p.10
Liver Disease: Evaluation and Complications
What predominates in the hepatocellular pattern of liver disease?
Liver injury, inflammation, and necrosis.
p.9
Common Gastrointestinal Disorders and Their Symptoms
What are the cardinal signs of acute intestinal obstruction?
Colicky abdominal pain, abdominal distention, emesis, and obstipation.
p.7
Irritable Bowel Syndrome: Diagnosis and Management
What is the most common pattern of altered bowel habits in IBS?
Constipation alternating with diarrhea.
p.6
Inflammatory Bowel Disease: Ulcerative Colitis vs. Crohn's Disease
What are common laboratory findings in Ulcerative Colitis?
Elevated acute phase reactants, fecal lactoferrin, calprotectin, hypoalbuminemia, anemia, and leukocytosis.
p.7
Irritable Bowel Syndrome: Diagnosis and Management
What is the best management for postprandial pain in IBS?
Antispasmodics 30 minutes before meals.
p.7
Common Gastrointestinal Disorders and Their Symptoms
What defines a true diverticulum?
Saclike herniation of the entire bowel wall.
p.6
Inflammatory Bowel Disease: Ulcerative Colitis vs. Crohn's Disease
What is the typical involvement pattern in Ulcerative Colitis?
Continuous, symmetric, and diffuse involvement of the colon only, with the rectum typically involved.
p.15
Liver Disease: Evaluation and Complications
What are the three major lesions of Alcoholic Liver Disease (ALD)?
Fatty liver, alcoholic hepatitis, cirrhosis.
p.18
Pancreatic Disorders: Acute and Chronic Conditions
What is the most common cause of Acute Pancreatitis?
Gallstones, followed by alcohol.
p.16
Common Gastrointestinal Disorders and Their Symptoms
What changes during pregnancy contribute to a cholelithogenic state?
Sluggish gallbladder contraction and impaired gallbladder emptying.
p.16
Common Gastrointestinal Disorders and Their Symptoms
What is the most frequent demographic for emphysematous cholecystitis?
Elderly men and diabetics.
p.12
Liver Disease: Evaluation and Complications
What are the three primary complications of portal hypertension?
Ascites, hypersplenism, and gastroesophageal varices with hemorrhage.
p.7
Diagnostic Criteria for Gastrointestinal Diseases
What is the best imaging method to diagnose diverticulitis?
CT scan showing thickened colonic wall > 4 mm and inflammation within the pericolic fat.
p.1
Gastrointestinal Anatomy and Physiology
What causes contraction of the muscularis mucosa?
Meissner Plexus/Submucosal Plexus.
p.16
Common Gastrointestinal Disorders and Their Symptoms
What are the two major types of gallstones?
Cholesterol stones (>80%) and pigment stones (<20%).
p.6
Inflammatory Bowel Disease: Ulcerative Colitis vs. Crohn's Disease
What is the most common site of inflammation in Crohn's Disease?
The terminal ileum, which can also involve the colon.
p.18
Pancreatic Disorders: Acute and Chronic Conditions
What does the Turner Sign indicate?
Blue-red-purple or green-brown discoloration of the flanks from tissue catabolism of hemoglobin.
p.9
Common Gastrointestinal Disorders and Their Symptoms
What sequence of symptoms helps distinguish appendicitis from gastroenteritis?
Nausea followed by the development of abdominal pain.
p.7
Common Gastrointestinal Disorders and Their Symptoms
What is diverticulitis?
Inflammation of a diverticulum.
p.5
Peptic Ulcer Disease and Its Complications
What is the most common clinical manifestation of Gastrinoma?
Peptic ulcer, followed by diarrhea.
p.12
Liver Disease: Evaluation and Complications
What is the most common cause of ascites?
Portal hypertension related to cirrhosis.
p.1
Gastrointestinal Anatomy and Physiology
What is the role of Auerbach Plexus/Myenteric Plexus?
