Gastroenterology

Gastroenterology US Medical PG Question 1: A 54-year-old man presents to the clinic for epigastric discomfort during the previous month. He states he has not vomited, but reports of having epigastric pain that worsens after most meals. The patient states that his stool “looks black sometimes.” The patient does not report of any weight loss. He has a past medical history of gastroesophageal reflux disease, diabetes mellitus, peptic ulcer disease, and Crohn’s disease. The patient takes over-the-counter ranitidine, and holds prescriptions for metformin and infliximab. The blood pressure is 132/84 mm Hg, the heart rate is 64/min, the respiratory rate is 14/min, and the temperature is 37.3°C (99.1°F). On physical examination, the abdomen is tender to palpation in the epigastric region. Which of the following is the most appropriate next step to accurately determine the diagnosis of this patient?

• A. Treat with PPI, clarithromycin, and amoxicillin before doing lab and imaging tests
• B. Urea breath testing
• C. Serology for Helicobacter pylori
• D. CT abdomen
• E. Endoscopy with biopsy (Correct Answer)

Gastroenterology Explanation: ***Endoscopy with biopsy*** - Given the patient's age (>50 years), new-onset epigastric pain, history of **peptic ulcer disease**, and "black sometimes" stools suggesting **melena** or **upper gastrointestinal bleeding**, an endoscopy with biopsy is crucial. - This procedure allows direct visualization of the esophageal, gastric, and duodenal mucosa, enabling identification of ulcers, erosions, or masses, and tissue collection for **histopathological examination** (e.g., for *H. pylori* infection, malignancy, or Crohn's disease involvement). *Treat with PPI, clarithromycin, and amoxicillin before doing lab and imaging tests* - This approach, known as **"triple therapy,"** is a treatment for **H. pylori infection**, but it should not be initiated without a confirmed diagnosis in this patient presenting with alarm symptoms. - Doing so without a prior diagnosis could mask underlying pathology, such as **malignancy**, and delay appropriate treatment. *Urea breath testing* - **Urea breath testing** is a non-invasive method to detect active *H. pylori* infection. - While useful, it does not allow for direct visualization of the mucosa or biopsy collection, which is essential given the patient's **alarm features** like age and potential bleeding. *Serology for Helicobacter pylori* - **H. pylori serology** detects antibodies to *H. pylori*, indicating past or present infection. - It cannot differentiate between active and past infection and, importantly, does not provide information about the **mucosal integrity** or allow for biopsy of suspicious lesions. *CT abdomen* - A **CT scan of the abdomen** can visualize abdominal organs and detect masses or significant inflammation. - However, it is not the primary diagnostic tool for evaluating the **upper gastrointestinal mucosa** and cannot directly identify ulcers, erosions, or provide tissue for biopsy in the same way an endoscopy can.

Gastroenterology US Medical PG Question 2: A 45-year-old male presents to his primary care doctor complaining of abdominal pain. He reports a three-month history of intermittent burning pain localized to the epigastrium that worsens 2-3 hours after a meal. He attributes this pain to increased stress at his job. He is otherwise healthy and takes no medications. He does not smoke or drink alcohol. His temperature is 98.8°F (37.1°C), blood pressure is 130/85 mmHg, pulse is 90/min, and respirations are 18/min. Physical examination reveals mild epigastric tenderness to palpation. A urease breath test is positive. Which of the following treatments is most appropriate first-line therapy for this patient?

• A. Octreotide
• B. Sulfasalazine
• C. Amoxicillin, clarithromycin, and omeprazole (Correct Answer)
• D. Tetracycline, omeprazole, bismuth, and metronidazole
• E. Pantoprazole

