Clin Med Final - GI Flashcards
problem w sigmoid colon innervation
Hirshsprung
MC site diverticulosis
sigmoid colon
UC v Crohns
UC is colon only, Crohns anywhere mouth to anus
apple core lesion d/t annular growth
colon Ca
flattened intestinal villi w/ T lymphocytes between
celiac sprue
Diarrhea, macrophages in intestinal lamina propria, organism T. whippelii
Whipple’s dz
Acute pancreatitis followed by severe abd pain, guarding, intestinal paralysis
acute peronitis - high mortality
psuedomembranous colitis commonly caused by what bug
C.diff
baby vomits everything back up, they might have
esopahgeal atresia
spasm of LES w/ esophageal dialation above, birds beak esophagus
achalasia
laceration of vessels at GE junction causing sev. vomiting
mallory-weiss
transition of esophageal epi from squamous to columnar
Barrett’s, need periodic monitoring as pre-ADENOMA
projectile vomiting in young boy
congenital pyloric stenosis
peptic ulcers are mostly found in
duodenum > distal stomach
“strawberry gallbladder” w/ cholesterol esthers
cholesterolosis (incidental finding)
smooth muscle hypertrophy of GB, “rokitansky aschoff sinuses”
chronic cholecystitis
2 common causes of acute pancreatitis
alcoholic, bile stones that obstruct papilla of Vater
pain in upper abdomen radiating to back, Xray calcifications, steatorrhea, DM
chronic pancreatitis
pancreatic Ca usually exocrine or endocrine
exocrine
adenocarcinomas in HEAD of pancreas
dx pancreatic Ca
ECRP
pt presses on neck to help swallow
Zencjers diverticulum
ring of mucosal tissue in esophagus that can cause probs swallowing
schatzki’s ring
pt has mild sx classic of GERD… next step?
lifestyle mods, antacid/PPI/H2block, metalchlopromide
tobacco and EtOH cause cancers of this cell type
squamous (distinct from Barretts)
tests for H. pylori
urea breath test, stool antigen
tx: 2 week abx (gram neg)
gastrin-secreting tumo of pancreas and duodenum (assoc w MEN1) that causes too much stomach acid, and therefore PUD
Zollinger Ellison Syndrome
bloating/anorexia, wt loss, there is bezcoar on endoscopy
gastroparesis
gastroparesis causes
DM, shingles/infxn, AI, benzos/CCB/narcotic. (more too)
gastroparesis tx
avoid high fiber, surgical removal of old food, metoclopramide, gastric pacer
Peyer’s patches
part of MALT in intestine, immune defense
IgA in lamina propria of intestine serves what function
immune defense
3rd MCC death in kids <5yo
gastroenteritis
in developed countries, gastroenteritis is ___ borne, in developing, _____borne
food, water
rice water stool in pt in developing country, 14h-5d after exposure
V. cholerae
V. cholerae tx
hydration, single dose doxy
MCC traveler’s diarrhea
ETEC
ETEC tx
2-4d course, but macrolide or floroquinolone can shorten it
beaver fever, fatty/smelly stools
Giardia
Giardia dx
fecal antigen test, enterotest (gelatin capsule on a string pulled back up)
Giardia tx
metronidazole tid 7d
Gram neg rod causing fever, mucoid bloody diarrhea, can progress to HUS if untreated
Shigella
Comma shaped G- causing bloody watery stools, pain relief w pooping; potential complication is GBS
Campylobacter
Shigella tx
floroquinolone
Campylobacter tx
if sx >7d, azithro… but typically self resolves