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Rosh Review Gastroenterology | Questions & Answers (100 %Score) Latest Updated
2024/2025 Comprehensive Questions A+ Graded Answers | With Expert Solutions


What medication is know known to induce esophagitis?

Tx? - 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)

What presents with progressive, painless jaundice, fatigue, weight loss, depression,
Icterus, with palpable, non-tender gallbladder, migratory thrombophlebitis?

Dx and 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

What are the physical exam findings typically seen in pancreatic cancer? - 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

,What is the most common type of pancreatic cancer? - Adenocarcinoma involving the
head of the pancreas

What electrolyte abnormality is common in pancreatitis? - Hypocalcemia!

When is Ranson's criteria performed?

What is included in representing high mortality probability? - 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

What presents with fatigue, weakness, peripheral neuropathy, glossitis, pallor?

Dx and Tx? - 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

What is the only vitamin deficiency that results in peripheral neuropathy? - B12!

What presents with depression, irritability, anemia, sensory and motor deficits ( absent
reflexes, paresthesias), dementia, nausea, vomiting and diarrhea? - Vitamin B12
Deficiency!

DX:
Peripheral Smear:
Megaloblastic anemia (Macrocytic, hypersegmented neutrophils)

Methylamonic acid and Homocysteine levels:
BOTH ELEVATED

Tx:
Parenteral replacement of B12

What is the most common cause of vitamin B12 deficiency? - Usually due to inadequate
absorption associated with PERNICIOUS ANEMIA or secondary to gastric disease!

What presents with fever, chills, abdominal pain in patient with history of cirrhosis, with
ascites, shifting dullness noted upon examination?

Dx and Tx? - Spontaneous Bacterial Peritonitis!

Dx:
Labs:
PMNs >250**** basis of diagnosis
WBCs >1,000
pH <7.34

Paracentesis:
Gold standard for analyzing fluid

Gram stain/culture:
Positive (usually gram negative bacteria is responsible)

Tx:
Thoracentesis and Broad Spectrum ABX (IV CEPHALOSPORINS) *

What is the most common organism causing spontaneous bacterial peritonitis? - E coli
and Streptococcus

, What are risk factors for developing Hepatitis C? - IV drug use, transplant surgeries,
intranasal cocaine use, tattoos, and blood transfusions

What is the most frequent complaint in patients with chronic hepatitis C infection? -
Fatigue

What type of hepatitis is associated with daycare outbreaks, contaminated shellfish and
water? - Hepatitis A!

What hepatitis type is associated with travelers and inhabitants of India, Mexico, Africa
and Southeast Asia? - Hepatitis E!

What types of Hepatitis are transmitted by parenteral transmission? - B,C,D

This includes blood contact with infected blood products, bodily fluids or needles.

What type of Hepatitis is more common in contact with infected blood products than
through sexual contact?

What Hepatitis is common through perinatal transmission? - IV:
Hepatitis C!

Perinatal:
Hepatitis B!

Which of the hepatitis viruses is the only one which is a DNA virus? - Hepatitis B!

What is indicated by HBsAg? - Active infection

What is indicated by Anti-HBs? - Recovered or immunized

What is indicated by Anti-HBc IgM? - Early marker for infection, positive in window
period

What is indicated by Anti-HBc IgG? - Best indicator for prior Hepatitis B Virus!

Chronic, latent

What is indicated by HBeAg? - High infectivity

What is indicated by Anti-HBeAb? - Low infectivity

What is the definition of diarrhea? - >3 or more loose or watery stools /day

or loose stool >1 month

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