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Uworld Step 2 > Block 51, 52, 53: GI > Flashcards

Block 51, 52, 53: GI Flashcards

1
Q

clinical presentation for acute choledocholithiasis

A

acute-onset right upper quadrant or epigastric pain

- pain worse in supine position and at night

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2
Q

painless jaundice in a patient with conjugated hyperbilirubinemia and marked elevated alkaline phosphatase

A

biliary obstruction due to pancreatic or biliary cancer

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3
Q

does hepatitis C have elevated alkaline phosphatase

A

no

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4
Q

does autoimmune hepatitis have elevated alkaline phosphatase

A

no

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5
Q

define acute liver failure

A
  • elevated aminotransferase
  • encephalopathy
  • INR greater than 1.5
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6
Q

risk of what cancer is increased with UC

A

colorectal cancer

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7
Q

complication of UC

A
  • toxic megacolon
  • uveitis
  • primary sclerosing cholangitis
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8
Q

when should patients with an affected first- degree relative be screened for colon cancer

A

age 40 or 10 years before the age of the relative’s diagnosis

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9
Q

hallmarks of secretory diarrhea

A
  • larger daily stool volumes
  • occurs during fasting or sleep
  • reduced stool osmotic gap
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10
Q

what is most consistent reversible risk factor for pancreatic cancer

A

cigarette smoking

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11
Q

active erosive gastropathy

A

development of hemorrhagic lesions after ischemia or exposure of gastric mucosa to various injurious agents ( alcohol, aspirin, cocaine)

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12
Q

epigastric pain and intermittent melena

A

duodenal ulcer

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13
Q

2 main causes of duodenal ulcer

A

H. pylori infection

NSAID

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14
Q

management for duodenal ulcer

A

antibiotics and acid suppression

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15
Q

features that distinguish biliary colic from cholecystitis are

A

pain resolves within 4-6 hours

absence of abdominal tenderness, fever and leukocytosis

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16
Q

where can pain occur for biliary colic secondary to gallstones

A
  • RUQ or epigastric region
  • right-sided shoulder pain
  • subscapular discomfort
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17
Q

initial evaluation and management of patients with variceal hemorrhage is

A

mainting circulation
preventing and treating complications
stop cause of bleeding

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18
Q

if a patient has continuous hematemesis and depressed level of consciousness, what is a major risk

A

aspiration

- endotracheal intubation

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19
Q

burning, localized pain and regional hyperesthesia/allodynia, in the context of recent cancer treatment?

A

herpes zoster ( shingles)

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20
Q

unexplained chronic abdominal pain, weight loss and food aversion, postprandial epigastric pain

A

chronic mesenteric ischemia

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21
Q

positive urine bilirubin assay is indicative of

A

conjugated bilirubin

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22
Q

Rotor’s syndrome

A

chronic or fluctuating conjugated hyperbilirubinemia due to defect in hepatic secretion of conjugated bilirubin into biliary system

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23
Q

Besides alcohol and gallstones causing acute pancreatitis, what else can cause it

A

medication

  • diuretics
  • anti seizure ( valproic acid)
  • antibiotics ( metronidazole)
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24
Q

hallmark lab values for ischemic hepatopathy

A
  • rapid and massive increase in transaminases

- modest elevations in total bilirubin and alkaline phosphatase

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25
Q

name 2 granulomatous diseases

A

tuberculosis and sarcoidosis

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26
Q

barium contrast enema can detect what disease

A

UC and Crohn

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27
Q

can diverticulitis cause urine problems

A

yes frequency and urgency

- bladder irriation from inflamed sigmoid colon

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28
Q

chronic dysphagia to both solids and liquids, regurgitation, difficulty belching and mild weight loss

A

achalasia

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29
Q

esophageal webs are associated with what vitamin deficiency

A

iron

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30
Q

what is used to diagnose achalasia

A

manometry

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31
Q

prophylactic treatment for nonbleeding varices

A

beta blockers

- if contraindicated do endoscopic variceal ligation

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32
Q

acronym for causes of acute pancreatitis

A

I GET SMASHED

  • idiopathic
  • gallstones
  • ethanol
  • trauma
  • steroids
  • mumps
  • autoimmune
  • scorpion sting
  • hypercalcemia
  • ERCP
  • drugs
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33
Q

specific serum test for pancreatitis

A

serum lipase

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34
Q

what signs do you see on acute pancreatitis for PE

A

Grey turner sign: flank ecchymoses
Cullen sign: periumbilical ecchymoses
Fox sign: ecchymosis of inguinal ligament

35
Q

yellow-red papules on patient’s arm can suggest what

A

xanthomas.

