Diana Flores
Quiz por , criado more than 1 year ago

GI practice

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Diana Flores
Criado por Diana Flores mais de 8 anos atrás
Fechar

Clin Med GI

Questão 1 de 84

1

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

Selecione uma das seguintes:

  • Peptic Ulcer disease

  • GERD

  • Functional dyspepsia

  • Gastroparesis

Explicação

Questão 2 de 84

1

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

Selecione uma das seguintes:

  • Amiodarone

  • Amlodipine

  • Methotrexate

  • Omeprazole

Explicação

Questão 3 de 84

1

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

Selecione uma das seguintes:

  • Folic acid and thiamine

  • Carbs and calories

  • Methylprednisone

  • Diuretics

Explicação

Questão 4 de 84

1

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

Selecione uma das seguintes:

  • Hepatic encephalopathy

  • INR <1.6

  • Total bilirubin < 10mg/dL

  • Decreased PTT

Explicação

Questão 5 de 84

1

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

Selecione uma das seguintes:

  • Weight loss

  • Dysphagia

  • Anemia

  • Hematochezia

Explicação

Questão 6 de 84

1

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

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 7 de 84

1

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

Selecione uma das seguintes:

  • ROME III criteria

  • Duke's criteria

  • BARD criteria

  • Ranson's criteria

Explicação

Questão 8 de 84

1

High consumption of tea and caffeine are cirrhosis protectant

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 9 de 84

1

Which of the following is a cause secondary constipation?

Selecione uma das seguintes:

  • Dysynergic defecation

  • Hypercalcemia

  • Psychosocial problems

  • Weight gain

Explicação

Questão 10 de 84

1

Which of the following characterizes acute diarrhea?

Selecione uma das seguintes:

  • More than 3 BM/day

  • More than 200-300 mL in <48 hours

  • Persisting for more than 2 weeks

  • More than 5 BM/day

Explicação

Questão 11 de 84

1

Which of the following is NOT true regarding inflammatory diarrhea?

Selecione uma das seguintes:

  • Bloody diarrhea

  • Associated with LLQ cramping

  • Diarrhea is usually high in volume

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

Explicação

Questão 12 de 84

1

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

Selecione uma das seguintes:

  • CT scan

  • A-Fetoprotein

  • HBsAg levels

  • ERCP

Explicação

Questão 13 de 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?

Selecione uma ou mais das seguintes:

  • Non-inflammatory diarrhea

  • Inflammatory diarrhea

  • Crohn's

  • IBS

Explicação

Questão 14 de 84

1

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

Selecione uma das seguintes:

  • Aging

  • Gallstones

  • Alcohol

  • Smoking

Explicação

Questão 15 de 84

1

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

Selecione uma das seguintes:

  • GERD

  • Hepatitis

  • Pancreatitis

  • Cholecystitis

Explicação

Questão 16 de 84

1

What does Ranson's Criteria measure?

Selecione uma das seguintes:

  • 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

Explicação

Questão 17 de 84

1

Crohn's disease has a high comorbidity in for gallstones

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 18 de 84

1

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

Selecione uma ou mais das seguintes:

  • Ceftriaxone

  • Octreotide

  • ASA

  • NSAIDS

  • Clofibrate

Explicação

Questão 19 de 84

1

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

Selecione uma das seguintes:

  • Toxic metabolite

  • Genetic causes

  • Idiopathic

  • Hemochromatosis

Explicação

Questão 20 de 84

1

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

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 21 de 84

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 22 de 84

1

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

Selecione uma ou mais das seguintes:

  • E. coli

  • Staph aureus

  • Shigellosis

  • Salmonellosis

  • Campylobacter

  • STEC

  • Bacillus

  • Clostridium

  • Giardia

  • C. diff

Explicação

Questão 23 de 84

1

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

Selecione uma das seguintes:

  • IV lactated ringer

  • Bisocodyl

  • Fluoroquinolones

  • Gatorade

Explicação

Questão 24 de 84

1

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

Selecione uma das seguintes:

  • Fever and chills

  • RUQ abdominal pain

  • Fever

  • Hypotension

Explicação

Questão 25 de 84

1

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

Selecione uma das seguintes:

  • 1

  • 2

  • 3

  • 5

Explicação

Questão 26 de 84

1

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

Selecione uma das seguintes:

  • Emperic use

  • Patient with fever, tenesmus

  • Bloody stools without STEC infection

  • Presence of fecal lactoferrin

Explicação

Questão 27 de 84

1

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

Selecione uma das seguintes:

  • Malabsorption of osmotically active substances

  • Endocrine tumors

  • Bile malabsorption

  • Chronic infection

Explicação

Questão 28 de 84

1

How is carb malabsorption diagnosed?

