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Undeleted > Gastroenterology/Endocrine > Flashcards

Gastroenterology/Endocrine Flashcards

1
Q

Risks for CRC (4)

A

over 50yrs
villous adenomas
UC/Crohns
high fat and low fiber diet

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2
Q

Major polyposis syndromes (5)

A 
FAP-pancolonic
Gardner's-soft tissue tumors + FAP
Turcots-polyps + CNS tumors
Peutz-Jeghers-hamartoms of GI, pigmented lips/genitals
Lynch syndrome-early onset CRC
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3
Q

Mgt of CRC

A

CEA every 3-6 months
annual colonoscopy
annual CT of abd for 5 years

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4
Q

Structure most affected in acute mesenteric ischemia

A

SMA

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5
Q

Dx of acute mesenteric ischemia

A

mesenteric angiography

thumbprinting on barium enema

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6
Q

Sx of chronic mesenteric ischemia

A

dull abd pain after meals

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7
Q

Causes of Ogilvie’s syndrome

A

surgery/trauma
sepsis
narcotics/anticholinergics

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8
Q

Drugs assc with Pseudomembranous colitis (3)

A

clindamycin
ampicillin
cephalosporins

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9
Q

Complications of cirrhosis

A 
Portal HTN
varices
HCC
hepatic encephalopathy
hepatorenal/hepatopulmonary syndrome
Spontaneous bacterial perotinitis
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10
Q

Portal HTN dx

A

serum/ascites albumin gradient (SAAG)
>1.1g/dL=portal HTN
<1.1g/dL=something else

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11
Q

Dx of spontaneous bacterial perotinitis

A

> 250 WBCs on paracentesis

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12
Q

Tx for Wilson’s disease

A

D-penicillamine

Zn (competes for uptake)

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13
Q

Complications of hemachromatosis (6)

A 
cirrhosis
cardiomyopathy
DM
hypothyroidism
arthritis
hyperpigmentation
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14
Q

Asscs with hepatic adenomas (2)

A

oral contraceptives

anabolic steroids

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15
Q

Assc with hepatocellular carcinoma (4)

A

Hep B/C
cirrhosis
aflatoxin/vinyl chloride/thorotrast
schistosomiasis

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16
Q

Marker for HCC

A

AFP

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17
Q

Assc with cysts of the liver (2)

A

poylcystic kidney disease

hydatid liver disease (echinococcus)

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18
Q

Dx of entamoeba histolytica

A

bloody diarrhea
stool Ag
increased LFTs

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19
Q

Sx of conjugated hyperbilirubinemia

A

dark urine/pale stools

nontoxic

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20
Q

Sx of unconjugated hyperbilirubinemia

A

neuro deficits
crosses BBB
toxic

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21
Q

Causes of conjugated hyperbilirubinemia (5)

A 
Rotors/Dubin Johnson
biliary obstruction
cirrhosis
oral contraceptives
PBC/PSC
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22
Q

Causes of unconjugated hyperbilirubinemia (4)

A

hemolytic anemia
Gilbert’s
Crigler-Najjar
physiologic jaundic of newborn

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23
Q

Dx of gallstones

A

Ultra sound

HIDA if US no conclusive

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24
Q

Dx of choledocholithiasis

A

US first

ERCP

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25
Q

Reynolds Pentad of cholecystitis

A 
jaundice
fever
RUQ pain
shock
altered mental status
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26
Q

Primary sclerosing cholangitis findings

A

intra and extrahepatic ducts involved
bead like dilatations
assc with UC

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27
Q

Primary biliary cirrhosis findings

A

intrahepatic duct narrowing
xanthomata/xanthelasmata
osteoporosis

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28
Q

Dx of PBC

A

(+) antimitochondrial Abs

increased cholesterol/HDL

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29
Q

Risk factors for cholangiocarcinoma (4)

A

PSC
PBC
clonorchis sinensis
choledochal cysts

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30
Q

Causes of acute pancreatitis (6)

A 
EtOH
gallstones
ERCP
mumps/coxsackie B
scorpion bites
hypercalcemia/hyperlipidemia
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31
Q

