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Systemic Disease > 07. GI > Flashcards

07. GI Flashcards

1
Q

GERD is incompetence of what?

A

Lower esophageal sphincter

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2
Q

Prolonged GERD may lead to what?

A

Esophagitis and stricture

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3
Q

What are the 3 types of stricture in GERD?

A

*Barett’s esophagitis
Metaplasia
Pre-cancerous

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4
Q

GERD may indicate what?

A

Hiatus hernia - protrusion of the stomach throught the diaphragm

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5
Q

What are typical Txs for GERD?

A 
Proton pump inhibitors
Prikinetics
H2 blockers
Lifestyle change
Surgical repair of hernia
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6
Q

What causes gastritis?

A

Helicobacter pylori

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7
Q

Is helicobacter gram positive or negative?

A

Negative - can live in an acid environment

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8
Q

What are the signs and symptoms of gastritis?

A

Dyspepsia
Bleeding of gastric mucosa
Peptic ulcer disease

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9
Q

What is chronic pancreatitis?

A

Persistent inflammation of the pancreas

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10
Q

What are the 2 typical causes of chronic pancreatitis?

A

Chronic alcohol abuse

Idiopathic

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11
Q

What are the symptoms of pancreatitis?

A

Recurrent attacks of pain

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12
Q

What are the 2 complications of chronic pancreatitis?

A

Mal-absorption and glucose intolerance

Diabetes

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13
Q

What are the retinal signs of chronic pancreatitis?

A

Ischemic retinopathy (CWS, NFL hemes, diffuse edema, capillary non-perfusion on ICG)

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14
Q

Ischemic retinopathy from chronic pancreatitis appears similar to what?

A

Purtscher’s retinopathy

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15
Q

What are the etiologies of ischemic retinopathy due to chronic pancreatitis?

A

Fat emboli
Complement induced leukocyte aggregation
Fibrin embolization

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16
Q

What is the common name for gastroenteritis?

A

Stomach flu

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17
Q

Gastroenteritis is an inflammation of what?

A

Stomach and small intestines

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18
Q

What are the typical causes of gastroenteritis?

A

Viral (norovirus, rotavirus, adenovirus)
Bacterial (clostridium, slamonella, shigella…)
Parasitic (giardia)

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19
Q

What is the correct term for Gardner’s syndrome?

A

Familial adeno-polyposis

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20
Q

What is the inheritance of Gardner’s?

A

AD

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21
Q

What 3 things are included in the syndrome that makes up Gardner’s syndrome?

A

Intestinal polyposis
Soft tissue tumors
Benign osseous bone growths

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22
Q

What are the 2 GI signs of Gardner’s?

A

Intestinal polyposis

Adenocarcinoma of the colon

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23
Q

What is the most important musculoskeletal finding in Gardner’s?

A

Osteomas of the skull and facial bones

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24
Q

What are the 2 major dermatologic findings in Familial Adeno-Polyposis?

A

Epidermoid cysts

Neurofibromas

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25
Q

What are the typical retinal findings in Gardner’s?

A

Multiple foci of RPE hypertrophy

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26
Q

What is Crohn’s disease?

A

IBS - chronic inflammatory disease that usually affects the distal ileum

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27
Q

Crohn’s is typically in the distal ileum, but can occur where else?

A

Anywhere in the GI tract

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28
Q

What gene is associated with Crohn’s?

A

HLA-B27

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29
Q

Crohn’s is associated with what other autoimmune diseases?

A

Ankylosing spondylitis

Erythema Nodosum

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30
Q

What are the “important” ocular findings in Crohn’s?

A 
Decreased tears - reduced vitamin A
Night blindness
Repeated sub-conj hemorrhages
Non-granulomatous episcleritis
Scleritis and scleromalacea
Chronic pan-uveitis
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31
Q

What is definitive for Crohn’s?

A

X-ray, barium enema with string sign

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32
Q

What characterizes ulcerative colitis?

A

Chronic inflammation and ulcerative disease of the colon

33
Q

What other symptoms/signs are associated with ulcerative colitis?

A

Bloody diarrhea
Mouth ulcers
Erythema nodosum
Finger clubbing

34
Q

What ocular findings are seen with ulcerative colitis?

A

Acute anterior uveitis
Peripheral corneal infiltrates
Conjunctivitis

35
Q

What causes Whipple’s disease?

A

Bacterial infection of Tropheryma whippeli

36
Q

Whipple disease mostly affects what?

A

Intestinal tract

37
Q

What are the typical findings of Whipple?

