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Boards Prep > Clinical Correlations of the Upper GI System - Esophagus, Stomach, Gallbladder > Flashcards

Clinical Correlations of the Upper GI System - Esophagus, Stomach, Gallbladder Flashcards

1
Q

What is gastroparesis?

A

Delayed emptying of the stomach into the intestines that may cause early satiety, bloating, and vomiting of undigested food

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2
Q

What is the most common complication of cholelithiasis?

A

Acute cholecystitis

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3
Q

What are the two most common types of esophageal cancer?

A

Squamous cell carcinoma, adenocarcinoma (due to Barrett’s)

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4
Q

What are bezoars?

A

Persistent concretions of foreign matter that cannot exit the stomach

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5
Q

What is the most common cause of GERD?

A

Lower esophageal sphincter dysfunction

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6
Q

This type of esophageal dysmotility is characterized by powerful swallowing due to the overactivity of excitatory neurons.

A

Nutcracker Esophagus

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7
Q

What is gallstone ileus?

A

Impaction of a gallstone in the ileum. May present with intermittent symptoms

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8
Q

True/False. ALT and AST levels are generally elevated in cases of choledocholithiasis.

A

True - serum bilirubin, ALP, and GGT are also usually elevated and exceed ALT & AST elevation

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9
Q

This pathology is characterized by calcification of the gallbladder.

A

Porcelain gallbladder

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10
Q

Acute cholecystitis may be treated with antibiotics. What is the recommended treatment for chronic cholecystitis?

A

Cholecystectomy

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11
Q

Adenocarcinoma is most associated with Barrett’s esophagus. What are the risk factors for squamous cell carcinoma of the esophagus?

A

Smoking, excessive alcohol use, high temperature liquids (?). esophageal disease

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12
Q

What is gallbladder hydrops?

A

Distension of the gallbladder with mucus, water, or clear liquid due to prolonged obstruction

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13
Q

How are esophageal perforations diagnosed?

A

Chest x-ray showing free air

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14
Q

What endoscopic features characterize eosinophilic esophagitis?

A

Linear furrows, exudates, concentric rings (“trachealization”)

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15
Q

Barrett’s esophagus is an acquired consequence of GERD. What histologic change is present?

A

Metaplastic columnar epithelium that replaces the stratified squamous epithelium

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16
Q

What is the cause of esophageal varices?

A

Portal hypertension

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17
Q

What is the presentation of pain due to biliary colic?

A

Pain in the RUQ that crescendos/decrescendos

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18
Q

This disease has a cottage cheese appearance and is most common in HIV patients. What is the causative pathogen and treatment?

A

C. albicans treated with fluconazole

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19
Q

What is the most common benign tumor of the stomach?

A

Leiomyoma

20
Q

What is the treatment for mild gastroparesis?

A

Dietary modifications (low-fat foods), prokinetic agents (promote gastric contraction)

21
Q

True/False. Early gastric cancers only penetrate the mucosal layer.

A

True - submucosal layer is not infiltrated

22
Q

What symptoms are present in Charcot’s triad and with what disease is the triad associated?

A

Cholangitis - fever, jaundice, RUQ pain

23
Q

What is the most common internal cancer worldwide?

A

Gastric carcinoma

24
Q

What is Boerhaave’s Syndrome?

A

Full-thickness tear of the esophagus, often due to a sudden increase in intraesophageal pressure combined with negative intrathoracic pressure from vomiting or straining.

25
Q

Endoscopic variceal ligation may be used to prevent variceal bleeds. What pharmacological options are used for prophylaxis?

A

Nonselective beta-blockers (propranolol, nadolol)

26
Q

What is the imaging of choice to diagnose biliary colic?

A

Ultrasound

27
Q

Most ingested foreign objects pass spontaneously through the stomach. What foreign bodies should be removed?

A

Sharp objects, objects greater than 2cm in width and 5cm in length

28
Q

This disease is characterized by chronic symptoms and/or mucosal damage produced by abnormal reflux of gastric contents into the esophagus.

A

Gastroesophageal Reflux Disease (GERD)

29
Q

This drug class is the most effective in healing erosive esophagitis and managing symptoms of GERD.

A

PPIs - may take some time to become effective

30
Q

Gastric ulcers have been linked to what cancers?

A

Gastric adenocarcinoma, lymphoma

31
Q

Zollinger-Ellison Syndrome is characterized by hypersecretion of gastrin. What is the cause?

A

Gastrinoma

32
Q

What is the most common cause of gastroparesis?

A

Idiopathic causes

33
Q

This biliary pathology presents with acute necro-inflammatory disease of the gallbladder due to stasis and ischemia.

A

Acalculous Cholecystitis

34
Q

These are sac-like outpouching of the mucosa and submucosa of the esophagus diagnosed with a barium x-ray.

A

Zenker’s diverticulum

35
Q

What are the most common causes of acid peptic disorders?

A

H. pylori infection, NSAIDs

36
Q

Gastric volvulus occurs when the stomach wraps around itself. What are the two types of gastric volvulus?

A

Organoaxial, mesenteroaxial

37
Q

What disorder is most recognizable as associated with gastroparesis?

A

Diabetes Mellitus

38
Q

True/False. An endoscopy should be done to diagnose Boerhaave’s syndrome.

A

False - full esophageal tears are a contraindication for endoscopy

39
Q

True/False. Biliary malignancy is a rare, but highly fatal pathology often discovered incidentally.

A

True - Risk factors include porcelain bladder, gallbladder hydrops, cholelithiasis, and primary sclerosing cholangitis.

40
Q

This type of esophageal tear is not full-thickness.

A

Mallory Weiss tear

41
Q

Cholangitis with Charcot’s tried, altered mental status, and hypotension is termed…?

A

Reynold’s pentad

42
Q

What is Murphy’s sign?

A

Pain in the RUQ due to palpation with inhalation. A positive test indicates acute cholecystitis.

43
Q

What is the treatment for eosinophilic esophagitis?

A

High-dose PPIs, oral steroids (more likely for adults)

44
Q

Where in the GI tract are most gastrinomas found?

A

Duodenum

45
Q

What is the treatment for acid peptic disorders?

A

Removal of offending agent, PPIs

46
Q

What is the recommended treatment for H. pylori infection?

A

Clarithromycin, amoxicillin, PPI

*Metronidazole may be substituted for amoxicillin in cases of penicillin allergy

47
Q

This esophageal disorder is characterized by symptoms of dysphagia, regurgitation, and heartburn with gradual onset.

A

Achalasia - loss of inhibitory innervation

Boards Prep (116 decks)

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