Diana Flores
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Diana Flores
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Clin Med GI

Clin Med GI

Question 1 of 84

1

Which of the following is the MOST common cause of chronic dyspepsia?

Select one of the following:

  • Peptic Ulcer disease

  • GERD

  • Functional dyspepsia

  • Gastroparesis

Explanation

Question 2 of 84

1

Which of the following drugs causes Non-alcoholic fatty liver disease?

Select one of the following:

  • Amiodarone

  • Amlodipine

  • Methotrexate

  • Omeprazole

Explanation

Question 3 of 84

1

Which of the following is NOT a treatment for Alcoholic Fatty liver disease?

Select one of the following:

  • Folic acid and thiamine

  • Carbs and calories

  • Methylprednisone

  • Diuretics

Explanation

Question 4 of 84

1

Which of the following is an indication to a patient with alcoholic fatty liver?

Select one of the following:

  • Hepatic encephalopathy

  • INR <1.6

  • Total bilirubin < 10mg/dL

  • Decreased PTT

Explanation

Question 5 of 84

1

Which of the following symptoms is NOT an indication for upper endoscopy?

Select one of the following:

  • Weight loss

  • Dysphagia

  • Anemia

  • Hematochezia

Explanation

Question 6 of 84

1

If IgG serology or urea breath test is negative and patient is not using NSAIDS, peptic ulcer disease is excluded.

Select one of the following:

  • True
  • False

Explanation

Question 7 of 84

1

Which of the following is a scoring system to predict advanced fibrosis?

Select one of the following:

  • ROME III criteria

  • Duke's criteria

  • BARD criteria

  • Ranson's criteria

Explanation

Question 8 of 84

1

High consumption of tea and caffeine are cirrhosis protectant

Select one of the following:

  • True
  • False

Explanation

Question 9 of 84

1

Which of the following is a cause secondary constipation?

Select one of the following:

  • Dysynergic defecation

  • Hypercalcemia

  • Psychosocial problems

  • Weight gain

Explanation

Question 10 of 84

1

Which of the following characterizes acute diarrhea?

Select one of the following:

  • More than 3 BM/day

  • More than 200-300 mL in <48 hours

  • Persisting for more than 2 weeks

  • More than 5 BM/day

Explanation

Question 11 of 84

1

Which of the following is NOT true regarding inflammatory diarrhea?

Select one of the following:

  • Bloody diarrhea

  • Associated with LLQ cramping

  • Diarrhea is usually high in volume

  • Fecal leukocytes or lactoferrin are usually present in infections with invasive organisms

Explanation

Question 12 of 84

1

Which of the following do you use to screen for hepatocellular carcinoma?

Select one of the following:

  • CT scan

  • A-Fetoprotein

  • HBsAg levels

  • ERCP

Explanation

Question 13 of 84

1

Mikey is a 28 y/o male who presents to your clinic c/o 6 episodes of persistent, watery diarrhea that began today with associated periumbilical cramping, nausea, and multiple episodes of vomiting. He denies any fever, chills, weight loss, hematemesis, melena, hematochezia, or arthralgias. Pt states his symptoms began about 8 hours after going out to eat with his friend. He denies any recent traveling. Electrolytes were drawn and shows patient is hypokalemic. Stool culture is pending. Which of the following is the most common cause of his symptoms?

Select one or more of the following:

  • Non-inflammatory diarrhea

  • Inflammatory diarrhea

  • Crohn's

  • IBS

Explanation

Question 14 of 84

1

Which of the following is NOT a direct cause of pancreatitis?

Select one of the following:

  • Aging

  • Gallstones

  • Alcohol

  • Smoking

Explanation

Question 15 of 84

1

Which of the following diseases can also be seen to have concomitant pleural effusion and atelectasis?

Select one of the following:

  • GERD

  • Hepatitis

  • Pancreatitis

  • Cholecystitis

Explanation

Question 16 of 84

1

What does Ranson's Criteria measure?

Select one of the following:

  • The severity of acute alcoholic pancreatitis

  • The different treatment regimens depending on severity of pancreatitis

  • How to diagnose a patient with IBS

  • To predict advanced fibrosis

Explanation

Question 17 of 84

1

Crohn's disease has a high comorbidity in for gallstones

Select one of the following:

  • True
  • False

Explanation

Question 18 of 84

1

Choose ALL that apply: Which of the following can protect against gallstones?