A

Fever, cough, diarrhea, arthralgia, anemia, weight loss
Small, white vitreous opacities
Retinal hemes/exudates
Exudative material over the pars plana

38
Q

What are the classic signs of Celiac?

A

Malabsorption - diarrhea, steatorrhea, adominal distention, muscle wasting, growth retardation

39
Q

What age range is less likely to GI symptoms of Celiac?

A

Adults or older children

40
Q

What percent of Celiac pts have positive serologic tests?

A

40%

41
Q

What is the serology oc Celiac?

A

IgA tissue transglutaminase (IgA tTg) antibody - 95% sensitive and specific

42
Q

What test gives the confirmatory Dx of celiac?

A

Endoscopic biopsy of the proximal dudenum and distal duodenum

43
Q

What are the 2 most “important” esophageal cancers?

A

Squamous cell carcinoma

Adenocarcinoma

44
Q

What part of the esophagus typically contracts a squamous cell carcinoma?

A

Proximal 2/3

45
Q

What are the risk factors for an esophageal squamous cell?

A

Smoking

Alcohol intake

46
Q

Where in the esophagus does an adenocarcinoma typically occur?

A

Distal 1/3

47
Q

What typically causes an esophageal adenocarcinoma?

A

Reflux esophagitis

48
Q

Reflux esophagitis will more commonly lead to what, rather than adenocarcinoma?

A

Barrett’s esophagitis

49
Q

What most commonly causes stomach cancer?

A

H Pylori

50
Q

What are some examples of monogenic disorders?

A 
Thalassemia
Sickle cell
Hemophilia
Cystic fibrosis
Tay Sachs
51
Q

How does trisomy 21 occur?

A

Chromosome 21 is trans-located to another location

52
Q

Down’s typically presents with what?

A 
Decreased muscle tone as infants
Mental retardation
Characteristic flat face, slanting eyes, irregular ears
Microcephaly
Short stature
Extensible joints
53
Q

What characteristic of Down’s is detected by ultrasound?

A

Extra skin around the neck

54
Q

Why is a Down’s patient’s lifespan typically short?

A

Heart disease

Increased incidence of leukemia

55
Q

What are 2 common systemic diseases in Down’s?

A

Hypothyroidism

Diabetes

56
Q

Down’s patients commonly have an early onset of what disease?

A

Alzheimer’s

57
Q

What are the “important” ocular findings associated with Down’s?

A

K-cone

Brushfield’s spots

58
Q

What is Turner’s Syndrome?

A

Partial/complete monosomy of X chromosome in females

59
Q

Turner’s syndrome is an issue with what chromosome?

A

X

60
Q

What are the “important” systemic findings in Turner’s syndrome?

A

Thyroid disorders
Cardiac disease
Short, webbed neck
Anomalous external ears

61
Q

What are the “important” ocular findings in Turner’s?

A

Blue sclera
Microcornea
K-cone
Brushfield’s spots

62
Q

Klinefelter’s syndrome is an anomaly of what gene?

A

X

63
Q

Klinefelter’s results in a phenotypical (male/female)

A

Female

64
Q

What is the gene anomaly in Klinefelter’s?

A

Double X

65
Q

What are typical findings in Klinefelters?

A

Tall (Marfanoid)
Learning difficulties
Verbal IQ deficits, auditory processing, reading difficulty
May have normal IQ

66
Q

What gender does Triple X affect?

A

Females

67
Q

What are the signs/symptoms of Triple X?

A

No signs
Menstrual irregularity
Mildly impaired intellect

68
Q

Fragile X often results in what condition?

A

Autism

69
Q

What is the hallmark of Cri du Chat?

A

Pitched mewing cry after birth

Marked mental and physical retardation

70
Q

What are the ocular findings of trisomy 13?

A

Microphthalmia
Colobomas
Slanted palpebral fissures

71
Q

What are the ocular findings of Trisomy 18?

A

Microphthalmia

72
Q

What ocular finding occurs in Alagille syndrome?

A

Posterior embryotoxin of the angle

73
Q

When should the neural tube be complete?

A

28 days after conception

74
Q

An occult lesion of spinabifida shows what on the spine?

A

Hair tuft

75
Q

What are the two types of failure that cause coloboma?

A

Ectodermal vesicle failure

Mesodermal fold failure

76
Q

What are the “important” ocular findings of ectodermal failure coloboma?

A

Optic pits

Morning glory disc

77
Q

What type of failure results in eyelid coloboma?

A

Mesodermal fold failure to close

78
Q

What things can cause colobomas?

A

CHARGE syndrome
Alcohol
Vitamin A deficiency
Maternal infection with CMV or Toxo

Systemic Disease (12 decks)

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