Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

(OMS1) GIGU Exam > DSA 1: GI Clinical Correlations > Flashcards

DSA 1: GI Clinical Correlations Flashcards

1
Q

Make sure to review the medical terminology and imaging examples on the slides

A

Ok

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the GI red flags?

A

throat issues: dysphagia, odynophagia
bleeding issues: melena, hematemesis
signs of malignancy: weight loss, severe pain, palpable mass, lymphadenopathy GI cancer hx
losing body fluids: vomiting, Iron deficiency anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the common ddx for RUQ pain?

A 
cholecystitis
pyelonephritis
ureteric colic
hepatitis
pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are common ddx for LUQ pain?

A

gastric ulcer
pyelonephritis
ureteric colic
pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are common ddx for RLQ pain?

A 
appy
colic
inguinal hernia
IBD
UTI
testicular torsion/gyn stuff
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are common ddx for LLQ pain?

A 
-diverticulitis
colic
inguinal hernia
IBD
UTI
testicular torsion/gyn stuff
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are common ddx for epigastric pain?

A

peptic ulcer dz
cholecystitis
pancreatitis
MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are common ddx fo peri-umbilical pain?

A

small and large bowel obstruction
appy (early)
AAA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the difference between visceral and parietal pain?

A

Visceral: stimulation of visceral pain fibers secondary to damage to visceral organ = not localized

Somatic: stimulation of somatic pain fibers secondary to inflammation of parietal peritoneum over diseased organ = localized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some important questions to ask when patient complains of nausea and vomiting?

A
  • appearance of the vomit
  • how often
  • projectile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Oropharyngeal dysphagia and what is the usual cause

A
  • trouble initiating swallowing

- neuro issues, muscular/rheumatic, infectious, structural or motility disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is esophageal dysphagia and what is the usual cause?

What questions should you ask your patient?

A
  • difficulty swallowing, usually mechanical obstruction or motility issue
  • ask if patient has difficulty with solids, liquids, and if progressive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the routine labs for GI complaints?

A 
CBC
CMP
BMP (if no liver concern)
UA
Preg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What labs are useful for evaluating pancreatitis, liver function and jaundice?

A

Pancreatitis - lipase, also amylase
liver - PT/PTT
Jaundice - fractionated bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does a CBC with diff tell you?

A

Blood cell count with breakdown of WBC components

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the important things to look for in a BMP?

A

Na, Cl, K, CO2, BUN, Creatinine and glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the important things to look for in a CMP, especially for liver function?

A

Albumin, ALT, AST, alkaline phosphatase
Bilirubin, globulin and protein
PT/INR, GGT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What important tests should you order if ruling out Zolinger Ellison Gastrinoma?

A

fasting gastrin

secretin stimulation test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is acute abdominal series good for?

What is a KUB good for?

Be sure to look at the images on slides

A

-initial/quick screening for free air/constipation
usually not diagnositic

-kidneys, ureters, urinary bladder evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a barium swallow xray/esophagram good for?

Be sure to look at the images on slides

A

-differentiating between mechanical lesions or motility disorders (esophageal issues/narrowing)

21
Q

What is an esophagogastroduodenoscopy (EGD) good for?

Be sure to look at the images on slides

A
  • upper endoscopy, good for heartburn, dysphagia, odynophagia
  • direct visualization, allows biopsy and dilation
22
Q

What is a colonoscopy good for?

Be sure to look at the images on slides

A

-lower GI issues (colon bleeding/cancer etc)

23
Q

What is an ultrasound good for?

Be sure to look at the images on slides

A
  • good for fluid filled structures such as Gall bladder, bladder, kidneys, vessels or heart
  • also good for FAST scan (checking for abdominal bleeding after trauma)
24
Q

What is the ERCP (endoscopic retrograde cholangiopancreatography) good for?

How about MRCP?

A
  • visualizing the biliary tree/pancreatic duct for evaluating gall bladder dz, both diagnostic and therapeutic
  • specifically good for bile duct visualization, diagnostic only, not therapeutic
25
Q

What is a HIDA scan good for?

A

specifically measures gallbladder function

HIDA + CCK (gallbladder ejection fraction) = biliary dyskinesia if lower than <38%

26
Q

What is an abdomen/pelvis CT scan good for?

A

best test to order when ddx is broad, gives most info about abdominal pathology

27
Q

Why should you think about GERD/Gastritis/PUD together?