Causes contraction of the inner circular and outer longitudinal muscles for motility.
p.12
Liver Disease: Evaluation and Complications
What is the recommended sodium restriction for patients with ascites?
Less than 2 grams of sodium per day.
p.6
Inflammatory Bowel Disease: Ulcerative Colitis vs. Crohn's Disease
What is a defining lesion in Crohn's Disease?
Crypt abscesses and ulcers.
p.18
Pancreatic Disorders: Acute and Chronic Conditions
What does the Cullen Sign indicate?
Blue discoloration around the umbilicus from hemoperitoneum.
p.8
Common Gastrointestinal Disorders and Their Symptoms
Define fecal incontinence.
Involuntary passage of rectal material for at least 1 month in an individual with a developmental age of at least 4 years.
p.14
Liver Disease: Evaluation and Complications
What is the most feared complication of Viral Hepatitis?
Fulminant hepatitis (massive hepatic necrosis).
p.11
Liver Disease: Evaluation and Complications
What PT prolongation indicates a poor prognostic sign in acute viral hepatitis?
>5 seconds not corrected by parenteral vitamin K.
p.6
Inflammatory Bowel Disease: Ulcerative Colitis vs. Crohn's Disease
What are the major symptoms of Ulcerative Colitis (UC)?
Diarrhea, rectal bleeding, tenesmus, and passage of mucus.
p.7
Diagnostic Criteria for Gastrointestinal Diseases
What laboratory features argue against a diagnosis of IBS?
Elevated sedimentation rate, presence of leukocytes or blood in stool, stool volume > 200-300 ml/day.
p.6
Inflammatory Bowel Disease: Ulcerative Colitis vs. Crohn's Disease
What is a common treatment for moderate to severe Crohn's Disease?
Oral corticosteroids, methotrexate, and anti-TNF agents.
p.2
Common Gastrointestinal Disorders and Their Symptoms
What is the male to female ratio for Meckel's Diverticulum?
2:1 male to female ratio.
p.8
Common Gastrointestinal Disorders and Their Symptoms
What is Anismus?
The result of attempting to defecate against a closed pelvic floor (nonrelaxing puborectalis).
p.10
Liver Disease: Evaluation and Complications
What indicates poor prognosis in fulminant hepatitis?
Hepatic encephalopathy during acute hepatitis.
p.17
Diagnostic Criteria for Gastrointestinal Diseases
What is the preferred initial procedure for diagnosing and treating biliary tract issues?
ERCP with endoscopic sphincterotomy.
p.18
Pancreatic Disorders: Acute and Chronic Conditions
What is the major symptom of Acute Pancreatitis?
Steady and boring abdominal pain located in the epigastrium and periumbilical region, which may radiate to the back, chest, flanks, and lower abdomen.
p.15
Liver Disease: Evaluation and Complications
What are the most important risk factors for developing Alcoholic Liver Disease?
Quantity and duration of alcohol intake.
p.6
Inflammatory Bowel Disease: Ulcerative Colitis vs. Crohn's Disease
What role do antibiotics play in Ulcerative Colitis?
There is no role for antibiotics in active or quiescent UC.
p.6
Inflammatory Bowel Disease: Ulcerative Colitis vs. Crohn's Disease
What is a unique feature of Crohn's Disease regarding lesions?
Skip lesions with normal intervening mucosa.
p.12
Liver Disease: Evaluation and Complications
What is the first indication of portal hypertension in the liver?
Hypersplenism with thrombocytopenia.
p.16
Common Gastrointestinal Disorders and Their Symptoms
What is the treatment of choice for uncomplicated acute cholecystitis?
Early cholecystectomy (within 72 hours).
p.18
Pancreatic Disorders: Acute and Chronic Conditions
What diagnostic test has the best sensitivity/specificity for Chronic Pancreatitis?
Secretin stimulation test.
p.8
Common Gastrointestinal Disorders and Their Symptoms
What is the best management for newly diagnosed fistula in ano?