Select one or more of the following:

  • Ceftriaxone

  • Octreotide

  • ASA

  • NSAIDS

  • Clofibrate

Explanation

Question 19 of 84

1

Which of the following is NOT associated with increase incidence of chronic pancreatitis?

Select one of the following:

  • Toxic metabolite

  • Genetic causes

  • Idiopathic

  • Hemochromatosis

Explanation

Question 20 of 84

1

An APACHE II score less than or equal to 8 correlates with mortality in acute pancreatitis?

Select one of the following:

  • True
  • False

Explanation

Question 21 of 84

1

Which of the following is the reason for development of chronic pancreatitis?

Select one of the following:

  • Acute pancreatitis causes an inflammatory process that results in injury and fibrosis

  • Edema or obstruction in the ampulla of Vater that causes reflux of bile into pancreatic ducts and causes direct and permanent injury of the pancreatic acinar cells by activated pancreatic enzymes

  • The development of chronic pancreatitis is unknown

  • None of the above

Explanation

Question 22 of 84

1

Which of the following pathogens are seen in inflammatory diarrhea? Choose ALL that apply.

Select one or more of the following:

  • E. coli

  • Staph aureus

  • Shigellosis

  • Salmonellosis

  • Campylobacter

  • STEC

  • Bacillus

  • Clostridium

  • Giardia

  • C. diff

Explanation

Question 23 of 84

1

Which of the following should be given to a post who requires severe rehydration due to multiple episodes of diarrhea and vomiting?

Select one of the following:

  • IV lactated ringer

  • Bisocodyl

  • Fluoroquinolones

  • Gatorade

Explanation

Question 24 of 84

1

Which of the following is NOT included in Charcot's triad?

Select one of the following:

  • Fever and chills

  • RUQ abdominal pain

  • Fever

  • Hypotension

Explanation

Question 25 of 84

1

How many stool samples are required to check for ova and parasites?

Select one of the following:

  • 1

  • 2

  • 3

  • 5

Explanation

Question 26 of 84

1

Which of the following is NOT indicated for antibiotic use in patients with acute diarrrhea?

Select one of the following:

  • Emperic use

  • Patient with fever, tenesmus

  • Bloody stools without STEC infection

  • Presence of fecal lactoferrin

Explanation

Question 27 of 84

1

Increased osmotic gap (>125) in indicative of what?

Select one of the following:

  • Malabsorption of osmotically active substances

  • Endocrine tumors

  • Bile malabsorption

  • Chronic infection

Explanation

Question 28 of 84

1

How is carb malabsorption diagnosed?

Select one of the following:

  • Elimination trial for 2-3 weeks

  • Hydrogen breath test

  • Osmotic gap greater than 125

  • Both A and B

  • Both B and C

Explanation

Question 29 of 84

1

Which of the followings the routine stool study for checking steatorrhea?

Select one of the following:

  • Sudan stain

  • Serologic testing

  • Endoscopy

  • Somalian test

Explanation

Question 30 of 84

1

Total weight and fat of 24 hour stool collection that shows <200-300g/24 hr indicates:

Select one of the following:

  • Osmotic diarrhea

  • Secretory diarrhea

  • Diarrhea caused by motility disorders (such as IBS)

  • Chronic infection

Explanation

Question 31 of 84

1

Select from the dropdown list to complete the text.

Large volume of bright red blood is typically due to a ( colonic, Rectosigmoid, Anus, Lesion in the right colon ) source

Explanation

Question 32 of 84

1

It's important to perform an NG tube aspiration in patients with acute lower GI bleeds

Select one of the following:

  • True
  • False

Explanation

Question 33 of 84

1

Patient presents to your clinic with fever, abdominal pain, and distention. He also states he has had decrease in urinary output and his mind has felt "fuzzy" and has been feeling forgetful for the past 2 days. Which of the following is necessary in order to make a dx and to treat the patient?

Select one of the following:

  • CBC with diff

  • Paracentesis

  • ERCP

  • Ultrasound to evaluate the liver size and amount of ascites that is present

Explanation

Question 34 of 84

1

Patient presents to your office c/o clay-colored stool and dark urine, as well as jaundice. You draw LFTs and and enzyme immunoassay and recombinant immunoblot assay since the patient has admitted to you that he has multiple sexual partners without using protection. You find that the patient is positive for Anti-HCV and HCV RNA genotype type 1. Which of the following treatments is indicated for this patient?