Selecione uma das seguintes:

  • Elimination trial for 2-3 weeks

  • Hydrogen breath test

  • Osmotic gap greater than 125

  • Both A and B

  • Both B and C

Explicação

Questão 29 de 84

1

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

Selecione uma das seguintes:

  • Sudan stain

  • Serologic testing

  • Endoscopy

  • Somalian test

Explicação

Questão 30 de 84

1

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

Selecione uma das seguintes:

  • Osmotic diarrhea

  • Secretory diarrhea

  • Diarrhea caused by motility disorders (such as IBS)

  • Chronic infection

Explicação

Questão 31 de 84

1

Selecione da lista do Menu para completar o texto.

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

Explicação

Questão 32 de 84

1

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

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 33 de 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?

Selecione uma das seguintes:

  • CBC with diff

  • Paracentesis

  • ERCP

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

Explicação

Questão 34 de 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?

Selecione uma das seguintes:

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

  • Peginterferon followed by ribavirin

  • Dasabuvir alone (NS5B NNPIs)

  • Daclatasvir (NS5A inhibitors)

Explicação

Questão 35 de 84

1

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

Selecione uma das seguintes:

  • Norfloxacin

  • Bactrim

  • Cefotaxime

  • Metronidazole

Explicação

Questão 36 de 84

1

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

Selecione uma das seguintes:

  • Hiatal hernias

  • Gastroparesis

  • Delayed gastric emptying

  • Strictures

Explicação

Questão 37 de 84

1

Which of the following is NOT a symptom of GERD?

Selecione uma das seguintes:

  • Pain 30-60 min after eating

  • Epigastric pain relieved with eating

  • Relief of pain with antacids

  • Heartburn with asthma symptoms

Explicação

Questão 38 de 84

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 39 de 84

1

Typical GERD patient does not require initial studies

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 40 de 84

1

Which of the following esophageal abnormalities is worse?

Selecione uma das seguintes:

  • A

  • B

  • C

  • D

Explicação

Questão 41 de 84

1

When is it NOT indicated to perform a barium esophagography?

Selecione uma das seguintes:

  • To identify stricture

  • To visualize esophageal webs and rings

  • Zenker diverticulum

  • These are all indicated

Explicação

Questão 42 de 84

1

Which of the following is NOT an indication for fundoplication?

Selecione uma das seguintes:

  • Barrett's

  • Patients with poorly controlled symptoms

  • Patients with extraesophageal symptoms and recurrence of symptoms

  • Patient that does not respond to PPI bid

Explicação

Questão 43 de 84

1

Which of the following is true regarding Barrett's?

Selecione uma das seguintes:

  • 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

Explicação

Questão 44 de 84

1

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

Selecione uma das seguintes:

  • Serotonin 5-HT3 receptor antagonists

  • Neurokinin receptor antagonists with steroids and serotonin antagonists

  • Dopamine antagonist

  • All can be used to treat acute N/V

Explicação

Questão 45 de 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?

Selecione uma das seguintes:

  • CT of the abdomen/pelvis

  • Abdominal Ultrasound

  • Barium X-ray to show stenosis

  • EGD

Explicação

Questão 46 de 84

1

Which of the following treatments is indicated for pyloric stenosis?

Selecione uma das seguintes:

  • Pyloromyotomy

  • Dilation with flexible bougies

  • Anticholinergics to relax the sphincter

  • Fundoplication

Explicação

Questão 47 de 84

1

Which of the following gastric neoplasms have the worst prognosis?

Selecione uma das seguintes:

  • Ulcerative carcinoma

  • Superficial

  • Polypoid carcinoma

  • Linitis plastic

Explicação

Questão 48 de 84

1

Which of the following is not true regarding gastric neoplasms?

Selecione uma das seguintes:

  • 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

Explicação

Questão 49 de 84

1

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

Selecione uma das seguintes:

  • Psychiatric problems

  • Neuro diseases of the colon

  • Spinal cord diseases

  • All of the above

Explicação

Questão 50 de 84

1

Which of the following conditions can be treated with gancyclovir?

Selecione uma das seguintes:

  • CMV esophagitis

  • Candida esophagitis

  • Herpes simplex esophagitis

  • AIDS esophagitis

Explicação

Questão 51 de 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?

Selecione uma das seguintes:

  • Endoscopy with biopsy and brushings

  • Colonoscopy with biopsy

  • FOBT

  • Stool sample

Explicação

Questão 52 de 84

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 53 de 84

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 54 de 84

1

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

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 55 de 84

1

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

Selecione uma das seguintes:

  • Alcoholism

  • Smoking

  • Obesity

  • Hypercholesteronemia

Explicação

Questão 56 de 84

1

Where are Mallory-Weiss tears located?

