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GIGU Exam 1 > CIS GI Correlations - Dr. Arnce > Flashcards

CIS GI Correlations - Dr. Arnce Flashcards

1
Q 
Eructation
Edentulous
Dysphagia
Odynophagia
Mittelsschmerz
A 
Burping 
X teeth
X Swallowing 
Painful Swallowing 
Ovulation at mid cycle
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2
Q

Icterous

A

Yellow Sclera
Due to liver failure and elevated bilirubin
Also jaundice of skin happens

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3
Q

Hematemesis

A

Blood vomit or coffee-ground like vomit

Ulcer in stomach, upper GI tract artery ulcer

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4
Q

Melena

A

Black tarry stools

90% due to UGIB (upper GI Bleed)

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5
Q

Hematochezia

A

Red or maroon Blood in stools

Usually due to Lower GI Bleeds
Or MASSIVE Upper GI Bleeds

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6
Q

Hemoccult/ Gastroccult

A

Exam to check if there is blood in the stool (Hemo) or vomit (gastro)

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7
Q 
Very big distended belly 
Capid  Medusa ( arterial darkening on the skin of tummy)
A

Acidis
Liver Failure
(Hepatic Portal HTN)

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8
Q

Keketsia

A

Very skinny bony

Due to chronic COPD or Cancer, or malnutrition

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9
Q

STOOLS:

  1. Light colored white
  2. Dark Black , positive for blood
  3. Karent Jelly Stool (Bloody bright red)
A
  1. Acolic Stool: especially alarming in newborn ( Biliary Atresia)- absence of Bile (newborn: congenital Biliary Atresia, Adult: Gallstones or something obstructing bile formation)
  2. UGIB
  3. Intussusception (in children)- one part of GI folds in to another part
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10
Q

Black stool that tests positive for blood, and there is no blood what can cause this

A

Iron pills
Pepto-Bismol

Beets and red food coloring- can cause red stool

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11
Q

18yo F right lower Quadrant ABD Pain , elevated WBCs
CT Scan
RLQ

A
  1. Appendicitis
  2. LQs
    - Ureteric Colic
    - Inguinal Hernia
    - IBD
    - UTI
    - Gynaecological Testicular Torsion
    - Ectopic Pregnancy
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12
Q

Differential Diagnosis

A

Most common things that can cause the CC and also life threats

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13
Q

LLQ Pain

A
  1. Diverticulitis
  2. LQs
    - Ureteric Colic
    - Inguinal Hernia
    - IBD
    - UTI
    - Ectopic Pregnancy
    - Gynaecological Testicular Torsion
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14
Q

RUQ

A 
GB/Liver -Cholecystitis
Hepatitis 
UQs
-Pyelonephrits
- Ureteric Colic
- Pneumonia
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15
Q

LUQ

A 
Stomach (Gastric Ulcer)
UQs
-Pyleonephritis
-Ureteric Colic
-Pneumonia
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16
Q

Epigastric Pain

A

Peptic Ulcer Disease
Cholecystitis
Pancreatitis
Myocardial Infarction

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17
Q

Peri-umbilical Region

A

Small- Bowel obstruction
Large-Bowl Obstruction
Appendicitis
ABD. Aortic Aneurysms

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18
Q

CBC
Chemistry
Urinalysis

A
  1. WBC Count
  2. Electrolytes and acidonic (HCO3)
  3. UTI
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19
Q

Projectile vomit in child

A

PYLORIC STENOSIS

Not normal - children

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20
Q

Bile Throw-up

A

Yellow

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21
Q

Poop looking color vomit and smells like poop

A

Feculent vomit

BOWL OBSTRUCTION

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22
Q

1Coffee ground looking vomit

2 bright red

A

PEPTIC ULCER DISEASE

Aortic Ulcer or verscial bleed

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23
Q

67yo F postmenopause, Periumbilical ABD Pain. N, V

X Bowl movement and many ABD surgeries in past

A

SI Obstruction- risk factor for many ABD surgeries

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24
Q

Small Bowl Obstruction
Risk Factors:
Sx:
Tx:

A
  1. Past pelvic- ADHESIONS or ABD surgery, hernia, Intestinal inf., neoplasm, past irradiation
  2. N, V, Cramping pain in ABD, distended ABD, obstipation (X pass flatus or stool)
  3. Nasogastric Tube
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25
Q

58yo M vomiting blood

Qs to ask

A 
Cough vs vomit
Coffee ground or bright red
Picture of it
Have you done this in the past
Past out or lightheaded 
COP, ABD pain, SOB
26
Q

Peptic Ulcer Disease

What should you order for Diagnostic

A

NOT CT

EGD

27
Q

Esophageal Varices

Order what

A

EGD

Bright red stool and distended ABD

28
Q

Oropharyngeal Dysphagia -invitation of swallowing

Can be Sx of what

A

Parkinson’s

29
Q

Esophageal Dysphagia can be Sx of what

A

Esophageal Cancer
Schatzki Ring- ring in esophagus
Achalasia
Scleroderma

30
Q

Sinkers Diverticulum

A

Ring that is higher up and in the Diverticulum pouch

Can cause food regurgitation or bad breath, aspirations

31
Q

Dysphagia worsening over time

A

PROGRESSIVE DYSPHAGIA

32
Q

45yo M progressive dysphagia, travels to centra America a lot
Regurgitation at night
Blood smear: Trypanosoma Cruzi

