Ihi Final Gi Questions

Front 1

At what location does esophageal atresia most often occur?

Back 1

* Near the tracheal bifurcation

Front 2

Where do esophageal webs most commonly occur?

Back 2

* Upper esophagus

Front 3

What is the Plummer Vinson Triad?

Back 3

* atrophic glossitis, esophageal webs, and iron deficient anemia

Front 4

A pt with bad breath and a "lump" in their throat probably has this type of pulsion diverticulum:

Back 4

* Zenker diverticulum (on posterior wall of esophagus, d/t incomplete relaxation of upper esophagus)

Front 5

Esophageal varices is due to?

Back 5

* Portal HTN causing increased blood flow through the AZYGOUS system

Front 6

Hiatal hernia most associated with increased pressure is:

Back 6

* Paraesophageal (rolling) hernia

Front 7

Main sign of esophagitis is:

Back 7

* Odynophagia (painful swallowing)

Front 8

Most common esophageal malignancy is caused by:

Back 8

* Smoking and EtOH (squamos cell esophageal cancer)

Front 9

Someone with myasthenia gravis has difficulty swallowing, what treatment should be given?

Back 9

* Endrophonium

Front 10

Sarcoidosis causes what sphincter to become non-compliant?

Back 10

* The UES

Front 11

Where does scleroderma affect the esophagus?

Back 11

* Affects the distal esophagus and LES-- prone to GERD

Front 12

Esophageal disorder that has normal (but strong) peristalsis:

Back 12

* Nutcracker esophagus-- dysfunction of the afferent limb

Front 13

A person who has had a vagotomy has affected what phase of the MMC?

Back 13

* Phase III, now undigested food isn't moved out of the stomach

Front 14

Define portal HTN:

Back 14

* Free portal vein pressure greater than 10mmHg and a wedge pressure no more than 5mmHg over the IVC pressure

Front 15

How do you screen for hepatocellular carcinoma (HCC)?

Back 15

* AFP levels and ultrasound every 6 months

Front 16

A pt with elevated bilirubin but normal ALT/AST probably has:

Back 16

* A drug RXN (99% of the time)

Front 17

An infant with projectilve vomiting around the 2nd - 4th wk of life:

Back 17

* Pyloric stenosis

Front 18

Most common cause of ulcers?

Back 18

* NSAIDS

Front 19

Chronic gastritis can lead to:

Back 19

* Gastric carcinoma and pernicious anemia

Front 20

Gastrinoma and enlarged rugae:

Back 20

* Zollinger-Ellison

Front 21

Where is the weakness with a Zenker diverticulum?

Back 21

* The cricopharyngeus in the upper esophagus

Front 22

Distal esophageal dilation with a hypotensive LES is due to:

Back 22

* Scleroderma (Achalasia is dilation with a hypertensive/increased tone LES)

Front 23

Most common cause of Boerhaave's syndrome is:

Back 23

* Endoscopy rupture to the distal esophagus

Front 24

Cause of achalasia:

Back 24

* Absent ganglion cells in myenteric plexus (get distal esophageal dilation with LES that doesn't relax)

Front 25

Most common benign tumor of the esophagus:

Back 25

* Leiomyoma

Front 26

Hypertrophic gastropathy with hyperplasia of mucus cells and hypoproteinemia (protein-losing enteropathy):

Back 26

* Menetrier's disease

Front 27

Can duodenal ulcers be malignant?

Back 27

* Duodenal ulcers are never malignant

Front 28

Zollinger-Ellison (gastrinoma) is associated with what endocrine disorder:

Back 28

* Men I (the 3 P's) Pancreatic (ZE), Parathyroid, Prolactinoma

Front 29

Risk factors for gastric adenocarcinoma:

Back 29

* Nitrosamides (Japan), H. pylori infection, Type A gastritis (auto Ab's to parietal cells), and Menetrier's disease (hyperplasia of mucus cells)

Front 30

Sometimes called linitis plastica, has SIGNET RINGS, and produces Krukenberg tumors in ovaries:

Back 30

* Diffuse gastric adenocarcinoma

Front 31

Common metastasis site for gastric adenocarcinoma:

Back 31

* Virchow's node (left supraclavicular)

Liver, Lung, then Ovary

Front 32

If a patient has hematochezia (massive rectal blood loss) think:

Back 32

* Angiodysplasia or diverticulosis

Front 33

Osmotic gap is:

Back 33

* 300 - 2 (Na+ + K+)

Secretory = less than 50
Osmotic = over 100

Front 34

How can chronic pancreatitis cause malabsorption?

