Gi- Mksap

Front 1

Tx. for suspected nephrolithiasis

Back 1

Noncontrast helical abdominal CT.

Front 2

Tx for suspected abdominal perforation

Back 2

Supine and upright radiographs. Acute abdomen refers to sever pain less than 24 hrs in duration.

Front 3

Dx rebound tenderness and severe diffuse abdominal pain

Back 3

Acute abdomen with peritonitis.

Front 4

Dx.severe abdominal pain with syncope, leukocytosis, anemia, and low BP

Back 4

ruptured AAA

Front 5

Dx. pain w defecation, new onset of amount of stool or a change in consistency of the stool

Back 5

irritable bowel syndrome.

Front 6

Dx. crampy abdominal pain and bloody stool in a patient w atherosclerotic disease.

Back 6

Ischemic colitis. Also seen is a CT scan indicating thickening of the bowel wal in a segmental pattern. Also seen in crohns disease.

Front 7

Dx. left lower quadrant pain, fever, and elevated leuks.

Back 7

Diverticulitis. Dont use colonoscopy for fear of perf. Use contrast CT.

Front 8

HUS causes

Back 8

Usually caused by infection from shiga toxin in EColi O157.

Front 9

Dx patient with diarrhea and tenesmus 6 weeks after radiation therapy

Back 9

Radiation proctitis. Tx is flexible sigmoidoscopy. Also see are mucosal telangiectasias and mucosal fibrosis.

Front 10

Dx. patient positive for antiendomysial antibodies.

Back 10

Celiac disease.

Front 11

Dx pt. w colitis, diarrhea of 10-15 times er day, lower abdominal pain, cramping, fever, and leukocytosis.

Back 11

C. difficile. Common in patient after antibiotic administration. Two toxins a and b, both are strong. Treat w oral vanc and flagyl.

Front 12

Tx for salmonella gastroenteritis

Back 12

Symptomatic, it resolved by itself. Tx only for immunocompromised, if they are less than 2 or over 50, if they are hospitalized, if they have chance for endocarditis

Front 13

Elevated alk phos levels

Back 13

Is the only way to really differentiate cholestatic injuries from hepatocellular. Hepatocellular can give you AST ALT elevations as well as hyperbillirubin.

Front 14

Dx indirect hyperbillirubinemia in an asymptomaptic patient w normal hemoglobin levels.

Back 14

Gilbert syndrome, you dont have to do anything about it. Impaired billirubin conjugation.

Front 15

Tx for patient w symptomatic gallstones

Back 15

Always cholecystectomy. the only time you use ERCP is if there is biliary obstruction due to choledocholithiasis, it literally cant get to the gallbladder.

Front 16

Dx. elevation of bilirubin and alk phos levels.

Back 16

PSC. 85% of patients also have IBD

Front 17

dx patient w antimitochondrial antibody

Back 17

PBC

Front 18

Dx. biliary colic, leukocytosis, positive murphy sign, and gallstones, and pericholecystic fluid, thickening of the gallbladder

Back 18

acute cholecytitis

Front 19

Dx. ruq pain, fever, and JAUNDICE

Back 19

Charcot triad for acute cholangitis. Need biliary obstructin.

Front 20

Tx for acute cholangitis

Back 20

Remove teh stone by ERCP

Front 21

Sensitivity of ultrasanogrophy for a choledocholithiasis

Back 21

only 50-75%, if it smells like it, go with clinical instinct.

Front 22

Therapy for patients w pancreatic necrosis

Back 22

Imipenam therapy. Decreases incidence of sepsis, and other complications.

Front 23

Alarm symptoms of GERD

Back 23

namely dysphagia, odynophagia, hematemesis.

Front 24

Tx of choice for erosive or severe esophagitis

Back 24

omeprazole

Front 25

Tx strategy for a gastric ulcer

Back 25

Biopsy alwasy for gastric ulcers. Duodenal ulcers

Front 26

Dx painless lower GI bleeding.

Back 26

Most common source is diverticulosis, or vasula extasia

Front 27

Screening test for hepatocellular carcinoma

Back 27

Ultrasound plus alpha fetoprotein.

Hint 27

D

Front 28

Dx fatigue, nausea, vomiting, jaundice, and ALT/AST greater than 1000

Back 28

hep A

Front 29

Dx anti smooth muscle antibody, ANA, elevated LFTs,

Back 29

think autoimmune hepatitis. Drug induced not associated with ANAs.

Front 30

What is first line therapy for hepatic encephalopathy.

Back 30

Lactulose. Steroids have no role. TIPS has no role.

Front 31

Most common cutaneous manifestation of IBD

Back 31

erythema nodosum. This is most common with crohns. Pyoderma gangrenosum is more common w UC.

Front 32

Dx a histology of cryptitis, crypt abscesses, and crypt architecture distortion. Erythema of rectum to splenic flexture.

Back 32

UC. Crohns is patchy (cobblestone) and spares the rectum.

Front 33

What is the first line therapy for UC

Back 33

mesalamine or other 5-aminosalicylate agent such as sulfasalazine, mesalamine. Prednisone is 2nd line.

Front 34

Dx chronic watery diarrhea wo bleeding. Colonoscopy is normal.

Back 34

Microscopic colitis. Can exclude cdiff based on the normal colonoscopy. This would show raised yellow or off white plaques in the colorectal mucosa. Two types of microscopic colitis, collagenous or lymphocytic, these may be seein in biopsy.

Front 35

Dx Diarrhea w colonoscopy of Flattening of the vili and inflammation of the small intestine associated with travel

Back 35

Tropical sprue . Treat with doxy or bactrim and vit b 12 and folic acid.