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Hannah MS2 GI > CLIN > Flashcards

CLIN Flashcards

(50 cards)

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1
Q

UGIB vs LGIB Cr/BUN

A

UGIB: 30:1 (and increased INR)
LGIB normal
renal 20: 1

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2
Q

what pathology is associated with “rapid bolus IV contrast CT 3 days after to assess necrosis”

A

acute pancreatitis

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3
Q

RF of cholelithiasis

A

F’s
-female, forty, fertile, fat, FH, fair
and crohns

protective- low fat diet, PA, caffeine, Mg+, Polyunsat fats, high fiber, statin tx, and ASA

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4
Q

what is the estimated fecal osmolarity gap

A

<50

*high osm gap (>75) seen in osmotic but not secretory diarrhea

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5
Q

hematochezia/melena (LGIB indicator) ddx

A
  1. IBD (UC)
  • <50 yo (infectious colitis, anorectal dz: fissures/hemorhhoids, MECKEL DIVERTICULUM)
  • > 50 yo (malignancy, diverticulosis, ischemic colitis, angiodysplasia
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6
Q

hx associated with gastroparesis

A

early satiety, N/V 1-3 pp, ab pain

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7
Q

most common noninfectious cause of acute diarrhea

A

meds (ABX most common)

*but 90% is infectious cause

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8
Q

when is lympgranuloma venerum (fever bloody diarrhea, painful perianal ulcers, and bubobes-inguinal adenopathy) seen

A

chlaymdia infection of anorectic (proctitis)

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9
Q

what is seen on US of acute cholecystitis

A

GB thickening, pericholecystic fluid, sonographic murphys sign

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10
Q

physical exam findings of PUD

A

PE: hyperactive bowels sounds, mild localized tenderness on deep palpation

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11
Q

sx and causes of proctitis

A

(anorectal infection/inflammation)

sx: anorectal discomfort, tenesmus, constipation, mucus, bloody discharge, psuedodiarrhea
causes: sexually transmitted during anal sex: gonorrhea, clamydia, herpes, or treponema pallidum

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12
Q

what is condylomata accuminata

A

genital warts due to HPV

should distinguish from condylomata lata in secondary syphilis

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13
Q

dx for acute pancreatitis

A

2/3 needed

  1. epigastric pain
  2. lipase/amylase 3x UL
  3. CT changes of pancreatitis
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14
Q

sx of AVM

A

(angioectasias)
- sx: painless bleeding from melena (UGIB) to hematochezia/occult blood (LGIB) seen in patients >70 yo with chronic renal failure or aortic stenosis

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15
Q

sx of N/V (feculent, dirty) constipation and distention and PE of high pitched tinkling bowel sounds

A

acute small bowel obstruction caused by adhesions

-RF: multiple surgery, diverticulosis, Crohns

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16
Q

two causes of bile salt malabsorption and associated sx

A
  1. crohns associated ileal resection
  2. bacterial overgrowth (tested with breath tests)
    sx: mild steatorrhea, secretory diarrhea, minimal weight loss, bleeding tendency (Loss of ADEK), osteoporosis, and hypocalcemia
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17
Q

must stop ___ before fecal antigen test or urea breath test for dx of PPI for fear of false ___

A

stop PPI to prevent false negative

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18
Q

all celiac patients get ____ due to known complication

A

get dual energy X-ray densitometry scans to asses for osteoporosis

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19
Q

sx, labs, and PE of acute cholecystitis

A

sx: fever, severe RUQ pain/tenderness, N/V
PE: jaundice, Murphys sign, palpable GB
labs: increased AST/ALKP/GGT/ serum amylase

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20
Q

when is saponification seen

A

acute pancreatitis (because decreased calcium)

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21
Q

imaging and DX of ischemic colitis

Study These Flashcards
A

imaging - x-ray shows “thumb printing” colonic dilation and edema
dx: CT angio = gold standard

22
Q

3 types of presentation associated with IBS

Study These Flashcards
A
  1. spastic colon ( chronic pain, constipation )
  2. alternating diarrhea/constipation
  3. chronic painless diarrhea
23
Q

when do you need to further eval chronic diarhhea for more than just common causes

Study These Flashcards
A
  1. nocturnal diarrhea
  2. wt loss
  3. anemia
    4 +FOBT
    *FAWN
24
Q

causes of perianal pruritus (pruritus ani)