Gastroenterology Explanation: ***Amoxicillin, clarithromycin, and omeprazole*** - The patient's symptoms (epigastric burning pain worsening 2-3 hours after meals) and a **positive urease breath test** strongly suggest a *Helicobacter pylori* infection causing a peptic ulcer or gastritis. - The standard first-line eradication therapy for *H. pylori* is **triple therapy**, which typically includes a **proton pump inhibitor (PPI)** like omeprazole and two antibiotics, usually **amoxicillin** and **clarithromycin**. *Octreotide* - **Octreotide** is a somatostatin analog used primarily for conditions causing excessive hormone secretion, such as **variceal bleeding**, neuroendocrine tumors (e.g., carcinoid syndrome, VIPomas), and acromegaly. - It is not indicated for the treatment of *H. pylori* infection or peptic ulcer disease in this context. *Sulfasalazine* - **Sulfasalazine** is an anti-inflammatory drug primarily used in the management of **inflammatory bowel disease (IBD)**, such as ulcerative colitis and Crohn's disease, and some forms of rheumatoid arthritis. - It has no role in the eradication of *H. pylori* or the treatment of peptic ulcer disease. *Tetracycline, omeprazole, bismuth, and metronidazole* - This combination, known as **quadruple therapy**, is primarily used as **second-line treatment** for *H. pylori* eradication, especially in cases of **treatment failure** with triple therapy or in areas with **high clarithromycin resistance**. - While effective, it's not the initial first-line approach when there's no known resistance or prior treatment failure. *Pantoprazole* - **Pantoprazole** is a proton pump inhibitor (PPI) that reduces gastric acid secretion and would alleviate the patient's symptoms. - However, using a PPI alone would only suppress symptoms and **would not eradicate the underlying *H. pylori* infection**, allowing the infection and potential ulceration to persist.

Gastroenterology US Medical PG Question 3: A 45-year-old man comes to the emergency department because of a 1-day history of black, tarry stools. He has also had upper abdominal pain that occurs immediately after eating and a 4.4-kg (9.7-lb) weight loss in the past 6 months. He has no history of major medical illness but drinks 3 beers daily. His only medication is acetaminophen. He is a financial consultant and travels often for work. Physical examination shows pallor and mild epigastric pain. Esophagogastroduodenoscopy shows a bleeding 15-mm ulcer in the antrum of the stomach. Which of the following is the strongest predisposing factor for this patient's condition?

• A. Alcohol consumption
• B. Age above 40 years
• C. Helicobacter pylori infection (Correct Answer)
• D. Acetaminophen use
• E. Work-related stress

Gastroenterology Explanation: ***Helicobacter pylori infection*** - The patient presents with classic symptoms of a **peptic ulcer disease** including **melena**, **epigastric pain** immediately after eating, and **weight loss**. While not explicitly mentioned, **H. pylori infection** is the most common cause of gastric and duodenal ulcers, especially in the absence of NSAID use. - The chronic nature of the symptoms and the location of the ulcer in the **antrum** further support H. pylori as the primary predisposing factor, as it leads to mucosal inflammation and damage. *Alcohol consumption* - While **chronic alcohol consumption** can irritate the gastric mucosa and contribute to gastritis, it is generally considered a minor risk factor for peptic ulcer disease compared to H. pylori or NSAID use. - The patient's 3 beers daily is likely not sufficient to directly cause a bleeding gastric ulcer of this magnitude. *Age above 40 years* - **Age** itself is not a direct predisposing factor for peptic ulcers, although the incidence of ulcers tends to increase with age. - This is more likely due to the cumulative exposure to risk factors like H. pylori and NSAIDs over time, rather than age being an independent cause for ulcer formation. *Acetaminophen use* - **Acetaminophen (paracetamol)** is generally considered safe for the gastric mucosa and does not cause ulcers in therapeutic doses, unlike NSAIDs. - It works through a different mechanism of action and does not inhibit cyclooxygenase-1 (COX-1) in the gastric lining, which is responsible for ulcer formation with NSAIDs. *Work-related stress* - While **stress** can exacerbate symptoms of gastrointestinal conditions, it has not been scientifically proven to be a direct cause of peptic ulcer formation. - The role of psychological stress in ulcer genesis is considered minimal compared to established factors like H. pylori and NSAIDs.