Selecione uma das seguintes:

  • At the gastroesophageal junction

  • At the pharyngeal-esophageal junction

  • In the upper 1/3 of the esophagus

  • None of the above

Explicação

Questão 57 de 84

1

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

Selecione uma das seguintes:

  • Cautery with probe

  • Injection with epinephrine

  • Injection with botox

  • Endoclip placement

Explicação

Questão 58 de 84

1

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

Selecione uma das seguintes:

  • Barium x-ray

  • Upper endoscopy

  • CBC with diff

  • Abdominal CT

Explicação

Questão 59 de 84

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 60 de 84

1

Which of the following can NOT cause persistent hiccups?

Selecione uma das seguintes:

  • Infections

  • Uremia

  • Hypercapnia

  • Neoplasms

Explicação

Questão 61 de 84

1

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

Selecione uma das seguintes:

  • Upper endoscopy

  • Barium esophagogram

  • Transesophageal ultrasound

  • CT scan

Explicação

Questão 62 de 84

1

Which of the following does not characterize Esophageal webs?

Selecione uma das seguintes:

  • Thin, diaphragm-like membrane

  • Typically occurs in the mid or upper esophagus

  • Usually located in the distal esophagus

  • Can occur with eosinophilic esophagitis

Explicação

Questão 63 de 84

1

Which of the following does not characterize Esophageal rings?

Selecione uma das seguintes:

  • 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

Explicação

Questão 64 de 84

1

How are patients with esophageal webs treated?

Selecione uma das seguintes:

  • Bougie dilators

  • Endoscopic electrosurgical incision of the ring

  • Treat with long-term PPIs in pts with heartburn

  • All of the above

Explicação

Questão 65 de 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?

Selecione uma das seguintes:

  • Barium swallow

  • Upper endoscopy with biopsy

  • Transesophageal ultrasound

  • CT scan

Explicação

Questão 66 de 84

1

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

Selecione uma das seguintes:

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

  • Portal hypertension

  • Increase pressures in the esophagus

  • Idiopathic cause

Explicação

Questão 67 de 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?

Selecione uma das seguintes:

  • Upper esophageal myotomy

  • Surgical diverticuloectomy

  • Incising the septum between the esophagus and the diverticulum

  • These are all treatment options

Explicação

Questão 68 de 84

1

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

Selecione uma das seguintes:

  • Esophageal varices

  • Mallory-Weiss tears

  • Boerhaave syndrome

  • Cirrhosis

Explicação

Questão 69 de 84

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 70 de 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?

Selecione uma das seguintes:

  • Non-selective beta blockers

  • B1 selective beta blockers

  • Corticosteroids

  • ASA

Explicação

Questão 71 de 84

1

IBS is usually present with nocturnal symptoms.

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 72 de 84

1

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

Selecione uma das seguintes:

  • Fresh frozen plasma

  • Vitamin K

  • Platelets

  • Thrombin

Explicação

Questão 73 de 84

1

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

Selecione uma das seguintes:

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

  • Bleed; vitamin K

  • increased portal hypertension; selective beta blockers

  • Liver cancer; 5-ASA

Explicação

Questão 74 de 84

1

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

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 75 de 84

1

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

Selecione uma das seguintes:

  • Stage of the disease at initial presentation

  • Screening

  • The severity of patient's symptoms

  • The carcinoembryonic antigen (CEA) measurement

Explicação

Questão 76 de 84

1

Rectal cancer has a worse prognosis than colon cancer

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 77 de 84

1

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

Selecione uma das seguintes:

  • Hemoccult II

  • Sensitive FOBT

  • Rectal exam

  • Colonoscopy as first test

Explicação

Questão 78 de 84

1

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

Selecione uma das seguintes:

  • Scope the entire colon with colonoscopy

  • Start patients on chemotherapy

  • Obtain routine studies for staging

  • Obtain a double contrast barium enema

Explicação

Questão 79 de 84

1

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

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 80 de 84

1

Which of the following does require bowel prep?

Selecione uma das seguintes:

  • Upper GI obstruction

  • Suspected acute diverticulitis

  • Recent bowel surgery

  • When used for screening

Explicação

Questão 81 de 84

1

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

Selecione uma das opções:

  • VERDADEIRO
  • FALSO

Explicação

Questão 82 de 84

1

The majority of the appendices are present in the ____________

Selecione uma das seguintes:

  • Retrocecal fossa

  • Anterocecal fossa

  • Lateralocecal fossa

  • Inferocecal fossa

Explicação

Questão 83 de 84

1

What is the diagnostic standard for appendicitis?

Selecione uma das seguintes:

  • Abdominal US

  • Abdominal CT

  • Abdominal X-ray

  • none of the above

Explicação

Questão 84 de 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?

Selecione uma das seguintes:

  • Cholangitis

  • Supperative cholangitis

  • Choledocolithiasis

  • Cholescystisis

Explicação