A

similar pathophysiology, diagnostic workup and treatment

28
Q 
GERD
cause
clinical sx
workup
treatment
A
  • LE sphincter gastric reflux > injury to esophageal tissue
  • heartburn worse after eating, regurgitation (worse when supine)
  • can dx just based on classic sx, but do upper endoscopy if associated with non-classical symptoms
  • lifestyle modification, antacids, h2 blockers, surface agents, proton pump inhibitor

*Be sure to look at what GERD looks like on endoscopy

29
Q

Peptic ulcer disease

Major risk factors?

A
  • gastric or duodenal mucosa damage that acid reached the muscular mucosa and damaged it too, most common UGIB cause
  • H. pylori infection and NSAIDs
30
Q

Gastric vs Duodenal ulcer

A

Gastric: usually at lesser curvature of antrum, caused by mucosa damage leading to parietal cell loss (low H_ secretion)

Duodenal: usually at proximal duodenum, caused by enhanced H+ secretion leading to mucosa damage

31
Q

How do you dx and treat gastric and duodenal ulcers?

A
  • both dx with EGD

- both treated with H. pylori eradication and proton pump inhibitors

32
Q

What is the significance of H. pylori infection?

A

associated with a bunch of GI diseases

  • urease hydrolyses urea to NH3+ > increases pH and protects organism > able to penetrate gastric mucosa
  • H. pylori also exacerbates mucosal inflammation
33
Q

How do you test for H. Pylori?

A

Urea breath test (gold standard)
Fecal antigen

Make sure patient stops proton pump inhibitors 14 days before taking these tests

34
Q

UGIB:
clinical pearls

What is the major DDX for UGIB?

A

bleeding above the ligament of Treitz (duodenum and up)
Pearls: hematemesis, coffee ground emesis, melena, if pt has hx of UGIB, bleeding is likely from the same site as before

-Peptic ulcer disease

35
Q

What can cause UGIB?

A

-blood thinners, B blockers, meds with iron or bismuth

36
Q

LGIB

What is the major DDX for LGIB?

A

-bleeding below the ligament of Treitz (jejunum and down)

Diverticulosis

37
Q

Esophageal and gastric varices

A
  • dilated veins due to portal HTN

- can also cause UGIB (esp in cirrhosis)

38
Q

What are three ways cholelithiasis/cholecystitis can present?

A
  • asymptomatic
  • RUQ pain worse after greasy food
  • complications of gallstone dz (e.g. pancreatitis)
39
Q

Cholecystitis vs. Choledocholithiasis vs. Cholangitis

A
  1. ) obstruction at cystic duct or gallbladder neck > inflamed gall bladder, LFTs normal since liver not affected
  2. ) obstruction at common bile duct > liver and gallbladder can’t drain the bile, LFTs elevated
  3. ) obstruction at common duct > inflamed biliary tree + presence of air
40
Q

Gallstone pancreatitis

Dysfunctional GB

A
  • stone stuck in pancreatic duct > elevated LFTs and lipase/amylase
  • no stones, normal LFT, but with symptoms of biliary colic
41
Q

Pancreatitis
Classic sx
workup

A
  • severe epigastric pain + n,v, elevated lipase/amylase

- routine AP labs, + lipase, UA, CMP, preg, CT (if imaging needed)

42
Q

Appendicitis
Classic sx
workup

A

-starts visceral around umbilicus, migrates to RLQ
-routine AP labs, CT (US for kids)
tx with surgery

43
Q

Diverticulosis/Diverticulitis
Classic sx
workup

A

-LLQ pain, +/-n,v,fever (opposite of appy)
-routine AP labs, + CMP, UA, preg, CT
tx with abx or surgery

44
Q

Primary Achalasia
cause
symptoms

A
  • LES doesn’t relax > no peristalsis

- dysphagia, regurgitation, bird beak appearance of distal esophagus

45
Q

Secondary Achalasia
cause
symptoms

A
  • can be caused by Chaga’s disease

- same symptom as primary but with systemic symptoms of Chaga’s (swollen bite site, Romana sign - swollen eyelid)

46
Q

Zollinger Ellison Syndrome (ZES) Gastrinoma

When should you consider this dz?

A
  • gastrinoma secreting gastin, elevated gastrin and + secretin test
  • ulcers at weird locations
47
Q

Parasympathetic innervation of GI:

A

Vagus N. (from esophagus to transverse colon)

S2-S4/pelvic splanchnic nerves (from descending colon downards)

48
Q 
Sympathetic innervations of the following: 
Esophagus
Stomach
Liver and Gall bladder
Pancreas 
Small intestine
Colon
Appendix
A
  • T2-8
  • T5-9
  • T6 -9
  • T5-11
  • T5-9, T9-12
  • T9-L2
  • T12

(OMS1) GIGU Exam (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions