Kgi 350-400

Front 1

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

Back 1

A350. Familial Polyposis Coli; Autosomal Dominant

Front 2

Q351. Definition: condition in which 3 or more relatives of a patient and at least one first-degree relative, develops colon cancer at an early age; What are the genetics?; When and How often should a colonoscopy be performed on this individual or his/her offspring?

Back 2

A351. Hereditary Non-Polyposis Colon CA; Autosomal Dominant; Colonoscopy: Start at age 25; repeat every 1 - 2 years

Front 3

Q352. Definition: disorder characterized by polyposis coli, supernumerary teeth, osteomas and fibrous displasia of the skull and mandible; What are the genetics?

Back 3

A352. Gardner's syndrome; Autosomal Dominant

Front 4

Q353. Definition: multiple polyposis of the small intestine with multiple pigmented melanin macules in the oral mucosa or presents with freckles on lips; What other cancer is it assoc with?

Back 4

A353. Puetz-Jeghers syndrome; assoc with: GYN Cancer

Front 5

Q354. Definition: Polyposis with medulloblastoma or glioma

Back 5

A354. Turcot's syndrome

Front 6

Q355. MC complaint or presentation of Colon CA

Back 6

A355. Intermittent Rectal Bleeding

Front 7

Q356. Order of steps for resuscitation in the general approach to GI bleeds; (6)

Back 7

A356. 1. Establish IV with (2) large-bore IV caths; 2. Evaluate for Hemodynamic instability (hypotension, tachycardia); 3. Type and cross, CBC, coag study; 4. IV fluid and blood; 5. Vasopressors if BP does not respond to aggressive fluid; 6. GI and Surgical evaluation

Front 8

Q357. *When do you answer: Capsule Endoscopy?

Back 8

A357. Procedure of choice for suspected small bowel bleeding not detected in upper or lower endoscopy

Front 9

Q358. How may UGI bleeds present?; (4)

Back 9

A358. Hematemesis;; Coffee ground emesis;; Melena;; Hematochezia (BRBPR)

Front 10

Q359. How may a LGI bleed present?; (2)

Back 10

A359. Hematochezia (BRBPR);; Melena

Front 11

Q360. Etiology of UGI bleed; (5)*

Back 11

A360. Mallory's Vices Gave (her) An Ulcer:; Mallory-Weiss tear;; Varices;; Gastritis;; Arteriovenous Malformation;; Ulcer (peptic)

Front 12

Q361. Dx tests for UGI or LGI (same tests); (6)

Back 12

A361. Gastric Lavage;; Rectal exam;; CBC;; Endoscopy;; Bleeding scan;; Arteriography

Front 13

Q362. Test that detects active bleeding by infusing a radioactive colloid and watching it collect in the GI; When is this the correct answer?

Back 13

A362. Bleeding Scan; correct: Next step in patient with severe GI bleeding in whom the lower endoscopy is unable to find the source.

Front 14

Q363. Etiology of LGI bleed; (6)*

Back 14

A363. Can U Cure Aunt Di's Hemorrhoids?; Cancer or Polyps;; Upper GI bleed (Rule-out);; Colitis;; Angiodysplasia;; Diverticulosis;; Hemorrhoids

Front 15

Q364. What class (and drug example) of anti-diarrheal agents is contraindicated in diarrhea that is due to infectious agents?; Why?

Back 15

A364. Opiates (Loperamide); because they promote longer contact time b/t bacteria and intestinal mucosa

Front 16

Q365. By asking the Quantity of diarrhea, how can it help with the Diff Dx in relation to site of problem?

Back 16

A365. Small bowel: Large-volume, Watery diarrhea; Large Bowel: Small-volume diarrhea

Front 17

Q366. Bugs that cause Bloody Diarrhea; (5)*

Back 17

A366. CASES:; Campylobacter;; Amoeba (E. Histolytica);; Shigella;; E.coli;; Salmonella

Front 18

Q367. What is acute (<2 weeks) of diarrhea usually due to?

Back 18

A367. Infectious etiology

Front 19

Q368. What should the stool be tested for if infectious diarrhea is suspected?; (4); which must be done with 3 different bowel movements over 3 days?

Back 19

A368. Leukocytes;; Ova and Parasites (over 3 days);; C. Difficile;; Culture

Front 20

Q369. Bug Dx: patient vomits within 6 hours of eating something with mayonnaise

Back 20

A369. Staphylococcus

Front 21

Q370. Bug Dx: patient has vomiting/diarrhea after eating reheated rice from leftover Chinese food

Back 21

A370. Bacillus Cereus

Front 22

Q371. Bug Dx: patient has vomiting and severe watery diarrhea after eating shellfish

Back 22

A371. Vibrio Cholera

Front 23

Q372. Bug Dx: patient has flatulence and foul-smelling diarrhea after a camping trip; Tx?

