AG-ACNP – GI QUESTIONS & ANSWERS
What is the medical management of ulcerative colitis? Correct Ans-mesalamine (Canasa)
suppositories or enemas x 3-12 weeks
Hydrocortisone suppositories and enemas
Define mesenteric infarct. Correct Ans-Inadequate blood flow through the mesenteric
circulation leading to ischemia and gangrene of the bowel
What is the number one cause of mesenteric infarct? Correct Ans-Arterial or venous
thrombosis/emobolism.
What is the classic symptom of a mesenteric infarct? Correct Ans-Pain out of proportion to
physical exam findings
Sudden onset or cramping, colicky abdominal pain (usually after eating)
What is the diagnostic for mesenteric infarct? Correct Ans-Abdominal films
CT scan
What lab value is elevated in mesenteric infart? Correct Ans-Amylase
What is the medical management of mesenteric infarct? Correct Ans-Emergency surgical
intervention
,Define appendicitis. Correct Ans-Inflammation of the appendix caused by obstruction of the
appendiceal lumen. Surgical emergency - untreated, will develop gangrene within 36 hrs.
Pain associated with appendicitis is: Correct Ans-RLQ pain
Worse sitting still, and coughing
What is Psoas sign? Correct Ans-Pain with right thigh extention
What is Obturator's Sign? Correct Ans-Pain with internal rotation of flexed right thigh
What is a positive Rovsing's Sign? Correct Ans-RLQ pain when LLQ is pushed on
McBurney's Point is associated with what GI disorder? Correct Ans-Appendicitis. Pain
illicited with one finger on right lower quadrant
What is the standard diagnostic for appendicitis? Correct Ans-CT scan`
What is the medical management of appendicitis? Correct Ans-Stat surgical consult
IV broad spectrum abx
IVF
Pain management
, What is the most critical assessment finding in the differential diagnosis of the acute abdomen
with peritonitis, such as in a patient with a bowel perforation? Correct Ans-Rigidity
50 yo. M presents with complaints of decreased stool caliber, constipation, and black tarry stool.
You would:
a. consult general surgery for colon cancer resection
b. consult oncology
c. order more tests
d. 2 units PRBC stat Correct Ans-C. Order more tests
What is the classic xray finding associated with mesenteric infarct? Correct Ans-
thumbprinting on abdominal film
What two antibiotics are associated with C. difficile? Correct Ans-Clindamycin
Ampicillin
What is the drug of choice for treatment of C. diff? Correct Ans-metrondiazole (Flagyl)
Projectile vomiting is a hallmark symptoms of what GI disease? Correct Ans-Acute
pancreatitis
What is the medical management of ulcerative colitis? Correct Ans-mesalamine (Canasa)
suppositories or enemas x 3-12 weeks
Hydrocortisone suppositories and enemas
Define mesenteric infarct. Correct Ans-Inadequate blood flow through the mesenteric
circulation leading to ischemia and gangrene of the bowel
What is the number one cause of mesenteric infarct? Correct Ans-Arterial or venous
thrombosis/emobolism.
What is the classic symptom of a mesenteric infarct? Correct Ans-Pain out of proportion to
physical exam findings
Sudden onset or cramping, colicky abdominal pain (usually after eating)
What is the diagnostic for mesenteric infarct? Correct Ans-Abdominal films
CT scan
What lab value is elevated in mesenteric infart? Correct Ans-Amylase
What is the medical management of mesenteric infarct? Correct Ans-Emergency surgical
intervention
,Define appendicitis. Correct Ans-Inflammation of the appendix caused by obstruction of the
appendiceal lumen. Surgical emergency - untreated, will develop gangrene within 36 hrs.
Pain associated with appendicitis is: Correct Ans-RLQ pain
Worse sitting still, and coughing
What is Psoas sign? Correct Ans-Pain with right thigh extention
What is Obturator's Sign? Correct Ans-Pain with internal rotation of flexed right thigh
What is a positive Rovsing's Sign? Correct Ans-RLQ pain when LLQ is pushed on
McBurney's Point is associated with what GI disorder? Correct Ans-Appendicitis. Pain
illicited with one finger on right lower quadrant
What is the standard diagnostic for appendicitis? Correct Ans-CT scan`
What is the medical management of appendicitis? Correct Ans-Stat surgical consult
IV broad spectrum abx
IVF
Pain management
, What is the most critical assessment finding in the differential diagnosis of the acute abdomen
with peritonitis, such as in a patient with a bowel perforation? Correct Ans-Rigidity
50 yo. M presents with complaints of decreased stool caliber, constipation, and black tarry stool.
You would:
a. consult general surgery for colon cancer resection
b. consult oncology
c. order more tests
d. 2 units PRBC stat Correct Ans-C. Order more tests
What is the classic xray finding associated with mesenteric infarct? Correct Ans-
thumbprinting on abdominal film
What two antibiotics are associated with C. difficile? Correct Ans-Clindamycin
Ampicillin
What is the drug of choice for treatment of C. diff? Correct Ans-metrondiazole (Flagyl)
Projectile vomiting is a hallmark symptoms of what GI disease? Correct Ans-Acute
pancreatitis