Seton (vessel loop or silk tie placed through the tract).
p.16
Common Gastrointestinal Disorders and Their Symptoms
Which organisms are most frequently isolated in gallbladder bile?
Escherichia coli, Klebsiella spp., Streptococcus spp., Clostridium spp.
p.15
Liver Disease: Evaluation and Complications
What is Zieve's Syndrome?
Hemolytic anemia with spur cells and acanthocytes in patients with severe alcoholic hepatitis.
p.7
Common Gastrointestinal Disorders and Their Symptoms
What is the initial treatment for symptomatic uncomplicated diverticular disease (SUDD)?
Bowel rest with confirmation of inflammation and infection.
p.8
Common Gastrointestinal Disorders and Their Symptoms
Where is the most common location for anal fissures?
Posterior position, followed by anterior.
p.5
Common Gastrointestinal Disorders and Their Symptoms
What type of gastritis primarily involves the fundus and body?
Type A Gastritis (Autoimmune).
p.11
Liver Disease: Evaluation and Complications
What differentiates Budd-Chiari Syndrome from cardiac cirrhosis?
Extravasation of RBCs in BCS (not in cardiac cirrhosis).
p.3
Diagnostic Criteria for Gastrointestinal Diseases
What is the most sensitive test for diagnosing GERD?
24-hour ambulatory pH monitoring.
p.3
Diagnostic Criteria for Gastrointestinal Diseases
What is the endoscopic hallmark of GERD?
Erosive esophagitis at the esophagogastric junction.
p.16
Common Gastrointestinal Disorders and Their Symptoms
What is the most important mechanism in the formation of gallstones?
Increased biliary secretion of cholesterol lithogenic bile.
p.14
Liver Disease: Evaluation and Complications
What autoantibody is present in chronic Hepatitis D?
Antibodies to liver-kidney microsomes (anti-LKM3).
p.17
Common Gastrointestinal Disorders and Their Symptoms
What are the most common biliary anomalies in infancy?
Atretic and hypoplastic lesions of the extrahepatic and large intrahepatic bile ducts.
p.5
Peptic Ulcer Disease and Its Complications
What is the treatment of choice for Gastrinoma?
PPIs (Proton Pump Inhibitors).
p.4
Peptic Ulcer Disease and Its Complications
What is the most discriminating symptom of duodenal ulcers?
Pain that awakens the patient from sleep (between midnight and 3 AM).
p.4
Peptic Ulcer Disease and Its Complications
What is the typical pain pattern in duodenal ulcers?
Occurs 90 minutes to 3 hours after a meal and is frequently relieved by antacids or food.
p.17
Diagnostic Criteria for Gastrointestinal Diseases
What is the preferred approach if CBD stones are suspected?
Preoperative ERCP with endoscopic papillotomy and stone extraction prior to laparoscopic cholecystectomy.
p.13
Liver Disease: Evaluation and Complications
What is the criterion for chronic HBV infection?
HBsAg remains detectable beyond 6 months.
p.1
Gastrointestinal Hormones and Their Functions
What does Gastrin stimulate?
Parietal cells in the fundus for HCl secretion and growth of gastric mucosa.
p.4
Peptic Ulcer Disease and Its Complications
What are the most commonly performed operations for duodenal ulcers?
Highly selective vagotomy and vagotomy with antrectomy.
p.17
Liver Disease: Evaluation and Complications
What are the typical cholangiographic findings in PSC?
Multifocal stricturing and beading involving both the intra- and extrahepatic biliary tree.
p.6
Inflammatory Bowel Disease: Ulcerative Colitis vs. Crohn's Disease
What are the typical endoscopic findings in Ulcerative Colitis?
Fine mucosal granularity, loss of haustral folds, and symmetric ulceration.
p.10
Liver Disease: Evaluation and Complications
What does staging of liver disease indicate?
The point in the natural history of the disease, such as early or late, precirrhotic, cirrhotic, or end-stage.
p.9
Common Gastrointestinal Disorders and Their Symptoms
What are the cardinal manifestations of peritonitis?
