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Clin Med > Clin Med Final - GI > Flashcards

Clin Med Final - GI Flashcards

1
Q

problem w sigmoid colon innervation

A

Hirshsprung

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2
Q

MC site diverticulosis

A

sigmoid colon

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3
Q

UC v Crohns

A

UC is colon only, Crohns anywhere mouth to anus

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4
Q

apple core lesion d/t annular growth

A

colon Ca

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5
Q

flattened intestinal villi w/ T lymphocytes between

A

celiac sprue

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6
Q

Diarrhea, macrophages in intestinal lamina propria, organism T. whippelii

A

Whipple’s dz

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7
Q

Acute pancreatitis followed by severe abd pain, guarding, intestinal paralysis

A

acute peronitis - high mortality

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8
Q

psuedomembranous colitis commonly caused by what bug

A

C.diff

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9
Q

baby vomits everything back up, they might have

A

esopahgeal atresia

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10
Q

spasm of LES w/ esophageal dialation above, birds beak esophagus

A

achalasia

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11
Q

laceration of vessels at GE junction causing sev. vomiting

A

mallory-weiss

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12
Q

transition of esophageal epi from squamous to columnar

A

Barrett’s, need periodic monitoring as pre-ADENOMA

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13
Q

projectile vomiting in young boy

A

congenital pyloric stenosis

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14
Q

peptic ulcers are mostly found in

A

duodenum > distal stomach

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15
Q

“strawberry gallbladder” w/ cholesterol esthers

A

cholesterolosis (incidental finding)

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16
Q

smooth muscle hypertrophy of GB, “rokitansky aschoff sinuses”

A

chronic cholecystitis

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17
Q

2 common causes of acute pancreatitis

A

alcoholic, bile stones that obstruct papilla of Vater

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18
Q

pain in upper abdomen radiating to back, Xray calcifications, steatorrhea, DM

A

chronic pancreatitis

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19
Q

pancreatic Ca usually exocrine or endocrine

A

exocrine

adenocarcinomas in HEAD of pancreas

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20
Q

dx pancreatic Ca

A

ECRP

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21
Q

pt presses on neck to help swallow

A

Zencjers diverticulum

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22
Q

ring of mucosal tissue in esophagus that can cause probs swallowing

A

schatzki’s ring

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23
Q

pt has mild sx classic of GERD… next step?

A

lifestyle mods, antacid/PPI/H2block, metalchlopromide

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24
Q

tobacco and EtOH cause cancers of this cell type

A

squamous (distinct from Barretts)

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25
Q

tests for H. pylori

A

urea breath test, stool antigen

tx: 2 week abx (gram neg)

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26
Q

gastrin-secreting tumo of pancreas and duodenum (assoc w MEN1) that causes too much stomach acid, and therefore PUD

A

Zollinger Ellison Syndrome

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27
Q

bloating/anorexia, wt loss, there is bezcoar on endoscopy

A

gastroparesis

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28
Q

gastroparesis causes

A

DM, shingles/infxn, AI, benzos/CCB/narcotic. (more too)

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29
Q

gastroparesis tx

A

avoid high fiber, surgical removal of old food, metoclopramide, gastric pacer

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30
Q

Peyer’s patches

A

part of MALT in intestine, immune defense

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31
Q

IgA in lamina propria of intestine serves what function

A

immune defense

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32
Q

3rd MCC death in kids <5yo

A

gastroenteritis

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33
Q

in developed countries, gastroenteritis is ___ borne, in developing, _____borne

A

food, water

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34
Q

rice water stool in pt in developing country, 14h-5d after exposure

A

V. cholerae

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35
Q

V. cholerae tx

A

hydration, single dose doxy

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36
Q

MCC traveler’s diarrhea

A

ETEC

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37
Q

ETEC tx

A

2-4d course, but macrolide or floroquinolone can shorten it

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38
Q

beaver fever, fatty/smelly stools

A

Giardia

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39
Q

Giardia dx

A

fecal antigen test, enterotest (gelatin capsule on a string pulled back up)

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40
Q

Giardia tx

A

metronidazole tid 7d

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41
Q

Gram neg rod causing fever, mucoid bloody diarrhea, can progress to HUS if untreated

A

Shigella

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42
Q

Comma shaped G- causing bloody watery stools, pain relief w pooping; potential complication is GBS

A

Campylobacter

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43
Q

Shigella tx

A

floroquinolone

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44
Q

Campylobacter tx

A

if sx >7d, azithro… but typically self resolves

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45
Q

hamburger gastroenteritis that can cause HUS

A

STEC

46
Q

STEC/ETEC tx

A

dilution, NO ABX or promotility

47
Q

when to treat Salmonella

A

immuno comp, gallstones…. otherwise no abx as may prolong the time one “carries” the dz

48
Q

Hispanic male w/ 4 wk jaundice, cramps, wt loss, diarrhea

A

Amoeba histolytica, concern for liver abcess

49
Q

Amoeba histolytica tx

A

metronidazole

50
Q

test for C. diff

A

NAAT stool test

51
Q

rose spots, consitutional sx, +/- neuropsych

A

typhoid fever

52
Q

typhoid fever tx (following culture of lesions/stool)

A

cipro, cefrtiaxone

53
Q

childhood vax to px bad infantile GE

A

rotavirus

54
Q

don’t give loperamide if they have

A

bloody/dysentry diarrhea

55
Q

ileac resection leds to what type of diarrhea

A

secretory (Cl secreted, water follows)

