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GI2 E1 > CISes > Flashcards

CISes Flashcards

1
Q

primary lesion of SCC from HPV is…

A

tonsillar crypts, base of the tongue, posterior oropharynx

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2
Q

p16, SCC LN in the neck is caused by

A

HPV,

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3
Q

oncogenic viruses

A

EBV
HIV
HPV
Hep B + Hep C

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4
Q

viruses that can cause mono, with grey white exudeate, pharyngitis, tonsillitis

A

EBV

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5
Q

histo changes with EBV-mono

A

atypical lymphocytes

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6
Q

what are the infections of the oral cavity

A

mucormucosis (necrotic ulcer in mouth, move up to eye/brain)

diptheria= tough grey white membrane

candida

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7
Q

histo of pyogenic granuloma

A

organizing granulation tissue

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8
Q

histo of traumatic/irritative fibroma

A

submucosal fibrous deposition

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9
Q

associates with aphthous ulcers

A

reactive

can be increased in certain families, celiac, IBD, behcet

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10
Q

air fluid levels in the GI system is associated with

A

SBO

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11
Q

papillary cystadenoma lymphomatosum

A

warthin tumor

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12
Q

causes and trx of primary peritonitis

A

ascities, cirrhosis, E Coli

3rd gen cephalospoin, pipercillin, thizobactum

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13
Q

causes and trx of secondary peritonitis

A

bacteria from a viscus

abx and surgery

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14
Q

what infection can be from a swimming pool

A

cryptosporidium

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15
Q

what infection is associated with guillan barre

A

campylobacter

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16
Q

what infection increases risk of strongyloides infection

A

HTLV risk factor

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17
Q

emergent complication of C Dif

A

toxic megacolon –> perforation

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18
Q

sx of diverticulitis

A

LLQ + constipation + liquid stools

fever
leukocytosis

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19
Q

what is boas sign

A

GB, pain on R shoulder and scap

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20
Q

what pathologies can you use ablation for

A

barrett’s esophagus and PUD

adenocarcinoma (w EGD)

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21
Q

who do you screen for Hep C

A

anyone between 1945-1965 at least once

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22
Q

what things can you see with a barium swallow

A

webs, strictures, diffuse spasm, zenkers, achalasia

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23
Q

what pathologies will you use an urgent EGD

A

varices, PUD

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24
Q

a ______ state, as seen in ____ ds, can lead to clotting seen in Budd Chiari syndrome. initial trx is ____, and when you eventually do a liver biopsy you will see ___

A

hypercoagulable
crohn
CE US
nutmeg liver

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25
Q

infant with intestinal obstruction and down syndrome

A

hirschsprung

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26
Q

between 3rd to 5th week of life in a male, regurge, projectile vomiting, frequent demands for refeeding

A

pyloric stenosis

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27
Q

what is an omphalocele

A

congenital incomplete formation of the diaphragm allows the abdominal viscera to herniate into the thoracic activity

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28
Q

diverticulitis trx

A

NPO (–> progress to liquid diet) , start abx

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29
Q

what things you can treat with esophageal ablation

A

barrett’s esophagus, PUD

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30
Q

trx if there is pnueumomediastinum

A

air in the mediastinum

emergent surgery

UNLESS THEY JUST HAD A LAPROSCOPY, WE DID THAT TO THEM

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31
Q

trx for acute pancreatitis

A

aggressive IV hydration

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32
Q

trx for ascending cholangitis

A

urgent ERCP

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33
Q

what kind of anemia do you have with vit B12 def

A

hypoblastic (NOT iron defiecient)

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34
Q

lost Hgb and low Hct

A

iron deficient anemia

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35
Q

what is the trx for SBO

A

NG tube to suction

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36
Q

infection associated with ‘trip to mexico’

A

travelers diarrhea, ETEC

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37
Q

HFE mutation is associated with what infection

A

yersinia bc of iron overload

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38
Q

perforation of what will cause a hemoperitonium

A

liver and spleen

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39
Q

xray for hemo vs pneumo peritonium

A

pnuemo: upright, black on top
hemo: lat decubitus = black on bottom

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40
Q

obstructing distal mass in barrett’s is caused from

A

stress related change in phenotype of squamous epithelium

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41
Q

increased risk of what with polyp>10 mm in GB

A

GB CA

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42
Q

what is CA 19-9 used to look for

A

pancreatic CA

or cholangiocarcinoma

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43
Q

what leads to cholangiocarcinoma and how does the latter present

A

primary sclerosing cholangitis

itching, jaundice, RUQ, beads on a string, UC

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44
Q

clinical presentation of hepatocellular carcinoma

A

alpha fetoprotein

RUQ pain

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45
Q

painless jaundice = ___

can be associated with

A

pancreatic CA

new onset DM, alcoholism/cirrhosis, enlarged GB

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46
Q

high MCV levels is indicative of

normal range for MCV

A

macrocytic anemia (B12 deficiency)

