Kgi 1-50

Front 1

Q001. (3) causes of viral Esophagitis

Back 1

A001. HSV; VZV; CMV

Front 2

Q002. (5)* causes of Bacterial Esophagitis

Back 2

A002. My Pnew Strep Lacts Crypt:; Mycobacterium TB;; Pneumocystis Carnii;; Strep;; Lactobacillus;; Cryptospordium

Front 3

Q003. *When is a Barium Esophagram the best initial test?; when is it the most accurate?; (3)

Back 3

A003. Dysphasia (that shows no signs of obstruction...for obstruction it would be Upper Endoscopy); most accurate:; 1. Esoph Webs; 2. Esoph Rings; 3. Esoph Diverticuli

Front 4

Q004. Dx: Odynophagia (pain with swallowing), dysphagia, esophageal bleeding, N/V, chest pain, (or asymptomatic)

Back 4

A004. Infectious Esophagitis

Front 5

Q005. Dx: Infectious esophagitis with nodular filling defects on barium esophagram; Tx?

Back 5

A005. Candida; Tx: Fluconazole PO

Front 6

Q006. Causes: Infectious esophagitis with vesicles and descrete erosions on endoscopy; (2); Tx?

Back 6

A006. HSV or VZV; Tx: Acyclovir for HSV

Front 7

Q007. Dx: Infectious esophagitis with intranuclear inclusions on biopsy via endoscopy; Tx?

Back 7

A007. CMV; Tx: Ganciclovir IV

Front 8

Q008. Who should upper endoscopy screening be offered to?; (2)

Back 8

A008. 1. Patients with GERD and Symptom for > 5 years (to check for Barrett's esophagus); 2. Patients with Esophageal varices

Front 9

Q009. Dx: A Full-thickness tear usu in the weak left posterolateral wall of distal esophagus; (3) causes?

Back 9

A009. Boerhaave's Syndrome; Causes:; Forceful vomiting;; Cough;; Trauma

Front 10

Q010. Dx: A Partial-thickness tear usu in the right posterolateral wall of the distal esophagus and results in bleeding that resolves spontaneously; Cause?

Back 10

A010. Mallory-Weiss syndrome; Cause: Forceful vomiting

Front 11

Q011. medical Tx for non-bleeding Esophageal Varices

Back 11

A011. Propranolol

Front 12

Q012. What is the next step in the Tx of a patient with GERD that has persistent Symptom after 4 weeks of Tx with a PPI?

Back 12

A012. 24-hour Esophageal pH recording

Front 13

Q013. If patient has mediastinal and subcutaneous emphysema, what esophageal problem do they have?

Back 13

A013. Full-thickness tear; (Boerhaave's syndrome)

Front 14

Q014. Dx sign: "Crunching sound" heard with heartbeat; what is it due to?

Back 14

A014. "Hammon's crunch" (Mediastinal emphysema); From: Full-thickness esophageal tear (Boerhaave's syndrome)

Front 15

Q015. *What is the Diagnostic test of choice for Boerhaave's syndrome or a partial esophageal perforation?; What is the most accurate test?

Back 15

A015. Dx test: Gastrograffin (water-soluble contrast); most accurate: CT scan

Front 16

Q016. Tx for esophageal tear; (1 for each type)

Back 16

A016. Partial-thickness (Mallory-Weiss): may resolve spontaneously; Full-thickness (Boerhaave's): Surgery

Front 17

Q017. Definition: Pharyngeal or esophageal pouch due to a defect in the muscular wall of the posterior hypopharynx

Back 17

A017. Zenker's Diverticulum

Front 18

Q018. Dx: Halitosis, regurgitation of food after eating it, frequent aspiration, esophageal obstruction

Back 18

A018. Zenker's Diverticulum

Front 19

Q019. Dx test for Zenker's Diverticulosis; (2 possible); Tx (2 possible)

Back 19

A019. Tests: Barium swallow;; Endoscopy; Tx:; Surgical removal;; Cricopharyngeal myotomy

Front 20

Q020. Dx: 56-yo man complains of food feeling "stuck" on its way down and vomiting food he ate days ago

Back 20

A020. Zenker's Diverticulum

Front 21

Q021. Definition: Neurogenic disorder of esophageal motility with absence of normal peristalsis and impaired relaxation of the LES

Back 21

A021. Achalasia

Front 22

Q022. Definition: Esophageal motility disorder with frequent non- peristaltic contractions

Back 22

A022. Diffuse Esophageal Spasms; (DES)

Front 23

Q023. What esophageal problem affects 70% of people with Scleroderma?

Back 23

A023. Achalasia

Front 24

Q024. What type of problem does dysphagia to solids and liquids indicate?; (2 examples); To just solids?; (3 examples)

Back 24

A024. Solids + Liquids: Motility problem (Achalasia; DES); Solids only: Mechanical problem (Tumor; Schatzki's ring; Plummer-Vinson syndrome)

Front 25

Q025. Dx: weight loss, cough, dysphagia of both solids and liquids, "bird's beak" on CXR; Tx options?; (2 drugs and 2 procedures)

Back 25

A025. Achalasia; Tx options:; Nitroglycerin;; Local Botulinum toxin;; Balloon Dialation;; Sphinctor Myotomy

Front 26

Q026. Dysphagia to both solids and liquids, diffuse chest pain, "corkscrew" appearance on CXR; DES Drug Tx options? (2 possible)

