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Gastroenterology > Amboss pearls > Flashcards

Amboss pearls Flashcards

1
Q

most likely causal organism for: Reheated food/ Rice

A

Bacillus cereus

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2
Q

most likely causal organism for:
bloody diarrhea of 2 incubation days after eating contaminated food (raw poultry or unpasteurized milk or contact w infected animals lk dogs

A

Campylobacter jejuni

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3
Q

most likely causal organism for: inflammatory diarrhea +-bloody after contaminated milk or pork.
+- tenderness in the right lower quadrant “pseudo appendicitis”
Couple days of incubation .
Nausa vomit 2 hours after ingestion

A

Yersinia enterocolitica

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4
Q

most likely causal organism for: bloody diarrhea +-N/V
Raw beef, vegetables, milk
2-10d incubation period

A

Escherichia coli EHEC

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5
Q

most likely causal organism for:
1-3h after ingestion N/V
Mayonnaise, canned meats

A

Staphylococcus aureus

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6
Q

most likely causal organism for:
1-4 wk incub period. Loose stools +mucus+bright red blood. Painful defectation. Abdominal pain. cramps. anorecxia wl6 fever,

A

Entamoeba histolytica

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7
Q

most likely causal organism for:
high-grade fever, severe vomiting, and inflammatory (watery-bloody) diarrhea

(poultry, poorly pasteurized eggs, and milk

incubation period is 6–48 hours

A

Salmonella enteritidis

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8
Q

most likely causal organism for:

heat-labile Enterotoxins
watery diarrhea
abdominal cramping, nausea, and possibly vomiting

incubation period of 9 hours to 3 days

most common cause of traveler’s diarrhea.

A

Enterotoxigenic Escherichia coli

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9
Q

most likely causal organism for:

bloody diarrhea. It has an incubation period of 1–3 days

A

Shigella dysenteriae

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10
Q

most likely causal organism for:

16–72 hours after ingestion of undercooked seafood

most common cause of diarrhea in Japan

A

Vibrio parahaemolyticus

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11
Q

Vibrio parahaemolyticus Tx

A

usually supportive, but administering doxycycline or fluoroquinolones may be considered in severe cases

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12
Q

Kehr’s sign

A

pain to the left shoulder as a result of irritation of the left hemidiaphragm. Occurs because both left phrenic nerve, which innervates the left hemidiaphragm, and the left supraclavicular nerves, which innervate the skin over the shoulder, have common cranial nerve roots (C3 and C4). Most common cause is splenic injury.

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13
Q

Cystic fibrosis CxFx

A

(chronic sinopulmonary disease, exocrine pancreatic insufficiency

frequent infections +-respiratory

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14
Q

Cystic fibrosis Dx

A

. Sweat chloride test, or quantitative pilocarpine iontophoresis, is the gold standard

Defective chloride channels lead to elevated chloride in sweat gland secretions; levels > 60 mmol/L on two or more occasions are diagnostic for this condition

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15
Q

Cystic fibrosis Patho

A

CFTR (cystic fibrosis transmembrane conductance regulator) gene mutations (the most common mutation is DeltaF508). The mutated CFTR gene encodes defective chloride channels in the cell membrane of exocrine glands, leading to hyperviscosity of secretions, blockage of exocrine glands and, subsequently, chronic inflammation with permanent organ damage

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16
Q

more specific marker to detect alcohol use disorder.

and the most sensitive marker

A

, carbohydrate-deficient transferrin (CDT)

It is the optimal AUD marker because it can be detected even weeks after chronic alcohol use.

γ-GT the most sensitive marker for acute consumption

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17
Q

lead poisoning: Cx Fx

A

intestinal colic (cramping abdominal pain), anemia (fatigue, pale conjunctivae), and radial nerve palsy (weakened wrist extension)

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18
Q

is an occupational hazard for battery factory workers is

A

chronic lead poisoning

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19
Q

Chronic lead poisoning cx fx

A

peripheral neuropathy, abdominal colic, anemia, and Burton’s line

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20
Q

Dermatitis Herpetiformis Dx

A

microabscesses in the papillatu dermis are seen on light microscopy.
Inmmunofluorescense shows deposits of IgA at the tips of dermail papillae

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21
Q

most common parasite from this source: undercooked meat

A

Trichinella spiralis

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22
Q

most common parasite from this source: freshwater snails

A

Schistosoma mansoni

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23
Q

most common parasite from this source: undercooked fish

A

Clonorchis sinensis

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24
Q

most common parasite from this source: foxes, dogs, cats.

