Gastroenterology
📚 Ace Gastroenterology on USMLE Step 2 CK!
This high-yield rapid review covers the most frequently tested GI topics, helping you maximize your score!
🔹 Esophageal Disorders
✅ GERD:
Heartburn, regurgitation, cough;
Dx: pH monitoring; Tx: PPIs
✅ Achalasia:
Dysphagia to both solids & liquids, bird’s beak on barium swallow;
Tx: Myotomy, Botox
✅ Esophageal cancer:
Squamous cell (upper 2/3) – smoking/alcohol,
Adenocarcinoma (lower 1/3) – Barrett’s;
Dx: Endoscopy with biopsy
🔹 Peptic Ulcer Disease & H. pylori
✅ Duodenal ulcers: Pain improves with food
✅ Gastric ulcers: Pain worsens with food
✅ H. pylori diagnosis: Urea breath test, stool antigen
✅ Tx: Triple therapy – PPI + Clarithromycin + Amoxicillin (or Metronidazole)
🔹 Hepatology (Liver Disorders)
✅ Hepatitis B & C: B – DNA virus, C – RNA virus, chronic risk
✅ Cirrhosis Complications: Portal HTN → Varices, Ascites, Hepatic Encephalopathy (Tx: Lactulose)
✅ Nonalcoholic Fatty Liver Disease (NAFLD): Obesity-related, ALT > AST, Tx: Lifestyle modification
🔹 Inflammatory Bowel Disease (IBD)
✅ Ulcerative Colitis: Continuous, mucosal inflammation, rectal involvement, Tx: 5-ASA, steroids, colectomy for severe disease
✅ Crohn’s Disease: Skip lesions, transmural, fistulas, Tx: Immunomodulators (Azathioprine), TNF inhibitors
🔹 Pancreatic Disorders
✅ Acute Pancreatitis: Epigastric pain radiating to back, ↑ Lipase >3x, Tx: NPO, IV fluids, pain control
✅ Chronic Pancreatitis: Calcifications + Steatorrhea + Diabetes, Tx: Enzyme replacement
✅ Pancreatic Cancer: Painless jaundice, Courvoisier’s sign, Dx: CT scan
🔹 Biliary Disease
✅ Cholelithiasis (Gallstones): RUQ pain after fatty meals, Dx: US
✅ Cholecystitis: Murphy’s sign, Dx: US, HIDA scan if unclear
✅ Choledocholithiasis: Dilated ducts, ↑ Bilirubin, Tx: ERCP
💡 USMLE Pro Tips:
✔ Understand pathophysiology – not just memorization
✔ Know key diagnostic tests – US vs CT vs Endoscopy
✔ Management is key! First-line vs definitive therapy
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