GI

Question 1

ROVSING sign

Answer 1

Palpation of left lower quadrant, illicits pain in right lower quadrant “Zing”

Question 2

Markle sign or heel drop test

Answer 2

Pain in right lower quadrant when dropping down onto heels, hopping or driving on bumpy roads

Question 3

What is the medical term for inflammation of the appendix?

Answer 3

APPENDICITIS

APPENDICITIS is a common cause of abdominal pain and may require surgical intervention.

Question 4

What is another name for rebound tenderness?

Answer 4

BLUMBERG’S SIGN

This sign indicates pain upon lifting the hand after palpation of the abdomen.

Question 5

What does McBurney’s sign refer to?

Answer 5

TENDERNESS WITH PALPATION OF McBURNEY POINT

McBurney Point is located 2/3 distance between the umbilicus and anterior iliac spine.

Question 6

What does the iliopsoas sign indicate?

Answer 6

PAIN UPON LIFTING THE RIGHT LEG AGAINST RESISTANCE OF THE EXAMINER’S HAND

This sign may suggest irritation of the iliopsoas muscle due to appendicitis.

Question 7

What does the obturator’s sign indicate?

Answer 7

PAIN WITH INTERNAL ROTATION OF RIGHT HIP JOINT (WITH RIGHT KNEE FLEXED)

This sign is used to assess for appendicitis or pelvic inflammatory disease.

Question 8

What is Murphy’s sign?

Answer 8

PAIN ON INSPIRATION WITH PALPATION OF SUBCOSTAL AREA (UNDER RIB CAGE)

Murphy’s sign is typically associated with cholecystitis.

Question 9

What virus is Hepatitis D closely associated with?

Answer 9

Hepatitis B virus (HBV)

The presence of HBV is required for complete virion assembly and secretion.

Question 10

Patients with Hepatitis D are always dually infected with _______.

Answer 10

HBV

This indicates that Hepatitis D cannot exist without the presence of Hepatitis B.

Question 11

What are the four quadrants of abdominal complaints?

Answer 11

• RUQ
• RLQ
• LUQ
• LLQ

These quadrants help in localizing abdominal pain and identifying potential causes.

Question 12

Right upper quadrant

Answer 12

CHOLECYSTITIS or gallbladder or hepatitis

Question 13

Right lower quadrant

Answer 13

Appendicitis

Question 14

Left upper quadrant

Answer 14

Pancreatitis

Question 15

Left lower quadrant

Answer 15

Diverticulitis sigmoid colon

Question 16

What is the first-line treatment for non-severe C. difficile infection?

Answer 16

• Oral fidaxomicin
• Oral vancomycin

Treatment duration is typically for 10 days.

Question 17

What are the risk factors associated with C. difficile infection?

Answer 17

• Recent antibiotic use
• Hospitalization
• Older age

These factors increase the likelihood of developing the infection.

Question 18

What is not recommended as a treatment for patients with C. difficile infection?

Answer 18

Probiotics

Probiotics are not part of the recommended treatment protocol.

Question 19

What clinical manifestation suggests a C. difficile infection?

Answer 19

Acute diarrhea (more than three loose stools in 24 hours)

This symptom, along with risk factors, should raise suspicion for the infection.

Question 20

What are the components of Bismuth quadruple therapy for H. pylori treatment?

Answer 20

• Bismuth
• Metronidazole
• Tetracycline
• Proton pump inhibitor (PPI)
  “My poor tummy burns”

Recommended for patients with prior exposure to macrolides or in areas with high clarithromycin resistance.

Question 21

What is the recommended treatment for H. pylori in patients without risk factors for macrolide resistance?

Answer 21

Clarithromycin
Amox
PPI
“CAP”

Used when there are no penicillin allergies or prior macrolide exposure.

Question 22

In patients allergic to penicillin, which antibiotic can be used instead of amoxicillin?

Answer 22

Metronidazole

Provides an alternative for those with penicillin allergies.