80-96

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47
Q

subcutaneous emphysema suggests what

A

Boerhave + iatrogenic esophageal perforation

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48
Q

bamboo spine, lead pipe sign presents in

A

ulcerative colitis

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49
Q

creeping fat and string sign on xray

A

crohn ds

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50
Q

calprotectin presents in

A

crohn ds

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51
Q

+ grey turner sign points towards

A

acute pancreatitis

retroperitoneal bleed

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52
Q

‘sigmoid dilation of the esophagus’

A

achalasia

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53
Q

ankylosing spondylitis is associated with?

A

IBD

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54
Q

papilovesicular rash is associated with what entity

A

celiac

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55
Q

microbio and sx of whipple ds

A

G+, we PAS + Mø

joint pain, heart murmur, chronic diarrhea

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56
Q

crohn can lead to what systemic condition

A

decreased Vit K, –> decreased coag

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57
Q

what lab values will present with chronic pancreatitis

A

decreased fecal chemotrypsin, decreased fecal elastase

hypokalemia with chronic diarrhea

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58
Q

pencil thin stools, benign skin lesions showing up all of a sudden on back

A

colon CA

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59
Q

link IBD to choleangiocarcinoma

A

ulcerative colitis –> pulmonary sclerosing cholangitis –> choleangiocarcinoma

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60
Q

clinical presentation of angioectasia

A

painless bleeding, FOBT

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61
Q

sx presentation of eosinophilic esophagitis

A

food impaction

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62
Q

what is asterixis and what is it used for

A

hand flapping

liver failure

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63
Q

signet ring cells + virchows node + krukenburg

A

gastric adenocarcinoma

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64
Q

xray presentation differences between emphysematous and porcelain gallbladder

A

black air around the GB and liver = emphysematous gallbladder

white calcification of the GB = porcelain GB

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65
Q

what are adenomatous polyps associated with

A

adenocarcinoma of the STOMACH

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66
Q

what hx can lead to fundic gland polyp

A

PPI

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67
Q

trx for a variceal bleed

A

IV octeotide

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68
Q

80% of chronic pancreatitis patients develop

A

DM

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69
Q

risk factors for chronic pancreatitis

A

TIGER-O

toxic metabolite=  alc
idiopathic
genetic= i.e. CFTR
autoimmune= IgG4
obstructive= stricture, stone, tumor
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70
Q

previous abd surgery and now obstruction

A

fibrous adhesion

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71
Q

really fat air filled colon on left, with super thin right colon

coffee bean sign,

A

sigmoid volvulus

72
Q

lactic acidosis in GI obstruction

A

ischemia with sigmoid volvulus

73
Q

what is the first episode of IgG4 mediacted acute pancreatitis called

A

sentinal acute pancreatic ecent

74
Q

IPEX syndrome

A

super severe abd enteropathy, presents with days old baby with severe diarrhea

,
defected CD4, FOXP3 mutation
X linked

75
Q

trx for PUD stomach ulcer

A

pantoprazole IV

76
Q

trx for cholangitis

A

emergent ERCP

77
Q

clinical presentation for acute pancreatitis

trx

A

epigastric pain with lipase 3x ULN

vigorous rehydration, IV NS @ 250 cc/hr

78
Q

what is the Ranson Criteria and what is it used for

A

acute pancreatitis

admission= age >55
WBC >16k
LDH>350
AST>250
glucose >200
@48 hours= hCt decreased by 10%
BUN >5
Ca <8
PO2 <60
base deficit > 4
fluid sequestration >6
79
Q

what is BISAP used for and what is it

A

acute pancreatitis

BUN >25
impaired mental status
SIRS (WBC, tachy, tachypnea)
Age>60
pleural effusion (check w auscultation)
80
Q

what is HAPS used for and what is it

A

acute pancreatitis- for when not a big deal

no abd tend, normal hematocrit, normal serum Creatinine

81
Q

E Coli can lead to what complications

A

HUS

scattered bruising, mucosal hemorrhage, LE edema, hypotension

82
Q

bloody diarrhea associated with recently quit smoking

A

ulcerative colitis

83
Q

migrating thrombophlebitis w pancreatic CA

A

Trousseau sign of malignancy

84
Q

what is the rome criterion for

A

IBS

>8= bad

85
Q

what are diagnostic tests for acute hepatitis

A

acetaminophen levels,

Rumack-Matthew

86
Q

most common location for crohn

A

ileocecal calves

87
Q

____ is always involved in ulcerative colitis

88
Q

biopsy finding with ulcerative colitis

A

crypt abscess

89
Q

broad based ulcer and pseudopolyp formation is what IBD

A

ulcerative colitis

90
Q

transmural inflammation is what IBD

91
Q

what is biliary dyskinesia

dx testing?