Gastroenterology US Medical PG Question 4: A family doctor in a rural area is treating a patient for dyspepsia. The patient had chronic heartburn and abdominal pain for the last 2 months and peptic ulcer disease due to a suspected H. pylori infection. For reasons relating to affordability and accessibility, the doctor decides to perform a diagnostic test in the office that is less invasive and more convenient. Which of the following is the most likely test used?

• A. Steiner's stain
• B. Culture of organisms from gastric specimen
• C. Stool antigen test (Correct Answer)
• D. Detection of the breakdown products of urea in biopsy
• E. Serology (ELISA testing)

Gastroenterology Explanation: ***Stool antigen test*** - This **non-invasive** and **cost-effective** test detects *H. pylori* antigens in stool, making it suitable for a rural setting with limited resources. - It is highly sensitive and specific, useful for both initial diagnosis and confirming eradication after treatment. *Steiner's stain* - **Steiner's stain** (Steiner silver stain) is primarily used for histological visualization of *Legionella* species, and **not for** *H. pylori* detection in routine clinical practice. - It requires an **endoscopic biopsy**, making it more invasive and costly than the stool antigen test. *Culture of organisms from gastric specimen* - This method requires an **endoscopic biopsy** and specialized culture facilities, which may not be available in a rural doctor's office. - It is more expensive and time-consuming, and primarily used when **antibiotic resistance** is suspected. *Detection of the breakdown products of urea in biopsy* - This refers to the **rapid urease test** (e.g., CLOtest), which is performed on a **gastric biopsy** obtained during endoscopy. - While quick, it is an **invasive procedure** requiring endoscopy, which contradicts the patient's and doctor's preferences for a less invasive test. *Serology (ELISA testing)* - **Serology** detects antibodies to *H. pylori* but cannot differentiate between **active infection** and **past exposure**. - Its utility in monitoring eradication is limited, and it's generally not recommended as the primary diagnostic test due to its inability to confirm active infection.

Gastroenterology US Medical PG Question 5: A 52-year-old man comes to the physician because of a 3-month history of upper abdominal pain and nausea that occurs about 3 hours after eating and at night. These symptoms improve with eating. After eating, he often has a feeling of fullness and bloating. He has had several episodes of dark stools over the past month. He has smoked one pack of cigarettes daily for 40 years and drinks 2 alcoholic beverages daily. He takes no medications. His temperature is 36.4°C (97.5°F), pulse is 80/min, and blood pressure is 110/70 mm Hg. Abdominal examination shows epigastric tenderness with no guarding or rebound. Bowel sounds are normal. Which of the following treatments is most appropriate to prevent further complications of the disease in this patient?

• A. Intravenous vitamin B12 supplementation
• B. Truncal vagotomy
• C. Amoxicillin, clarithromycin, and omeprazole (Correct Answer)
• D. Fundoplication, hiatoplasty, and gastropexy
• E. Distal gastrectomy with gastroduodenostomy

Gastroenterology Explanation: ***Amoxicillin, clarithromycin, and omeprazole*** - This patient's symptoms (epigastric pain 3 hours after eating and at night, improvement with eating, dark stools) are highly suggestive of a **duodenal ulcer complicated by upper gastrointestinal bleeding**. The most common cause of duodenal ulcers is *H. pylori* infection. - The recommended first-line treatment for *H. pylori* infection involves a triple therapy regimen, including two antibiotics (like **amoxicillin and clarithromycin**) to eradicate the bacteria and a **proton pump inhibitor (omeprazole)** to reduce acid production and promote ulcer healing. *Intravenous vitamin B12 supplementation* - This treatment is appropriate for **vitamin B12 deficiency**, which can occur in conditions like atrophic gastritis, pernicious anemia, or following gastric resections, but is not indicated for acute peptic ulcer disease and wouldn't address the primary pathology. - There is no clinical indication in the patient's presentation (e.g., neurological symptoms, macrocytic anemia) to suggest a deficiency in vitamin B12. *Truncal vagotomy* - **Truncal vagotomy** is a surgical procedure that was historically performed to reduce gastric acid secretion by cutting the vagus nerve. It is rarely used now due to the effectiveness of medical therapies for peptic ulcer disease. - This invasive surgical option is generally reserved for refractory cases of peptic ulcer disease not responsive to medical management, or when complications like uncontrolled bleeding or perforation necessitate surgical intervention. *Fundoplication, hiatoplasty, and gastropexy* - These surgical procedures are primarily used to treat **gastroesophageal reflux disease (GERD)** and **hiatal hernia**, not peptic ulcer disease. - Fundoplication wraps the stomach fundus around the lower esophagus to reinforce the lower esophageal sphincter, addressing reflux symptoms which are not the primary complaint here. *Distal gastrectomy with gastroduodenostomy* - **Distal gastrectomy** is a major surgical procedure involving the removal of the distal part of the stomach. It is typically reserved for severe complications of peptic ulcer disease (e.g., perforation, obstruction, recurrent bleeding unresponsive to other treatments) or gastric cancer. - While it might be considered in extreme cases of complicated peptic ulcer, it is not the initial or most appropriate treatment for preventing further complications in a patient who has yet to receive standard anti-*H. pylori* therapy.