A

ACHALASIA: throwing up food (not going into stomach) - stay in esophagus due to lower sphincter does not relax and lower 2/3 motility disorder
Esophageal Dysphagia: Motility Disorder

Bird beak appearance in imaging

33
Q

Regurgitation at night
Progressive dysphagia
No travel history
Lower sphincter does not relax of esophagus

A

ACHALASIA

34
Q

H Pylori physiological happenings

A

Mucosal barrier breakdown from cytotoxin producing motile flagellated microaerophilic gram- Rod

35
Q

Duodenum Ulcer physiology

A

Decreased Gastric Acid secretion -> loss of protective mucosal barrier

36
Q

ACHALASIA physiology

A

Loss of Nitric Oxide- producing inhibitory neurons in the myenteric plexus

37
Q

Zollinger Ellison Syndrome physiology

A

Gastric producing tumor

38
Q

GERD Physiology

A

= abnormally weak lower esophageal sphincter allowing gastric contents into the esophagus

39
Q

25yo M pituitary neoplasm HPI, comes CC of constipation, weight loss, Steatorrhea N, epigastric pain
Elevated CA+2, 1cm tumor in the pancreas
Diagnose definitely how:

A

ZOLLINGER ELLISON SYNDROME
High Gastrin level
+ Secretin stimulation test

40
Q

Blood smear with trypanosoma cruzi

A

Chagas disease

41
Q

45yo M Dysphagia, sharp burning epigastric pain, pain 45min after eating. V. Takes ibuprofen and has osteoarthritis
Where is the disease

A

Chronic steroidal use
Coffee ground poop
UGIB

42
Q

18yo F severe ABD pain for 6 hours, N no V, fever, elevated WBCs
RLQ pain when LLQ is palpated

A

Positive Rovsing’s sign

Appendicitis at T12- sympathetic of the appendix

43
Q

Murphy sign

A

Gallbladder

44
Q

Tenderness at McBurney’s Point

A

RLQ tenderness only - appendicitis

45
Q

Rovsing’s sign

A

LLQ palpating causes RLQ pain

46
Q

Tenderness over Costovertebral angles

A

Lloyd’s punch

47
Q

35yo M from Guatemala
6mos dyspepsia, epigastric ABD pain
CBC: microcytic anemia
EGD: and biopsy = malt lymphoma (bulges in the esophagus)

A

H Pylori Infection

48
Q

56yo F postmenopause dyspepsia, epigastric ABD pain for 3mos progressive, when eating initially helps and then 3.5hrs after eating gnawing pain,
What should we order

A

Urea Breath test - for H pylori

49
Q

Barium Esophagram

A

ACHOLASIA or regurgitating food (esophageal motility dysfunction)

50
Q

When do you do a Urea breath test

A

Looking for H Pylori

51
Q

Dyspepsia

A

Indigestion

Burning, bloated, N, upper ABD pain after start of eating

52
Q

What can help you visualize the biliary tree and provide an intervention (theraputic)

A

(Gallbladder pancreas)
ERCP= Endoscopic Retrograde Cholangiopancreatography
Diagnostic and therapeutic for the biliary tree

53
Q

Magnetic Resonance Cholangiopancreatography

A 
Can only used to Dx biliary tree 
No intervention (therapeutic = fix something)
54
Q

Kidney-ureter-bladder X-ray

A

Diagnostic

55
Q

Colonoscopy

A

Dx and Theraputic however nothing to do with biliary tree

56
Q

Esophagoduodenoscopy (EGD)

A

Dx peptic ulcer, not theraputic

However not anything to do with biliary tree

57
Q 
40 yo F RUQ pain 
Ultrasound= gallstones
Elevated lipase and LFT’s 
Can there be a stone any other place 
How to test
A

Elevated Lipase= Pancreas problem (blocked pancreatic duct)
Elevated LFT’s = Liver problem (blocked biliary system, common bile duct)

TO GET BOTH: blocked at common bile duct under pancreatic duct, PROXIMAL TO SPHINCTER OF ODDI
Test= MRCP or ERCP

58
Q

Air in the diaphragm medical term = free air

A

Pneumoperitoneum

Usually due to gastric or duodenal ulcer

59
Q

CMP shows (comprehensive metabolic panel)

A

Total Bilirubin - liver function test also, AST, ALT, alkaline phosphatase

60
Q

Low CO2
Elevated Creatinine
Low GFR
elevated lactic acid

A

Acidonic
Kidney problems
Kidney failure
Septic or dehydrated

61
Q

Normal Bilirubin level

And also what does high ammonia show

A

1.4 H

Liver failure

GIGU Exam 1 (19 decks)

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