Gastrointestinal Flashcards

1
Q
  • Alcoholism, not gallstones as etiology
  • Calcification of the pancreas
  • Steatorrhea
  • Diabetes mellitus
  • Normal amylase and lipase
A

Chronic pancreatitis

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2
Q
  • “Apple core” lesion on barium enema
  • Chronic occult bleeding with iron deficiency anemia
  • Changes in stool caliber
A

Colorectal cancer

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3
Q
  • “Bird beak” appearance of lower esophagus
  • Dysphagia to fluids and solids
A

Achalasia

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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)
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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

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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

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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

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8
Q
  • Consumption of undercooked or contaminated pork
  • Fever, bloody stool with mucus
  • Fecal leukocytes
  • May mimic appendicitis (mesenteric lymphadenitis)
A

Yersinia enterocolitica

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9
Q
  • Diet high in untreated corn, lack of tryptophan
  • Dermatitis
  • Diarrhea
  • Dementia
A

Vitamin B3 (niacin) deficiency

(AKA: pellagra)

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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

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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

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12
Q

Esophagitis following taking NSAIDs or bisphosphonates

A

Pill-induced esophagitis

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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

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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

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15
Q
  • Fried rice
  • Short incubation period (within 6 hours)
  • Prominent nausea and vomiting
A

Bacillus cereus gastroenteritis

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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
Q
  • 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
A

Boorhaave syndrome

26
Q
  • “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
A

Vibrio cholerae

27
Q
  • 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
A

Crohn disease

28
Q
  • Right upper quadrant abdominal pain
  • Precipitation of pain following fatty foods or large meals
  • Positive Murphy’s sign
A

Acute cholecystitis

29
Q
  • Severe abdominal pain out of proportion to physical findings
  • MC involves superior mesenteric artery
  • Occurs commonly due to atrial fibrillation-associated emboli
A

Acute mesenteric ischemia

30
Q
  • Solid food dysphagia progressing to fluid dysphagia
  • Hx of Barrett’s esophagitis (adenocarcinoma)
  • Hx of smoking and ETOH (squamous cell carcinoma)
A

Esophageal cancer

31
Q
  • 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
A

Intussusception

32
Q
  • Vomiting
  • Mental delays
  • Increased deep tendon reflexes
  • Urine with musty (mousy) odor
A

Phenylketonuria