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NPLEX 2 > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

How can you improve O&P sensitivity?

A

Loosen the bowels - herbs, water, magnesium

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2
Q

Which Ig rises with infxn and reduces with remission and is often specific to mucus membranes?

A

IgA

H. pylori often

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3
Q

Name the referred pain pattern: 5th left rib to mid lumbar region, midline to left lateral border: dorsal and ventral epigastric areas

A

Stomach

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4
Q

Name the referred pain pattern: same position as stomach on right half of body. Dorsal and ventral. Right scapula.

A

Liver

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5
Q

Name the referred pain pattern: Murphy’s point, RUQ, right scapula

A

GB

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6
Q

Name the referred pain pattern: McBurney’s point, RLQ, Right dorsal flank, celiac area

A

Appendix

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7
Q

Name the referred pain pattern: Celiac, local area of lg intestine

A

Colon, Sm intestine

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8
Q

Name the referred pain pattern: suprapubic area, sacral area

A

Rectum

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9
Q

Name the referred pain pattern: Costovertebral area, bilateral dorsal flanks, R and L dorsal iliac crests

A

Kidneys

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10
Q

Name the referred pain pattern: left inferior iliac crest, left inguinal area, left labia/testicle

A

Ureter

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11
Q

T/F: Initial abd pain is often remote to the organ.

A

T

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12
Q

DDX Central/Celiac pain

A

Acute/early appy, acute small bowel obs, gastritis, pancreatitis, intestinal colic

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13
Q

DDX RUQ pain

A

Pleuritic pain, acute appy, cholecystitis, leaking duodenal ulcer, subphrenic abscess (hx of laparoscopic procedure)

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14
Q

DDX LUQ pain

A

Subphrenic abscess, perforated gastric ulcer, jejunal diverticulitis, splenic pain

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15
Q

DDX RLQ pain

A

Crohns, Appy, Mesenteric adenitis, leaking duodenal ulcers

less common: cholecystitis, biliary peritonitis, acute pancreatitis, inflamed Meckel’s diverticulum

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16
Q

DDX LLQ pain

A

Diverticulitis, peritonitis, pericolitis

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17
Q

DDX left inguinal/iliac pain

A

Back: ureteric pain, kidney pain

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18
Q

Term: motility disorder of the esophagus secondary to loss of neurons from mesenteric plexus. LES fails to relax with swallowing.

A

Achalasia

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19
Q

T/F: Gastric ulcer is better w/ eating. Duodenal ulcers are worse w/ food.

A

F - Gastric worse w/ food. Duodenal better w/ eating

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20
Q

What should you consider when a pt presents with recurrent ulcer-like symptoms that do no respond to treatment?

A

CA - do endoscopy

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21
Q

Two of the MC etiology for pancreatitis?

A

Alcohol, gallstones

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22
Q

Lab tests to run with pancreatitis.

A

Amylase and lipase.

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23
Q

If tot bili is elevated, MUST check direct and indirect. If indirect is elevates, what is the cause? Direct?

A

Indirect/Unconjugated - Gilbert’s syndrome, poor glucuronidation, or excessive lysis

Direct - hepatocellular dz, biliary obs

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24
Q

What is the only DNA virus of the Hepatitis family?

A

Hep B

25
Q

Lab findings in cirrhosis.

A

Decreased serum albumin and prolonged PT

26
Q

MC gastric cancer.

A

Adenocarcinoma

27
Q

Which imaging is more sensitive in pancreatic cancer?

What symptom occurs in 25-50% of patients w/ pancreatic CA?

A

CT

Hyperglycemia

28
Q

Which two genetic conditions run in families and highly inc the risk of colon CA esp before the age of 40?

A

Familial polyposis and Lynch syndrome

29
Q

When do you start screening colonoscopies? What does screening include?

A

50-75

Colonoscopy, sigmoidoscopy, and fecal occult blood.

