Amedco - Quiz

July 2017 JPGN


A   - Mycophenolate Mofetil
B   - Cyclosporine
C   - Tacrolimus
D   - Budesonide

A   - hirsutism
B   - hypertension
C   - hypertrichosis
D   - diarrhea

A   - Tacrolimus
B   - Cyclosporine
C   - Mycophenolate mofetil
D   - Unclear based on current data available.

A   - Alternative first line therapeutic options to prednisone +/- azathioprine currently include cyclosporine and budesonide
B   - Response to therapy is defined as minimal or no serum AST or ALT abnormality on the lowest dose of medication possible, in addition to low Immunoglobulin level and minimal or no inflammation on liver biopsy
C   - Budesonide is contraindicated in children with cirrhosis
D   - Patients with autoimmune sclerosing cholangitis have more difficult to treat disease

A   - Mycophenolate mofetil is a good second-line treatment option for children with autoimmune hepatitis
B   - Mycophenolate mofetil is a prodrug that increased T cell and B cell proliferation
C   - Mycophenolate mofetil has a mild side effect profile that is well tolerated by most patients.
D   - Mycophenolate mofetil is easy to start based on simple monitoring and infrequent need for blood work compared to other second-line therapeutic options in autoimmune hepatitis.

A   - The esophagus should not be biopsied because it is normal in appearance.
B   - The distal esophagus only should be biopsied because this will likely detect esophageal reflux.
C   - Four biopsies of the distal esophagus should be collected because eosinophilic esophagitis is a patchy condition.
D   - At least two areas of the esophagus should be biopsied because eosinophilic esophagitis is patchy and may be present despite grossly normal esophageal mucosa.

A   - Visually inspect the duodenum, stomach and esophagus and base the need for biopsy upon gross appearance
B   - Biopsy the distal duodenum and esophagus regardless of gross appearance
C   - Biopsy the distal duodenum and collect two esophageal biopsies if these areas appear abnormal
D   - Biopsy the distal duodenum, duodenal bulb, and collect biopsies from at least two separate areas of the esophagus, regardless of visual appearance.

A   - Positive ImmunoCAP testing to a common food allergen (ie, milk, soy, or egg)
B   - 15 or more eosinophils in at least one microscopy high power field on esophageal biopsy
C   - Persistence of esophageal eosinophilia following a proton pump inhibitor trial
D   - Clinical symptoms such as vomiting, food impactions, or heartburn.

A   - During endoscopy for a patient who may have eosinophilic esophagitis, biopsy of the stomach and duodenum are also recommended by diagnostic guidelines.
B   - During endoscopy for a patient who may have celiac disease, biopsy of the esophagus and stomach are also recommended per diagnostic guidelines to exclude intraepithelial lymphocytosis extending beyond the duodenum.
C   - A diagnosis of celiac disease is excluded in a patient lacking clinical symptoms.
D   - A diagnosis of eosinophilic esophagitis is excluded in a patient with one histologically normal biopsy submitted to the pathologist.