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Flashcards in GIT Deck (401):
1

Cause of whipple disease

Tropherima whippeli

2

clue for whipple

PAS positive during biopsy

3

Extra intestinal manif of Whipple(2)

Polyarthropathy Migratoire
Heart problem-->CHF

4

What can you in late stage of whipple

Dementia

5

Clue for Celiac disease

Biopsy showing villous atrophy

6

Marker for cealiac disease(2)

IGA anti tissue transglutaminase
IGA anti endomysial antibodies

7

What can cause negativity of these markers in case of celiac disease(IGATT)

IGA deficiency

8

Other name of cealiac disease

celiac sprue

9

in GIT what can happen in celiac sprue

Malabsorption

10

Consequences of Malabsorption in celiac sprue(3)

Low
Vit D
Vit K
Iron

11

consequence of low vit D in celiac disease

hypocalcemia

12

consequence of hypocalcemia and low vit D in celiac disease(3)

Osteomalacia
bone pain
fracture

13

consequence of vit A deficiency in adult

Hyperkeratosis

14

Low vit K consequence

easy bruising

15

Clue for Achalasia

dysphagia for solids and liquids

16

Dx of Celiac and whiple

intestinal Biopsy

17

workup for achalasia(3)

baryum swallow
Manometry
endoscopy

18

finding in Bayum swallow for achalasia

bird beak appearance

19

Finding during manometry in Achalasia(3)

Elevating resting LES pressure
Incomplete LES relaxation
Absence of peristaltism in the esophageal body

20

why performing endoscopy in achalasia

to rule out a cancer in distal esophagus

21

quid of pseudo achalasia

cancer in distal esophagus causing achalasia

22

what to thing in achalasia and weight loss

cancer de l 'oesophage

23

when thinking of cancer in achalasia(3)

Symptom > 6 months
patient more than 60 years
Weight loss

24

cause of constipation in multiple myeloma

Hypercalcemia

25

first thing to do in front of constipation

check calcium

26

Symptoms of hypercalcemia(4)

constipation
increased urination
neurologisc Symptom
renal dysfunction

27

most common complication of gastric ulcer

hemorrage

28

What to do if you suspect abdominal viscus perforation

chest x ray

29

chest x ray in abdominal viscus perforation

free air under the diaphragm

30

high yield question,characteristics of malignancy in polyps(3)

Macro:sessile
Micro:villous type
size:> 2,5 cm

31

Most common non neoplastic polyp in colon?

Hyperplastic

32

polyps in Peutz jeghrer syndrome

hamarthoma

33

quid of shifting phenomenon in acute appendicitis(2)

pain in ombilic
later pain oin RLQ

34

why shifting phenomenon occurs

visceral pain followed by somatic pain

35

exolanation of shifting phenomenon

Periombilical pain is visceral
but RLQ pain is somatic

36

what cause somatic pain in RLQ in appendicitis

irritation of parietal peritoneum

37

clue for acute pancreatitis

epigastric pain
worse when standing or lying supine
inproved with sitting up or leaning forward

38

etiology of acute pancreatitis(6)

chronic alcoholism
Gallstones
Hyperlipidemia
drugs
infection
trauma

39

infection causing acute pancreatitis(3)

CMV
leginella
aspergillus

40

hyperlipidemia causing acute pancreatitis

type 1 ,4 et 5

41

drugs causing acute pancreatitis(3)

dianoxine
azathioprine
acid valproic

42

work up for acute pancreatitis(3)

Amylase and lipase
echo
CT

43

amylase and lipase in acute pancreatitis

3 a 4 fois la normale

44

local complication in acute pancreatitis(4)



pancreatic pseudocyst
pancreatic necrosis (necrotizing)
pancreatic abces
peripancreatic fluid

45

regional complication in acute pancreatitis(2)

ileus
Gi bleeding

46

A distance complication in acute pancreatitis(3)

ARDS
Left side pleural effusion
acute renal failure

47

clue for duodenal ulcer

pain relieved by eating

48

clue for gastric ulcer

pain worsened by eating

49

surveillance of patient with cirrhosis(2)

upper digestive endoscopy
sonograhy abdomen

50

when to perform sono abd in cirrhosis surveillance and why(2)

q 6 mois
to look for hepato cellular carcinoma

51

upper digestive endoscopy in cirrhosis why?

