Gastroenterology Questions And
Answers.
Save
Bisphosphonates! (ALENDRENATE, RISEDRONATE)
Important patient education to remain upward for 30 minutes, and drink with plenty of
water
Tx:
Antacids to decrease mucosal irritation
Also can occur with NSAIDs, ASA, Ferrous sulfate (Iron), Antibiotics (tetracycline,
doxycycline) - Question-What medication is know known to induce esophagitis?
Tx?
Pancreatic Cancer!
Most common cause:
SMOKING!
Dx:
CT
Tumor Marker--> CA19-9
Increased Direct Bilirubin (causes dark colored urine)
Tx:
Whipple** to resect head of pancreas
PANCREATICODUODENECTOMY*** = Whipple - Question-What presents with
progressive, painless jaundice, fatigue, weight loss, depression, Icterus, with palpable,
non-tender gallbladder, migratory thrombophlebitis?
Dx and Tx?
Painless Jaundice, Icterus , Dark colored urine (direct bilirubin increased), fatigue,
weight loss
Trousseaus:
Migratory thrombophlebitis
(hyper coagulability that accompanies most cancers)
Courvoisier sign:
Palpable nontender gallbladder
,Gastroenterology Questions And
Answers.
Save
Virchow's Node & Sister Mary Joseph Node - Question-What are the physical exam
findings typically seen in pancreatic cancer?
Adenocarcinoma involving the head of the pancreas - Question-What is the most
common type of pancreatic cancer?
Hypocalcemia! - Question-What electrolyte abnormality is common in pancreatitis?
At Admission and 48 hours after admission
LDH >350
Glucose >200
WBC >16,000
Age >55
AST >250
Calcium <8
Hematocrit fall >10%
BUN rise >5
PO2 <60
Base deficit >4
Fluid Sequestration >6
Score >7 = 100% mortality
Score >5 = 40% mortality - Question-When is Ranson's criteria performed?
What is included in representing high mortality probability?
Cobalamin (B12) Deficiency!
Dx:
,Gastroenterology Questions And
Answers.
Save
Methylamonic and Homocysteine levels:
BOTH ELEVATED**
(In folate, homocysteine will be normal, differentiating factor)
Peripheral Smear:
Macrocytic Anemia, Megaloblastic (hypersegmented neutrophils)
Tx:
Parenteral B12 - Question-What presents with fatigue, weakness, peripheral
neuropathy, glossitis, pallor?
Dx and Tx?
B12! - Question-What is the only vitamin deficiency that results in peripheral
neuropathy?
Vitamin B12 Deficiency!
DX:
Peripheral Smear:
Megaloblastic anemia (Macrocytic, hypersegmented neutrophils)
Methylamonic acid and Homocysteine levels:
BOTH ELEVATED
Tx:
Parenteral replacement of B12 - Question-What presents with depression, irritability,
anemia, sensory and motor deficits ( absent reflexes, paresthesias), dementia, nausea,
vomiting and diarrhea?
Usually due to inadequate absorption associated with PERNICIOUS ANEMIA or
secondary to gastric disease! - Question-What is the most common cause of vitamin
B12 deficiency?
Spontaneous Bacterial Peritonitis!
Dx:
Labs:
PMNs >250**** basis of diagnosis
WBCs >1,000
pH <7.34
, Gastroenterology Questions And
Answers.
Save
Paracentesis:
Gold standard for analyzing fluid
Gram stain/culture:
Positive (usually gram negative bacteria is responsible)
Tx:
Thoracentesis and Broad Spectrum ABX (IV CEPHALOSPORINS) * - Question-What
presents with fever, chills, abdominal pain in patient with history of cirrhosis, with
ascites, shifting dullness noted upon examination?
Dx and Tx?
E coli and Streptococcus - Question-What is the most common organism causing
spontaneous bacterial peritonitis?
IV drug use, transplant surgeries, intranasal cocaine use, tattoos, and blood
transfusions - Question-What are risk factors for developing Hepatitis C?
Fatigue - Question-What is the most frequent complaint in patients with chronic hepatitis
C infection?
Hepatitis A! - Question-What type of hepatitis is associated with daycare outbreaks,
contaminated shellfish and water?
Hepatitis E! - Question-What hepatitis type is associated with travelers and inhabitants
of India, Mexico, Africa and Southeast Asia?
B,C,D
This includes blood contact with infected blood products, bodily fluids or needles. -
Question-What types of Hepatitis are transmitted by parenteral transmission?
IV:
Hepatitis C!
Perinatal:
Hepatitis B! - Question-What type of Hepatitis is more common in contact with infected
blood products than through sexual contact?