Gastroenterology US Medical PG Question 6: A previously healthy 37-year-old man comes to the physician for the evaluation of an 8-week history of intermittent burning epigastric pain. During this period, he has also felt bloated and uncomfortable after meals. He has not had weight loss or a change in bowel habits. He has no personal or family history of serious illness. He takes no medications. He does not smoke. He drinks 1–3 beers per week. Vital signs are within normal limits. Abdominal examination shows mild epigastric tenderness on palpation without guarding or rebound tenderness. Bowel sounds are normal. The remainder of the examination shows no abnormalities. Which of the following is the most appropriate next step in management?

• A. Urea breath test (Correct Answer)
• B. Helicobacter pylori eradication therapy
• C. Helicobacter pylori serum IgG
• D. Upper gastrointestinal endoscopy
• E. Proton pump inhibitors

Gastroenterology Explanation: ***Urea breath test*** - The patient presents with classic symptoms of **dyspepsia**, and given his age (<60 years) and absence of **alarm symptoms** (e.g., weight loss, dysphagia, GI bleeding), an initial non-invasive test for **_Helicobacter pylori_** is appropriate. - A **urea breath test** is a highly sensitive and specific non-invasive method to detect active _H. pylori_ infection. *Helicobacter pylori eradication therapy* - This therapy should only be initiated after a confirmed diagnosis of **_H. pylori_ infection**. - Treating empirically without confirmation can lead to **antibiotic resistance** and unnecessary side effects. *Helicobacter pylori serum IgG* - A serum IgG test indicates only **prior exposure** to _H. pylori_ and does not distinguish between active and past infection. - Therefore, it is **not suitable for diagnosing current active infection** or for confirming eradication. *Upper gastrointestinal endoscopy* - **Upper GI endoscopy** is indicated for patients over 60 with new-onset dyspepsia, or for those younger than 60 who present with **alarm symptoms** (e.g., weight loss, dysphagia, recurrent vomiting, GI bleeding, anemia). - This patient currently has no alarm symptoms, making endoscopy an overly aggressive initial approach. *Proton pump inhibitors* - While **PPIs** are effective for symptom relief in dyspepsia, they can mask underlying _H. pylori_ infection or other serious conditions if used empirically without proper investigation. - Furthermore, PPIs can cause **false-negative results** for _H. pylori_ tests like the urea breath test, so they should ideally be stopped for 1-2 weeks before testing.

Gastroenterology US Medical PG Question 7: A 47-year-old man presents with recurrent epigastric pain and diarrhea. He has had these symptoms for the last year or so and has been to the clinic several times with similar complaints. His current dosage of omeprazole has been steadily increasing to combat his symptoms. The pain seems to be related to food intake. He describes his diarrhea as watery and unrelated to his meals. Blood pressure is 115/80 mm Hg, pulse is 76/min, and respiratory rate is 19/min. He denies tobacco or alcohol use. An upper endoscopy is performed due to his unexplained and recurrent dyspepsia and reveals thickened gastric folds with three ulcers in the first part of the duodenum, all of which are negative for H. pylori. Which of the following is the best next step in this patient's management?

