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USMLE Secrets > Gastroenterology > Flashcards

Gastroenterology Flashcards

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USMLE® Step 1 flashcards
1
Q

Is PUD more common in men or women?

A

Men

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2
Q

Which type of ulcer is mainly caused by H. pylori?

A

Duodenal

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3
Q

Which blood type is associated with each type of ulcer?

A

Gastric - A

Duodenal - O

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4
Q

What is the gold standard for diagnosis of PUD? Which test is used more frequently and why?

A

Gold standard is upper endoscopy

GI barium study is typically used bc its cheaper and less invasive

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5
Q

What blood work should you check if you suspect Z-E syndrome?

A

Gastrin (secreted by the gastrinoma)

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6
Q

What are the basic 3 drugs for PUD triple therapy?

A

1) PPI
2) Clarithromycin
3) Amoxicillin

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7
Q

What is dumping syndrome?

What actually occurs and why does it happen?

A

Weakness, dizziness, sweating, and nausea or vomiting after eating after abdominal surgery

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8
Q

What is the most common cause of achlorhydia?

A

Pernicious anemia

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9
Q

What is pernicious anemia?

A

Antiparietal cell antibodies destroy acid-secreting parietal cells causing achlorhydia and B12 deficiency

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10
Q

What antibiotics would be used for diverticulitis?

A

Fluoroquinolone plus metronidazole

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11
Q

What kind of diarrhea is caused by lactose intolerance?

A

Osmotic

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12
Q

What happens in osmotic diarrhea?

A

Non absorbable solutes in the bowel that retain water

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13
Q

What happens in secretory diarrhea?

A

Bowel secreting too much fluid

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14
Q

What are some main causes of secretory diarrhea?

A

Bacterial toxins
VIPoma
ileal resection

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15
Q

Which one stops when the patient stops eating, osmotic, malabsorptive, and/or secretory diarrhea?

A

Osmotic and malabsorptive

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16
Q

What is are 3 the most common cause of malabsorptive diarrhea?

A

Celiac disease
Crohns disease
Postgastroenteritis

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17
Q

What is the overall cause of exudative diarrhea?

A

Bowel wall inflammation

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18
Q

What are the 3 basic signs of HUS?

A

Thrombocytopenia
Hemolytic anemia
Acute renal failure

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19
Q

When should you watch for HUS?

A

After bacterial diarrhea in a child (esp Shigella or E coli)

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20
Q

What dermatologic condition should you look for in celiac disease?

A

dermatitis herpetiformis

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21
Q

What do you treat IBD with?

A

5-ASA +/- sulfa drug when stable

Steroids and immune modulators (azathioprine) during flares

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22
Q

What are the two main causes of toxic megacolon?

A

UC

C diff

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23
Q

What is the classic radiological sign of Crohns?

A

String sign admist widely spaced bowel loops from spasm and edema associated with active inflammation

24
Q

What is the classic radiological sign of long standing UC?

A

loss of haustration

25
Q

What abx are given to cover bowel flora?

A

ceftriaxone and flagyl

26
Q

What do you treat hep C with?

A

Pegylated interferon alpha + ribavirin

+ a protease inhibitor for genotype 1

27
Q

Which Hep C genotype is most common in the US? Which types have the best treatment success?

A

Type 1

Types 2&3

28
Q

What is the specific cause of GERD?

A

Relaxation of the LES

29
Q

What 5 drugs are classic causes of drug-induced hepatitis?

A 
Acetaminophen
TB drugs (RIP)
Halothane
HMG-CoA reductase inhibitors
Carbon tetrachloride
30
Q

What are the serological markers for autoimmune hepatitis?

A

Anti-sm Abs

Antinuclear Abs

31
Q

What is the inheritance of hemochromatosis?

A

AR

32
Q

What is the inheritance of Wilson dz?

A

AR

33
Q

What is low in Wilson dz?

A

Ceruloplasmin

34
Q

How do you treat Wilson dz?

A

Penicillamine (copper chelator)

35
Q

What is the classic description of someone with alpha 1 antitrypsin deficiency?

A

Young adult who develops cirrhosis and emphysema without risk factors for either

36
Q

What level of alpha 1 trypsin is diagnostic for deficiency?

A
37
Q

What is the inheritence for alpha 1 antitrypsin def?

A

AR

38
Q

What is the common abx of choice for bacterial peritonitis?

A

Cefoxatime

39
Q

What is the Tx for hyperammonemia?

A

decrease protein intake
lactulose (prevents absorption)
neomycin (last resort)

40
Q

Dark urine + jaundice suggests….

A

Conjugated bilirubinemia

41
Q

Why is unconjugated bili not excreted in the urine?

A

It is tightly bound to albumin

42
Q

What is Courvoisier sign?

A

Jaundice with palpably enlarged gallbladder

43
Q

What medications can cause cholestasis?

A

Birth control pills
TMP-SMX
phenothiazines
Androgens

44
Q

What physiological state can cause cholestasis?

A

Pregnancy

45
Q

What are 3 main signs/results that suggest primary biliary cirrhosis?

A

Pruritis
Jaundice
Antimitochondrial Ab

46
Q

What are the two treatment options for primary biliary cirrhosis?

A

Symptomatic Tx with cholestyramine

Definitive Tx with liver transplant

47
Q

Which dz is primary sclerosing cholangitis associated with?

A

UC

48
Q

What is Charcot triad?

A

fever
RUQ pain
jaundice

49
Q

What disease is associated with achalasia?

A

Chagas

50
Q

What is the treatment for achalasia?

A

CCBs
pneumatic balloon dilatation
botulism toxin injection
myotomy

51
Q

Do pts with achalasia have a in increased risk of esophageal cancer?

A

yes

52
Q

How do you diagnose esophageal spasm?

A

Esophageal manometry

53
Q

Esophageal adenocarcinoma is typically in which part of the esophagus?

A

Proximal

54
Q

What is Grey Turner sign?

A

blue-black flank

55
Q

What is Cullen sign?

A

blue-black umbilicus

56
Q

What should you not use for dx if you suspect GI perforation? What should you use instead?

A

barium

water soluable gastrografin

USMLE Secrets (6 decks)

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