to rule out varices

52

prevention of esophageal varices

non selective B blocker

53

Tetrad of carcinoid syndrome

flushing
diarrhea
wheezing
valvular heart disease

54

cause of carcinoid syndrome

carcinoid tumor

55

localisation of carcinoid tumor(4)

small intestine
appendix
colon
bronchial tubes

56

physiopatho of symptoms in carcinoid tumor

tumor secreting serotonin

57

RX of carcinoid tumor

octreoctide

58

complication of flushing in Carcinoid syndrome (2)

Hypotension
tachycardia

59

quid of rome 3 criteria

dx IBS(inflammatory bowel syndrome)

60

rome 3 criteria what symptom in center

abdominal cramps

61

rome 3 criteria(5)

abdominal cramps
3 days /month
2 month consecutifs and>/ 2 de ces symptomes
-symptoms improved with bowel mvts
-change infrequency of stool
-change in form in stool

62

in what situation to not consider IBS(4)

abdominal cramps plus rectal bleeding
" " plus weight loss
" " plus anemia
nocturnal abdominal awakening the patient

63

colonoscopy in IBS

normal colonic mucosae

64

condition for carcinoid tumor to produce serotonin

when tumor has metastasis in liver

65

work up for carcinoid syndrome

5 hydroxy indol acetic in urine and blood

66

quid of 5 HIAA

metabolites of serotonin

67

why liver metastasis produces this syndrome

5 hydroxytryptophan is degraded in the liver to inactivate 5HIAA

68

precursor of serotonin(5 hydrohy tryptamine)

tryptophan

69

role of tryptophan

synthesis of niacin

70

why you have low niacin i carcinoid tumor(2)

tryptophan is used to produce serotonin
niacin is low produced

71

Niacin deficiancy symptom(4D)

Diarrhea
Dementia
Dermatitis
Death

72

origin of folate

green leafy vegetables and liver meat

73

why cooked food lack folate(toast type diet)

folate is heat sensitive

74

Most common cause of meleana(2)

upper GI bleeding
lower GI bleeding proximal to the splenic flexure

75

Most common cause of upper GI bleeding

peptic ulcer disease

76

clue for zollinger ellison syndrome(2)

multiple gastric and duodenal ulcer
fat in stool

77

Why fat in stool in zollinger ellison syndrome

inactivation of pancreatic enzyme by hyper acid production by stomach

78

quid of succusion splash

you place a sthetoscope on upper abdomen and rock the patient back and forth
you will hear a splash

79

interpretation of succusion splash

gastric outlet obstruction

80

what to do in presence of a patient with generalized adenopathy,weihgt loss and diarrhea?

test for HIV

81

differentiate Mono from HIV

no weight loss in Mono

82

characteristic of rash in pellagra

present on sun exposed area

83

cause of Zn deficiency(2)

total parenteral nutrition
malabsorption

84

clue for ZN deficiency(3)

alopecia
pustulous or bullous lesion periorificial
wound healing impaired

85

lieu of Zn absorption

jejunum

86

cause of pancreatic cholera

VIPOMA

87

pancreatic mass plus watery diarrhea

Vipoma

88

what vipoma secretes

vasoactive intestinal peptide

89

link between Vipoma and an carcinoid syndrome

both can produce flushing

90

more common cause of cirrhosis(4)

Hep B et C
alcoholic liver disease
non alcoholic fatty liver disease
hemochromatosis

91

Less common cause of cirrhosis(7)

autoimmune
PBC
PSC in IBD
Alpha 1 antitrypsine
cardiac cirrhosis
medications
wilson disease

92

medication causing cirrhosis(2)

metotrexate
INH

93

most common cause of cirrhosis in US(2)

Hep B and C
alcohol

94

Marker of PBC

antimitochondrial antibody

95

acute pancreatitis and suspiscion of gallstones

perform US

96

most common cause of acute pancreatitis (2)

alcohol
gallstones

97

first thing to do in patient with acute pancreatitis

U/S to rule out cholelithiasis and choledocholithiasis

98

first image in pancreatitis

sono abdomen

99

risk # 1 for pancreatitis cancer

chronic pancreatitis

100

the second major risk factor for pancreatic ca(2)

hereditary
and environmental

101

whta's the major hereditary risk for pancreatic cancer(3)

hereditary pancreatitis
germline mutation
first relative with pancreas cancer

102

germline mutation for hereditary pancreatic cancer(3)