• A. Fasting serum gastrin levels (Correct Answer)
• B. Secretin stimulation test
• C. CT scan of the abdomen
• D. Somatostatin receptor scintigraphy
• E. Serum calcium levels

Gastroenterology Explanation: ***Fasting serum gastrin levels*** - The patient's presentation with **recurrent epigastric pain**, **multiple duodenal ulcers**, **thickened gastric folds**, and the need for **increasing dosages of omeprazole** strongly suggests **Zollinger-Ellison syndrome (ZES)**, caused by a gastrinoma. - **Fasting serum gastrin levels** are the initial diagnostic test for ZES; elevated levels confirm excessive gastrin production. *Secretin stimulation test* - This test is typically performed when **fasting serum gastrin levels are equivocal** (e.g., mildly elevated) to confirm the diagnosis of ZES. - It is not the initial best step, as **fasting gastrin levels** are simpler and often sufficient for initial diagnosis. *CT scan of the abdomen* - A CT scan is used for **tumor localization** after a diagnosis of ZES has been established. - It is not the primary diagnostic test for ZES itself, as it won't directly measure gastrin levels. *Somatostatin receptor scintigraphy* - This imaging study is highly sensitive for **localizing gastrinomas**, especially in metastatic disease, and is often used after biochemical confirmation of ZES. - It is not indicated as the initial diagnostic step and is part of the work-up for staging rather than diagnosis. *Serum calcium levels* - While **hypercalcemia** can be associated with **Multiple Endocrine Neoplasia type 1 (MEN1)**, which includes gastrinomas, it is not the best initial diagnostic test for Zollinger-Ellison syndrome itself. - Elevated calcium would be a secondary finding, and direct measurement of gastrin is essential for diagnosing ZES.

Gastroenterology US Medical PG Question 8: A 52-year-old woman presents with mild epigastric pain and persistent heartburn for the past 2 months. An endoscopy is performed and reveals inflammation of the stomach mucosa without evidence of ulceration. A biopsy is performed and reveals intestinal metaplasia with destruction of a large number of parietal cells. She is diagnosed with chronic atrophic gastritis. Which of the following is characteristic of this patient’s diagnosis?

• A. Serum gastrin levels are decreased.
• B. Caused by a gram-negative rod that is urease positive
• C. It is the most common cause of folate deficiency in the US.
• D. Destruction of the mucosa of the stomach is mediated by T cells. (Correct Answer)
• E. MALT lymphoma is a common complication.

Gastroenterology Explanation: ***Destruction of the mucosa of the stomach is mediated by T cells.*** - The type of chronic atrophic gastritis described, characterized by **parietal cell destruction** and **intestinal metaplasia**, is consistent with **autoimmune gastritis** (Type A gastritis). - Autoimmune gastritis is mediated by **T cells** attacking gastric parietal cells, leading to their destruction and subsequent **achlorhydria** and loss of intrinsic factor. *Serum gastrin levels are decreased.* - Destruction of **parietal cells** leads to **achlorhydria** (lack of gastric acid), which removes the negative feedback on **G cells**. - This results in **compensatory hypergastrinemia**, meaning serum gastrin levels are typically *elevated*, not decreased. *Caused by a gram-negative rod that is urease positive* - This describes **Helicobacter pylori infection**, which is the cause of **Type B gastritis** (environmental chronic atrophic gastritis) and typically affects the antrum. - The patient's presentation with **destruction of parietal cells** and **intestinal metaplasia** is more consistent with **autoimmune (Type A) gastritis**, which is not caused by H. pylori. *It is the most common cause of folate deficiency in the US.* - **Folate deficiency** is more commonly associated with **poor dietary intake**, **alcoholism**, malabsorption disorders (e.g., celiac disease), and certain medications. - While chronic atrophic gastritis can lead to **vitamin B12 deficiency** due to loss of intrinsic factor, it is not the most common cause of folate deficiency. *MALT lymphoma is a common complication.* - **MALT (mucosa-associated lymphoid tissue) lymphoma** is a known complication of chronic **H. pylori infection**, especially when it leads to gastritis and lymphoid follicle formation. - While chronic inflammation is a risk factor for malignancy, MALT lymphoma is less commonly associated with **autoimmune gastritis** compared to H. pylori-induced gastritis.

