Crohn's macrocytic anemia neuro sx

Answer 42

B12 deficiency

Question 43

Extraintestinal manifestations of IBD

Answer 43

``` sclerosing cholangitis uveitis arthritis colon cancer risk erythema nodosum pyoderma gangrenosum ```

Question 44

dysphagia to both liquids and solids

Answer 44

achalasia

Question 45

mechanism of achalasia

Answer 45

decreased ability of the lower esophageal sphincter to relax

Question 46

Vessels that are abnormally connected in esophageal varices

Answer 46

left gastric vein and azygos vein

Question 47

vessel that bleeds into the duodenum

Answer 47

gastroduodenal artery

Question 48

100s of polyps at a young age | high malignant potential

Answer 48

Familial adenomatous polyposis

Question 49

Associated with osteomas, dental, lipomas/skin, ampullary cancers, retinal pigment hypertrophy in small intestine

Answer 49

Gardner's syndrome

Question 50

Proximal LI | associated with endometral/ovarian tumors

Answer 50

Nonpolyposis syndrome (Lynch)

Question 51

``` SI LI stomach polyps mucocutaneous pigmentation ovary/breast/uterus/pancreas cancers ```

Answer 51

Peutz-Jeghers syndrome

Question 52

LI, SI, stomach rare malignant potential hamartomas congenital abnormalaties

Answer 52

juvenile polyposis

Question 53

Use and mechanism of N-acetylcysteine

Answer 53

for acetaminophen OD | restores glutathioine availability by binding to NAPQI metbaolite

Question 54

Onset of ascites while on OCP

Answer 54

Budd-chiari- hepatic vein obstruction

Question 55

GI AE of methotrexate

Answer 55

hepatic fibrosis

Question 56

AE of metaclopramide (used for nausea or gastroparesis)

Answer 56

tardive dyskinesia

Question 57

Drugs that can induce autoimmune hepatitis

Answer 57

Nitrofurantoin | minocycline

Question 58

neonate abdominal distention narrow rectosigmoid with dilitation above

Answer 58

Hirshprung's

Question 59

Mechanism of Hirshprungs

Answer 59

failure of migration of neural crest cells

Question 60

Down syndrome abdominal distention/vomiting on day 1 double bubble on x-ray

Answer 60

Duodenal atresia

Question 61

<10 y/o painless lower GI bleeding no diarhea

Answer 61

Meckel's diverticulum

Question 62

``` Neonate jaundice hepatomegaly E coli sepsis low glucose urine has reducing substances ```

Answer 62

galactosemia- from deficiency of galactose-1-phosphate uridyl transferase

Question 63

Newborn coughing/chocking in feeds aspiration pneumonia

Answer 63

tracheo-esophageal fistula

Question 64

5-6 week old infant forceful postprandial vomiting alkalosis low CL

Answer 64

pyloric stenosis

Question 65

Diarrhea mental status change rash

Answer 65

Vitamin B3 (niacin) "pellagra" (3Ds- diarrhea, dementia, dermatitis)

Question 66

Night blindness

Answer 66

Vitamin A deficiency

Question 67

Peripheral neuropathy

Answer 67

deficiency of | Vit B1, B6, B12

Question 68

Macrocytic anemia

Answer 68

Folate or B12 deficiency

Question 69

Swollen gums poor wound healing brusing

Answer 69

Vitamin C deficiency

Question 70

Neonatal hemorrhage | home birth

Answer 70

Vitamin K deficiency

Question 71

Rickets | breast fed baby

Answer 71

Vitamin D deficiency