Gastrointestinal Flashcards
1
Q
- Alcoholism, not gallstones as etiology
- Calcification of the pancreas
- Steatorrhea
- Diabetes mellitus
- Normal amylase and lipase
A
Chronic pancreatitis
2
Q
- “Apple core” lesion on barium enema
- Chronic occult bleeding with iron deficiency anemia
- Changes in stool caliber
A
Colorectal cancer
3
Q
- “Bird beak” appearance of lower esophagus
- Dysphagia to fluids and solids
A
Achalasia
4
Q
- Bone pain (most common symptom)
- Skull enlargement (cotton wool appearance on x-ray)
- Abnormal bone remodeling
- Markedly elevated alkaline phosphatase
A
- Paget disease of the bone
- (AKA: osteitis deformans)
5
Q
- CAVO signs (hallmark): cramping, abdominal pain, vomiting, and obstipation (no flatus)
- Post-surgical adhesions
- High-pitched tinkling on abdominal auscultation
- Visible peristalsis
- Multiple air-fluid levels in “step ladder” appearance
- Dilated bowel loops
A
Small bowel obstruction
6
Q
- Cholestasis (increased GGT and alkaline phosphatase)
- Charcot’s triad: fever/chills + RUQ pain + jaundice
- Reynold’s pentad: Charcot’s + hypotension + AMS
A
Acute ascending cholangiitis
7
Q
- Consumption of contaminated water from remote sources
- AKA: “Beaver fever,” “backpacker’s diarrhea”
- Frothy, greasy, foul-smelling diarrhea (no blood or pus)
A
Giardia lamblia
8
Q
- Consumption of undercooked or contaminated pork
- Fever, bloody stool with mucus
- Fecal leukocytes
- May mimic appendicitis (mesenteric lymphadenitis)
A
Yersinia enterocolitica
9
Q
- Diet high in untreated corn, lack of tryptophan
- Dermatitis
- Diarrhea
- Dementia
A
Vitamin B3 (niacin) deficiency
(AKA: pellagra)
10
Q
- Dysphagia
- Regurgitation of undigested food
- Globus sensation in throat
- Coughing and choking sensation
- Halitosis (due to food retention in pouch)
A
Zenker’s diverticulum
11
Q
- Epigastric pain that radiates to the back
- Hx of gallstones > alcohol abuse
- Worsened with lying supine or eating
- Relieved with leaning forward
- Increased amylase and lipase
- Hypocalcemia
- “Sentinel loop” localized ileus of small bowel in LUQ (on abdominal CT)
A
Acute pancreatitis
12
Q
Esophagitis following taking NSAIDs or bisphosphonates
A
Pill-induced esophagitis
13
Q
- “Fat fair fertile females over forty”
- Biliary colic: episodic and abrupt RUQ pain
- Nausea precipitated by fatty foods or large meals
A
Cholelithiasis
14
Q
- Food (such as mayonnaise, dairy products, eggs, salads, meats) left out at room temperature for > 4 hours
- Short incubation period (within 6 hours)
- Prominent nausea and vomiting
A
Staphylococcus aureus gastroenteritis
15
Q
- Fried rice
- Short incubation period (within 6 hours)
- Prominent nausea and vomiting
A
Bacillus cereus gastroenteritis
16
Q
Hydrogen breath test
A
Lactose intolerance
17
Q
- Hyperkeratotic follicular papules
- Hemorrhage: vascular fragility, gum bleeding
- Impaired wound healing
- Hematologic: anemia, glossitis, malaise, weakness
A
Vitamin C deficiency
(AKA: scurvy)
18
Q
- Left lower quadrant pain that is colicky
- Limited to colon (rectum always involved) – hence “colitis”
- Tenesmus and urgency
- Bloody diarrhea (hallmark)
- Uniform inflammation on colonoscopy
- “Stovepipe Sign” = loss of haustral markings
A
Ulcerative colitis
19
Q
- Malabsorption: diarrhea, bloating/abdominal distention and pain, steatorrhea
- Dermatitis herpetiformis
- Transglutaminase IgA antibodies test positive
A
Celiac disease (sprue)
20
Q
- Most common cause of viral gastroenteritis worldwide
- Associated with cruise ships, hospitals, restaurants
- Predominant symptom is vomiting
A
Norovirus gastroenteritis
21
Q
- Night blindness
- Squamous metaplasia to conjunctiva, respiratory tract
- Bitot’s spots: white spots on the conjunctival mucosa
A
Vitamin A deficiency
22
Q
- “Olive-shaped” nontender, mobile mass to the right of the epigastrium
- Non-bilious, projectile vomiting
- Hypokalemia and hypochloremic metabolic alkalosis (from vomiting)
A
Pyloric stenosis
23
Q
- Painless jaundice
- Weight loss
- Pruritis (due to bile salts in the skin)
- Courvoisier’s sign: palpable, nontender, distended gallbladder
- Trousseau’s malignancy sign: migratory phlebitis
- Tumor marker CA 19-9
A
Pancreatic carcinoma
24
Q
- Raw or undercooked shellfish or contact with brackish water
- Gastroenteritis with necrotizing fasciitis and cellulitis
A
Vibrio vulnificus
25
* Retrosternal chest pain
* Worse with deep breathing and swallowing
* Crepitus on chest auscultation (subcutaneous emphysema)
* Hamman’s sign: mediastinal crackling sound accompanying each heartbeat
* Pneumomediastinum on CXR
Boorhaave syndrome
26
* “Rice water stools” (gray with flecks of mucus with possible fishy odor
* No fecal odor, blood, or pus
* Profound secretory diarrhea = severe dehydration and hypovolemia
* Outbreaks in areas of poor sanitation and overcrowding
Vibrio cholerae
27
* Right upper quadrant abdominal pain
* Any level of GI tract (terminal ileum is most common site)
* “Skip lesions” and “cobblestoning” on colonoscopy
* “String Sign” = barium flow through narrowed inflamed and scarred areas due to transmural strictures
Crohn disease
28
* Right upper quadrant abdominal pain
* Precipitation of pain following fatty foods or large meals
* Positive Murphy’s sign
Acute cholecystitis
29
* Severe abdominal pain out of proportion to physical findings
* MC involves superior mesenteric artery
* Occurs commonly due to atrial fibrillation-associated emboli
Acute mesenteric ischemia
30
* Solid food dysphagia progressing to fluid dysphagia
* Hx of Barrett’s esophagitis (adenocarcinoma)
* Hx of smoking and ETOH (squamous cell carcinoma)
Esophageal cancer
31
* Telescoping or invagination of an intestinal segment
* Vomiting + abdominal pain + “currant jelly” stools with blood
* Sausage-shaped mass in the RUQ
* Dance’s sign: emptiness in the RLQ abdomen
Intussusception
32
* Vomiting
* Mental delays
* Increased deep tendon reflexes
* Urine with musty (mousy) odor
Phenylketonuria