Acute abdominal pain and tenderness, usually with fever.
p.8
Common Gastrointestinal Disorders and Their Symptoms
What is Procidentia?
Circumferential, full-thickness protrusion of the rectal wall through the anal orifice.
p.18
Pancreatic Disorders: Acute and Chronic Conditions
What is the most important treatment intervention for acute pancreatitis?
Safe, aggressive intravenous fluid resuscitation.
p.15
Liver Disease: Evaluation and Complications
What is the cornerstone of treatment for Alcoholic Liver Disease?
Complete abstinence from alcohol.
p.11
Liver Disease: Evaluation and Complications
What are the most common causes of striking elevations in aminotransferases?
Ischemic liver injury, toxin- or drug-induced liver injury, acute biliary obstruction.
p.17
Common Gastrointestinal Disorders and Their Symptoms
What is the most common type of cholangitis?
Nonsuppurative acute cholangitis.
p.10
Liver Disease: Evaluation and Complications
What is the screening test for Hepatopulmonary Syndrome?
Oxygen saturation by pulse oximetry.
p.10
Liver Disease: Evaluation and Complications
What are the most commonly used liver function tests?
Serum bilirubin, serum albumin, prothrombin time (PT).
p.17
Common Gastrointestinal Disorders and Their Symptoms
What are the risk factors for concomitant CBD stones?
History of jaundice or pancreatitis, gallstones, abnormal liver function tests, and evidence of a dilated CBD.
p.1
Gastrointestinal Anatomy and Physiology
What initiates carbohydrate digestion in the mouth?
Salivary amylase (ptyalin).
p.4
Peptic Ulcer Disease and Its Complications
What antibiotics are used to eradicate H. pylori?
Amoxicillin, Clarithromycin, Metronidazole, Tetracycline, Levofloxacin.
p.17
Liver Disease: Evaluation and Complications
What is a dreaded complication of PSC?
Development of cholangiocarcinoma.
p.9
Diagnostic Criteria for Gastrointestinal Diseases
What classical findings are seen in patients with small-bowel obstruction on abdominal radiography?
A 'staircasing' pattern of dilated air and fluid-filled small-bowel loops >2.5 cm in diameter.
p.6
Inflammatory Bowel Disease: Ulcerative Colitis vs. Crohn's Disease
What is a significant complication associated with Ulcerative Colitis?
Toxic colitis, which can cause severe pain and bleeding.
p.7
Common Gastrointestinal Disorders and Their Symptoms
What is the most common cause of hematochezia in patients over 60 years?
Hemorrhage from a colonic diverticulum.
p.8
Common Gastrointestinal Disorders and Their Symptoms
What is Goodsall's Rule for fistulas?
Posterior fistula: curved tract to enter anal canal at posterior midline; exceptions exist for fistulas exiting >3 cm from the anal verge.
p.17
Common Gastrointestinal Disorders and Their Symptoms
What is the treatment of choice for patients with common duct stones?
Endoscopic biliary sphincterotomy (EBS) followed by spontaneous passage or stone extraction.
p.11
Liver Disease: Evaluation and Complications
What are the expected findings in autoimmune hepatitis?
ANA or SMA, elevated Ig levels.
p.2
Common Gastrointestinal Disorders and Their Symptoms
What are the components of the Triad of Choledochal Cyst?
Jaundice, abdominal mass, biliary pain.
p.5
Inflammatory Bowel Disease: Ulcerative Colitis vs. Crohn's Disease
What are the most common ocular complications of IBD?
Conjunctivitis, anterior uveitis/iritis, and episcleritis.
p.1
Gastrointestinal Hormones and Their Functions
What triggers Cholecystokinin (CCK) secretion?
All types of food, especially fatty acids.
p.17
Liver Disease: Evaluation and Complications
What is the only approved treatment for PBC?
Ursodeoxycholic acid (UDCA).
p.4
Peptic Ulcer Disease and Its Complications
What causes severe peptic ulcer diathesis secondary to gastric acid hypersecretion?
