ITE Board Review: Gastroenterology Part II questions with correct answers

16. B0002 Diagnose microscopic colitis with celiac disease CORRECT ANSWER • Least common inflammatory bowel disease, does not cause significant macroscopic abnl • Char. Findings: chronic diarrhea w/o abdominal pain or weight loss • C-scope w/ biopsies is required for diagnosis → mucosa appears normal on gross examination. Histologic changes are limited to the colon unless in setting of celiac disease. Celiac associated with this condition accounts for recurrent diarrhea (70-fold increased risk). • Further classified into collagenous colitis or lymphocytic colitis based on histology 17. B0004 Treat fistulizing Crohn disease CORRECT ANSWER Fistula: Infliximab or adalimumab 18. B0016 Diagnose alcoholic hepatitis CORRECT ANSWER • Complication of chronic, daily, heavy alcohol use > 8 years • Acute alcoholic binges → fatty liver • Clinical presentation: ranges from asymptomatic to development of jaundice/fever/portal hypertension findings • AST/ALT: ranges from <300 - 500 units/L → AST/ALT > 2.0 • Judge severity of alcoholic hepatitis by using > of the following: o Maddrey Discriminant Function (MDF) score > 32 o MELD score > 18 o Glasgow Alcoholic Hepatitis Score (GAHS) > 9