A

all normal tests but pain with eating + sx of GB

HIDA scan w CCK show low ejection fraction

92
Q

ASCA Ab associated with what

93
Q

risk factor for cholangiocarcinoma and bile duct CA

A

primary sclerosing cholangitis, ulcerative colitis

94
Q

lab associated with pancreatic insufficiency

A

trypsinogen

95
Q

labs to order for acute pancreatitis

A

fasting lipid panel

96
Q

labs to look for acute hepatitis

A

tylenol levels/acetominophen

increased AST/ALT

97
Q

with hepatic encephelopathy, coming in with confusion, what labs do you check

A

ammonia levels

98
Q

what is charcots triad

A

for ascending cholangitis

fever + jaundice + RUQ

99
Q

what is raynauds pentad

what do you do with it

A

for ascending cholangitis
= v sick, may die

charcots triad + confusion + hypotension

CT= fever + jaundice + RUQ

get blood cultures, bacteremia could happen so look out for it

100
Q

trx for ascending cholangitis

A

FIRST GET INR

then get an ERCP

101
Q

pancreatic pseudocyst is full of

when do you get one

A

necrotic material

chronic pancreatitis or trauma

102
Q

PanIN

A

precursor for pancreatic adenocarcinoma

103
Q

aflatoxin associated with

A

hepatocellular CA

104
Q

differentiate between labs for hepatobiliary vs cholestatic syndrome

A

hepatobiliary = increased AST/ALT

cholestatic syndrome= increased bilirubin, alkaline phosphate

105
Q

McBurney=

A

appendicitis

106
Q

rovsing sign=

A

appendicitis

push on L, get pain on R

107
Q

most common CA for the pancreas

A

adenocarcinoma = gland forming

108
Q

acholic stools and tea colored urine

A

gallblader stones (acute cholelithiasis–> acute cholecystitis)

109
Q

courvoisier sirn

A

no pain and jaundice

pancreatic CA

110
Q

hx associated with nonbenign gallstones

A

beriatric surgery + weight loss + RUQ pain

111
Q

imaging for choledocolithiasis

A 
emergent ERCP (dx+trx)
US (dilate common bile duct)
112
Q

labs for proximal vs distal gall stones

A

proximal = increased ALT/AST, alkaline phosphate, leukocytes

distal= increased ALT/AST, alkaline phosphate, pancreatitis, leukocytosis

113
Q

Murphy’s sign

A

acute cholecystitis in the cystic duct

114
Q

complications of acute cholecystitis

A

gangrene, perforation, DM, emphysematous GB

115
Q

GERD can lead to what kind of CA

A

esophageal adenocarcinoma

116
Q

complication of eosinophilic esophagitis

clinical presentations

A

esophageal perforation

=subQ emphysema and crepitus, Haman’s sign
corrogated rings in the esophagus–> trachealization (feline)

117
Q

what GB stones show with hemolytic anemia

A

pigment stones

118
Q

rokitansky-aschoff sinuses are associated with what

A

chronic pancreatitis

119
Q

what organisms can be seen with a urine Ag

A

strep pneumoniae

legionella pnuemonia

120
Q

colon CA screening?

A

colonoscopy

FOBT

121
Q

what pathology in the GI system can lead to RLL lung changes

A

gallstones

122
Q

top causes of esophageal varices

A

cirrhosis

shistosoma mansoni

123
Q

schatzki’s rings vs esophageal webs

A

a single ring going around the whole esophagus

vs webs are thin-diaphragm like membranes of squamous mucosa

124
Q

warthy starry silver stain

125
Q

prussian blue stain

126
Q

chronic, erythema and nodularity in the antrum with numeral spiral organisms on the surface, and lymphoepithelial lesions

A

MALToma associated with

127
Q

in what setting do you see granulomatous gastritis

A

crohn ds

=erythema nodosum, clubbing, pericholangitis

128
Q

what etiology leads to signet ring cells, seen in what pathologies

A

CDH1 loss

whipple ds, adenocarcioma

129
Q

what skin lesions can be seen with celiac ds

A

dermatitis herpetiformis

130
Q

spindle/epithelial tumors

A

stromal tumors

131
Q

etiology of hirschsprung ds

A

aganglionic megacolon

132
Q

associations with necrotizing enterocolitis

A

premature babies, present upon feeding

=transmural necrosis

133
Q

anal squamous cell carcinoma is associated with what hx

A

maternal HPV

134
Q

high pitched bowel sounds

135
Q

air in the bowel, sudden onset, abd distension

most likely location of the etiology
complication

A

intestinal volvulus

sigmoid colon
infarction from twisting, vasc change bc mesentery is pulled

136
Q

intussusception + peri/intraoral mucocutaneous lesions + hamartomatous polyps + gelatinous stools

