Kgi 300-350

Front 1

Q300. Tx for Carcinoid tumor; (3)

Back 1

A300. Surgical excision;; Radiation therapy;; Antihormonal therapy

Front 2

Q301. What is a 72-hour Fecal Fat test?; When is the only time it is used?

Back 2

A301. 72-hour FFT: Detects Intestinal Malabsorption; Only used: if you strongly suspect fat malabsorption and the Sudan Black stain is negative (best initial test for fat malabsorption is Sudan Black stain)

Front 3

Q302. Type of GI cancer in the:; 1. Espophagus (2); 2. Duodenum and Jejunum; 3. Ileum (3)

Back 3

A302. Esophagus: Squamous and Adenocarcinoma; Duodenum and Jejunum: Adenocarcinoma; Ileum: Carcinoid, Lipoma and Lymphoma

Front 4

Q303. Definition: Aquired condition of the colon in which sac-like protrusions of colonic mucosa herniate through a defect in the muscular layer

Back 4

A303. Diverticulosis

Front 5

Q304. MCC of massive GI bleed in patients over 60-yo

Back 5

A304. Diverticulosis

Front 6

Q305. Dx: painless rectal bleeding; underlying Cause?

Back 6

A305. Diverticulosis; inflammed diverticula erodes thru a colonic artery usually on RIGHT side

Front 7

Q306. what is the non-Rx Tx for Diverticulosis?; if refractory?

Back 7

A306. Bleeding scan and embolization;; Refractory: Surical removal

Front 8

Q307. Difference b/t True and False Diverticula; which is more common?; on the right side (ascending colon)?

Back 8

A307. True: herniation involving the full bowel wall thickness (right side and tend to bleed); False: only mucosal herniation thru muscular wall (more common)

Front 9

Q308. Dx: LLQ pain, fever, high WBC, possible sigmoid mass

Back 9

A308. Diverticulitis

Front 10

Q309. Dx test for diverticulitis; What test should never be done?

Back 10

A309. Abdominal CT; Never do Colonoscopy (risk of perforation)

Front 11

Q310. Tx for Diverticulitis; (3 hospital management and 2 sets of choices for Antibiotics Tx)

Back 11

A310. NPO, IV fluids, Pain control;; Antibiotics: FQ and Metronidazole; or Clindamycin and Gentamicin

Front 12

Q311. MC fistula associated with Diverticular Disease; how does it present?

Back 12

A311. Colovesicular; (presents with recurrent UTI)

Front 13

Q312. MCC of nosocomial pseudomembranous colitis

Back 13

A312. C. difficile

Front 14

Q313. Dx: Crampy, diffuse abdominal pain, fever, watery (occasionally bloody) diarrhea; recent URI

Back 14

A313. Pseudomembranous Colitis

Front 15

Q314. Dx: 68-yo man in the hospital for 3 weeks for pneumonia returns with new-onset diarrhea

Back 15

A314. C. difficile induced; Pseudomembranous Colitis

Front 16

Q315. When is the only time Vancomycin is given PO?; What is the other Tx for this problem?

Back 16

A315. Pseudomembranous colitis; also Tx with: Metronidazole PO

Front 17

Q316. Dx tests for Pseudomembranous Colitis; (3)

Back 17

A316. C. difficile toxin in stool;; Fecal Leukocytes;; Sigmoidoscopy (yellowish membranous plaques adhering to mucosa)

Front 18

Q317. Dx: fluctuating constipation and diarrhea, increased with stress, lack of systemic symptoms

Back 18

A317. Irritable Bowel syndrome

Front 19

Q318. Tx for IBS; (2 together)

Back 19

A318. 1. High-fiber / Low-fat diet;; 2. Antispasmotic / Antidiarrheal

Front 20

Q319. What (2) Dx must be ruled-out when giving a Dx of IBS, because they present similarly?

Back 20

A319. Giardia infection; Lactose intolerance

Front 21

Q320. Between ULCERATIVE COLITIS and Crohn's, which is:; 1. More common in Men; 2. More common in women; 3. Greater risk for Colon CA

Back 21

A320. 1. CD; 2. UC; 3. UC

Front 22

Q321. What unusual topical Tx is there for Inflammatory Bowel Disease to improve Symptoms?

