Internal Medicine Board Review Flashcards - This eBook contains 50 Gastroenterology Flashcards. The Flashcards are review questions and can be used to study for medical board exams including the USMLE Step Exams and the ABIM Internal Medicine Exam. More questions can be found at www.knowmedge.com

1. Gastroenterology
Includes 50 Flashcards for Board Exam prep
www.knowmedge.com
INTERNAL MEDICINE BOARD REVIEW FLASHCARDS

2. K N O W M E D G E
INTERNALMEDICINEBOARDREVIEWFLASHCARDS
Gastroenterology
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4. What are some common symptoms seen
in diverticulitis?
Question 1
- Lower left sided abdominal pain (often severe and
sudden)
- Fever
- Change in bowel habits
- Constipation
- Diarrhea
- Bloating
Answer 1

5. Rectal bleeding is a common symptom in
(Diverticulitis or Diverticulosis?)
Question 2
Rectal bleeding is rarely seen in patients
with diverticulitis. It is much more
common in patients with diverticulosis.
Answer 2

6. After a night of heavy drinking, patient
begins to retch and cough violently
before seeing blood in his emesis. Likely
diagnosis?
Question 3
Extreme retching and violent coughing
preceding hematemesis is a clue for
Mallory-Weiss tear.
Answer 3

7. What are the two most common causes
of lower GI bleed in the elderly?
Question 4
Diverticular bleeding and Angiodysplasia
are the most common causes of lower GI
bleed in the elderly (age greater than 60)
Answer 4

8. Definitive diagnosis of a Mallory-Weiss
tear is made by __________.
Question 5
Definitive diagnosis of a Mallory-Weiss
tear is made by
Esophagogastroduodenoscopy (EGD)
Answer 5

9. What are common signs and symptoms
seen in esophageal cancer?
Question 6
Signs and symptoms of esophageal
cancer include dysphagia (difficulty
swallowing), odynophagia (painful
swallowing), weight loss, cough or
hoarseness.
Answer 6

10. How do gastric and duodenal ulcers
differ based on their most common
cause?
Question 7
Gastric ulcers are generally caused by
excessive NSAID use. Duodenal ulcers
are generally caused by Helicobacter
pylori (H. pylori)
Answer 7

11. How do gastric and duodenal ulcers
differ in terms of their relation to food
intake?
Question 8
Gastric ulcers typically worsens with
food intake. Duodenal ulcers typically
improve with food intake.
Answer 8

12. Which medication class can lead to
peptic ulcers independently: Steroids or
NSAIDs?
Question 9
NSAIDs can induce ulcers by themselves
but steroids alone are not ulcerogenic.
The combination of NSAIDs and steroids
are ulcerogenic and can increase the
bleeding risk of ulcers significantly.
Answer 9

13. Young patients who have intermittent
dysphagia to solid foods such as bread or
meats are likely to have what condition?
Question 10
Schatzki or lower esophageal ring
Answer 10

14. Systemic sclerosis (or scleroderma)
causes dysphagia to solids, liquids or
both?
Question 11
It is a motility problem that is expected
to cause dysphagia to both solids and
liquids.
Answer 11

15. What is the initial test to be ordered
when "Steakhouse syndrome" is
suspected?
Question 12
Barium swallow
Answer 12

16. In Nissen fundoplication, what part of
the stomach is used to wrap around the
lower esophageal sphincter to increase
its tone?
Question 13
The fundal portion of the stomach
Answer 13

17. In osmotic diarrhea, what is the stool
osmotic gap?
Question 14
Greater than 100mOsm/kg
Answer 14

18. What are the 4 main categories of
chronic diarrhea?
Question 15
Secretory, Osmotic, Exudative, Increased
motility
Answer 15

19. What is the most likely symptom is
patients experiencing VIPoma?
Question 16
Voluminous, watery diarrhea
Answer 16

20. In secretory forms of diarrhea, how does
fasting affect the large/frequent bowel
movements?
Question 17
Little/No effect
Answer 17

21. How is the stool osmotic gap calculated?
What number is it less than in secretory
diarrhea?
Question 18
Stool osmotic gap = 290 - 2 (Stool
Potassium + Stool Sodium).
Value < 50mOsm/kg in secretory
diarrhea
Answer 18

22. Diet containing what sugar-like
compounds can cause diarrhea?
Question 19
High sorbitol or fructose diet
Answer 19

23. Diet containing what sugar-like
compounds can cause diarrhea?
Question 20
Metformin
Answer 20

24. What type of a diet is recommended for
patients with chronic pancreatitis?
Question 21
Low-fat diet with addition of fat-soluble
vitamins (A, D, E, K).
Answer 21

25. What type of triglycerides may be
recommended in the diet for a patient
with chronic pancreatitis?
Question 22
Medium-chain triglycerides (MCTs)
Answer 22