Complications from acute pancreatitis

A

pancreatic pseudocyst (2wks after attack)
ARDS
pancreatic ascites

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32
Q

Tx for acute pancreatitis

A

IV fluids
NPO
meperidime/fentayl for pain
enteral nutrition w/in 72hrs

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33
Q

Tx for chronic pancreatitis

A

analgesics
pancreatic enzymes
H2 blockers

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34
Q

Risk factors for pancreatic cancer (4)

A

smoking #1
chronic pancreatitis
EtOH
benzidine/naphthylamine

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35
Q

Sx of pancreatic cancer (3)

A

jaundice/palpable gallbladder
DM
migratory thrombophlebitis

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36
Q

Causes of lower GI bleed (6)

A 
diverticulosis (#1 over 60yrs)
angiodysplasia
IBD
CRC
ischemic colitis
hemorrhoids
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37
Q

Dx of GI bleeds

A

endoscopy/colonoscopy
slow bleed-bleeding scan
active bleed-arteriography

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38
Q

Causes of achalasia (3)

A

adenocarcinoma of stomach
Chagas
idiopathic

39
Q

Tx for Zenker’s diverticulum

A

criocpharyngeal myotomy

40
Q

Gastric ulcer asscs (3)

A

type A blood
smoking
eating does NOT improve pain

41
Q

Duodenal ulcer asscs (3)

A

type O blood
NSAIDs
eating relieves pain

42
Q

Tx for H. pylori

A

clarithromycin
amoxicillin
PPI

43
Q

Causes of chronic gastritis (2)

A

H pylori

autoimmune gastritis

44
Q

Risks for gastric cancer (5)

A 
H pylori
pernicious anemia
Menetrier's disease
type A blood
atrophic gastritis
45
Q

Tx for small bowel obstruction

A

IV fluids
K+ repletion
abx
surgery if complete obstruction

46
Q

Extraintestinal sx of IBD (6)

A 
anterior uveitis
erythema nodosum
pyroderma gangrenosum
arthritis
PSC
aphthous ulcers
47
Q

Complications of Crohn’s disease (4)

A

fistulas
small bowel obstruction
VIt B12/bile acid malabsorption
cholelithiasis/nephrolithiasis

48
Q

Tx for Crohn’s

A

sulfasalazine
metronidazole
AZA, 6-MP

49
Q

Complications of ulcerative colitis (5)

A 
iron deficiency anemia
strictures
CRC
PSC
toxic megacolon
50
Q

Causes of hyperthyroidism (5)

A 
Grave's
multinodular toxic goiter
thyroid adenoma
Hashimoto's/subacute (transient)
postpartum
51
Q

Sx of hyperthyroid

A

arrhythmia/Afib
increased DTR’s
pretibial myxedema

52
Q

Dx of hyperthyroidism

A

low TSH

pregnancy has increased TBG

53
Q

Tx for hyperthyroidism (4)

A

methimazole/PTU (agranulocytosis)
beta blocker for sx
ipodate/iopaniac acid
131 radioactive iodine

54
Q

Tx for thyroid storm (5)

A 
IV fluids/cooling blankets
Glc
PTU q2hr + iodine
beta blocker
dexamethasone
55
Q

Tx for subacute thyroiditis

A

NSAIDs

ASA

56
Q

Types of thyroid cancers (4)

A

papillary-most common, radiation risk
medullary-calcitonin, assc with MENII
follicular-Huerthle cells, spreads early
anaplastic-bad

57
Q

Causes of hyperprolactinoma (5)

A 
prolactinoma
H2 blocker/metoclopramide/estrogen
pregnancy
renal failure
hypothyroidism
58
Q

Tx for hyperprolactinemia

A

bromocriptine
cabergoline
for 2 yrs then taper

59
Q

Sx of acromegaly

A

hypertrophic cardiomyopathy
DM
hyperhidrosis
HTN

60
Q

Dx of acromegaly

A

elevated IGF-1

oral Glc suppression test

61
Q

Sx of carniopharyngioma (4)