Gastroenterology US Medical PG Question 9: A 28-year-old male presents to his primary care physician with complaints of intermittent abdominal pain and alternating bouts of constipation and diarrhea. His medical chart is not significant for any past medical problems or prior surgeries. He is not prescribed any current medications. Which of the following questions would be the most useful next question in eliciting further history from this patient?

• A. "Does the diarrhea typically precede the constipation, or vice-versa?"
• B. "Is the diarrhea foul-smelling?"
• C. "Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life"
• D. "Are the symptoms worse in the morning or at night?"
• E. "Can you tell me more about the symptoms you have been experiencing?" (Correct Answer)

Gastroenterology Explanation: ***Can you tell me more about the symptoms you have been experiencing?*** - This **open-ended question** encourages the patient to provide a **comprehensive narrative** of their symptoms, including details about onset, frequency, duration, alleviating/aggravating factors, and associated symptoms, which is crucial for diagnosis. - In a patient presenting with vague, intermittent symptoms like alternating constipation and diarrhea, allowing them to elaborate freely can reveal important clues that might not be captured by more targeted questions. *Does the diarrhea typically precede the constipation, or vice-versa?* - While knowing the sequence of symptoms can be helpful in understanding the **pattern of bowel dysfunction**, it is a very specific question that might overlook other important aspects of the patient's experience. - It prematurely narrows the focus without first obtaining a broad understanding of the patient's overall symptomatic picture. *Is the diarrhea foul-smelling?* - Foul-smelling diarrhea can indicate **malabsorption** or **bacterial overgrowth**, which are important to consider in some gastrointestinal conditions. - However, this is a **specific symptom inquiry** that should follow a more general exploration of the patient's symptoms, as it may not be relevant if other crucial details are missed. *Please rate your abdominal pain on a scale of 1-10, with 10 being the worst pain of your life* - Quantifying pain intensity is useful for assessing the **severity of discomfort** and monitoring changes over time. - However, for a patient with intermittent rather than acute, severe pain, understanding the **character, location, and triggers** of the pain is often more diagnostically valuable than just a numerical rating initially. *Are the symptoms worse in the morning or at night?* - Diurnal variation can be relevant in certain conditions, such as inflammatory bowel diseases where nocturnal symptoms might be more concerning, or functional disorders whose symptoms might be stress-related. - This is another **specific question** that should come after gathering a more complete initial picture of the patient's symptoms to ensure no key information is overlooked.

Gastroenterology US Medical PG Question 10: A 55-year-old female presents to clinic with recurrent episodes of abdominal discomfort and pain for the past month. She reports that the pain occurs 2-3 hours after meals, usually at midnight, and rates it as moderate to severe in intensity when it occurs. She also complains of being fatigued all the time. Past medical history is insignificant. She is an office secretary and says that the job has been very stressful recently. Her temperature is 98.6°F (37.0°C), respiratory rate is 15/min, pulse is 67/min, and blood pressure is 122/98 mm Hg. Her BMI is 34. A physical examination reveals conjunctival pallor and mild tenderness over her epigastric region. Blood tests show: Hb%: 10 gm/dL Total count (WBC): 11,000 /mm3 Differential count: Neutrophils: 70% Lymphocytes: 25% Monocytes: 5% ESR: 10 mm/hr Which of the following is the most likely diagnosis?

