Rosh Review- Gastroenterology Exam Questions and Answers Solved Correctly
Bisphosphonates! (ALENDRENATE, RISEDRONATE)
Important patient education to remain upward for 30 minutes, and drink with plenty of water
Tx:
Antacids to decrease mucosal irritation
Also can occur with NSAIDs, ASA, Ferrous sulfate (Iron), Antibiotics (tetracycline, doxycycline) - Answers
What medication is know known to induce esophagitis?
Tx?
Pancreatic Cancer!
Most common cause:
SMOKING!
Dx:
CT
Tumor Marker--> CA19-9
Increased Direct Bilirubin (causes dark colored urine)
Tx:
Whipple** to resect head of pancreas
, PANCREATICODUODENECTOMY*** = Whipple - Answers What presents with progressive, painless
jaundice, fatigue, weight loss, depression, Icterus, with palpable, non-tender gallbladder, migratory
thrombophlebitis?
Dx and Tx?
Painless Jaundice, Icterus , Dark colored urine (direct bilirubin increased), fatigue, weight loss
Trousseaus:
Migratory thrombophlebitis
(hyper coagulability that accompanies most cancers)
Courvoisier sign:
Palpable nontender gallbladder
Virchow's Node & Sister Mary Joseph Node - Answers What are the physical exam findings typically seen
in pancreatic cancer?
Adenocarcinoma involving the head of the pancreas - Answers What is the most common type of
pancreatic cancer?
Hypocalcemia! - Answers What electrolyte abnormality is common in pancreatitis?
At Admission and 48 hours after admission
LDH >350
Glucose >200
WBC >16,000
,Age >55
AST >250
Calcium <8
Hematocrit fall >10%
BUN rise >5
PO2 <60
Base deficit >4
Fluid Sequestration >6
Score >7 = 100% mortality
Score >5 = 40% mortality - Answers When is Ranson's criteria performed?
What is included in representing high mortality probability?
Cobalamin (B12) Deficiency!
Dx:
Methylamonic and Homocysteine levels:
BOTH ELEVATED**
, (In folate, homocysteine will be normal, differentiating factor)
Peripheral Smear:
Macrocytic Anemia, Megaloblastic (hypersegmented neutrophils)
Tx:
Parenteral B12 - Answers What presents with fatigue, weakness, peripheral neuropathy, glossitis,
pallor?
Dx and Tx?
B12! - Answers What is the only vitamin deficiency that results in peripheral neuropathy?
Vitamin B12 Deficiency!
DX:
Peripheral Smear:
Megaloblastic anemia (Macrocytic, hypersegmented neutrophils)
Methylamonic acid and Homocysteine levels:
BOTH ELEVATED
Tx:
Parenteral replacement of B12 - Answers What presents with depression, irritability, anemia, sensory
and motor deficits ( absent reflexes, paresthesias), dementia, nausea, vomiting and diarrhea?
Usually due to inadequate absorption associated with PERNICIOUS ANEMIA or secondary to gastric
disease! - Answers What is the most common cause of vitamin B12 deficiency?
Spontaneous Bacterial Peritonitis!
Bisphosphonates! (ALENDRENATE, RISEDRONATE)
Important patient education to remain upward for 30 minutes, and drink with plenty of water
Tx:
Antacids to decrease mucosal irritation
Also can occur with NSAIDs, ASA, Ferrous sulfate (Iron), Antibiotics (tetracycline, doxycycline) - Answers
What medication is know known to induce esophagitis?
Tx?
Pancreatic Cancer!
Most common cause:
SMOKING!
Dx:
CT
Tumor Marker--> CA19-9
Increased Direct Bilirubin (causes dark colored urine)
Tx:
Whipple** to resect head of pancreas
, PANCREATICODUODENECTOMY*** = Whipple - Answers What presents with progressive, painless
jaundice, fatigue, weight loss, depression, Icterus, with palpable, non-tender gallbladder, migratory
thrombophlebitis?
Dx and Tx?
Painless Jaundice, Icterus , Dark colored urine (direct bilirubin increased), fatigue, weight loss
Trousseaus:
Migratory thrombophlebitis
(hyper coagulability that accompanies most cancers)
Courvoisier sign:
Palpable nontender gallbladder
Virchow's Node & Sister Mary Joseph Node - Answers What are the physical exam findings typically seen
in pancreatic cancer?
Adenocarcinoma involving the head of the pancreas - Answers What is the most common type of
pancreatic cancer?
Hypocalcemia! - Answers What electrolyte abnormality is common in pancreatitis?
At Admission and 48 hours after admission
LDH >350
Glucose >200
WBC >16,000
,Age >55
AST >250
Calcium <8
Hematocrit fall >10%
BUN rise >5
PO2 <60
Base deficit >4
Fluid Sequestration >6
Score >7 = 100% mortality
Score >5 = 40% mortality - Answers When is Ranson's criteria performed?
What is included in representing high mortality probability?
Cobalamin (B12) Deficiency!
Dx:
Methylamonic and Homocysteine levels:
BOTH ELEVATED**
, (In folate, homocysteine will be normal, differentiating factor)
Peripheral Smear:
Macrocytic Anemia, Megaloblastic (hypersegmented neutrophils)
Tx:
Parenteral B12 - Answers What presents with fatigue, weakness, peripheral neuropathy, glossitis,
pallor?
Dx and Tx?
B12! - Answers What is the only vitamin deficiency that results in peripheral neuropathy?
Vitamin B12 Deficiency!
DX:
Peripheral Smear:
Megaloblastic anemia (Macrocytic, hypersegmented neutrophils)
Methylamonic acid and Homocysteine levels:
BOTH ELEVATED
Tx:
Parenteral replacement of B12 - Answers What presents with depression, irritability, anemia, sensory
and motor deficits ( absent reflexes, paresthesias), dementia, nausea, vomiting and diarrhea?
Usually due to inadequate absorption associated with PERNICIOUS ANEMIA or secondary to gastric
disease! - Answers What is the most common cause of vitamin B12 deficiency?
Spontaneous Bacterial Peritonitis!