BRCA-1
BRCA-2
Peutz jegher

103

Environmental risk for pancreatic cancer(4)

cigarette
obesity
low exercice
non hereditary pancreatitis

104

epigastric pain and ictere best test to do

U/S to rule out biliairy obstruction

105

epigastric pain and weight loss best test to do

CT abdomen

106

anal fissure treatment

stool softener
local anesthetic

107

why use local anesthetic in anal fissure

to remove the spasm

108

Patient seen in ED with hypotension and hematemesis(3)
or any patient received in ED

Airway
Breath
Circulation

109

Patient after several episodes of vomiting develops hematemesis

Malorry weiss syndrome

110

cause of mallory weiss

increased intragastric pressure causes tear in gastric mucosa and distal esophagus

111

what arteries are involved in Mallory weiss

submucosal arteries in proximal stomach and distal esophagus

112

pourcentage of bleeding caused by mallory weiss

10%

113

risk for barret

adenocarcinoma of esophagus

114

type of esophagus cancer in alcohol and smoker

SCC

115

Cause of increased bilirubin mainly conjugated with high ALP(5)

PSC
PBC
Choledocholithiasis
pregnancy
cholangiocarcinoma

116

work up for increased bilirubin conjugue with high ALP(3)

CT
U/S
Antimitochindrial antibody

117

Approach of hyperbilirubinemia(2)

Conjugue
non conjugue

118

approach of bilirubin conjugue(3)

know if it's AST ALT ALP normal
Predominance of ALP
Predominance of AST/ALT

119

cause high bilirubin non conjugue

gilbert
hemolysis
reduced uptake

120

cause high bilirubin conjugue with normal everything else(2)

Rotor
dubin jhonson

121

Cause increased bilirubin conjugue and high AST ALT predominantely(2)

hepatitis
hemochromatosis

122

cause of Hepatitis(6)

viral
ischemic
autoimmune
toxin
drug
alcohol

123

chest pain and dysphagia in young girl

spasm diffus de l'oesophage

124

work up for spasm diffus de l'oesophage

eosphagram
manometry

125

esophagram for spasm diffus de l'oesophage

corkskrew apperance

126

manometry for spasm diffus de l'oesophage

contraction and relaxation of LES

127

RUQ pain after cholecystectomy

post cholecystectomy syndrome

128

cause of post cholecystectomy syndrome(2)

biliairy
extra biliairy

129

biliary cause of post cholecystectomy syndrome(2)

cystic duct stone
common bile duct retained

130

extra biliary cause of post cholecystectomy syndrome(2)

pancreatitis
PUD

131

Dx of post cholecystectomy syndrome

ERCP
MRCP(Magnetic resonnance cholangiopancreatography)

132

what the two main things to look pseudomembranous colitis

WBC
Creatine level

133

CAT si WBC

Metronidazole

134

CAT si WBC> 15000 and creat> 1,5 fois baseline

oral vancomycin

135

CAT si WBC> 15000 and creat> 1,5 fois baseline plus ileus

oral vancomycin plus IV metro
or rectal vancomycin switch)

136

CAT si WBC> 20000 plus megacolon toxic plus ileus and lactate >/ 2,2

surgery

137

surgery for pseudomembranous colitis

si WBC> 20000 plus megacolon toxic plus ileus and lactate >/ 2,2

138

type de surgery in pseudomembranous colitis

subtotal colectomy
diverting loop ileostomy with colonic lavage

139

antibiotic most commonly involved in pseudomembranous colitis(4)

clindamycin
quinolone
penicilin
cephalosporin

140

confirmatory dx fror pseudomembranous colitis

Cdif toxin by PCR

141

indication of fidaxomycin in pseudomembranous colitis(2)

reccurent colitis
sevfer colitis not able to tolerate oral vancomycin

142

microcytic anemia first cause

GI blood loss

143

work up GI in microcytic anemia(2)

endoscopy
colonoscopy

144

in the work up of microcytic anemia what to do if endoscopy and colonoscopy are negative

capsule endoscopy to look small intestine

145

MEN 1

3 tumors
gastrinoma
2 adenomas(pituitaire and parathyroid)