26. 30,000 units of what enzyme is
recommended for patients with chronic
pancreatitis?
Question 23
Lipase
Answer 23

27. Any patient with Crohn’s disease and a
new limp must be ruled out for what
complication?
Question 24
Psoas (or iliopsoas) muscle abscess
Answer 24

28. What is the anatomic landmark which
differentiates upper & lower GI bleeds?
Question 25
Ligament of Treitz
Answer 25

29. What is the most common location of
colonic diverticula?
Question 26
Sigmoid colon
Answer 26

30. ______________ is the formation of
outpouchings in the lining of the bowel
and can cause rectal bleeding
Question 27
Diverticulosis is the formation of
outpouchings in the lining of the bowel
and can cause rectal bleeding
Answer 27

31. Diverticuli can be seen in the context of
what four main conditions?
Question 28
Asymptomatic diverticulosis, Painful
diverticulosis, Diverticular bleed,
Diverticulitis
Answer 28

32. A clue to upper GI bleed would be an
abnormally high BUN:Creatinine ratio
greater than ___:___.
Question 29
A clue to upper GI bleed would be an
abnormally high BUN:Creatinine ratio
greater than 30:1
Answer 29

33. What test is ordered before a patient
undergoes Nissen fundoplication for the
treatment of GERD?
Question 30
Manometry study to confirm good
motility of the esophagus before Nissen
is done. If poor motility, achalasia can
result.
Answer 30

34. What test must any patient with GERD
experiencing alarm features undergo?
Question 31
EGD with biopsy to rule out
adenocarcinoma of the esophagus
Answer 31

35. What are alarm features associated with
GERD?
Question 32
Dysphagia, Hematemesis or
Unintentional weight loss
Answer 32

36. What causes the "Bird's beak" finding on
barium swallow and what is the
diagnosis?
Question 33
Dilated esophagus with tapered
gastroesophageal junction due to
increased lower esophageal sphincter
tone; seen in Achalasia
Answer 33

37. Dysphagia to liquids, difficulty in
initiating a swallow, coughing and
gagging suggest which anatomical
category of dysphagia?
Question 34
Oropharyngeal dysphagia
Answer 34

38. What is the appropriate test for
diagnosing oropharyngeal dysphagia?
Question 35
Modified barium swallow
(videofluoroscopy)
Answer 35

39. Barium swallow, Manometry, or EGD
with biopsy are studies that may be
involved in the work up which
anatomical category of dysphagia?
Question 36
Esophageal dysphagia
Answer 36

40. The hepatitis A vaccine is an inactivated
virus that is given in two doses usually
separated by ___ months.
Question 37
6
Answer 37

41. OCPs are associated with which hepatic
pathology?
Question 38
Hepatic adenoma
Answer 38

42. Which anaesthetic gas is associated with
idiosyncratic hepatotoxicity & high
mortality rates?
Question 39
Halothane
Answer 39

43. What are the two main side effects
associated with amlodipine?
Question 40
Peripheral edema and headaches
Answer 40

44. What is the hepatotoxic metabolite
derived from acetaminophen by CytP450
CYP2E1?
Question 41
N-acetyl-benzoquinone-imine (NAPQI)
Answer 41

45. What are the autoantibodies found in
patient with autoimmune hepatitis?
Question 42
ANA, anti smooth muscle antibody, anti
LKM, antibodies to "soluble liver
antigen/liver pancreas antigen",
antibodies to hepatic lectin
Answer 42

46. Which specific antiviral therapy is
contraindicated in patients with
autoimmune hepatitis?
Question 43
Interferon is contraindicated in patients
with autoimmune hepatitis as it can
worsen the disease
Answer 43

47. What is the mainstay of treatment of
autoimmune hepatitis?
Question 44
Glucocorticoid therapy
Answer 44

48. Enteral feeding for patients with severe
acute pancreatitis consists of a tube that
passes what anatomical landmark?
Question 45
The Ligament of Treitz, avoiding
pancreatic stimulation
Answer 45

49. What osmotic agents may be used to
treat opioid-induced constipation?
Question 46
Magnesium hydroxide, Lactulose and
Polyethylene glycol
Answer 46

50. What complication of chronic
pancreatitis, seen in about 5-10% of
cases can present as postprandial
abdominal pain and early satiety?
Question 47
Duodenum obstruction
Answer 47

51. In the stepwise approach to preventing
constipation in patients using opioid
medications, what is the first medication
to try?
Question 48
Stool softeners (e.g. docusate) with the
initiation of the opioid medication
Answer 48

52. What are the colonic stimulants that may
be used against opioid-induced
constipation when all other options fail?
Question 49
Bisacodyl and Senna
Answer 49

53. What is the class of anti-hypertensive
medications used to treat Raynaud's
phenomenom?
Question 50
Calcium channel blockers
Answer 50

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