©PREP4EXAMS@2024 [REAL EXAM DUMPS] Friday, July 19, 2024 6:13 AM
Rosh Review- Gastroenterology Practice
Questions and Answers (100% Pass)
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:
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,©PREP4EXAMS@2024 [REAL EXAM DUMPS] Friday, July 19, 2024 6:13 AM
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
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,©PREP4EXAMS@2024 [REAL EXAM DUMPS] Friday, July 19, 2024 6:13 AM
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!
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, ©PREP4EXAMS@2024 [REAL EXAM DUMPS] Friday, July 19, 2024 6:13 AM
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)
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