Back 34

* Less lipase to digest fats, so fats are stooled out --and--

Less trypsin to digest protein

Front 35

2 causes of bile salt deficiency:

Back 35

* Crohns and resected Ileum

Front 36

2 small bowel disease that would have decreased absorption of D-xylose:

Back 36

* Whipples and Celiac disease (d/t blunting of villit)

Pancreatic enzymes aren't need for xylose

Front 37

Celiac disease primarily affects what part of the small bowel:

Back 37

* The duodenum and jejunum

Front 38

Whipples disease affects:

Back 38

* PAS mac's in lamina propria obstruct lymphatics and chylomicron reabsorption

Front 39

Most common cause of small bowel obstruction:

Back 39

* Adhesions from previous surgery

Front 40

Artery that supplies the small bowel:

Back 40

* The Superior Mesenteric supplies most of the small bowel

Front 41

Where is pressure the highest: the mouth, esophagus, or stomach?

Back 41

* stomach (+ pressure), mouth (even), esophagus (- pressure)

stomach > mouth > esophagus

Front 42

Where does the superior mes and inferior mes overlap (watershed area)?

Back 42

* At the splenic flexure

Front 43

Where does angiodysplasia occur?

Back 43

* Dilation of mucosal/submucosal venules in the cecum and right colon-- Hematochezia in the elderly

Front 44

If you found pancreatic rests and heterotopic gastic mucousa near the ileocecal valve this would mean:

Back 44

* Pt has a meckel's diverticulum (omphalomesenteric/vitelline duct remnant)

Front 45

How do you diagnose a mecke's diverticulum?

Back 45

* Tc nuclear scan show parietal cells in ectopic gastric mucosa

Front 46

Wide mouthed diverticula in the small bowel is suggestive of:

Back 46

* Systemic sclerosis

Front 47

Most common cause of hematochezia:

Back 47

* Diverticul-OSIS (not diverticulitis)

Front 48

Which is associated with malignancy Crohns or ulcerative colitis?

Back 48

* Ulcerative colitis can be precancerous

Front 49

A pt with bouts of diarrhea and constipation but everything else is normal:

Back 49

* Irritable bowel syndrome

Front 50

A pt with flushing a diarrhea might have:

Back 50

* Carcinoid tumor

Front 51

Where do malignant lymphomas occur in the intestine?

Back 51

* Peyers patches of terminal ileum

Front 52

A solitary polyp found in the rectum of a kids is:

Back 52

* A juvenile retention polyp

Front 53

AD polyp disorder where there are polyps in the small intestine and mucosal pigmentation of buccal surfaces and lips:

Back 53

* Peutz-Jaghers polyposis

Front 54

Sessile polyp that can secrete potassium and protein rich mucous and has a risk of malignancy:

Back 54

* Villous adenomas

Front 55

Polyposis syndromes that are AD:

Back 55

* Familial polyposis (inactive APC gene) and Gardner's (polyps, osteomas, and desmoid tumors)

Front 56

Only AR polyposis syndrome that is also associated with CNS tumors:

Back 56

* Turcot's polyposis syndrome

Front 57

Most common site of rectal cancer:

Back 57

* Rectosigmoid > R colon > L colon

Colonscopy is gold standard dx'tic

Front 58

"Napkin ring" appearance with a change in bowel habits-- what type of cancer?

Back 58

* Left sided (obstructive) cancer

Front 59

Most common metastasis site of colon cancer:

Back 59

* Liver, lung, bone, then brain

CEA is a B2 stage or higher

Front 60

Most common cause of appendicitis in kids:

Back 60

* Virus