146

MEN 2a

2 tumors
parathyroid hyperplasia
Pheo
Medullary thyroid cancer

147

clue for diarhhea cused cryptosporidium parvum(3)

HIV
low CD4
modified acid stain (oocyst)

148

acid fact stain plus oocyst

isospora belly

149

epidemio of isospora

no isospora is US

150

4 reasons to ask endoscopy in GERD(4)

> 50 ans
Symptoms> 5 ans
signes de danger
facteur de risque de ca

151

singnesd e danger dans GERD(5)

Persisting vomiting
digestive hemorrage
anemia
perte de poids
odynophagia and dysphagia

152

how's platelet in in chron

reactive thrombocytosis

153

Hallmark of chron(2)

involvement mouth to anus
fistula

154

Clue for chron(4)

chronic diarrhea
with abd pain and
weight loss in
young patient

155

Back pain and anemia in patient on warfarin

spontaneous retroperitoneal hematoma

156

epigastric pain cause(4)

MI
PUD
cholecystitis
Aortic dissection

157

epigastric pain with irradiation in both arms

infero post MI

158

Management of asymptomatic diverticulosis

high fiber intake

159

how constipation causes diverticuli

Increase presure in colon creates weak spots

160

quid of diverticuli

saclike protrusion of colonic wall

161

dysphagia for both solids and liquids

motility problem

162

Dysphagia for solids first then for liquids(2)

ca oesophage
stricture

163

best test for in case of dysphagia

baryum esophagram

164

if baryum esophagram is not conclusive next step in case of dysphagia

upper GI endoscopy

165

Ascites with fever and neurologic symptom(confusion and lethargy)

spontaneous bacterial infection(peritonitis)

166

criteria of SBP

> 250 WBC in fluid ascites

167

Important test for SBP DX

Paracenthesis

168

bugs causing SBP(2)

klebsiella
E coli

169

Rx of SBP

3 e generation cephalosporin

170

massive GI bleeding by cirrhosis RX first

ABC de l'urgence
octreoctide

171

Massive hemorrage with depressed consciousness

Intubation is indicated

172

indication of platelet transfusion in GI bleeding caused by cirrhosis

platelet

173

how to stop hemorrage in cirrhosis(2)

band ligation
or sclerotherapy

174

patient returning from mexico develops foul smelling diarrhea

giardiasis

175

zone in the US with giardiasis

rocky mountains

176

rx of giardiasis

Metronidazole

177

how giardiasis causes digestive problem

by adhering to mucosal surface by adhesive disks causing malabsorption

178

3 types of polyps(3)

hyperplastic
adenoma
hamartoma

179

pill esophagitis (3)

koh
quinidine
iron

180

antibio causing esophagitis

cycline

181

nsaids causing esophagitis

all NSAIDS

182

biphosphonate and pill esophagitis

alendronate

183

colonic angyodysplasia

painless GI bleeding
plus aortic stenosis

184

Quid of Heyde's syndrome

painless GI bleeding
plus aortic stenosis

185

why GI bleeding in Heyde's syndrome

Because of AV malformation

186

management of non bleeding cirrhosis

non selective B blocker

187

non selective b blocker used in non bleeding cirrhosis

propranolol
nadolol

188

mangement of non bleeding cirrhosis if B blocker is contreindicated

primary preventive band ligation

189

how BB prevents bleeding in cirrhosis

decreased portal flow

190

GI bleeding with anemia

packed red blood cell

191

condition of packed red blood cell in anemia

Hb

192

quid of speed ball

cocaine and heroin use

193

risk of speed ball use

rhabdomyolysis

194

vaccin a donner in IV drud user

Hep B vaccine

195

cause of hypotension in severe pancreatitis(Necrotizing pancreatitis)

increased capillary permeability

196

quid of severe pancreatitis

pancreatitis plus at least one organ failure

197

cullen sign

periumbilical bluish discoloration

198

Meaning of cullen sign

hemoperitoneum(pancreatitis)