Select one of the following:

  • Simeprevir (Olysio) (NS3/4A protease inhibitors)

  • Peginterferon followed by ribavirin

  • Dasabuvir alone (NS5B NNPIs)

  • Daclatasvir (NS5A inhibitors)

Explanation

Question 35 of 84

1

Which of the following drugs are not indicated for treatment of spontaneous bacterial peritonitis?

Select one of the following:

  • Norfloxacin

  • Bactrim

  • Cefotaxime

  • Metronidazole

Explanation

Question 36 of 84

1

Which of the following is MOST associated with Barrett's esophagitis?

Select one of the following:

  • Hiatal hernias

  • Gastroparesis

  • Delayed gastric emptying

  • Strictures

Explanation

Question 37 of 84

1

Which of the following is NOT a symptom of GERD?

Select one of the following:

  • Pain 30-60 min after eating

  • Epigastric pain relieved with eating

  • Relief of pain with antacids

  • Heartburn with asthma symptoms

Explanation

Question 38 of 84

1

Which of the following is not an indication for upper endoscopy in patient who presents with GERD?

Select one of the following:

  • Patient's with dysphagia or odyophagia

  • Patient with iron deficiency anemia

  • Patients who are 55 years of age or older

  • Patients with an acid taste in their mouth, which would represent abnormal esophageal acid exposure

Explanation

Question 39 of 84

1

Typical GERD patient does not require initial studies

Select one of the following:

  • True
  • False

Explanation

Question 40 of 84

1

Which of the following esophageal abnormalities is worse?

Select one of the following:

  • A

  • B

  • C

  • D

Explanation

Question 41 of 84

1

When is it NOT indicated to perform a barium esophagography?

Select one of the following:

  • To identify stricture

  • To visualize esophageal webs and rings

  • Zenker diverticulum

  • These are all indicated

Explanation

Question 42 of 84

1

Which of the following is NOT an indication for fundoplication?

Select one of the following:

  • Barrett's

  • Patients with poorly controlled symptoms

  • Patients with extraesophageal symptoms and recurrence of symptoms

  • Patient that does not respond to PPI bid

Explanation

Question 43 of 84

1

Which of the following is true regarding Barrett's?

Select one of the following:

  • Columnar cells are replaced by metaplastic squamous epithelium

  • It occurs more in females than in males

  • It is an orange-gastric type epithelium

  • None of the above

Explanation

Question 44 of 84

1

Which of the following CANNOT be used to treat acute nausea and vomiting?

Select one of the following:

  • Serotonin 5-HT3 receptor antagonists

  • Neurokinin receptor antagonists with steroids and serotonin antagonists

  • Dopamine antagonist

  • All can be used to treat acute N/V

Explanation

Question 45 of 84

1

Three week old child is brought in to the ER by his parents after they report he has been having projectile vomiting. Your physical exam shows signs of dehydration as well as an "olive-shaped" mass. Which of the following imaging studies will you want to obtain first to confirm your diagnosis?

Select one of the following:

  • CT of the abdomen/pelvis

  • Abdominal Ultrasound

  • Barium X-ray to show stenosis

  • EGD

Explanation

Question 46 of 84

1

Which of the following treatments is indicated for pyloric stenosis?

Select one of the following:

  • Pyloromyotomy

  • Dilation with flexible bougies

  • Anticholinergics to relax the sphincter

  • Fundoplication

Explanation

Question 47 of 84

1

Which of the following gastric neoplasms have the worst prognosis?

Select one of the following:

  • Ulcerative carcinoma

  • Superficial

  • Polypoid carcinoma

  • Linitis plastic

Explanation

Question 48 of 84

1

Which of the following is not true regarding gastric neoplasms?

Select one of the following:

  • Patients will have guaiac positive stool

  • Upper endoscopy with biopsy is the most accurate test

  • Abdominal CT is the most accurate test

  • It is common in Japan

Explanation

Question 49 of 84

1

Which of the following is NOT a cause of fecal impaction?

Select one of the following:

  • Psychiatric problems

  • Neuro diseases of the colon

  • Spinal cord diseases

  • All of the above

Explanation

Question 50 of 84

1

Which of the following conditions can be treated with gancyclovir?

Select one of the following:

  • CMV esophagitis

  • Candida esophagitis

  • Herpes simplex esophagitis

  • AIDS esophagitis

Explanation

Question 51 of 84

1

Patient presents with dysphagia, odynophagia, and substernal chest pain. You also notice some oral thrush on physical exam. Which of the following studies will you order in order to obtain your diagnosis?

