GI

Question 1

What 2 types of hepatitis are transmitted via fecal/oral route?

Answer 1

A and E

Question 2

What 2 types of hepatitis are usually found together?

Answer 2

B and D

Question 3

Which of the following profiles is consistent with immunity to hep B secondary to vaccination?

Answer 3

hepatitis B surface antigen (HBsAg) will be negative,

anti-hepatitis B surface antibody (anti-HBs) will be positive.

Question 4

What is the bx finding associated with Barrett esophagus?

Answer 4

Chronic GERD changes the cellular makeup of the distal esophagus from stratified squamous epithelium to columnar-lined epithelium with goblet cells and is diagnosed via endoscopy with biopsy.

Question 5

Which type of hepatitis is associated with cirrhosis?

Answer 5

Hep C

Question 6

What is Boerhaave syndrome?

Answer 6

Full thickness tear of the esophagus usually to severe vomiting

Question 7

What is quadruple therapy for H pylori infection? When is it indicate?

Answer 7

bismuth subsalicylate 300 mg four times daily

metronidazole 250 mg four times daily

tetracycline 500 mg four times daily

omeprazole
______

recent macrolide use or increased local resistance to macrolides

Question 8

What is the triple therapy for H pylori?

Answer 8

clarithromycin
amoxicllin (metro if allergy to PCN)
omeprazole

Question 9

What are the 3 Ds associated with niacin (b3) deficiency?

Answer 9

dermatitis
diarrhea
dementia

Question 10

What type of hepatitis is associated with immune complex phenomena leading to arthritis, glomerulonephritis and vasculitis?

Answer 10

Hep B

Question 11

ascites albumin gradient is a specific test that is used for confirming the presence of ______

Answer 11

portal hypertension

Question 12

carcinoid tumors secrete ______ and will need to be followed with _____ levels

Answer 12

serotonin

5HIAA levels

Question 13

retrocardiac air-fluid level should make you think of what dx?

Answer 13

sliding hiatal hernia

Question 14

Rice water diarrhea, what dx? What treatment?

Answer 14

cholera

doxy or cipro

Question 15

What is the tx for cholera for preg pts?

Answer 15

azithro

Question 16

What are the alarm symptoms for gastrointestinal disorders that require evaluation with esophagogastroduodenoscopy?

Answer 16

Dysphagia, odynophagia, weight loss, blood in stool, anemia, age > 40–50 years, and chronic symptoms without a diagnosis

Question 17

Zenker diverticulum is a rare herniation of the mucosal and submucosal layers of the esophagus in the _____, a weak point defined on the sides by the bilateral _________ muscles and at the base by the _______ muscle

Answer 17

Killian triangle

inferior pharyngeal constrictor

cricopharyngeal

Question 18

Which histopathologic term is commonly used to describe a gastric malignant cell?

Answer 18

Signet ring cell, which may also be found in other gastrointestinal, genital, and breast cancers

Question 19

The oncologist makes a note of a positive Trousseau syndrome in the documentation. Which of the following is she referring to?

Answer 19

tender migratory thrombophlebitis

Question 20

What is the MC type of pancreatic cancer? What is the classic presentation?

Answer 20

adenocarcinoma

painless jaundice

Question 21

_______ is the MC cause of inherited colorectal cancer

Answer 21

Lynch syndrome

Question 22

Lynch syndrome causes predominantly ______ tumors. Describe them.

Answer 22

right-sided

adenomas tend to be larger, flatter, and more proximal; progression to carcinoma occurs more rapidly; and there is a higher risk of synchronous or metachronous colorectal cancers

Question 23

________ is required for definitive diagnosis of Lynch syndrome

Answer 23

Pathogenic germline mutations in the mismatch repair or EPCAM gene

Question 24

What is the screening recommendations for pts with Lynch syndrome?

Answer 24

perform an annual or biannual colonoscopy beginning at the earliest of the following two options: age 20–25 years or 2–5 years prior to the earliest age of colorectal cancer in the family

Question 25

Lynch syndrome is strongly associated with cancer in what 2 organs?