Back 26

A026. Diffuse Esophageal Spasms (DES); Tx options:; 1. Nitroglycerin;; 2. Anticholinergics

Front 27

Q027. When is an Esophageal Manometry the test of choice?; (2)

Back 27

A027. 1. an Inconclusive Barium or upper endoscopy; 2. Description of a Motility problem (Achalasia, DES, Nutcracker esophagus)

Front 28

Q028. Etiology of Achalasia; (2)

Back 28

A028. Scarring of Auerbach's plexus from: Chagas Disease; or Ganglionic degeneration

Front 29

Q029. Definition: Hypopharyngeal webs (thin mucosal structures protruding into lumen of the esophagus) associated with iron deficiency anemia

Back 29

A029. Plummer-Vinson Syndrome

Front 30

Q030. Definition: Narrow lower esophageal ringlike outgrowth associated with dysphagia

Back 30

A030. Schatzki's Ring

Front 31

Q031. Etiology of GERD; (4)*

Back 31

A031. HIDE:; Hiatal hernia;; Incompetent LES tone; Delayed Gastric emptying;; Esopageal motility decreased

Front 32

Q032. (5)* causes of Delayed Gastric Emptying

Back 32

A032. Delayed Food GAG: DM;; Fatty foods;; Gastroparesis;; Anticholinergics;; Gastric outlet obstruction

Front 33

Q033. (8)* causes of a decreased LES tone

Back 33

A033. Coffee CAN Cause Esophageal Sphinctor Problems:; Coffee;; Chocolate;; Alcohol;; Nitrates;; Calcium channel blockers;; Estrogen;; Smoking;; Progesterone

Front 34

Q034. Differential of Chronic Cough; (3)*

Back 34

A034. GAP in breathing:; GERD;; Asthma / Chronic Bronchitis;; Post-nasal drip

Front 35

Q035. Dx: Substernal chest pain, dysphagia, hypersalivation, cough, wheezing

Back 35

A035. GERD

Front 36

Q036. What (3) lifestyle modifications should be told to patients with GERD?

Back 36

A036. Discontinue foods that lower LES tone;; Elevate head of bed;; No food < 3 hours before bed

Front 37

Q037. (2) drug Tx options for GERD; What can be done if medication doesn't work?

Back 37

A037. Proton Pump Inhibitor (1st);; H-2 Blocker; Final solution: Surgical fundoplication

Front 38

Q038. Definition: Esophageal damage, bleeding and friability due to prolonged exposure to gastric contents

Back 38

A038. Esophagitis

Front 39

Q039. (4)* complications of GERD

Back 39

A039. BEEP:; Barrett's Esophagus;; Esophagitis;; Esophageal cancer;; Peptic stricture

Front 40

Q040. (2) types of esophageal cancers and where each is formed in esophagus

Back 40

A040. Squamous: Upper 2/3 of esophagus; Adenocarcinoma: Lower 1/3 of esophagus

Front 41

Q041. Risk factors for CA of the esophagus; (7)*

Back 41

A041. ABCDEF:; Alcohol;; Barrett's esophagus;; Cigarettes;; Diverticuli (Zenker's);; Esophageal web (P-V synd), Esophagitis (reflux or irritants);; Familial

Front 42

Q042. What causes Barrett's?; What can it become?; How often should a patient with Barrett's have an upper endoscopy?

Back 42

A042. BARRett's: Becomes Adenocarcinoma, Results from Reflux; UE: Barrett's: every 2 - 3 years

Front 43

Q043. What is the Alkaline Tide?

Back 43

A043. Parietal cells secreting HCl into the gastric lumen and bicarb into the gastric venous circulation, which goes to the gastric mucous cell

Front 44

Q044. What hormones/NT stimulate parietal cells?; (3)

Back 44

A044. Holds Gastric Acid:; Histamine (H-2);; Anticholinergic (from vagus);; Gastrin

Front 45

Q045. What hormone stimulates release of Gastrin? From what cells and where?

Back 45

A045. Gastrin-releasing peptide; (from G-cells in antrum of stomach)

Front 46

Q046. What hormone inhibits Gastrin? From which cells?

Back 46

A046. Somatostatin; (from D-cells in the pancreas and GI mucosa)

Front 47

Q047. What inhibits the Gastric Bicarb secretion (from the alkaline tide) from entering the mucous gel to line the stomach?; (4)

Back 47

A047. NSAIDs;; Alcohol;; Acetazolamide;; Alpha-blockers

Front 48

Q048. What increases the thickness of the mucous gel of the stomach?; What decreases it?; (2)

Back 48

A048. Increases: Prostaglandin E; Decreases (by inhibiting PGE): NSAIDs; Steroids

Front 49

Q049. Dx: A patient has large, multiple ulcers that are recurrent and distal in origin. First test?; What are diagnostic levels?; if this Dx is still suspected and diagnostic levels of the first test are not reached, what is the next test?; what syndrome is it assoc with?

Back 49

A049. Zollinger-Ellison syndrome; First test: Gastrin Level (> 1,000pg/mL is diagnostic); Next if not at Dx level: Secretin Stimulation test (Gastrin levels will still be high); Assoc with: MEN-1

Front 50

Q050. Dx: 52-yo woman presents with 3 months of early satiety, weight loss, and vomiting

Back 50

A050. Gastric Outlet Obstruction