199

grey turner sign

reddish discoloration in flank

200

Meaning of grey turner sign

retroperitoneum(pancreatitis)

201

risk factor for severe pancreatitis

age > 75 ans
obesity
alcohol
CRP>150
Increase BUN
ARDS

202

rx of acute pancreatitis(3)

fluid
pain control
bowel rest

203

aspirin and GI bleeding

acute erosive gastritis

204

mechanism of action of aspirin

block cyclooxygenase pathway---> no prostaglandin

205

role of prostaglandine

effect protecteur sur la muqueuse gastrique

206

rx of acsites(4)

sodium and water restriction
spironolcatone
loop diuretic(1 l/day of diuresis)
frequent abdominal paracenthesis(2-4 l if renal perfusion is OK)

207

water restriction in cirrhosis

208

warning with diuretic in cirrhosis(spirono and furosemide)

agressive diuresis
can cause hepato renal syndrome

209

iron deficiency anemia in patient taking NSAIDS

GI bleeding

210

ca associated with hemochromatosis

hepatocellular carcinoma

211

what are the 3 mutations associated with Hemochromatosis(3)

HFE
L2824
H63D

212

cause of bacterial overgrowth(3)

motility problem
strictures in GI
other causes

213

motility problem causing overgrowth bacterial(2)

sclerodermia
diabetes

214

other causes of bacterial overgrowth(4)

end stage renal disease
cirrhosis
AIDS
advanced age

215

gold standard to Dx bacterial overgrowth

endoscopy with aspiration in jejunum

216

finding in endoscopy in jejunum aspiration in bacterial overgrowth

bacteria>10exposant 5 bact /ml

217

bacteria causing bacterial overgrowth(4)

E coli
lactobacillus
bacteroides
streptococci

218

manif of bacterial overgrowth

chronic diarrhea

219

Rx of bacterial overgrowth(2)

augmentin
or rifamixin pdt 7 a 10 jours

220

cause of mesenteric ischemia(abdominal angina)(2)

atherosclerosis
occlusion of visceral arteries

221

clue for mesenteric ishemia

severe abdominal pain after eating

222

Dx of abdominal angina(2)

Doppler abdomen
or
angiography

223

pain with foof d Dx(2)

PUD
abdominal angina

224

auscultation clue for abdominal angina

50 % des cas
abdominal bruit

225

similitude between Chron and TB

both have granuloma

226

characteristic of chron

transmural lesion
skip lesions
creeping fat appearrance
fistula/fissure
perianal disease
mouth to anus

227

why fistula in chron

transmural lesion

228

disease with granuloma(4)

TB
Chron
sarcoidosis
yersinia infection

229

initial bleeding management caused by varices(3)

fluid
octreoctide IV
sclerotherapy or band ligation

230

quid of octreoctide

somatostatin analog

231

next step in managing bleeding varices if success in initial step(2)

Bblocker
repeat endoscopic band ligation in 2 a 3 weeks

232

failure of initial management of varices

ballon tamponnade
or
TIPS or shunt surgery

233

TIPS

transjugular intrahepatic portosystemic shunt

234

if rebleeding after initial management next step(2)

try endoscopic rx
or
TIPS/Shunt surgery

235

tube used in ballon tamponade(3)

sengstaken blackmore
Minessota
linton nachlas

236

type of problem in zencker

motor dysfunction and incoordination

237

rx of zencker

crycopharyngeal myotomy

238

localisation of zencker

above upper esophageal sphincter

239

quid of zencker

posterior herniation through the fibers of cricopharyngeal muscles

240

what cause the herniation in zencker

incoordination between the contraction of pharynx and contraction of upper esophageal sphincter

241

complication of zencker(4)

trachea compression
aspiration pneumonia
erosion and bleeding
regurgitation

242

indication of H pylory

243

indication of endoscopy in dyspepsia(2)

>55 ans with new dyspepsia
any age with alarm symptom

244

quid of dyspepsia(3)

epigastric pain
bloating
early satiety

245

patient with dyspepsia,no alarm symptom an less 55 ans with negative H pylori

PPI for 4 a 8 semaines

246

cause of dyspepsia(5)