Back 22

A321. Nicotine dermal patch

Front 23

Q322. IBD: Inflammation of mucosa only

Back 23

A322. UC

Front 24

Q323. IBD: bloody diarrhea, rectal pain, more acute flares

Back 24

A323. UC

Front 25

Q324. IBD: tender RLQ mass, more chronic

Back 25

A324. CD

Front 26

Q325. IBD: Inflammation involves all bowel layers

Back 26

A325. CD

Front 27

Q326. IBD: Leads to fistulas, abscesses and involves granulomas

Back 27

A326. CD

Front 28

Q327. IBD: "Lead-pipe colon"

Back 28

A327. UC

Front 29

Q328. IBD: "Cobblestone appearance"

Back 29

A328. CD

Front 30

Q329. IBD: complications include perforation, stricture and megacolon

Back 30

A329. UC

Front 31

Q330. IBD: complications include abscess, fistula, perianal disease

Back 31

A330. CD

Front 32

Q331. (2) Drugs to Tx IBD that contain 5-ASA and Sulfapyridine; Which is also used to Tx Rheumatoid Arthritis?; Which only works in the colon?; Which works in the small bowel if taken orally,but need to be given by enema if needed for colon?

Back 32

A331. Sulfasalazine: only in colon (also Tx: RA); Mesalamine: oral for small bowel and enema for colon

Front 33

Q332. Tx for Inflammatory Bowel Disease; (5)*

Back 33

A332. Inflam SCAM:; Immunomodulators;; Sulfsalazine;; Corticosteroids;; Antibiotics (Metronidazole);; Mesalamine

Front 34

Q333. Which drug class for IBD works better for UC?

Back 34

A333. Corticosteroids

Front 35

Q334. Antibiotics Tx for Crohn's Disease

Back 35

A334. Metronidazole

Front 36

Q335. Immunomodulators used in Tx of Crohn's Disease; (4)*; Which is for severe cases?; Which (2) are purine analogs?

Back 36

A335. MIA-6:; Methotrexate;; Infliximab (severe cases);; Azathioprine (purine);; 6-Mercaptopurine (purine)

Front 37

Q336. What type of precursor to colon cancer is the worst?

Back 37

A336. Villous Polyps; (Villous are the Villains)

Front 38

Q337. Place of Colon CA: signs of anemia: pallor, weakness; possible dull abdominal pain

Back 38

A337. Right Colon

Front 39

Q338. Place of Colon CA: pencil-thin stools, rectal bleeding, constipation, vomiting

Back 39

A338. Left Colon

Front 40

Q339. What is the next step if you fecal occult blood test is positive?

Back 40

A339. Colonoscopy

Front 41

Q340. At what age should annual rectal exams begin?; Fecal occult blood test?; Flexible sigmoidoscopy or colonoscopy?; What if there is a family member with a History of colon cancer?

Back 41

A340. Annual Rectals: 40 years-old; FOBT: 50 years-old; Sigmoidoscopy / Colonoscopy:beginning at 50 years-old, for every 3-5 years; History of Colon CA: at 40yo or 10 years earlier then the family member's Dx (whichever is earlier)

Front 42

Q341. Dx: 70-yo woman presents with microcytic anemia, weight loss, and a vague abdominal pain that is not related to food or time of day

Back 42

A341. Colorectal CA

Front 43

Q342. Dx lab test findings for Colon CA; (3)

Back 43

A342. Anemia (iron deficiency);; elevated CEA;; Check LFTs (inc may indicate Mets)

Front 44

Q343. What type of colon polyp is benign?; Which (2) have malignant potential?

Back 44

A343. Benign: Tubular; Malignant potential: Villious; Tubulovillous

Front 45

Q344. What is done if a polyp is found on colonoscopy?; when is the colonoscopy repeated?

Back 45

A344. perform a polypectomy/Biopsy; repeat colonoscopy: 3 years

Front 46

Q345. In Endocarditis, which two bugs are assoc with Colon CA?

Back 46

A345. Strep Bovis;; Clostridium Septicum

Front 47

Q346. Duke's Classification of Staging and Prognosis for Colon CA; (A-D and 5-year survival percent)

Back 47

A346. A: Confined to Mucosa and Submucosa - >80%; B: Invasion of Muscularis propria - 60%; C: Local node involvement - 20%; D: Distant Mets - 3%

Front 48

Q347. First step in Tx for Colon Cancer; Next?; What Dx would lead to Radiation therapy?

Back 48

A347. 1. Surgical resection (cures 50% in stage A and B);; 2. Chemotherapy;; Radiation only for Rectal involvement

Front 49

Q348. Drug regimen for Colon Cancer; (2 plus one of 2 more)

Back 49

A348. 5-FU and Levimasole (stage B and higher); plus: Oxaliplatinum or Irinotecan

Front 50

Q349. Hereditary Colon CA Syndromes; (4)*; which is the only low-moderate risk (the rest being high risk)?

Back 50

A349. Family Has Growing Polyps:; Familial Polyposis Coli;; Hereditary Non-polyposis Colon CA;; Gardner's Syndrome;; Peutz-Jeghers Syndrome (low risk)

Front 51

Q350. Definition: thousands of adenomatous polyps appear throughout the colon by age 25 and cancer hits by 40-yo. What are the genetics?

Back 51

A350. Familial Polyposis Coli; Autosomal Dominant