• A. Pancreatitis
• B. Acute cholecystitis
• C. Duodenal peptic ulcer (Correct Answer)
• D. Gallbladder cancer
• E. Choledocholithiasis

Gastroenterology Explanation: ***Duodenal peptic ulcer*** - The patient's symptoms, including **abdominal pain 2-3 hours after meals** and **midnight pain**, are classic for a duodenal ulcer. This pain pattern is due to the buffering effect of food wearing off, allowing acid to irritate the ulcer. - The presence of **conjunctival pallor** and **anemia (Hb% 10 gm/dL)** suggests **chronic blood loss**, which is a common complication of peptic ulcers. *Pancreatitis* - Pancreatitis typically presents with **severe, epigastric pain radiating to the back**, often exacerbated by fatty meals. - Lab findings would usually show **elevated amylase and lipase**, which are not mentioned here. *Acute cholecystitis* - Characterized by **right upper quadrant pain** that is often constant and severe, sometimes radiating to the right shoulder or back. - This condition is usually associated with **fever**, **leukocytosis**, and **Murphy's sign**, which are absent in this presentation. *Gallbladder cancer* - While it can cause abdominal pain and weight loss, the classic cyclical pain pattern linked to meals is not characteristic. - It often presents with **jaundice** in advanced stages, which is not noted in this patient. *Choledocholithiasis* - Typically presents with **biliary colic**, which is episodic, severe right upper quadrant or epigastric pain, often radiating to the back. - It can lead to **obstructive jaundice** and **cholangitis**, symptoms not reported by the patient.

Gastroenterology Flashcard 1 of 10

Question: Clostridium difficile is a nosocomial infection that commonly follows _____ use

Answer: antibiotic (ie: ampicillin, clindamycin) (2 examples)

Gastroenterology Flashcard 2 of 10

Question: Gastric ulcers are usually due to _____ (~ 70%)

Answer: H. pylori

Gastroenterology Flashcard 3 of 10

Question: What is the most common (90%) form of chronic gastritis? _____

Answer: Chronic H. pylori gastritis

Gastroenterology Flashcard 4 of 10

Question: Helicobacter pylori infection can result in a(n) _____ anemia

Answer: iron deficiency

Gastroenterology Flashcard 5 of 10

Question: Duodenal ulcers are almost always due to _____ (~ 90%) and why?

Answer: H. pylori

Gastroenterology Flashcard 6 of 10

Question: benign prostatic hyperplasia (BPH)

Answer:

Extra Information: nodular enlargement of the periurethral (lateral and middle) lobes of the prostate, compressing the urethraurinary frequency, nocturia, difficulty starting/stopping flos, dysuriaincreased: free prostate-specific antigen (PSA)α1-antagonists (terazosin, tamsulosin); finasteridemen >50 y/ohyperplasia, NOT hypertrophyif untreated may lead to distention and hypertrophy of bladder, hydronephrosis, UTIs

Gastroenterology Flashcard 7 of 10

Question: vertigo

Answer: sensation of spinning while stationary; subtype of "dizziness" but distinct from "lightheadedness"

Gastroenterology Flashcard 8 of 10

Question: hypertriglyceridemia (hyperlipidemia type IV)

Answer:

Extra Information: defect in production of VLDLpancreatitiselevated VLDL and TGAD

Gastroenterology Flashcard 9 of 10

Question: Which parasitic infection can present with cysts in the brain? _____

Answer: Neurocysticercosis (Taenia solium)

Extra Information:  https://onlinemeded.org/spa/microbiology/helminths/acquire?ref=anki 

Gastroenterology Flashcard 10 of 10

Question: _____ is a cancer caused by HPV in HIV patients that often presents at the anus (in MSMs) or the cervix

Answer: Squamous Cell Carcinoma

Extra Information:   Watch Human papillomavirus (Papillomaviridae) [https://dashboard.sketchy.com/study/medical/courses/medical-microbiology/units/medical-microbiology-viruses/videos/medical-microbiology-viruses-dna-viruses-human-papillomavirus-papillomaviridae?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] Watch Anorectal Disorders [https://dashboard.sketchy.com/study/medical/courses/medical-microbiology/units/medical-microbiology-viruses/videos/medical-microbiology-viruses-dna-viruses-cytomegalovirus-herpesviridae?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] https://onlinemeded.org/spa/microbiology/dna-viruses/acquire?ref=anki