GERD
AINS
PUD
Malignancy
functionnal dyspepsia

247

workup for zollinger ellisson syndrome

gastrin level >1000 pg /ml

248

workup for zollinger ellisson syndrome gastrin test inconclusive next step

secretin stimulation test

249

biopsy finding in UC

neutrophylic cryptitis

250

patient after coronary bypass develops abdominal pain and bloody diarrhea

Ischemis colitis

251

why lactate is high in ischemic colitis

because of ischemia

252

what area is most commonly involved in ischemic colitis and why

-splenic flexure
rectosigmoid junction
vascularisation by ended artery

253

vascularisation of splenic flexure

narrow terminal branches of superior mesenteric artery

254

vascularisation of rectosigmoid junction

narrow terminal branches of inferior mesenteric artery

255

cause of ischemic colitis during coronary bypass (any surgery)

hypotension

256

watershed area involved in ischemic colitis

-splenic flexure
rectosigmoid junction

257

lactose intolerance workup(4)

H+ breath test
Low stool PH
high osmotic gap
osmotic substances in stools

258

quid of high osmotic gap

> 50

259

clue in lactose intolerance

no steatorrhea

260

quid of bright red blood cell per rectum(2)

scant hematochezia
minimal scant bleeding

261

Cause of red blood cell per rectum(4)

hemorroides
fissures
proctitis
rectal ulcer or Ca

262

Best test in red blood cell per rectum(2)

anoscopy
proctoscopy

263

quid of SAAG(2)

serum ascites albumin gradient
Albumin serum- albumin ascites

264

Value of SAAG in ascites caused by SBP

>1,1

265

Importance of SAAG

>/1,1 ascites is caused portal hypertension

266

spontaneous bacterial infection of ascites(3)

Hypotension
hypothermia
ileus

267

Dx of SBP

SAAG > 1,1
Albumin ascites

268

when to avoid quinolones in SBP

patient already receives it for SBP prophylaxis

269

first step in the workup of acute pancreatitis

amylase
lipase

270

what are the main criteria to Dx acute pancreatitis

epigastric pain radiating in the back
amylase and lipase >3 f la normale
CT or U/S

271

U/S of acute pancreatitis

hypoechoic image

272

the most useful blood test in acute pancreatitis

Lipase

273

why lipase is most useful blood test in acute pancreatitis

rises in 4-8 h
stay up 8-14 jours

274

what about amylase

rises in 6-12h
apres 5 jours disparait

275

patient with acute pancreatitis with amylase and lipase increases 3 f la normale

ni image is needed for the Dx of acute pancreatitis

276

when to do CT in acute pancreatitis

Dx is unclear
failure of treatment

277

chronic pancreatitis workup(2)

plain film
CT of abdomen

278

image in Plain film or CT of abdomen for chronic pancreatitis

calcification

279

cause of chronic pancreatitis(3)

alcohol
autoimmune
cystic fibrosis

280

symptom of chronic pancreatitis(4)

Diabetes
weight loss
malabsorption
epigastric pain

281

Rx of chronic pancreatitis(4)

Pain management
stop smoking
enzyme replacement
frequent small meals

282

clue for inflammatory diarrhea(5)

anemie
High ESR
Acute phase reactant
thrombocytosis
blood in stool or leucocyte

283

what to think in chronic inflammatory diarhhea

IBD

284

characteristics of fat malabsorption(3)

foul smelling diarrhea
difficult to flush
floating diarrhea

285

3 main problem causing steatorrhee(3)

pancreatic insufficiency
bile salt related
impaired intestinal surface epithelium

286

2 causes of pancreatic insufficiency

chronic pancreatitis
ca pancreatic

287

What can impair epithelium intestinal surface(3)

AIDS
celiac disease
giardiasis

288

problem with bile salt

foie
ileon

289

Hepatic problem related to malabsorption(2)

PBC
PSC

290

iIeal problem related to malabsorption(3)

cron
bacterial overgrowth
surgical resectionof ileon

291

other causes related to malabsorption(3)

whipple
ZES
Medication induced

292

Dx test for steatorrhea

sudan stain

293

clue for diverticulitis(3)