Back 23

A372. Giardia Lamblia; Tx: Metronidazole

Front 24

Q373. Bug Dx: patient has watery diarrhea following a recent course of Antibiotics; Tx? (2)

Back 24

A373. C. Difficile; Tx: Oral Metronidazole or Vancomycin

Front 25

Q374. Bug Dx: causes diarrhea from contaminated water in third- world countries

Back 25

A374. Vibrio Cholera

Front 26

Q375. Bug Dx: causes diarrhea and is assoc with Guillian-Barre syndrome

Back 26

A375. Campylobacter

Front 27

Q376. Bug Dx: causes diarrhea and is assoc with raw eggs

Back 27

A376. Salmonella

Front 28

Q377. Bug Dx: causes diarrhea and is common in AIDS patient

Back 28

A377. Cryptosporidium

Front 29

Q378. Basic Tx for all acute diarrhea. (2); If it is due to bacteria, what is added to Tx? (2 possible); If it is Parasitic?

Back 29

A378. All Acute Diarrhea:; 1. Rehydration and Electrolyte replacement;; 2. Anti-motility agent (AMA only if not infectious diarrhea) Bacteria:; 1. Ciprofloxacin;; 2. Bactrim (TMP-SMX) Parasite: Flagyl (Metronidazole)

Front 30

Q379. (3) viral causes of Acute Diarrhea

Back 30

A379. Rotavirus;; Norwalk virus;; CMV

Front 31

Q380. (5)* Classes for the etiology of Chronic Diarrhea

Back 31

A380. Something Old Died In Me:; Secretory;; Osmotic;; Decreased transit;; Inflammatory;; Malabsorption

Front 32

Q381. If fecal pH is < 5.5, what does it suggest the cause of diarrhea is?

Back 32

A381. Carbohydrate Malabsorption

Front 33

Q382. *What is a D-Xylose Test?; What (3) diseases make it abnormal?

Back 33

A382. D-Xylose: Test for chronic diarrhea that helps distinguish b/t malabsorption and Chronic Pancreatitis. Low levels in Urine = problem with small bowel mucosal transport. Abnormal results in:; 1. Celiac Disease; 2. Tropical Sprue; 3. Whipple's Disease

Front 34

Q383. How is the Osmotic gap determined for diarrhea (equation)?; what do the results indicate?

Back 34

A383. OG = 290 - 2(Na + K); > 50 mOsm = Osmotic component; < 50 mOsm = Secretory (or other cause)

Front 35

Q384. What would a 24-hour fasting help distinguish b/t with regards to chronic diarrhea?

Back 35

A384. Osmotic Diarrhea - resolves with fasting; Secretory Diarrhea - does not resolve with fasting

Front 36

Q385. diagnostic test for ppl w + fobt

Back 36

A385. COLONOSCOPY

Front 37

Q386. most common site of distant spread in colorectal cancer

Back 37

A386. liver

Front 38

Q387. what type of polyps are considered to have malignant potential

Back 38

A387. adenomatous polyps (villous > tubular)

Front 39

Q388. features of familial polyposis syndrome

Back 39

A388. autosomal dominant; hundreds of adenomatous polyps in colon; colon always involved, duodenum usually (90%) involved

Front 40

Q389. tx for familial polyposis syndrome

Back 40

A389. prophylactic colectomy

Front 41

Q390. clinical features of gardner's syndrome

Back 41

A390. autosomal recessive; polyps + osteomas, dental abnormalities, benign soft tissue tumors, desmoid tumors, sebaceous cysts; 100% risk of colon ca

Front 42

Q391. clinical features of turcot's syndrome

Back 42

A391. autosomal recessive; polyps + cerebellar medulloblastoma or gbm

Front 43

Q392. peutz-jeghers

Back 43

A392. single or multiple hamartomas scattered through gi tract (mostly in small bowel and colon); pigmented spots around lips and oral mucosa, genitalia, palmar surfaces; low malignant potential

Front 44

Q393. complications of peutz-jeghers

Back 44

A393. intussusception or bleeding

Front 45

Q394. familial juvenile polyposis coli

Back 45

A394. rare, small risk for colorectal cancer

Front 46

Q395. hereditary noNPOlyposis colorectal cancer

Back 46

A395. no adenomatous polyps; lynch syndrome 1 and 2; early onset colorectal cancer and other cancers

Front 47

Q396. #1 cause of colon obstruction in adults

Back 47

A396. colorectal cancer

Front 48

Q397. most life threatening presentation of colorectal cancer

Back 48

A397. colonic perforation

Front 49

Q398. presentation of a right sided colon tumor

Back 49

A398. obstruction not commonly seen (lumen is wider on right); change in bowel habits is rare; MELENA is most common type of bleed

Front 50

Q399. presentation of left sided colon tumor

Back 50

A399. smaller lumen diameter, so can present with obstruction, alternating constipation and diarrhea; narrowing of stools; HEMATOCHEZIA

Front 51

Q400. which side of colon is melena more common in?; hematochezia?

Back 51

A400. right; left