Question 23

Duodenal ulcer

Answer 23

The duodenal ulcers improved with eating but worsen 2 to 5 hours after a meal

Question 24

Cullens sign

Answer 24

Bluish discoloration around umbilicus

Question 25

Turners sign

Answer 25

Bluish discoloration around flank

Question 26

Sign of pancreatitis

Answer 26

Cullens and turner sign, amylase and lipase- 3x normal

Question 27

H pylori test

Answer 27

Urea breath test

Question 28

Nephrolithiasis

Answer 28

Colicky flank pain Avoid foods high in OXALATE

Question 29

GAMMA – GLUTAMYL TRANSBEPTIDASE (GGT) or serum 5 nucleotidase level

Answer 29

Should be obtained to confirm that the elevation of alkaline phosphatase is secondary to liver

Question 30

What are the **hallmark symptoms** of **Crohn's disease**?

Answer 30

* Crampy abdominal pain * Chronic intermittent diarrhea * Fatigue * Weight loss ## Footnote Crohn's disease is a subtype of inflammatory bowel disease, distinct from ulcerative colitis.

Question 31

How does **Crohn's disease** differ from **ulcerative colitis**?

Answer 31

* Crohn's disease involves transmural inflammation * Affects any portion of the gastrointestinal tract * Ulcerative colitis affects only the colon ## Footnote Both are subtypes of inflammatory bowel disease.

Question 32

What are the **endoscopic findings** specific to **Crohn's disease**?

Answer 32

* Cobblestone mucosal appearance * Skip areas * Pseudopolyps * Granulomas * Esophageal/duodenal ulceration * Gastric inflammation ## Footnote These findings help differentiate Crohn's disease from other gastrointestinal conditions.

Question 33

True or false: Patients with **irritable bowel syndrome** have mucosal inflammation on ileocolonoscopy.

Answer 33

FALSE ## Footnote Patients with irritable bowel syndrome do not exhibit mucosal inflammation.

Question 34

What does **gastritis** refer to?

Answer 34

Inflammation of the lining of the stomach ## Footnote Gastritis can be caused by various factors, including infections and irritants.

Question 35

IBS

Answer 35

FOODMOP Diet

Question 36

Ulcerative colitis affects only the **colon and rectum**. True or False?

Answer 36

TRUE ## Footnote Ulcerative colitis is specifically characterized by inflammation limited to the colon and rectum.

Question 37

What are the **subtypes** of inflammatory bowel disease?

Answer 37

* Ulcerative colitis * Crohn's disease ## Footnote These two conditions are the main subtypes of inflammatory bowel disease.

Question 38

Crohn's disease is characterized by **transmural inflammation** and may involve any portion of the gastrointestinal tract. True or False?

Answer 38

TRUE ## Footnote Crohn's disease can affect any area from the oral cavity to the perianal area.

Question 39

Both Crohn's disease and ulcerative colitis can cause **crampy abdominal pain** and _______.

Answer 39

diarrhea ## Footnote These symptoms are common in both conditions.

Question 40

Fill in the blank: Ulcerative colitis is characterized by **diffuse mucosal inflammation** of the _______.

Answer 40

colon ## Footnote This inflammation is specific to the mucosal layer of the colon.

Question 41

Screening test for hepatitis C virus (HCV)

Answer 41

Anti– HCV

Question 42

Choledochololithiasis

Answer 42

Patience with acute pancreatitis may present with scleral icterus due to obstructive jaundice secondary to chioledochollithiasis or edema of the head of the pancreas

Question 43

According to the **USPSTF**, what is the recommended age range for adults to be screened for **colorectal cancer**?

Answer 43

45 to 75 years ## Footnote This recommendation emphasizes the importance of early detection in this age group.

Question 44

Medical management for GERD

Answer 44

Proton pump inhibitor like pantoprazole

Question 45

Fill in the blank: McBurney's point is located at _______ from the anterior superior iliac spine.

Answer 45

1.5 to 2 inches ## Footnote This measurement is crucial for identifying the point associated with appendicitis.