Unregulated gastrin release from Zollinger-Ellison Syndrome (ZES) gastrinomas.
p.7
Irritable Bowel Syndrome: Diagnosis and Management
What is the initial therapy of choice for Diarrhea Predominant IBS (IBS-D)?
Peripherally acting opiate-based agents.
p.16
Diagnostic Criteria for Gastrointestinal Diseases
What is the radiographic diagnosis of emphysematous cholecystitis?
Gas within the gallbladder lumen on plain abdominal film.
p.16
Common Gastrointestinal Disorders and Their Symptoms
What does Courvoisier's Law suggest?
A palpably enlarged gallbladder indicates biliary obstruction is secondary to malignancy rather than calculous disease.
p.16
Common Gastrointestinal Disorders and Their Symptoms
What is the gold standard for treating symptomatic cholelithiasis?
Laparoscopic cholecystectomy.
p.18
Pancreatic Disorders: Acute and Chronic Conditions
What is the predominant symptom of Chronic Pancreatitis?
Abdominal pain or maldigestion and weight loss.
p.15
Liver Disease: Evaluation and Complications
What dose of acetaminophen typically produces clinical evidence of liver injury?
Single dose of 10-15 grams.
p.11
Liver Disease: Evaluation and Complications
In alcoholic liver disease, which enzyme is typically elevated?
AST (aspartate aminotransferase).
p.11
Liver Disease: Evaluation and Complications
Which enzyme is a more specific indicator of liver injury in viral hepatitis?
ALT (alanine aminotransferase).
p.15
Liver Disease: Evaluation and Complications
What antibodies are associated with Type I Autoimmune Hepatitis?
ANA antibodies (and p-ANCA).
p.13
Liver Disease: Evaluation and Complications
What is the first antibody to rise in Hepatitis B infection?
Anti-HBc antibody (1-2 weeks after HBsAg).
p.4
Peptic Ulcer Disease and Its Complications
What defines refractory peptic ulcers?
GU: failure to heal after 12 weeks of therapy; DU: failure to heal after 8 weeks of therapy.
p.10
Liver Disease: Evaluation and Complications
What are the grading categories for liver disease severity?
Active or inactive; mild, moderate, or severe.
p.18
Pancreatic Disorders: Acute and Chronic Conditions
What is the most frequent laterality of pleural effusion in Pancreatitis?
Most frequent on the left.
p.16
Diagnostic Criteria for Gastrointestinal Diseases
What does Murphy's Sign indicate?
Increased pain and inspiratory arrest suggestive of acute cholecystitis.
p.16
Common Gastrointestinal Disorders and Their Symptoms
What is Mirizzi's Syndrome?
Gallstone impacted in the cystic duct causing compression of the CBD, resulting in obstruction and jaundice.
p.2
Common Gastrointestinal Disorders and Their Symptoms
What are the two types of epithelia found in Meckel's Diverticulum?
Gastric and pancreatic epithelia.
p.11
Liver Disease: Evaluation and Complications
What key event is involved in hepatic fibrogenesis?
Stellate cell activation and collagen production.
p.14
Liver Disease: Evaluation and Complications
What is the goal of treatment in Hepatitis C?
To eradicate HCV RNA during therapy and document that the virus remains undetectable for at least 12 weeks after completion of therapy (SVR12).
p.1
Gastrointestinal Hormones and Their Functions
What do Enterochromaffin-Like Cells secrete?
Histamine in the stomach.
p.4
Peptic Ulcer Disease and Its Complications
What are the most potent acid inhibitory agents?
Proton Pump Inhibitors (PPIs).
p.17
Liver Disease: Evaluation and Complications
What is the most common cause of extrinsic bile duct compression?
Carcinoma of the pancreatic head.
p.12
Liver Disease: Evaluation and Complications
What is hepatorenal syndrome (HRS)?
Functional renal failure without renal pathology in patients with advanced cirrhosis or acute liver failure.
p.8
Mesenteric Vascular Disease
What is the optimal treatment for ischemic colitis?