A

Echinococcus granulosus

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25
Q

Li-Fraumeni syndrome Patho

A

autosomal dominant condition caused by a mutation in the p53 tumor suppressor gene.

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26
Q

Li-Fraumeni syndrome Cx Fx

A

multiple malignancies (e.g., sarcomas, adrenal gland and breast cancer, leukemia)

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27
Q

Turcot syndrome =

A

FAP or Lynch Sx+CNS malignancy

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28
Q

Peutz-Jeghers syndrome patho

A

autosomal dominant condition associated with a mutation in the STK11 gene

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29
Q

Peutz-Jeghers syndrome

A

hamartomatous polyps throughout the gastrointestinal tract (predominantly in the jejunum) and mucocutaneous hyperpigmentation of the lips, buccal mucosas, palms, and soles.

increased risk of colorectal CA and extraintestinal too!

30
Q

Toxic megacolon etiologies

A

Infectious colitis
Bacterial: C. difficile (pseudomembranous colitis), Salmonella, Shigella, Campylobacter infections
Parasitic: Trypanosoma cruzi (Chagas disease), E. histolytica (amebic dysentery) infections
Inflammatory colitis: Ulcerative colitis, Crohn disease

31
Q

chest pain, tachycardia, tachypnea, and crepitus over the chest .
Is Cx Fx for?

A

Esophageal perforation.

Hx of very recent endoscopy is frequent too.

32
Q

progressive hepatic dysfunction and cholestasis. + Hx of liver transplant =

A

CxFx of Chronic transplant rejection
Chronic>6m
acute <6

33
Q

accelerated coronary artery disease. + Hx of heat transplantation=

A

Chronic transplant rejection

34
Q

4-cm liver mass with a central hypoattenuated scar on a CT scan, which is diagnostic of

A

Focal nodular hyperplasia

35
Q

refractory peptic ulcer disease with multiple ulcerations and steatorrhea (foul-smelling, lightly-colored stools). These features suggest:

A

Gastrinoma or

Zollinger-Ellison syndrome

36
Q

gastrinoma should raise suspicion for

A

Multiple endocrine neoplasia

MEN 1

37
Q

The acute-onset, severe flank pain, microhematuria on dipstick, and hyperechoic mass on ultrasonography further indicate a

A

kidney stone.

38
Q

Symptoms of a kidney stone, intermittent arthralgias, abdominal pain, and fatigue further suggest:

A

primary hyperparathyroidism,

39
Q

primary hyperparathyroidism, occurs in ∼ 90% of individuals with :

A

MEN 1.

40
Q

Increased levels of PTH and hypercalcemia are the main diagnostic features of

A

pHPT

41
Q

nonbilious emesis following food intake, early satiety, weight loss, epigastric tenderness, and a succussion splash, all of which indicate

A

gastric outlet obstruction (GOO).

42
Q

In adults, GOO is caused by _______________________ in the majority of cases.

A

a malignant obstruction

43
Q

gastric outlet obstruction (GOO). A good initial test and a Dx confirmation test

A

initial: US
Conf: upper endoscopy, especialy in Gastrix CA expected.

44
Q

newborn presents with bilious vomiting, a distended abdomen, and sparse bowel sounds, all of which are consistent with bowel obstruction. The findings of dilated small bowel loops on abdominal x-ray and a microcolon indicate

A

Meconium ileus: failure to pass the first stool
and
Cystic fibrosis is its cause in > 90% of cases.

45
Q

meconium ileus Dx

A

Gastrografin enema and it’s the treatment too.

46
Q

Neuhauser sign

A

radiographic finding of a mottled (“soap bubble”) appearance in the distal ileum and/or caecum as a result of meconium mixing with swallowed air, often caused by meconium ileus.

47
Q

Meconium Ileus Gastrofarin findings

A

Neuhauser sign, microcolon, or meconium pellets.