56
Q

Crohn dx

A

72 fecal fat test

57
Q

colonic ischemia v ischemic colitis

A

colon ishema = obstructive (clots)

ischemic colitis = nonobs (hOtn, athersclerosis)

58
Q

Rome III criteria for IBS

A
  • recurrent abd pain
  • 3+ day/mo
    2 of following:
  • improve w/ defacation
  • onset a/w change in bowel habits
  • onset a/w change in stool form
59
Q

pain b/t R iliac crest and bellybutton

A

Mcburney’s

60
Q

RLQ pain w/ hip ext

A

psoas sign

61
Q

RLQ pain w/ int hip rot

A

obturator sign

62
Q

pain in RLQ while pushing on LLQ

A

Rovsing

63
Q

MC tx for IBS

A

fiber + probiotics, but many others d/t many pathways, include SSRI, etc

64
Q

massive dialation of right colon following surgery

A

Olgivie syndrome. Decompress or give neostigmaine

65
Q

kidney bean sign (dialated sigmoid colon)

A

sigmoid volvus

66
Q

ring-like holes (diaphragms) in the colon, person takes lots of NSAIDS

A

NSAID colopathy (d/t reduced PG and muscosal blood dlow)

67
Q

alk phos is elevated, you might consider

A

gallstones

68
Q

pain radiating to back w/ distension, N/V. hx etoh, NSAID, or gallstone

A

acute pancreatitis

69
Q

how to deliver nutrition in acute pancreatitis

A

Enteral

70
Q

what are cullen and grey turner sign for

A

acute pancreatitis, cullen’s is bellybutton

71
Q

ascites, elevated LFTs (early on), caused by hepatic vein thrombosis blocking outflow

A

Budd Chiari

72
Q

nutmeg liver

A

RHF, cor pulmonale

73
Q

mallory bodies

A

steatohepatitis

74
Q

NASH v. alcoholic steotosis

A

AST>ALT in alcoholic

75
Q

ground glass hepatocytes

A

HBV

76
Q

plasma cells w/ hepatitis

A

AI etiology

77
Q

eisinophil w/ hepatits

A

drug-induced

78
Q

bronze diabetes d/t decreased hepcidin in body

A

hemochromatosis

79
Q

Kayser Fleischer brown rings in the eyes, high rhodanine/low ceruloplasmin

A

Wilson’s dz (copper accumuation)

80
Q

onion skin fibrosis, IBD, M>F

A

primary sclerosing cholangitis

81
Q

granulomatous bile duct necrosis of liver, W>M

A

primary biliary cirrhosis

82
Q

people w/ HCV should be have US q6mo to test for

A

HCC

83
Q

neoplasms in female liver that grow w/ OCP or pg

A

benign heaptic neoplasm (no tx)

84
Q

tx for PSC/PBC

A

pRBC, ADEK supp, possible biliary stent

85
Q

tea-colored urine and flu like sx after trip to Asia

A

Hep A

86
Q

vertical transmission of HBV is enhanced by

A

e antigen (HBeAg+)

87
Q

pos anti-HBs, neg anti-HBc… does this person have a resolved infxn or hx of immunization

A

immunization

88
Q

when would you get the anti-HBV immunization HBIG?

A

mom that is HBV+, or PEP… there is a diff vax for everyone else

89
Q

pts born in these years have inc risk of HCV

A

1945-1965

90
Q

what % of ppl w/ acute HCV get it chronically

A

80%

91
Q

how to screen for HCV? how to tell if HCV is chronic or acute?

A

screen- anti-HCV

chronic/acute - HCV RNA (viral load)

92
Q

what’s a good biomarker for malnutrition

A

there isn’t really one

93
Q

starving w/ big bellies

A

kwashiorkor (protein def only)

94
Q

person has longstanding hx of heartburn, now it’s suddenly relieved. you are worried about

A

esophageal ca (destruction of pain fibers?)

95
Q

watery diarrhea <1L daily that stops w/ fasting. Na+K gap >50. muscosal dz of bowel is common.

A

osmotic MC lactase defic.

96
Q

watery diarrhea >1L daily w/ small osmotic gap

A

secretory MC enterotoxin mediated, VIPoma of pancreass

97
Q

> 6 BMs daily, <1 L, diarrhea

A

exudative: MC UC, Crohns, enterotoxin

98
Q

are most infectious diarrheas caused by bacteria or viruses

A

VIRAL. rotavirus in kids, noro in adults

99
Q

MC type of gallstones

A

cholesterol

100
Q

ursodoxycholic acid is a tx for

A

gallstones if they are small

101
Q

Charcot triad for cholangitis

A

fever, RUQ pain, jaundice

102
Q

cholangitis tx

A

ECRP

103
Q

choleangioma has highest incidence in what geographic area

A

SE Asia

104
Q

which is MC in NON-smokers: UC or CD

A

UC (quitting smoking can exacerbate it)

105
Q

“beads on a string” strictures/bloackages in bile duct

A

sclerosing cholangitis

106
Q

high unconj bili only suggests

A

hemolytic process

107
Q

equally elevated conj/unconj bili suggests

A

process w/in liver

108
Q

high conj suggests

A

gallstones/problem w/ bile ducts

109
Q

itching, xanthesamsa, xanthoma

A

chronic cholestasis

110
Q

what must you do for new-onset ascites

A

tap them to r/o bacterial perotinitis

Clin Med (12 decks)

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