Answers.
Save
Bisphosphonates! (ALENDRENATE, RISEDRONATE)
Important patient education to remain upward for 30 minutes, and drink with plenty of
water
Tx:
Antacids to decrease mucosal irritation
Also can occur with NSAIDs, ASA, Ferrous sulfate (Iron), Antibiotics (tetracycline,
doxycycline) - Question-What medication is know known to induce esophagitis?
Tx?
Pancreatic Cancer!
Most common cause:
SMOKING!
Dx:
CT
Tumor Marker--> CA19-9
Increased Direct Bilirubin (causes dark colored urine)
Tx:
Whipple** to resect head of pancreas
PANCREATICODUODENECTOMY*** = Whipple - Question-What presents with
progressive, painless jaundice, fatigue, weight loss, depression, Icterus, with palpable,
non-tender gallbladder, migratory thrombophlebitis?
Dx and Tx?
Painless Jaundice, Icterus , Dark colored urine (direct bilirubin increased), fatigue,
weight loss
Trousseaus:
Migratory thrombophlebitis
(hyper coagulability that accompanies most cancers)
Courvoisier sign:
Palpable nontender gallbladder
,Gastroenterology Questions And
Answers.
Save
Virchow's Node & Sister Mary Joseph Node - Question-What are the physical exam
findings typically seen in pancreatic cancer?
Adenocarcinoma involving the head of the pancreas - Question-What is the most
common type of pancreatic cancer?
Hypocalcemia! - Question-What electrolyte abnormality is common in pancreatitis?
At Admission and 48 hours after admission
LDH >350
Glucose >200
WBC >16,000
Age >55
AST >250
Calcium <8
Hematocrit fall >10%
BUN rise >5
PO2 <60
Base deficit >4
Fluid Sequestration >6
Score >7 = 100% mortality
Score >5 = 40% mortality - Question-When is Ranson's criteria performed?
What is included in representing high mortality probability?
Cobalamin (B12) Deficiency!
Dx:
,Gastroenterology Questions And
Answers.
Save
Methylamonic and Homocysteine levels:
BOTH ELEVATED**
(In folate, homocysteine will be normal, differentiating factor)
Peripheral Smear:
Macrocytic Anemia, Megaloblastic (hypersegmented neutrophils)
Tx:
Parenteral B12 - Question-What presents with fatigue, weakness, peripheral
neuropathy, glossitis, pallor?
Dx and Tx?
B12! - Question-What is the only vitamin deficiency that results in peripheral
neuropathy?
Vitamin B12 Deficiency!
DX:
Peripheral Smear:
Megaloblastic anemia (Macrocytic, hypersegmented neutrophils)
Methylamonic acid and Homocysteine levels:
BOTH ELEVATED
Tx:
Parenteral replacement of B12 - Question-What presents with depression, irritability,
anemia, sensory and motor deficits ( absent reflexes, paresthesias), dementia, nausea,
vomiting and diarrhea?
Usually due to inadequate absorption associated with PERNICIOUS ANEMIA or
secondary to gastric disease! - Question-What is the most common cause of vitamin
B12 deficiency?
Spontaneous Bacterial Peritonitis!
Dx:
Labs:
PMNs >250**** basis of diagnosis
WBCs >1,000
pH <7.34
, Gastroenterology Questions And
Answers.
Save
Paracentesis:
Gold standard for analyzing fluid
Gram stain/culture:
Positive (usually gram negative bacteria is responsible)
Tx:
Thoracentesis and Broad Spectrum ABX (IV CEPHALOSPORINS) * - Question-What
presents with fever, chills, abdominal pain in patient with history of cirrhosis, with
ascites, shifting dullness noted upon examination?
Dx and Tx?
E coli and Streptococcus - Question-What is the most common organism causing
spontaneous bacterial peritonitis?
IV drug use, transplant surgeries, intranasal cocaine use, tattoos, and blood
transfusions - Question-What are risk factors for developing Hepatitis C?
Fatigue - Question-What is the most frequent complaint in patients with chronic hepatitis
C infection?
Hepatitis A! - Question-What type of hepatitis is associated with daycare outbreaks,
contaminated shellfish and water?
Hepatitis E! - Question-What hepatitis type is associated with travelers and inhabitants
of India, Mexico, Africa and Southeast Asia?
B,C,D
This includes blood contact with infected blood products, bodily fluids or needles. -
Question-What types of Hepatitis are transmitted by parenteral transmission?
IV:
Hepatitis C!
Perinatal:
Hepatitis B! - Question-What type of Hepatitis is more common in contact with infected
blood products than through sexual contact?