Answer 25

colorectal and endometrial

Question 26

_______ is a rare an inherited disorder leading to severe elevated unconjugated bilirubin

Answer 26

Crigler-Najjar syndrome

Question 27

______ is a liver disease with decreased conjugation of bilirubin, leading to mildly elevated unconjugated bilirubin levels in the serum

Answer 27

Gilbert syndrome normal LFTs with mildly elevated unconjugated bilirubin

Question 28

________ is impaired conjugated bilirubin excretion due to defective MRP2 transporter which leads to conjugated hyperbilirubinemia

Answer 28

Dubin-Johnson Syndrome

Question 29

What population group should be screened for Hep C?

Answer 29

people aged 18-79 years old

Question 30

Anal fissures that occur in conjunction with Crohns dz and likely to be located _______

Answer 30

lateral anal fissure

Question 31

What is important to note about this xray? What is the likely dx?

Answer 31

likely adenocarcinoma of the colon pt is likely to present with constipation, obstructive symptoms or rectal bleeding

Question 32

________ pathogen is associated with colon malignancy, especially right-colon cancer

Answer 32

Strep bovis

Question 33

Which H2 receptor antagonist has the most SEs? including change in bowel habits, increased HA, dizziness, skin rashes, loss of libido and gynecomastia

Answer 33

cimetidine

Question 34

________ is the most concerning complication of TIPS procedure

Answer 34

hepatic encephalopathy

Question 35

_______ is the tx of choice for perianal fistula due to crohns

Answer 35

metro

Question 36

What blood type is associated with increased gastric ulceration risk?

Answer 36

type A

Question 37

_______ occurs within 2 weeks of exposure to hep A and prior to the development of antibodies

Answer 37

fecal shedding of HAV

Question 38

What type of hep may be associated with immune complex conditions leading to arthritis and glomerulonephritis

Answer 38

hep B

Question 39

________ causes "thumbprinting" on barium enema from the edematous mucosal fold

Answer 39

mesenteric ischemia

Question 40

What lab value is considered diagnostic for spontaneous bacterial peritonitis?

Answer 40

A peritoneal fluid absolute neutrophil count > 250 cells/µL

Question 41

What is the MOA behind acute gastroenteritis?

Answer 41

reduced absorption of electrolytes across the intestinal epithelium, as well as increased secretion of electrolytes due to the action of viral or bacterial toxins on sodium, potassium, chloride, and calcium channels in the intestinal wall.

Question 42

The _______, when positive= which indicates a retrocecal location of the appendix,

Answer 42

psoas sign

Question 43

Erythema and absence of rugal folds are endoscopic findings associated with what dx?

Answer 43

gastritis

Question 44

The most common initial presenting symptom of primary biliary cirrhosis is?

Answer 44

pruritis

Question 45

_______ is the most significant risk factor for the development of pancreatic cancer

Answer 45

Cigarette smoking

Question 46

______ used in the maintenance treatment of mild to moderate ulcerative colitis

Answer 46

Oral mesalamine

Question 47

What gastrointestinal structure is associated with the highest mortality if it perforates?

Answer 47

esophagus

Question 48

What area of the colon is most likely to be affected by ischemic colitis?

Answer 48

splenic flexure This portion of the colon is supplied by the marginal artery of Drummond, which is the communication point between the SMA and IMA. This area of the large intestine is prone to ischemia due to the artery’s small caliber and potential lack of vasa recta along this portion of the colon.

Question 49

Which of the following is the most common cause of acute pancreatitis in adult patients?

Answer 49

biliary tract pathology The most common cause of acute pancreatitis is biliary tract pathology (e.g., gallstones), which account for 35–75% of cases. Alcohol consumption accounts for 25–35% of cases.

Question 50

What are the preferred IRON chelation agents?

Answer 50

Currently, deferasirox is the preferred iron chelator for chronic iron overload since it has been shown to be similar in efficacy to other iron chelators and is associated with better patient adherence since it is administered orally once daily.