LLQ pain
fever
elderly

294

Diverticulitis rebelle aux antibiotiques DX(3)

complication
abcess
fistula
perforation

295

best test yto evaluate complication in diverticulitis

CT scan of abdomen

296

patient with barret and Heartburn 3 weeks later without Rx no more heart burn Dx?

benign peptic strictures

297

What to do in peptic benign strictures and why(2)

biopsy
to ruleout adenocarcinoma

298

quid of barret

intestinal metaplasuia of lower esophagus

299

cause of peptic strictures(4)

GERD
Scleroderma
radiation
caustic ingestion

300

clue for abdominal herpes pain

immunocompromised patient
develops abdominal pain elicits by light touch of abdomen

301

what will appear in 1 week in this patient with abdominal herpes

skin lesion

302

what appear first in herpes

the local pain

303

Pain and rash in herpes(2)

pain can precede rash
or
both can appear simultaneously

304

in manometry record how appears a contraction of esophagus

positive deflection

305

in manometry record how appears a relaxation of esophagus

negative deflection

306

next if ca gastric is detected

CT extent evaluation

307

UC with high ALP

PSC

308

what test to do in UC

sigmoidoscopy

309

sigmoidoscopy finding in UC(2)

Mild erythema
mucosal inflammation

310

complication of UC(2)

colorectal cancer
toxic megacolon

311

extraintestinal manif of UC(4)

PCS
uveitis
eryhtema nodosum
spondyloarthropathy

312

patietnn with multiple thrombophlebitis

check a cancer

313

why cancer can cause thrombophlebitis

Hypercoagulability

314

clue for factitious diarrhea

laxative abuse

315

confirmatory Dx of factitious diarrhea

biopsy

316

biopsy of factitious diarrhea

dark brown discoloration with lymph follicles shining through as a pale pathes(melanosis coli)

317

laxative causing melanosis coli

antraquinone containing laxative

318

antraquinone containing laxative

bisacodyl

319

Dx of zencker

contrast esophagram

320

Complication of PSC(5)

cholelthiasis
cholestasis
cholangiocarcinoma
colon ca
biliary stricture intra et extra hepatique

321

epigastric pain and weight loss

ca pancreas

322

Dx test for ca pancreas

CT abdomen

323

why patient on total parenteral nutrition develops gallstones

gallbladder stasis

324

why gallbladder stasis in total parenteral nutrition

because no food in duodenum to cause activate release of cholecystokinine

325

role of cholecystokinine

contraction of gallbladder

326

why ileal resection causes gallstones(3)

because of decreased enterohepatic cycle
hepatic bile is oversaturated with cholesterol
gallstone formation

327

why megaloblastic anemia in tropical sprue

B12-folic acid deficiency

328

dx of tropical sprue

blunting villi
chronic infiltrationof inflammatory cells(Lymphs,plasma cells,eosinophils)

329

important feature of tropical sprue

malabsorption

330

why in GI bleeding causes high BUN

bacteria in gut degraded hb en Urea

331

cause of BUN elevation with normal creat(3)

GI bleeding
prerenal azotemia
systemic steroids

332

major side effect of digoxin toxicity

anorexia

333

drug that can increase the level of digoxin

verapamil
furosemide

334

why verapamil causes increase level of digoxin

by decrease the renal clearance of digoxin

335

why furosemide causes increase level of digoxin

by causing hypokaliemia

336

cardiac problem in digoxin toxicity(2)

bidirectionnal ventricular tachycardia
accelarated junctionnal rythm

337

most common side effect of digoxin toxicity(3)

GI problem
anorexia
nausea
vomiting

338

medication for seizure causing pancreatitis

acid valproic

339

anti hta causing pancreatitis(2)

furosemide
thiazides

340

drugs used in IBD causing pancreatitis

sulfasalazine
5-ASA

341

immunosuppresor causing pancreatitis(2)

azathioprine
L asparaginase

342

patient with HIV with pancreatitis(2)

didanosine
pentamidine

343

Antibio involved in pancreatitis

metronidazloe
4 cycline

344

cause of renal failure in hepato renal syndrome

renal hypoperfusion

345

rx of hepatorenal syndrome

octreoctide
or
Midodrine

346

prerenal failure

urine Na+ less than 10meq/L

347

clue for intestinal occlusion(2)

vomiting
not passed gas

348

Dx of intestinal occlusion(2)

plain film of abdomen
multiple air fluid

349

rx for intestinal occlusion

surgery

350

cause of toxic megacolon(5)

