Gastroenterology Disorders Flashcards
7 cards from real Internal Medicine Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Gastroenterology Disorders flashcards as text
A 50-year-old with cirrhosis develops confusion, asterixis, and elevated ammonia. His medications include furosemide and spironolactone. What is the most appropriate immediate treatment for hepatic encephalopathy?
Answer: Lactulose titrated to 2-3 soft stools per day
Lactulose reduces ammonia production and absorption in the colon and is the first-line treatment for hepatic encephalopathy.
A patient with long-standing GERD undergoes EGD showing salmon-colored mucosa extending 4 cm above the gastroesophageal junction. Biopsy confirms intestinal metaplasia. What is the diagnosis and surveillance interval?
Answer: Barrett's esophagus without dysplasia; EGD every 3-5 years
Barrett's esophagus without dysplasia warrants surveillance endoscopy every 3-5 years per ACG guidelines.
A 35-year-old woman presents with recurrent watery diarrhea, bloating, and abdominal pain relieved by defecation. Colonoscopy and labs are normal. What is the most likely diagnosis?
Answer: Irritable bowel syndrome (IBS)
IBS is characterized by recurrent abdominal pain associated with defecation and altered stool frequency/form with no structural abnormalities.
A 65-year-old with known cirrhosis presents with sudden onset abdominal pain and fever. Paracentesis shows PMN count > 250 cells/µL. What empiric antibiotic is indicated for spontaneous bacterial peritonitis?
Answer: IV cefotaxime or ceftriaxone
Third-generation cephalosporins (cefotaxime, ceftriaxone) are the empiric treatment of choice for SBP due to coverage of gram-negative enteric organisms.
A 48-year-old presents with dysphagia to solids and liquids equally from the onset, regurgitation of undigested food, and a "bird-beak" appearance on barium swallow. Manometry shows absent peristalsis and incomplete LES relaxation. What is the diagnosis?
Answer: Achalasia
Achalasia is characterized by absent esophageal peristalsis and failure of LES relaxation, producing the classic bird-beak appearance on barium swallow.
A 42-year-old presents with jaundice, right upper quadrant pain, and fever (Charcot's triad). CT shows dilated bile ducts and a stone in the common bile duct. What is the most urgent intervention?
Answer: ERCP with stone extraction
Choledocholithiasis with cholangitis requires urgent ERCP with biliary decompression and stone extraction.
A 55-year-old with a history of NSAID use presents with melena and hematemesis. EGD shows a 1 cm duodenal ulcer with a visible vessel at its base. After endoscopic hemostasis, what is the next best pharmacologic management?
Answer: High-dose IV proton pump inhibitor infusion for 72 hours
High-risk ulcers treated endoscopically require high-dose IV PPI (bolus + infusion) for 72 hours to reduce rebleeding risk.