Resection of ischemic bowel and formation of a proximal stoma.
p.17
Liver Disease: Evaluation and Complications
What is the earliest lesion in Primary Biliary Cirrhosis (PBC)?
Chronic nonsuppurative destructive cholangitis.
p.12
Liver Disease: Evaluation and Complications
What are the most common indications for liver transplantation?
Hepatitis C infection and alcoholic liver disease.
p.10
Liver Disease: Evaluation and Complications
What does the Model for End-Stage Liver Disease (MELD) Score assess?
Serum bilirubin, serum creatinine, and PT-INR.
p.10
Liver Disease: Evaluation and Complications
What is a common symptom of hepatic failure?
Signs or symptoms of hepatic encephalopathy.
p.5
Peptic Ulcer Disease and Its Complications
What is the superior border of the Gastrinoma Triangle?
Cystic and common bile ducts.
p.4
Peptic Ulcer Disease and Its Complications
What are the most common causes of gastric and duodenal ulcers?
Helicobacter pylori and NSAIDs.
p.7
Gastrointestinal Bleeding Causes and Management
What is the best management for massive diverticular bleeding in an unstable patient?
Angiography with coiling.
p.16
Common Gastrointestinal Disorders and Their Symptoms
What is associated with a porcelain gallbladder?
Calcium salt deposition within the wall of a chronically inflamed gallbladder, associated with gallbladder carcinoma.
p.2
Irritable Bowel Syndrome: Diagnosis and Management
What is the average frequency of recurrent abdominal pain in Irritable Bowel Syndrome?
At least 1 day per week for the last 3 months.
p.2
Irritable Bowel Syndrome: Diagnosis and Management
What are the three criteria associated with abdominal pain in Irritable Bowel Syndrome?
1. Related to defecation, 2. Change in frequency of stool, 3. Change in form (appearance) of stool.
p.1
Gastrointestinal Anatomy and Physiology
What do Chief Cells secrete?
Pepsinogen in the stomach.
p.12
Liver Disease: Evaluation and Complications
What is the treatment for spontaneous bacterial peritonitis?
Third-generation cephalosporin.
p.4
Peptic Ulcer Disease and Its Complications
What is the test of choice for documenting eradication of H. pylori?
Monoclonal stool antigen test or a urea breath test (UBT).
p.2
Common Gastrointestinal Disorders and Their Symptoms
What are the three components of the Triad of Acute Cholecystitis?
Fever, leukocytosis, abdominal pain.
p.8
Mesenteric Vascular Disease
What is the clinical presentation of acute mesenteric ischemia?
Severe acute, nonremitting abdominal pain resulting from arterial embolus or thrombosis, out of proportion to physical findings.
p.2
Common Gastrointestinal Disorders and Their Symptoms
What are the components of the Triad of Hemobilia?
Obstructive jaundice, melena, abdominal pain.
p.2
Pancreatic Disorders: Acute and Chronic Conditions
What are the diagnostic criteria for Acute Pancreatitis?
Typical abdominal pain in the epigastrium, 3x or greater elevation in serum amylase and/or lipase levels, confirmatory findings on imaging.
p.3
Common Gastrointestinal Disorders and Their Symptoms
What is the common cause of Steakhouse Syndrome?
Schatzki ring in the lower esophagus.
p.17
Liver Disease: Evaluation and Complications
What is the imaging technique of choice for the initial evaluation of Primary Sclerosing Cholangitis (PSC)?
Magnetic resonance imaging (MRI) with magnetic resonance cholangiopancreatography (MRCP).
p.17
Common Gastrointestinal Disorders and Their Symptoms
What is the most common cause of persistent nonbiliary disorders?
Irritable bowel syndrome.
p.5
Diagnostic Criteria for Gastrointestinal Diseases
What is the first step in the evaluation of Gastrinoma?
Obtain a fasting gastrin level.
p.1
Gastrointestinal Anatomy and Physiology
What is secreted by Parietal Cells in the stomach?