UC
ischemic colitis
volvulus
diverticulus
obstructive cancer

351

LLQ pain(2)

diverticulitis
complicated Ca

352

localisation of celiac sprue

proximal intestine

353

test for diagnosing celiac sprue

D xylose test

354

D xylose test(3)

ingestion of D xylose
intact intestinal mucosa
urinary excretion 4,5-7,5g

355

absent peristaltic waves and low LES tone

scleroderma

356

UC plus fever Dx

rule out toxic megacolon

357

chronic bloody diarrhea

UC

358

Major criteria of Megacolon(4)

fever
HR>120
Neutrophilic leucocytes>10500
anemia

359

Minor criteria(4)

hypotension
electrolytes disturbances
altered sensorium
volume depletion

360

Dx of megacolon(2)

3 criteres major
plus one minor criteria

361

dx diffuse spasm of esophagus

manometry

362

clue for diffuse spasm of esophagus

retrosternal spasm
exacerbated by sttress and cold food

363

drug used in diffuse spasm

nitroglycerin

364

EKG in diffuse spasm of esophagus

normal

365

quid of angiodysplasia(2)

dialted
ectatic thin walled vessels lined by endothelium

366

disease with angyodysplasia(2)

end stage renal disease
aortic stenosis

367

cardiac problem in whipple disease(2)

CHF
valvular regurgitation

368

why many people with celiac disease has IDA antibody negative

because they have selective IGA deficiency

369

role of endoscopy in achalasia

to rule out ca du bas oesophage

370

quid of bird beak appearance

dilated esophagus with distal narrowing

371

level of calcemia to have constipation

> 12

372

severe epigastric pain spreadind all over the abdomen

chemical peritonitis due to perforated ulcer

373

quid of polyps

adenoma

374

condition of adenomas to become cancer(3)

villous
sessile
> 2,5 cm

375

CT of acute pancreatitis

focal or diffuse pancreatic enlargement with heterogenous enhancement

376

epigastric pain with high amylase and lipase and ALT>150 units/l

biliairy pancreatitis

377

3 types of IBS

constipation predominant
diarhhea predominat
Mixed

378

cause of pellagra

deficiency of NIACIN

379

patient with cirrhosis and smooth muscle antibody microsomal type 1 positive cause?

autoimmune

380

disease associated with autoimmune cirrhosis

thyroiditis

381

hows pancreatic hormone in chronic pancreatitis

Normal

382

post cholecystectomy syndrome work up(3)

abdomen U/S
ERCP
MRCP

383

Dx of C difficile

stool studies

384

microcytic anemia in elderly

FOBT
colonoscopy

385

meaning of negative FOBT in microcytic anemia(2)

cant't exclude GI blood loss with one FOBT negatif
perform colonoscopy

386

what to do in any patient with acute abdominal pain

rule out MI with EKG

387

chron granuloma

non caseating

388

DX of ZES

fasting gastrin level

389

cobble stone appearance

chron

390

neutrophilic abcess

crhon
UC

391

confirmatory DX of SBP(2)

Neutro >250micro/l
positive peritoneal fluid culture

392

post ERCP patient develops epigastric pain

iatrogenic acute pancreatitis

393

most common cause of malabsorption

alcoholic chronic pancreatitis

394

complication of UC requiring surveillance

colon carcinoma

395

Quid of PSC

stricture of medium sized and large intrahepatic and extra hepatic bile ducts

396

most common consistent reversible risk factor of pancreatic cancer

smoking

397

charateristic finding in imaging in pancreas ca (tete pancreas)

intra and extra hepatic biliairy tract dilation

398

what will increase during GI bleeding

BUN/Creat ratio

399

patient with UC develops fever weight loss and colonic dilation abdominal xray

toxic megacolon

400

management of toxic megacolon(3)

IV steroids
Fluid management
nasogastric decompression

401

Dx test for diverticulitis

ct scan of abdomen