Select one of the following:

  • Endoscopy with biopsy and brushings

  • Colonoscopy with biopsy

  • FOBT

  • Stool sample

Explanation

Question 52 of 84

1

Which of the following endoscopic findings would you expect to see in someone who has candidal esophagitis?

Select one of the following:

  • Diffuse, linear, yellow white plaques adhering to mucosa

  • One to several large shallow superficial ulcers

  • Multiple small deep ulcers

  • Single or multiple ulcers at the squamocolumnar junction

Explanation

Question 53 of 84

1

Which of the following endoscopic findings would you expect to see in someone who has CMV esophagitis?

Select one of the following:

  • Diffuse, linear, yellow white plaques adhering to mucosa

  • One to several large, shallow, superficial ulcers

  • Multiple small deep ulcers

  • Single or multiple erosions or ulcers at the squamocolumnar junction

Explanation

Question 54 of 84

1

Pill induced esophagitis will show one to a few discrete ulcers that can be shallow or deep on endoscopy

Select one of the following:

  • True
  • False

Explanation

Question 55 of 84

1

Which of the following is strong predisposing factor to Mallory-Weiss tears?

Select one of the following:

  • Alcoholism

  • Smoking

  • Obesity

  • Hypercholesteronemia

Explanation

Question 56 of 84

1

Where are Mallory-Weiss tears located?

Select one of the following:

  • At the gastroesophageal junction

  • At the pharyngeal-esophageal junction

  • In the upper 1/3 of the esophagus

  • None of the above

Explanation

Question 57 of 84

1

Which of the following is NOT a treatment of choice for Mallory-Weiss tears?

Select one of the following:

  • Cautery with probe

  • Injection with epinephrine

  • Injection with botox

  • Endoclip placement

Explanation

Question 58 of 84

1

What is the study of choice for diagnosing Mallory-Weiss tears?

Select one of the following:

  • Barium x-ray

  • Upper endoscopy

  • CBC with diff

  • Abdominal CT

Explanation

Question 59 of 84

1

Which of the following endoscopic findings is consistent with eosinophilic esophagitis?

Select one of the following:

  • White exudates or papules, red furrows, corrugated concentric rings, strictures

  • Multiple small deep ulcers

  • Single or multiple erosions or ulcers in distal esophagus

  • Diffuse plaques on mucosa

Explanation

Question 60 of 84

1

Which of the following can NOT cause persistent hiccups?

Select one of the following:

  • Infections

  • Uremia

  • Hypercapnia

  • Neoplasms

Explanation

Question 61 of 84

1

Which of the following studies is best to visualize esophageal webs and rings?

Select one of the following:

  • Upper endoscopy

  • Barium esophagogram

  • Transesophageal ultrasound

  • CT scan

Explanation

Question 62 of 84

1

Which of the following does not characterize Esophageal webs?

Select one of the following:

  • Thin, diaphragm-like membrane

  • Typically occurs in the mid or upper esophagus

  • Usually located in the distal esophagus

  • Can occur with eosinophilic esophagitis

Explanation

Question 63 of 84

1

Which of the following does not characterize Esophageal rings?

Select one of the following:

  • Smooth, circumferential, thin mucosal structures less than 4mm in thickness

  • They are associated in nearly all cases with hiatal hernias

  • Can occur with graft-versus-host disease

  • Located in the distal esophagus

Explanation

Question 64 of 84

1

How are patients with esophageal webs treated?

Select one of the following:

  • Bougie dilators

  • Endoscopic electrosurgical incision of the ring

  • Treat with long-term PPIs in pts with heartburn

  • All of the above

Explanation

Question 65 of 84

1

45 year old Caucasian male with a h/o of GERD and 60 pack year history of smoking presents to your office for multiple complaints including worsening dysphagia, unintentional weight loss, odynophagia, hematemesis, hoarseness of his voice, and some generalized, nonradiating chest pain. Which of the following tests will help you make a definitive diagnosis?

Select one of the following:

  • Barium swallow

  • Upper endoscopy with biopsy

  • Transesophageal ultrasound

  • CT scan

Explanation

Question 66 of 84

1

Which of the following best describes the cause of zenker diverticulum?

Select one of the following:

  • Loss of elasticity of upper esophageal sphincter causing restricted opening during swallowing

  • Portal hypertension

  • Increase pressures in the esophagus

  • Idiopathic cause

Explanation

Question 67 of 84

1

Patient presents c/o vague oropharyngeal dysphagia with some throat discomfort. She also states she has been waking up at night with choking episodes and notices she has been regurging undigested food. You perform a barium x-ray and notice protrusion of the phayngeal mucosa. Which of the following is the best treatment for this patient?