=dx and etiology

A

peutz jegher

STK11 gene mutation

137
Q

what can a DNA MMR be used in

A

lynch syndrome

138
Q

x APC is seen in what

A

adenocarcinoma
FAP
sporadic colon CA

139
Q

how can CAD/hx of aneurysm/embolism related to LUQ pain

A

–> blood vessel occlusion –> ischemic bowel ds most likely at the splenic flexure –> LUQ pain

140
Q

dx tests for a fungal cecal mass

A

(+) DRE hemooccult and anemia

141
Q

mucosal thickening on cecum, significant bleeding w biopsy

A

angiodysplasia

142
Q

presentation of IgA deficiency

related to what pathology in the GI system

A

anaphylactic rxns w blood transfusions
no skin rxns
IgA nephropathy

associated with celiac

143
Q

what neoplasms are associated with celiac ds

A

small intestine adenocarcinoma

T cell lymphoma

144
Q

volcano of pus in colon

145
Q

what is the clinical presentation of herpes simplex

A

more than one lesions both inside and outside of the mouth

start as a vesicle turn into an abscess

146
Q

hyperchromasia and more cytoplasm than nucleus in a cell, highly pleimorphic

= what kinds of changes

A

dysplastic

precancerous

147
Q

examples of neurofilaments

A 
cytokeratin
mucin
vimentin
desmin
p16
148
Q

differentiate between the location of HPV-associated and classic SCC

A

HPV associated= in tonsillar crypts, base of tongue, or oropharynx

classic= floor of the mouth, buccal and vestibule of tongue

149
Q

what CA metastasizes to virchow’s node

A

gastric CA

150
Q

microbio of agent that causes scarlett fever

A

group A beta hemolytic strep

151
Q

H pylori and smoking have a synergistic risk for

152
Q

NSAIDS+methotrexate + h pylori

A

risk for ulcer

153
Q

uncontrolled DM is a risk factor for

A

candidiasis

gastroparesis

154
Q

what do you do next for GERD sx that DON’T improve with meds

A

get gastrin levels to rule out zollinger ellison

155
Q

Ab to parietal cells

A

autoimmune gastritis

156
Q

when is a KUB indicated

A

suspectied SBO

157
Q

what is the primary lesions that leads to krukenberg tumors

A

gastric CA

158
Q

increased levels of amylase are seen in

when do you check

A 
MUMPs 
ectopic pregnancy
opioids
post abd surgery
intestinal obstruction
gastroenteritis

check for ethanol hx

159
Q

differentiate between the neoplasms that can be caused by h pylori vs autoimmune gastritis

A

h pylori –>MALToma and adenocarcinoma

autoimmune gastritis –> adenocarcinoma and carcinoid tumor

160
Q

which IBD is a risk factor for cholelithiasis

161
Q

cullen sign is assocaited with what

A

periumbilical redness,

acute pancreatitis

162
Q

portal HTN + ascites –> ?

A

spontaneous bacterial peritonitis

the bacteria from the intestine can flow out into ascites

163
Q

BUN:Cr > 30 –> ?

164
Q

what is a minnesota tube used for

A

esophageal dilation for esophageal varices

165
Q

which As are most likely to be effected with stomach acid leak

A

splenic and gastroduodenal

166
Q

next dx step if IBS sx with alarm sx

A

stool culture

alarm sx= fever, weight loss, acuteness, nocturnal diarrhea, hematochezia, fam hx,

167
Q

fecal elastase can be indicative of what

A

chronic pancreatic insufficiency

168
Q

fecal calprotectin can be indicative of what

A

crohn or UC

169
Q

Mg med use can result in what

A

osmotic diarrhea

170
Q

cirrhotic ds can lead to what complications

A 
rectal varices
hepatic encephalopathy (--> ammonia build up --> osmotic diarrhea)
171
Q

hyerkalemia and hypernatremia –>

A

constipation

172
Q

common sideeffect of metformin

A

watery diarrhea

173
Q

sx of flushing, malaise, M cramps

A 
carcinoid tumor
or VIPoma (pancreatic)
174
Q

omeprazole can increase risk for

175
Q

sx of toxic megacolon

A

perforation
met acidosis
respo distress

176
Q

risk factors for ischemic colitis

sx

A

CAD, vascular ds, vasoconstrictive drugs, marathon runners

acute severe cramping pain followed and relieved by bloody diarrhea

177
Q

mixed anemia with loss of duodenal villi –> __

how do you scan for this etiology

A

celiac ds

DEXA scan

GI2 E1 (19 decks)

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