HCl and Intrinsic Factor (IF).
p.8
Common Gastrointestinal Disorders and Their Symptoms
What is the most common type of fistula in ano (FIA)?
Intersphincteric, followed by transsphincteric.
p.2
Common Gastrointestinal Disorders and Their Symptoms
What does Reynolds' Pentad include in addition to Charcot's Triad?
Shock and altered mental status.
p.12
Liver Disease: Evaluation and Complications
What is hepatic encephalopathy?
Alteration in mental status and cognitive function occurring in the presence of liver failure.
p.8
Mesenteric Vascular Disease
What is the most significant indicator of survival in intestinal ischemia?
Timeliness of diagnosis and treatment.
p.3
Common Gastrointestinal Disorders and Their Symptoms
What is Globus sensation?
Perception of a lump or fullness in the throat, felt irrespective of swallowing.
p.13
Liver Disease: Evaluation and Complications
What increases the risks of cirrhosis and HCCA in Hepatitis B?
The level of HBV replication.
p.3
Diagnostic Criteria for Gastrointestinal Diseases
What is the test for evaluation of the proximal GIT?
Endoscopy/esophagogastroduodenoscopy (EGD).
p.3
Common Gastrointestinal Disorders and Their Symptoms
What is the typical presentation of Esophageal Squamous Cell CA?
Progressive dysphagia and weight loss.
p.3
Gastrointestinal Bleeding Causes and Management
What is Boerhaave Syndrome?
Full-thickness esophageal tear (rupture).
p.10
Liver Disease: Evaluation and Complications
What is the best physical exam maneuver to appreciate ascites?
Shifting dullness on percussion.
p.4
Peptic Ulcer Disease and Its Complications
Where is the most common location for duodenal ulcers?
The first portion of the duodenum, with ~90% located within 3 cm of the pylorus.
p.5
Gastrointestinal Bleeding Causes and Management
What is the most common presentation of GI bleeding?
Stress-Related Mucosal Injury (SRMI).
p.5
Gastrointestinal Bleeding Causes and Management
What is the treatment of choice for stress prophylaxis?
PPIs (preferably oral if tolerated).
p.10
Liver Disease: Evaluation and Complications
What is the rate-limiting step in bilirubin metabolism?
Transport of conjugated bilirubin into the bile canaliculi.
p.10
Liver Disease: Evaluation and Complications
What type of bilirubin is found in urine?
Conjugated/direct bilirubin (water-soluble).
p.3
Common Gastrointestinal Disorders and Their Symptoms
What are the typical symptoms of GERD?
Heartburn and regurgitation.
p.17
Liver Disease: Evaluation and Complications
Which organisms are most commonly involved in hepatobiliary parasitism?
Trematodes, including Clonorchis sinensis and Opisthorchis viverrini.
p.1
Gastrointestinal Anatomy and Physiology
What is the primary site for protein digestion?
Stomach (pepsin and denaturation by HCl).
p.1
Gastrointestinal Anatomy and Physiology
What nutrients are absorbed in the jejunum?
Carbohydrates, fats, proteins, and water.
p.17
Liver Disease: Evaluation and Complications
What antibodies are associated with PBC?
Antimitochondrial antibodies (AMA).
p.3
Gastrointestinal Bleeding Causes and Management
What is the classic history of a Mallory-Weiss Tear?
Vomiting, retching, coughing preceding hematemesis in an alcoholic patient.
p.13
Liver Disease: Evaluation and Complications
What enzyme does Hepatitis B use?
Reverse transcriptase enzyme.
p.13
Liver Disease: Evaluation and Complications
What does HBe Antigen (HBeAg) indicate?
It is a qualitative marker for infectivity/replication.
p.1
Gastrointestinal Hormones and Their Functions
What is the function of Enterochromaffin Cells?
Secretes serotonin in the stomach.
p.5
Common Gastrointestinal Disorders and Their Symptoms
What is the most common type of gastritis?
