Gastro Flashcards
1
Q
What disease has an apple core xray?
A
Cancer
2
Q
What disease has a stacked coin xray?
A
Intussusception
3
Q
What disease has a thumbprint xray?
A
Toxic mega colon
4
Q
What disease has a corckscrew xray?
A
Esophageal spasm
5
Q
What disease has a abrupt cutoff xray?
A
Volvulus
6
Q
What disease has a barium clumping x-ray?
A
Celiac Sprue
7
Q
What disease has a bird’s beak x-ray?
A
Achalasia
8
Q
What disease has a string sign x-ray?
A
Pyloric Stenosis
9
Q
What disease have solid dysphagia?
A
Schatzki rings, stricture, cancer
10
Q
What diseases have solid and water dysphagia?
A
Esophageal spasm, scleroderma, achalasia
11
Q
What is Barret’s Esophagus?
A
Metaplasia, ^ Adeno CA risk
12
Q
What are Esophageal Varices?
A
Vomit blood everywhere, portal HTN
13
Q
what is Mallory Weiss?
A
Tear LES mucosa, chronic vomiters
14
Q
What is Boerhaave´s?
A
Tear all layers of esophagus, left sided pneumo/pain/effusion
15
Q
what is Achalasia?
A
lost LES auerbach´s. bird beaks, Chaga´s, choke on solids
16
Q
What is Hirchsprung´s?
A
Lost rectum Auerbach´s, no meconium passage
17
Q
What is a Zenker´s diverticulum?
A
Cough undigested food from above UES, halitosis
18
Q
What is a tractiom diverticulum?
A
Eat big bolus => gets stuck above LES
19
Q
What is Plummer-Vinson Syndrome?
A
esophageal webs, spoon nails, Fe deficiency anemia
20
Q
What are Schatzki rings?
A
Esophageal webs in lower esophagus
21
Q
What is a TE fistula?
A
Choke with each feeding
22
Q
What is Esophageal atresia w/ TE fistula?
A
Vomit w/1st feed, doublé bubble, Downs
23
Q
What is Pyloric Stenosis?
A
Projectile vomiting (3-4 wk old), RUQ olive mass
24
Q
How does Choanal atresia presents?
A
turn blue with feeding
25
How is Tetrology of Fallot presentation different?
turn blue with crying
26
What makes Scleroderma unique?
low LES pressure
27
What makes Esophageal spasms unique?
high peristalsis
28
What makes Achalasia unique?
low peristalsis and high LES pressure
29
What disease has a RUQ olive mass?
Pyloric stenosis
30
What disease has a RLQ sausage mass?
Intussusception
31
What is a Bezoar?
Mass of hair or vegetables => antrum obstruction
32
What is Gastritis type A?
Upper GI bleed, anti parietal cell Ab
33
What is Gastritis type B?
Upper GI bleed, spicy foods, H. pylori
34
What is a duodenal ulcer?
Too much acid: pain after meal/ at night, type O blood, H. pylori, pain relieved by eating
35
what is a gastric ulcer?
Broken mucus layer: pain during meal, NSAIDs, type A blood
36
What is a sliding hiatal hernia?
Fundus slides from esophageal hiatus to thorax => sucks acid into thorax
37
What is Rolling hiatal hernia?
Fundus sticks trough hole in diaphragm, strangulates bowel "rolls through a hole"
38
What is Menetrier's disease?
Protein losing, thick stomach rugal folds
39
What defines Constipation?
< 3 BM per week
40
What defines diarrhea?
> 200g per day
41
What is Osmotic diarrhea?
watery
42
what is secretory diarrhea?
laxative use
43
What is inflammatory diarrhea?
Blood, pus
44
what is Celiac sprue?
Jejunum, wheat allergy, villous atrophy, anti-gliadal Ab
45
What is tropical sprue?
Ileum celiac sprue
46
What is Mesenteric Ischemia?
Pain out of proportion to exam
47
What bugs cause bloody diarrhea?
"CASES"
```
Campylobacter
Amoeba (E. histolytica)
Shiguella
E. coli
Salmonella
```
48
What is the difference b/w 1 Cirrhosis and 1 Sclerosing Cholangitis?
1 Biliary Cirrhosis: anti mitochondrial Ab, bile ductules destroyed, xanthelasma
1Sclerosing Cholangitis: p-ANCA Ab, bile duct inflammation, beading, onion skinning, associated with UC
49
What is Ascending cholangitis?
common duct stone gets ingected
50
what are the signs of alcoholic cirrhosis?
spider angioma, palmar erythema, Dupuytren's contractions, gynecomastia
51
What is Hepatorenal Syndrome?
Pts w/lver disease build up liver toxins that cause renal failure
52
What is Cholangitis?
Inflammation of bile duct => charcots triad, Reynolds pentad
53
What is Cholecystitis?
Inflammation of gall bladder => Murphy's sign
54
What is Cholelithiasis?
Formation of gallstones => RUQ colic
55
What is Choledocholithasis?
Gallstones obstructs bile duct
56
What is Cholestasis?
Obstruction of bile duct => pruritis, ^ alkaline phosphatase, jaundice
57
What is Conjugated bilirubin?
Water soluble "direct"
58
What is unconjugated bilirubin?
Fat soluble "indirect"
59
What is the most common type of gallstone?
Cholesterol (can't see on x-ray)
60
What type of gallstones can be seen on x-ray?
Ca-bilirubinate
61
What is Xanthoma?
Cholesterol buildup (elbow or Achilles)
62
What is Xanthelesma?
Triglyceride build up (under eye)
63
What does high cholesterol cause?
Atherosclerosis
64
What does high triglycerides cause?
Pancreatitis
65
What is type 1 Hyperlipidemia?
Bad Liver LL (CM)
66
What is type 2a Hyperlipidemia?
Bad LDL or B-100 receptors: trapped in ER (LDL only)
67
What is type 2b Hyperlipidemia?
Less LD/VLDL receptors (LDL/VLDL)
68
What is type 3 Hyperlipidemia?
Bad Apo E (IDL/VLDL)
69
What is type 4 Hyperlipidemia?
Bad Adipose LL (VLDL only)
70
What is type 5 Hyperlipidemia?
Bad C2 (VLDL/CM) b/c C2 stimulates LL
71
What is Crigler-Najjar?
Unconjugated bilirubin, usually in infants
72
What is Gilbert syndrome?
Glucuronyl transferase is saturated => stress unconjugated bilirubin
73
What is Rotor's?
Bad bilirubin storage=> conjugated bilirubin
74
What is Dubin-Johnson?
Bad bilirubin excretion => black liver
75
What is Cullen's sign?
Bleed around umbilicus => hemorrhagic pancreatitis
76
What is turner's sign?
Bleed into flank => hemorrhagic pancreatitis
77
What test is used for following pancreatitis?
Amylase- sensitive, breaks down carbs
Lipase- specific, breaks down TGs
78
What does Ranson's criteria tell you?
Poor prognosis for pancreatitis patients
79
What is Ranson's criteria at presentation?
"WAGLA"
```
WBC: >16k/ul (infection)
Age: >55 (usually multiple illness)
Glucose: >200 mg/dL (islet cells are fried)
LDH: >350 IU/L (cell death)
AST: >250 IU/L (cell death)
```
80
What is Ranson's criteria at 48 hr?
"BuCH was a SOB"
```
BUN: ^ >5 mg /dL (v renal blood flow)
Ca: 10% (bleed into pancreas)
Sequester >6 L fluid => 3rd spacing
pO2: ARDS)
Base deficit >4 mEq/L (diarrhea => pancreatic enzymes are dead)
```
81
What is Carcinoid syndrome?
Diarrhea, flushing, wheezing
82
What produces Currant Jelly sputum?
Klebsiella
83
What produces Currant Jelly stool?
Intussusception
84
What is Gardener's syndrome?
Familial polyposis w/bone tumors
85
What is Turcots syndrome?
Familial polyposis w/brain tumors
86
What is familial polyposis?
100% risk of colon cancer, APC defect=> annual colonoscopy at 5y/o
87
What is Peutz-Jegher syndrome?
Hyperpigmented mucosa => dark gums/vagina
88
What is Chron's disease?
IBD w/ cobblestones, melena, creeping fat, fistulas
89
What is ulcerative colitis?
IBD w/pseudopolyps, hematochezia, lead pipe colon, toxic megacolon
90
What is Intussusception?
Currant jelly stool, stacked coin enema, sx come and go
91
How does Diverticulosis present?
Bleeds
92
How does Diverticulitis presents?
Hurts
93
How does spatic colon presents?
Intermittent severe cramps
94
How does IBS presents?
Alternating diarrhea /constipation
95
How does external hemorrhoids present?
Pain
96
How does Internal Hemorrhoids present?
No pain
97
What is pseudo membranous colitis?
Overgrowth of C. Difficile due to normal flora being killed off, usually by Clindamycin use
98
What is whipple's disease?
T. Whippleii destroy GI tract, then spread causing malabsorption, arthralgia
99
What color is an upper GI bleed?
Black
100
What color is a lower GI bleed?
Red
101
What adds color to stool?
Bilirubin
102
What is the default color of stool?
Clay-colored
103
What is the default color of urine?
Tea-colored
