Clinical management scenarios for GI bleeding, liver disease, and pancreatitis tested on USMLE Step 2 CK.
40 cards · basic cards · AI-written, checked twice. Edit anything.
- What is the first priority in managing a hemodynamically unstable patient with upper GI bleeding, before endoscopy?
- Aggressive IV fluid resuscitation with crystalloids to restore hemodynamic stability
- In a hemodynamically stable patient with upper GI bleeding, below what hemoglobin level should transfusion generally be started?
- 7 g/dL (restrictive transfusion strategy)
- What is the most common cause of upper GI bleeding?
- Peptic ulcer disease
- Which medication is started empirically for suspected variceal hemorrhage before endoscopy?
- Octreotide
- Why are antibiotics such as ceftriaxone given prophylactically to cirrhotic patients with upper GI bleeding?
- They lower the risk of infection (SBP), rebleeding, and mortality
- Within what time frame should upper endoscopy be performed for acute upper GI bleeding?
- Within 24 hours of presentation
- Which Forrest classification finding carries the highest risk of rebleeding from a peptic ulcer?
- Forrest Ia, active spurting hemorrhage
- What procedure is indicated for esophageal variceal bleeding refractory to endoscopic therapy?
- Transjugular intrahepatic portosystemic shunt (TIPS)
- What is the most common cause of lower GI bleeding in adults over age 60?
- Diverticulosis
- What is the diagnostic test of choice for lower GI bleeding once the patient is stabilized?
- Colonoscopy
- ____ is a transmural esophageal rupture caused by forceful vomiting.
- Boerhaave syndrome
- Mucosal tear at the gastroesophageal junction caused by forceful vomiting or retching
- Mallory-Weiss tear
- What is recommended for primary prophylaxis of a first variceal bleed in a cirrhotic patient with high-risk varices?
- A nonselective beta blocker (propranolol or nadolol) or endoscopic variceal band ligation
- What is the most common cause of chronic liver disease in the United States?
- Nonalcoholic fatty liver disease (NAFLD)
- What is the gold standard test for diagnosing cirrhosis and staging fibrosis?
- Liver biopsy