Select one of the following:

  • Upper esophageal myotomy

  • Surgical diverticuloectomy

  • Incising the septum between the esophagus and the diverticulum

  • These are all treatment options

Explanation

Question 68 of 84

1

Which is the most common cause of GI bleed d/t portal HTN?

Select one of the following:

  • Esophageal varices

  • Mallory-Weiss tears

  • Boerhaave syndrome

  • Cirrhosis

Explanation

Question 69 of 84

1

Which of the following causes increase risk of bleed if present in esophageal varices?

Select one of the following:

  • Pressure gradient between the protal vein and inferior vena cava is greater than 6 mmHg

  • Presence of red wale markings

  • Presence of dysphagia

  • When bleeding spontaneously stops

Explanation

Question 70 of 84

1

Which of the following drugs can be given to patients with medium to large varices, small variceal red wale marks or advanced cirrhosis in order to prevent a bleed from ever occurring?

Select one of the following:

  • Non-selective beta blockers

  • B1 selective beta blockers

  • Corticosteroids

  • ASA

Explanation

Question 71 of 84

1

IBS is usually present with nocturnal symptoms.

Select one of the following:

  • True
  • False

Explanation

Question 72 of 84

1

What should be given to patients who have variceal bleading with an INR>1.8-2 or platelet count <50,000?

Select one of the following:

  • Fresh frozen plasma

  • Vitamin K

  • Platelets

  • Thrombin

Explanation

Question 73 of 84

1

Cirrhotic patients admitted with upper GI bleeds have more than 50% chance of ____________, and that is why they need prophylaxis with ____________.

Select one of the following:

  • Severe bacterial infection; IV fluoroquinolones or IV 3rd generation cephalosporins

  • Bleed; vitamin K

  • increased portal hypertension; selective beta blockers

  • Liver cancer; 5-ASA

Explanation

Question 74 of 84

1

Prolonged use of ASA and NSAIDs is known to decrease risk of cancer and carcinomas

Select one of the following:

  • True
  • False

Explanation

Question 75 of 84

1

What is the most important determinant of long-term survival:

Select one of the following:

  • Stage of the disease at initial presentation

  • Screening

  • The severity of patient's symptoms

  • The carcinoembryonic antigen (CEA) measurement

Explanation

Question 76 of 84

1

Rectal cancer has a worse prognosis than colon cancer

Select one of the following:

  • True
  • False

Explanation

Question 77 of 84

1

Which of the following is standard for detecting cancer and large adenomas in patients with chronic blood loss?

Select one of the following:

  • Hemoccult II

  • Sensitive FOBT

  • Rectal exam

  • Colonoscopy as first test

Explanation

Question 78 of 84

1

If polyps are found with flexible sigmoidoscopy, what would be the next best step?

Select one of the following:

  • Scope the entire colon with colonoscopy

  • Start patients on chemotherapy

  • Obtain routine studies for staging

  • Obtain a double contrast barium enema

Explanation

Question 79 of 84

1

A good colonoscopy study does not depend on the patient's prep before the procedure

Select one of the following:

  • True
  • False

Explanation

Question 80 of 84

1

Which of the following does require bowel prep?

Select one of the following:

  • Upper GI obstruction

  • Suspected acute diverticulitis

  • Recent bowel surgery

  • When used for screening

Explanation

Question 81 of 84

1

When using laser or coagulator on colonoscopy, you must remove air and use CO2 to avoid explosion

Select one of the following:

  • True
  • False

Explanation

Question 82 of 84

1

The majority of the appendices are present in the ____________

Select one of the following:

  • Retrocecal fossa

  • Anterocecal fossa

  • Lateralocecal fossa

  • Inferocecal fossa

Explanation

Question 83 of 84

1

What is the diagnostic standard for appendicitis?

Select one of the following:

  • Abdominal US

  • Abdominal CT

  • Abdominal X-ray

  • none of the above

Explanation

Question 84 of 84

1

Patient presents with fever and chills, jaundice, RUQ pain. Patient's wife states he has not been acting himself, stating pt had difficulty remembering her name today. Patient's blood pressure is 90/50, HR was 100, RR 14. Which of the following conditions are you likely concerned about?

Select one of the following:

  • Cholangitis

  • Supperative cholangitis

  • Choledocolithiasis

  • Cholescystisis

Explanation

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