48
Q

IgG antibodies against the hepatitis B core antigen indicate:

A

either active or inactive chronic infection (think Core for Chronic)

49
Q

The envelope antigen is only present during :

A

phases of viremia, which occurs in acute or active chronic infections (think Envelope for ‘Ective’).

50
Q

endoscopic findings of a displaced Z-line above the diaphragmatic hiatus with no evidence of paraesophageal herniation are consistent with

A

type I hiatal hernia.

51
Q

A pupillary diameter of > 5 mm during eye examination with a light is

A

abnormally large

52
Q

fever, myalgia, periorbital edema, splinter hemorrhages, eosinophilia, and an increased serum creatine kinase concentration, all of which suggest

A

an infection with Trichinella spiralis.

53
Q

The consumption of pasteurized dairy products is important for preventing infection with, _________ or ______.

each can have this symptoms ______
______

A

Listeria monocytogenes
CxFx: Healthy adults: self-limiting gastroenteritis (watery diarrhea)
Immunocompromised and pregnant: +flue-like symptoms.

also Brucella spp. tho it’s not frequent in the USA
flue-like symptoms.

54
Q

Roundworms (like Trichenella) can be treated with anthelmintic agents such as

A

albendazole and mebendazole.

55
Q

sclerodactyly, telangiectasias, and the Raynaud phenomenon, the combination of which suggests a diagnosis of

A

features of CREST syndrome, , part of the systemic sclerosis.

56
Q

systemic sclerosis. what does the C of CREST stand for?

A

calcinosis cutis (the “C”-feature in CREST), i.e small white calcium deposits on the pressure points of the extremities

57
Q

Achalasia patho

A

caused by progressive degeneration of the esophageal myenteric plexus, resulting in dysfunctional peristalsis,

58
Q

failure to thrive, lethargy, hepatomegaly, severe fasting hypoglycemia (causing hypoglycemic seizures), hyperlipidemia, and lactic acidosis.
are seen in

A

von Gierke’s disease (type a). A result of Glucose 6-phosphatase deficiency

59
Q

This young white man has fatigue, chronic diarrhea, abdominal pain, and thrombocytosis, which suggests

and if bloody

A

inflammatory bowel disease (IBD).

UC

60
Q

congenital ventral wall defect that leads to intestinal herniation through the involuted right umbilical vein

A

Gastroschisis

61
Q

Gastroschisis one good initial test (prenatal)

A

Alpha-fetoprotein

62
Q

Gastroschisis prenatal confirmatory test

A

fetal ultrasound will show free-floating bowel without a membranous sac.

63
Q

The most common long-term complication of caustic liquid ingestion is the development of

A

f esophageal strictures.

64
Q

A tumor in the descending colon with hepatic metastasis would most likely be

A

an adenocarcinoma, the most common type of colorectal cancer.

65
Q

can cause traveler’s diarrhea and typically presents with watery to bloody stools.

A

Enterotoxigenic Escherichia coli (ETEC)

66
Q

gram-negative rod that causes infection with diarrhea in newborns

A

Enteropathogenic Escherichia coli

67
Q

causes watery diarrhea, especially in AIDS patients.

, high-volume, watery diarrhea that has persisted for more than two weeks.

A

Cryptosporidium parvum

68
Q

most common protozoal cause of traveler’s diarrhea, THO it is not the most common cause of diarrheal illness among travelers.

A

Giardia intestinalis

69
Q

may be administered to treat patients with chronic hepatitis C infection (especially genotypes 2 and 3), nowadays typically as an alternative to direct-acting antivirals.

A

Interferon and ribavirin therapy

also can use

peginterferon alpha with ribavirin

70
Q

Abdominal pain at night, especially in the epigastric region, can be a symptom of

A

duodenal peptic ulcer disease (PUD)

71
Q

treatment In patients with uncomplicated symptomatic cholelithiasis who are poor surgical candidates long-term (6–24 months)

A

oral bile acid dissolution therapy with ursodeoxycholic acid (UDCA) is indicated. In addition to a low-fat diet and UDCA therapy, patients should exercise regularly and avoid lithogenic drugs (e.g., estrogen, fibrates)

72
Q

poorly controlled diabetes presents with subacute flank pain (left or right), fever, and pain with extension of the hip, all of which suggest a

A

Psoas muscle abscess

Gastroenterology (23 decks)

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