36
Q

3rd most common cause of acute pancreatitis

A

hypertriglycerides

37
Q

noncaseating granulomas suggests

A

Crohn’s

38
Q

clinical feature of diverticulosis

A

chronic constipation

39
Q

what can a patient do to lower the risk of diverticulosis

A
  • high fiber intake
40
Q

chronic, crampy abdominal pain; bloating and watery diarrhea after meals has

A

lactose intolerance

41
Q

cigarette smoking, high salt intake and consumption of N-nitroso compounds are risk factor for

A

gastric adenocarcinoma

42
Q

initial treatment for hepatic encephalopathy and hypokalemia

A

potassium repletion
fluids
lactulose

43
Q

total parenteral nutrition can cuase what to the gallbladder

A

gallbladder stasis –> cholecystitis

44
Q

UC vs. Crohn transmural inflammation

A

crohn

45
Q

perianal manifestation of Crohn’s

A

skin tags and fistulas

46
Q

tuberculous enteritis presents similar to what

A

Crohn’s disease

47
Q

primary biliary cholangitis

A

destruction of intrahepatic bile duccts

48
Q

complications of primary biliary cholangitis

A

malabsorption
metabolic bone disease
hepatocellular carcinoma
xanthelasmas

49
Q

what causes bile salt diarrhea

A

terminal ileal disease

50
Q

primary sclerosing cholangitis

A

inflammatory disorder of intrahepatic and extrahepatic biliary tree

51
Q

patient with abdominal pain, microcytic anemia, positive fecal occult blood, and hepatomegaly with a hard edge on liver palpation

A

GI malignancy mets to liver

52
Q

signs of portal hypertension

A

esophageal varices
spider nevi
Palmar erythema
caput medusa

53
Q

next step in management for post cholecystectomy

A

ERCP

Endoscopic retrograde cholangiopancreatography

54
Q

what can ursodeoxycholic acid treat

A
  • cholesterol gallstones
  • primary biliary chirrhosis
  • primary sclerosing cholangitis
55
Q

what are 2 signs of acute liver failure

A

encephalopathy

impaired synthetic function ( INR greater than 1.5)

56
Q

what clinical feature differentiates between acute liver failure and viral hepatitis

A

acute liver failure has hepatic encephalopathy

57
Q

what can cause red blood on toilet paper, few drops of blood in toilet after defecation,

A

hemorrhoids

58
Q

management for patient 50 and older with bright red blood per rectum

A

colonoscopy

59
Q

Management for patient less than 40 for bright red blood per rect

A

anoscopy

60
Q

Do you treat asymptomatic gallstones

A

no

61
Q

wha lab values are increased with patients who have upper GI bleed

A

BUN/Creatinine ratio

62
Q

patients with multiple duodenal ulcers refractory to treatment or ulcers distal to the duodenum or associated with chronic diarrhea

A

Zollinger-Ellison

63
Q

Zollinger-Ellison and pancreas

A

inactivation of pancreatic enzymes by increased stomach acid production

64
Q

stethoscope over upper abdomen and rocking patient back and forth at hips looks for what

A

called abdominal succussion splash

gastric outlet obstruction

65
Q

Irritable bowel syndrome

A

chronic abdominal pain with diarrhea and/or constipation

- passage of stool relieves pain

66
Q

crypt abscess is characteristic of what

A

Ulcerative colitis

67
Q

perianal fistulas are related to what

A

possible Crohn’s disease

68
Q

porcelain gallbladder increases the risk for

A

gallbladder adenocarcinoma

- associated with chronic cholecystitis

69
Q

risk factors for renal cell carcinoma

A

smoking
hypertension
obesity

70
Q

what sets pesudoachalsia different from achalasia

A

pseduo: significant weight loss
- rapid symptom onset
- greater than 60 years

71
Q

bactericidial antibiotic reserved for recurrent colitis or as initial therapy for pts with severe colitis who cannot take oral vancymycin

A

Fidaxomicin

72
Q

Most common source of liver metastases

A

Colorectal cancer

73
Q

alpha-fetoprotein measures what

A

hepatocellular carcinoma which occurs in setting of chronic liver disease

74
Q

skin hardening and telangiectasis may indicated

A

sclerosis

75
Q

what criteria is used for irritable bowel syndrome

A

Rome criteria

  • recurrent abdominal pain/discomfrot 3 days or more/month for last 3 months and 2 or more of the following
    1. improvement with bowel movement
    2. change in frequency of stool
    3. change in form of stool
76
Q

clinical features of partial small-bowel obstruction

A
  • postprandial abdominal discomfort
  • nausea
  • obstipation
77
Q

Small-intestine bacterial overgrowth clinical features

A

abdominal bloating
flatulence
diarrhea

78
Q

clinical features of zinc deficiency

A 
hypogonadism
impaired taste
impaired wound healing 
alopecia
skin rash with perioral involvement
79
Q

patients who depend on parenteral nutrition are at risk for what

A

trace mineral deficiency

80
Q

clinical features of copper deficiency

A

fragile hair
skin depigmentation
neurologic dysfunction
siderblastic anemia

81
Q

clinical features of Selenium deficiency

A

thyroid dysfunction

cardiomyopathy

82
Q

clinical features of esophageal rupture

A

acute chest pain
tachypnea
pleural effusion
- symptoms worse after endoscopy/trauma

83
Q

next step in management for esophageal rupture

A

endoscopy

Uworld Step 2 (30 decks)

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