Rosh Review- Gastroenterology Questions And Answers With Verified Solutions

A 75-year-old woman with a history of hypertension presents to the ED with right upper quadrant pain that has been gradually worsening over the past day. Her vital signs are: T 103°F, BP 100/60, HR 100, RR 22, and oxygen saturation 97% on room air. Physical exam reveals scleral icterus and right upper quadrant tenderness without rebound or guarding. A bedside right upper quadrant ultrasound demonstrates a common bile duct measuring 1 cm. Laboratory results are pending. What is the definitive management of this condition? - Answer-Ascending Cholangitis! TX: ERCP (Endoscopic retrograde cholangiopancreatography) Charcot's triad (fever, jaundice, and right upper quadrant pain); Does an alkaline button battery that passes into the stomach need to be emergently removed endoscopically? - Answer-No, if it has passed to the stomach it can be radiographically followed Most FBs that pass pylorus pass spontaneously Emergent endoscopy indicated if FB is battery, sharp, or signs of obstruction present During endoscopy, what hemostatic agent can be injected to control bleeding caused by a Mallory-Weiss tear? - Answer-Epinephrine How is the diagnosis of HIV confirmed? - Answer-Initial: ELISA Confirmatory: Western Blot Seroconverts 3-12 weeks post exposureIf a previously vaccinated hospital worker tests negative for HBsAb and is exposed to a HBsAg positive source, what is the recommended postexposure prophylaxis? - Answer-Hepatitis B immune globulin and hepatitis B vaccine. In a patient with right-sided pelvic pain, what is the imaging modality of choice? - Answer-Pelvic ultrasound with Doppler flow! It is sensitive for many GYN disorders and, in the hands of an experienced technician, compressive ultrasound can diagnose appendicitis. In patients with appendicitis, what physical sign occurs when right lower quadrant pain is elicited by passive right hip extension? - Answer-Psoas Sign! Irritable bowel syndrome is a common example of which subclass of chronic diarrhea? - Answer-Motility disorder, in which stool osmotic gap is normal Is an NG tube required in acute pancreatitis? - Answer-No, it is recommended for patients with intractable vomiting or ileus. Name another common risk factor for gallstones, especially in a patient post abdominal surgery. - Answer-TPN (Total parenteral nutrition) Prevention of polyps, and therefore colon cancer, involves which strategies? - Answer-Maintaining an appropriate weight, a diet high in fiber and low in fat, and tobacco and alcohol cessation. What are complications that can make hepatic encephalopathy worse? - Answer-Constipation, Increasing ammonia levels, renal failure, Gi bleeding, infection, diuretic therapy leading to hypokalemia and alkalosis What are Irremovable white lesions on lateral tongue associated with HIV diagnosis? - Answer-Oral Hairy Leukoplakia!What are longitudinal mucosal lacerations of the distal esophagus usually including the gastroesophageal junction? - Answer-Mallory Weiss Tear!