A

HA/papilledema
hyperprolactinemia
DM
panhypopituitarism

62
Q

Causes of hypopituitarism (3)

A

pituitary tumor (most common)
Sheehan’s syndrome
trauma

63
Q

Causes of Diabetes insipidus (4)

A

Li+ most common
hypercalcemia
pyelonephritis
demeclocycline

64
Q

Dx for diabetes insipidus

A

water deprivation test (urine osmolality does not increase)

65
Q

Tx for diabetes insipidus

A

central-desmopression/chlorpropamide

nephrogenic-thiazides

66
Q

Causes of SIADH (4)

A

neoplasms
CNS disorders
vincristine/SSRIs/oxytocin/morphine
vents with positive pressure

67
Q

Dx of SIADH

A

hyponatremia with elevated urine osmolality

68
Q

Tx for SIADH

A

IV NS and loop diuretics

69
Q

Sx of hypoparathyroid (3)

A

tetany
prolonged QT
cataracts

70
Q

Tx for hypoparathyroid

A

IV Ca2+

Vit D

71
Q

Causes of primary hyperparathyroid

A

adenoma of parathyroid

parathyroid hyperplasia

72
Q

Sx of hyperparathyroid

A 
nephrolithiasis
muscle pain/weakness
gout
constipation
short QT
73
Q

Causes of secondary hyperparathyroid (3)

A

CKD
Vit D deficiency
renal hypercalciuria

74
Q

Causes of Cushing’s syndrome (4)

A

excess exogenous steroids
ACTH secreting pituitary adenoma
adrenal adenoma
ectopic ACTH (malignancy)

75
Q

Dx of Cushing’s syndrome

A

low dose dexamethasone test
ACTH level
high dose dexamethasone test

76
Q

Tumors in MEN I

A

parathyroid
pancreatic
pituitary

77
Q

Tumors in MEN IIA

A

medullary thyroid
pheochromocytoma
parathyroid

78
Q

Tumors in MEN IIB

A

mucosal neuromas
medullary thyroid
pheochromocytoma
also marfinoid habitus

79
Q

Causes of primary hyperaldosteronism

A

adrenal adenoma

adrenal hyperplasia

80
Q

Sx of primary hyperaldosteronism (3)

A

HTN
metabolic alkalosis
hypokalemia

81
Q

Dx of primary hyperaldosteronism

A

aldosterone:renin >30

82
Q

Tx for primary hyperaldosteronism

A

adrenal adenoma resection

spironolactone for adrenal hyperplasia

83
Q

Causes of adrenal insufficiency (4)

A

autoimmune most common
TB
CMV/toxoplamosis
malignancy mets

84
Q

Sx of adrenal insufficiency (4)

A

hypoglycemia
hyperpigmentation
hyperkalemia/hypovolemia
abd pain

85
Q

Dx of adrenal insufficiency

A

ACTH test

decreased plasma cortisol

86
Q

Tx for adrenal insufficiency

A

daily glucocorticoids and fludrocortisone

87
Q

Dx of congenital adrenal hyperplasia

A

elevated 17-hydroxyprogesterone

88
Q

Tx for congenital adrenal hyperplasia

A

cortisol + mineralocorticoids

correct female genitalia

89
Q

Dx of DKA

A

Glc between 450-850
metabolic acidosis with AG
ketonemia

90
Q

Tx of DKA

A

IV fluids, D5W once Glc<250
IV insulin (0.1U/kg/hr) + bolus to start
K+ (as insulin will decrease)
subq insulin once AG closes

91
Q

Causes of hypoglycemia (5)

A 
exogenous insulin
adrenal insufficiency
insulinoma
EtOH
liver failure
92
Q

Sx of glucagonoma (3)

A

necrotizing migratory erythema
glossitis/stomatitis
hyperglycemia

93
Q

Sx of somatistatinoma (3)

A

gallstones
DM
steatorrhea

94
Q

Sx of VIPoma (4)

A

watery diarrhea
achlorhydria
hyperglycemia
hypercalcemia

Undeleted (71 decks)

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