Type B Gastritis (H. pylori-associated).
p.1
Gastrointestinal Anatomy and Physiology
What are Interstitial cells of Cajal known for?
They are pacemaker cells of the GI tract that generate slow waves.
p.11
Liver Disease: Evaluation and Complications
What is a key diagnostic finding in Wilson's disease?
Decreased serum ceruloplasmin and increased urinary copper.
p.8
Mesenteric Vascular Disease
What is a marker of intestinal nonviability?
Area of nonfluorescence >5 mm in diameter under UV illumination with Woods lamp.
p.12
Liver Disease: Evaluation and Complications
What are the most common organisms causing spontaneous bacterial peritonitis (SBP)?
Escherichia coli and other gut bacteria.
p.2
Common Gastrointestinal Disorders and Their Symptoms
What are the components of Charcot's Triad for Ascending Cholangitis?
Fever, RUQ pain, jaundice.
p.4
Peptic Ulcer Disease and Its Complications
What are the PUD-related complications in order of decreasing frequency?
GI bleeding > perforation > gastric outlet obstruction.
p.2
Liver Disease: Evaluation and Complications
What are the components of the Triad of Hepatopulmonary Syndrome?
Hypoxemia, pulmonary arteriovenous shunting, platypnea.
p.13
Liver Disease: Evaluation and Complications
What is the most significant non-percutaneous route of HBV transmission?
Intimate (especially sexual) contact.
p.3
Peptic Ulcer Disease and Its Complications
What is the most severe histologic consequence of GERD?
Barrett's metaplasia with the associated risk of esophageal adenocarcinoma.
p.17
Common Gastrointestinal Disorders and Their Symptoms
What is the most common associated entity in patients with biliary tract disease?
Nonalcoholic acute pancreatitis.
p.11
Liver Disease: Evaluation and Complications
What is the first test for suspected Budd-Chiari Syndrome?
Hepatic Vein Ultrasound with Doppler imaging.
p.12
Liver Disease: Evaluation and Complications
What is asterixis, also known as liver flap?
Sudden forward movement of the wrist after it is bent back on an extended arm; cannot be elicited if the patient is already comatose.
p.12
Liver Disease: Evaluation and Complications
What is the mainstay of treatment for hepatic encephalopathy?
Lactulose, to promote 2-3 soft stools per day.
p.11
Liver Disease: Evaluation and Complications
What is a characteristic finding in hemochromatosis?
Elevated iron saturation and serum ferritin.
p.12
Liver Disease: Evaluation and Complications
What characterizes Type 1 HRS?
Progressive impairment in renal function and significant reduction in creatinine clearance within 1-2 weeks.
p.4
Peptic Ulcer Disease and Its Complications
What is the most common cause of treatment failure in compliant patients?
Antibiotic-resistant H. pylori strains.
p.11
Liver Disease: Evaluation and Complications
What is a significant marker for hepatocellular cancer?
Elevated alpha-fetoprotein level >500 ng/mL.
p.1
Gastrointestinal Hormones and Their Functions
What is the action of Secretin?
Inhibits HCl secretion and increases biliary and pancreatic HCO3-.
p.1
Gastrointestinal Hormones and Their Functions
What does Motilin activate?
Interdigestive/migrating myoelectric complex during fasting.
p.3
Diagnostic Criteria for Gastrointestinal Diseases
What does Esophageal Manometry detect in achalasia?
Impaired LES relaxation and absent peristalsis.
p.4
Peptic Ulcer Disease and Its Complications
What is the surgery of choice for an antral ulcer?
Antrectomy (including the ulcer) with a Billroth I anastomosis.
p.1
Gastrointestinal Hormones and Their Functions
What does Glucose-dependent Insulinotropic Peptide (GIP) stimulate?
Insulin secretion and inhibits gastric emptying.
p.3
Gastrointestinal Bleeding Causes and Management
What is the procedure of choice in LGIB?
Colonoscopy after an oral lavage solution.