30
Q 
Name the etiologic agent (bacteria/virus/ameoba): 
Inc time: 4-12 hr
Diarrhea: Watery, profuse
Emesis: Pronounced
Abd pain: Mild
Fever: Absent
A

Staph aureus, Clostridium perfringens

31
Q 
Name the etiologic agent (bacteria/virus/ameoba): 
Inc time: 8-72 hr
Diarrhea: Watery, profuse
Emesis: Moderate
Abd pain: Mild
Fever: Absent
A

Vibrio cholera, enterotoxigenic E. coli

32
Q 
Name the etiologic agent (bacteria/virus/ameoba): 
Inc time: 2-7 d
Diarrhea: variable, watery
Emesis: mild
Abd pain: moderate
Fever: variable
A

E. coli, giardia

33
Q 
Name the etiologic agent (bacteria/virus/ameoba): 
Inc time: 1-3 d
Diarrhea: variable, often bloody
Emesis: mild
Abd pain: severe
Fever: mild
A

Hemorrhagic e. choli, clostridium difficile

34
Q 
Name the etiologic agent (bacteria/virus/ameoba): 
Inc time: 1-4 d
Diarrhea: often bloody
Emesis: milde
Abd pain: severe
Fever: moderate to high
A

Salmonella, campylobacter, Shigella, enteroinvasive E. coli, entamoeba histolytica

35
Q

Which is the enterohemorrhagic strain of E. coli?

A

O157:H7

Hemolytic-uremic syndrome can cause death via renal failure due to toxins produced.

36
Q

T/F: Cryptosporidiosis can be found in municipal water sources while Giardia is acquired by feces in water.

A

T

37
Q

Crohns or UC: “skip” lesions/irregular that are transmural

A

Crohn’s

38
Q

Crohns or UC: lead pip on barium xray

A

UC

39
Q

Crohns or UC: can be complicated by hemorrhage or toxic megacolon

A

UC

40
Q

Crohns or UC: can be complicated by fistula, abscess, or obstruction

A

Crohn’s

41
Q

Crohns or UC: string sign on barium xray

A

Crohn’s - due to strictures

42
Q

Crohns or UC: proximally contiguous from the colon only affecting the submucosa and mucosa

A

UC

43
Q

What are some extraintestinal manifestation of IBD?

A

Erythema nodosum, pyoderma gangrenosum, arthritis, AS, uveitis, fatty liver, primary sclerosing cholangitis

44
Q

What skin condition is associated with celiac’s dz?

A

Dermatitis herpetiformis

45
Q

What vitamin/mineral deficiencies often coincide with celiac sprue?

A

Vit B12, folate, iron

46
Q

What lab tests are performed to assess for celiac dz?

A

Serum IgA antiendomysial and tissue transglutaminase
Anti-gliadin (less specific can indicate intolerance)

Intestinal biopsy is gold standard

47
Q

What are two visible signs of pancreatitis?

A

Cullen’s sign - periumbilical hemorrhage visible as bruise

Grey-Turner sign - flank hemorrhage - producing visible bruise

48
Q

T/F: Must biopsy gastric ulcers for CA.

A

T

49
Q

What is the tumor marker for hepatocellular carcinoma?

A

alpha - fetoprotein

50
Q

What ratio of AST to ALT indicates alcoholic cirrhosis?

A

AST>ALT, greater than one

51
Q

What ratio of AST to ALT indicates viral hepatitis?

A

ALT>AST

52
Q

Which Hepatitis B antibody persists > 6mo if the infxn becomes chronic?

A

Hepatitis B Surface Antigen (HBsAg)

53
Q

What two liver markers are elevated in hepatocellular carcinoma?

A

ALT and GGT

54
Q

What tumor marker is elevated in gallbladder adenocarcinoma?

A

CA19-9

55
Q

For which GI infxn would you run a stoll culture and sensitivity?

A

Shigella, Salmonella, Campylobacter, and E. Coli

56
Q

What gene is a marker for Celiac’s Dz?

A

HLA-DQ2

57
Q

What imaging is best used in acute diverticulitis?

A

CT scan

58
Q

T/F: Smoking increase the risk of UC and decreases risk for Crohn’s.

A

F. Smoking inc risk for Crohn’s and lowers risk for UC.

59
Q

What is the tumor marker for colon CA?

A

CEA

NPLEX 2 (22 decks)

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