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GI Board test questions
Terms in this set (9)
• A 44 year old obese female presents to the emergency room complaining of right upper quadrant pain, nausea and a fever that has persisted over the last several hours. You immediately suspect gallbladder problems. Which of the following antibiotics is the best choice at this time?
o Ceftriaxone and vanco/metro
o This is the most appropriate choice. The most common organisms involved in this disease process include enteric gram negatives, streptococci, and anaerobes.
• A 26 year old female presents to the clinic for follow up after having her gallbladder removed two weeks ago. She complains of increased frequency of bowel movements and loose stools. She is concerned and wants you to prescribe her the appropriate medication. Which of the following is the next best step?
o Questran (cholestyramine) is a bile acid sequestrant and is indicated in the treatment of postprandial diarrhea which may be a possible side effect following a laparoscopic cholecystectomy due to increased concentration of bile acids in the colon.
• Which of the following medications is indicated in the treatment of a patient diagnosed with esophageal varices?
• A 35 year old male presents to the clinic for evaluation of recurrent peptic ulcers. The patient has no history of NSAID abuse or H. pylori infection. Which of the following is the most appropriate diagnostic study to order at this time?
o Gastrin levels
o The most likely diagnosis in this scenario is Zollinger Ellison syndrome. This should be suspected due to the fact that they have recurrent ulcerations with no major risk factors. Gastrin levels > 150 pg/mL is definitively diagnostic of this condition.
• Which of the following is the next step in the management of a patient who has elevated bilirubin levels on his routine annual lab work and a history of Gilbert's syndrome?
o This is a congenital disease that often goes undiscovered for many years. In this condition, the patient's liver has a difficult time processing bilirubin. This is completely benign and will resolve on its own, no medical therapy is necessary, and patients should be provided with reassurance.
• Which of the following is considered the best study in an unstable patient with suspected abdominal aortic aneurysm?
o This study is highly accurate in detecting AAA, especially prior to rupture and is indicated in the evaluation of an unstable patient.
• A 60 year old female presents to your clinic for evaluation of decreased appetite and significant weight loss over the last four months. She states that she feel tired most of the day and just wants to sleep and smoke. She also states that she often feels nauseated and has intermittent belly pain. Determined to find out what is causing this patient's symptoms, you complete a thorough physical exam and order lab work. The only pertinent finding on physical exam was a palpable non-tender gallbladder. Which of the following is the treatment of choice?
o This patient presentation is consistent with pancreatic cancer. She has a history of smoking and complains of weight loss with a positive Courvoisier's sign (palpable, nontender gallbladder). Sometimes jaundice is also seen in these patients. Pancreatic jejunostomy, more commonly known as the Whipple procedure, is the treatment of choice in these patients.
• Which of the following best represents the correct route of transmission for Hepatitis A?
o A vehicle borne disease is one in which individuals are infected by introduction through a vehicle such as water or food. Hepatitis A is transmitted via a fecal-oral route. Hepatitis E is also transmitted by this route.
1. hepatocellular carcinoma
2. colon cancer
3. multiple myeloma
4. pancreatic cancer
1. hepatocellular carcinoma: alpha-fetoprotein (AF))
2. colon cancer: o CEA
3. multiple myeloma: o Beta-2-microglobulin
4. pancreatic cancer: CA 19-9
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