GI Health Maintenance

Question 1

What cancer are the following risk factors for: older than 50, h/o polyps, inflammatory bowel dz, african american or jewish descent, type II DM

Answer 1

colorectal cancer

Question 2

Type of polyps that do NOT increase risk of colorectal cancer

Answer 2

hyperplastic

Question 3

Mutation in what gene is related to familial adenomatous polyposis?

Answer 3

APC gene

Question 4

develop thousands of polyps in the colon and rectum from teens to early adulthood. Cancer develops as early as age 20. By age 40 almost all people with this disorder have colon cancer if the colon isn’t removed to prevent it

Answer 4

familial adenomatous polyposis

Question 5

Defect in either the gene MLH1 or MSH2 but can be caused by other gene mutations. Multiple polyps develop. Lifetime risk of colorectal cancer in people with this condition may be 80%. Women with this are susceptible to endometrial cancer

Answer 5

HNPCC aka Lynch syndrome

Question 6

Treatment of what previous cancers increases risk for colorectal cancer?

Answer 6

testicular and prostate cancer

Question 7

Screening procedure that doesn’t require sedation or a specialist. Done every 5 yrs. Only views 1/3 of colon.

Answer 7

flexible sigmoidoscopy

Question 8

Preferred screening method that can view entire colon. Can biopsy and remove polyps. Done every 10 yrs. Requires full bowel prep and sedation

Answer 8

colonoscopy

Question 9

Screening procedure that can view entire colon. Doesn’t require sedation. Need full bowel prep and done every 5 yrs. Can’t remove polyps and can only detect polyps >1cm

Answer 9

double contrast barium enema

Question 10

Screening procedure that can view entire colon, is done every 5 yrs, requires bowel prep, doesn’t require sedation. Will need colonoscopy if abnormal

Answer 10

virtual colonoscopy

Question 11

Test that doesn’t require bowel prep, done at home, has to be done yearly, and require 3 different stool samples. May produce a lot of false positives

Answer 11

Fecal occult blood test (FOBT)

Question 12

Dietary restrictions for Fecal occult blood test (FOBT)

Answer 12

avoid NSAIDs, vitamin C, red meats

Question 13

What is the main difference between fecal immunochemical test (FIT) and Fecal occult blood test (FOBT)?

Answer 13

No pre-test dietary or medication restrictions for FIT

Question 14

At what age should African Americans begin colonoscopies?

Answer 14

45 yrs

Question 15

How often should a patient with inflammatory bowel disease (UC and Crohn’s) have a colonoscopy?

Answer 15

every 1-2 yrs

Question 16

How often should a patient with a personal h/o of adenomatous polyps or colon cancer have a colonoscopy?

Answer 16

1 yr post resection then every 3-5 yrs

Question 17

At what age should should a patient with familial adenomatous polyposis begin colorectal screening?

Answer 17

yearly flexible sigmoidoscopy beginning at age 10-12 years

Question 18

At what age should a patient with hereditary nonpolyposis colon cancer (HNPCC) being colorectal screening?

Answer 18

colonoscopy every 1-2 years beginning at age 20-25 years or 10 years before the youngest case in the immediate family

Question 19

What cancer are the following risk factors for: HBV, HCV, hereditary hemochromatosis, cirrhosis?

Answer 19

Hepatocellular carcinoma

Question 20

What patient populations are screened for hepatocellular carcinoma?

Answer 20

all cirrhotic patients and those w/chronic Hep B who are Asian/African or have family h/o

Question 21

If Casper the Ghost (who is obviously caucasian) had a chronic Hepatitis B + infection, what would be the screening guidelines for him?

Answer 21

Start men > 40. His girlfriend would start screening at 50 yrs

Question 22

What is the recommended screening test for hepatocellular carcinoma?

Answer 22

liver ultrasound every 6 months

Question 23

What cancer has the following risk factors: >55yrs, male, ETOH/tobacco use, obesity, and diet high in processed meats?

Answer 23

esophageal cancer

Question 24

Term for narrowing of distal esophagus

Answer 24

achalasia

Question 25

Term for esophageal papillomas

Answer 25

tylosis

Question 26

Medical conditions that can benefit from increasing the intake of dietary fiber

Answer 26

hemorrhoids, constipation, diarrhea, diverticulosis

Question 27

helps pull water into the colon making the stool softer and easier to pass and helps treat constipation

Answer 27

insoluble fiber

Question 28

helps to absorb water from the colon and can bulk up the stool to treat chronic diarrhea

Answer 28

soluble fiber

Question 29

Complications of chronic constipation

Answer 29

hemorrhoids, anal fissures, diverticulosis

Question 30

Daily fiber recommendations for men and women

Answer 30

Women - 25 grams per day. Men - 38 grams per day

Question 31

Percent of population between ages of 60 and 80 that have diverticular disease

Answer 31

~50%

Question 32

Risk factors for this medical condition include: large meals, laying down after a meal, obesity, ETOH, carbonation, coffee, tea, smoking, pregnancy

Answer 32

GERD

Question 33

What condition do the following meds cause to worsen: NSAIDs, beta-blockers, Ca channel blockers, bronchodilators, TCAs, Dopamine active drugs?

Answer 33

GERD