Study These Flashcards
A

poor anal hygiene or extreme hygiene causing irritation

sx: perianal itch, discomfort
- dx of exclusion

25
sx of ischemic colitis
sudden onset of cramping which is worse after food = "food fear" ; LLQ pain, desire to defecate, blood diarrhea, N/V , periumbilical pain unproportional to tenderness *pt young assoc with hx of cocaine use
26
what is the complication associated with secretory diarrhea
does not change with fasting, | the loss of lots of water can lead to electrolyte imbalances, decreased sodium, and metabolic acidosis
27
tx and complications of severe acute pancreatitis
tx: w/i 48 hour start nasogastric/jejenual tube feeding to decrease risk of multiorgan failure complications: decreased blood volume due to 3rd spacing leading to ATN, prerenal azotemia in 24 hr ; pleural effusion, psedocysts
28
how to diagnose gonorrhea vs trepenoma in the cause of proctitis
gonorheea: swab and culture from pharynx too chlamydia: dark field microscopy or flourescent Antibody test
29
pyrosis means
heart burn
30
3 causes of oropharyngeal dysphagia
1. esophageal web (proximal type) 2. Zenker Diverticulum 3. Sjogrens ( dry mouth)
31
sx of anal fissures
severe pain during defecation with following throbbing, mild hematochezia,
32
complication associated with hemorrhoid
thrombosed external hemorrhoid (blueish perianal nodule covered with skin)
33
complication of acute cholecystitis
GB gangrene
34
dx f=of gastroparesis
use gastric scintigraphy - use low fat/ solid meals (eggs) - gastric retention 60% 2 pp or >10% 4 hr pp = ABNL
35
what is lynch syndrome
HNPCC
36
how is cholelithiasis dx
US (stones cast an "acoustic shadow")
37
what is PTEN multiple harmatoma syndrome
"cowden dz" - hamatomous polyps, lipomas thru GI, trichilemmonas (face/neck), and cerebellar lesions - high malignancy rate in thyroid breath and GU
38
x ray of acute pancreatitis
1. "sentinel loop" LUQ air | 2. "Colon cutoff sign" transverse colon gas with abrupt end and lower lung atelectasis
39
steps when patient presents to clinic with hematemisis (sign of UGIB)
1. admit to ICU (sick? not sick/stable?) 2. asses hemodynamic status (shock? confusion?) 3. stabilize with 2 large bore IV lines (one in each arm) 4. EGD within 24 hr (can be dx and tx) 5. pharm: IV/oral PPI, octreotide (if portal HTN suspected) 6. possible blood transfusion
40
sx and PE associate with cholelithiasis
(gall stones: cholesterol or pigment/bilirubin stones) sx: biliary colic ( RUQ severe steady ache) 30-90 min pp, lasts hours and can radiate to RIGHT SCAPULA/BACK, N/V, jaundice PE: RUQ tenderness
41
lactase deficiency cause __ type of diarrhea
osmotic
42
what is overflow diarrhea of liquids ("paradoxical diarrhea") with overflow incontinence; on DRE find firm feces
``` fecal impaction (only liquids passing and obstruction is pressing on bladder causing incontinence) ```
43
what causes an "hour glass" stomach
sliding hiatal hernia | -associated with GERD and shatzki ring
44
what dz shows gas in SI/LI and what shows dilated loops of small bowel
``` gas = paralytic ileus loops= acute small bowel obstruction ```
45
what population is acute pancreatitis seen
- pts with gall stones <5mm | - heavy alcohol use
46
what causes "upside down stomach", bowel sounds in lower lung fields, or lung hypoplasia
paraesophageal hiatal hernia | *GERD not associated
47
most common cause of chronic diarrhea
meds, IBS, lactose intolerance
48
complications, labs, sx chronic cholecystitis
complication: increased risk of GB cancer, PORCELAIN GB seen on X-ray (calcified lesions) labs: NL sx: sax for years but when it turns acute sx are RUQ pain, and dyspepsia
49
what is the cause of no peristalsis and ABNL GI motility in gastroparesis
vagus N. damage can be associated with diabetes, parkinson's, surgery, MS, etc
50
2 causes of acute cholecystitis
1. gallstones in cystic duct | 2. no stones, associated with illness/infection

Hannah MS2 GI (10 decks)

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