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Gastrointestinal Flashcards

1
Q

What disease has a corkscrew x-ray?

A

Esophageal spasm

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2
Q

What disease has an apple core x-ray?

A

Cancer

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3
Q

What disease has a stacked coin x-ray?

A

Intussusception

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4
Q

What disease has a thumbprint x-ray?

A

Toxic megacolon

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5
Q

What disease has an abrupt cutoff x-ray?

A

Volvulus

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6
Q

What disease has a barium clumping x-ray?

A

Celiac sprue

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7
Q

What disease has a bird’s beak x-ray?

A

Achalasia

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8
Q

What disease has a string sign on x-ray?

A

Pyloric stenosis

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9
Q

What diseases have solid dysphagia?

A

Schatzki’s rings
Stricture
Cancer

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10
Q

What disease have solid and liquid dysphagia?

A

Esophageal spasm
Scleroderma
Achalasia

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11
Q

What is Barrett’s esophagus?

A

Metaplasia
Increased risk of adenocarcinoma

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12
Q

What are manifestations of esophageal varices?

A

Vomit blood everywhere
Portal HTN

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13
Q

What is Mallory-Weiss?

A

Tear LES mucosa
Chronic vomiters

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14
Q

What is Boerhaave’s?

A

Tear all layers of esophagus
Left-sided pneumo/pain/effusion

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15
Q

What is Achalasia?

A

Lost LES Auerbach’s
Bird’s beak
Can be d/t Chaga’s
Choke on solids

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16
Q

What is Hirschsprung’s?

A

Lost rectum Auerbach’s
No meconium passage

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17
Q

What are manifestations of a Zenker’s diverticulum?

A

Cough
Undigested food from above UES
Halitosis

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18
Q

What is a manifestation of a Traction diverticulum?

A

Eat big bolus
=> gets stuck above LES

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19
Q

What are manifestations of Plummer-Vinson syndrome?

A

Esophageal webs
Spoon nails
Iron deficiency anemia

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20
Q

What are Schatzki rings?

A

Esophageal webs in lower esophagus

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21
Q

What are signs of a TE fistula?

A

Choke w/ each feeding
Cough w/ each feeding

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22
Q

What are manifestations of esophageal atresia w/ TE fistula?

A

Vomit w/ 1st feeding
Huge gastric bubble

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23
Q

What are manifestations of duodenal atresia?
(Associated with what trisomy?)

A

Bilious vomiting w/ 1st feed
Double bubble on imaging

Associated w/ Trisomy 21 (Down’s)

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24
Q

What are manifestations of pyloric stenosis?

A

Projectile vomiting (3-4 wk old)
RUQ olive mass

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25
How does choanale atresia present? How does Tetrology of Fallot present differently
- Turns blue with feeding - turns blue with crying
26
What makes scleroderma unique?
Decr LES pressure
27
What makes esophageal spasms unique?
Incr peristalsis
28
What makes Achalasia unique?
Decr peristalsis Incr LES pressure
29
What disease has a RUQ olive mass?
Pyloric stenosis
30
What disease has a RLQ sausage mass?
Intussusception
31
What is a Bezoar?
Mass of hair or vegetables - in antrum - causes obstruction
32
What is gastritis type A?
Upper GI bleed Anti-parietal cell Ab
33
What is gastritis type B?
Upper GI bleed Spicy foods H pylori
34
What is a duodenal ulcer?
Too much acid Pain after meal/at night Increased incidence w/ type O blood Caused by H pylori Pain relieved by eating
35
What is a gastric ulcer?
Broken mucus layer Pain during meal NSAIDs Increased incidence w/ type A blood
36
What is a sliding hiatal hernia?
Fundus slides from esophageal hiatus to thorax => sucks acid into thorax
37
What is a rolling hiatal hernia?
Fundus sticks through hole in diaphragm Strangulates bowel
38
What is Menetrier’s disease?
Protein-losing Thick stomach rugal folds
39
What defines constipation?
<3 BM per week
40
What defines diarrhea?
>200g per day
41
What is osmotic diarrhea?
Watery
42
What is iatrogenic/surreptitious cause of secretory diarrhea?
Laxative use
43
What is seen in inflammatory diarrhea?
Blood Pus
44
What are specifics for celiac sprue?
Jejunum Wheat allergy Villous atrophy Anti-gliadin Ab
45
What is specific to tropical sprue?
Celiac sprue in ileum
46
What is manifestation of mesenteric ischemia?
Pain out of proportion to exam
47
What bugs cause bloody diarrhea?
“CASES” Campylobacter Amoeba (E histolytica) Shigella E. coli Salmonella
48
What is the difference b/w primary biliary cirrhosis and primary sclerosing cholangitis?
Primary biliary cirrhosis - anti-mitochondrial Ab - bile ductules destroyed - xanthelasma Primary sclerosing cholangitis - p-ANCA - bile duct inflammation - beading - onion skinning - associated w/ UC
49
What is ascending cholangitis?
Common duct stone gets infected
50
What are the signs of alcoholic cirrhosis?
Spider angioma Palmar erythema Dupuytren’s contractures
51
What is hepatorenal syndrome?
Patients w/ liver disease build up liver toxins that cause renal failure
52
What is cholangitis?
Inflammation of bile duct => Charcot’s triad & Reynold’s Pentax
53
What is Cholecystitis?
Inflammation of gall bladder => murphy’s sign
54
What is cholelithiasis?
Formation of gallstones => RUQ colic
55
What is choledocholithiasis?
Gallstone obstructs bile duct
56
What is cholestasis?
Obstruction of bile duct => pruritis => elev alk phos => jaundice
57
What is conjugated bilirubin?
Water-soluble = direct bilirubin
58
What is unconjugated bilirubin?
Fat soluble = indirect bilirubin
59
What is the most common type of gallstones?
Cholesterol (Cannot see on x-ray)
60
What type of gallstones can be seen on x-ray?
Calcium bilirubinate
61
What is a xanthoma?
Cholesterol buildup (Elbow or Achilles)
62
What is a Xanthelasma?
Triglyceride buildup (Under eye)
63
What does high cholesterol cause?
Atherosclerosis
64
What does high triglycerides cause?
Pancreatitis
65
What is type I hyperlipidemia?
Bad Liver LL (CM) - LPL deficiency - TG accumulation - pancreatitis
66
What is a type 2a hyperlipidemia?
Bad LDL or B-100 receptors Trapped in ER (LDL only) - LDL receptor deficiency - LDL buildup - Tendon xanthoma
67
What is a type 2b hyperlipidemia?
2a + VLDL Less LDL/VLDL receptors
68
What is type 3 hyperlipidemia?
Bad apoE (IDL/VLDL) - ApoE deficiency - remnant buildup (chylo & VLDL) - palmar xanthoma
69
What is type 4 hyperlipidemia?
“4 gets more” Bad adipose LL (VLDL only) - VLDL overproduction (VLDL has more letters) - TG accumulation - pancreatitis
70
What is type 5 hyperlipidemia?
Bad C2 (VLDL/chylomicrons) B/c C2 stimulates LL 5 = 1 + 4
71
What is Crigler-Najjar?
Unconjugated bilirubin Usually in infants
72
What is Gilbert’s syndrome?
Stress jaundice Glucoronyl transferase is saturated => unconjugated hyperbilirubinemia
73
What is Rotor’s syndrome?
Bad bilirubin storage => conjugated hyperbilirubinemia
74
What is Dublin-Johnson syndrome?
Bad bilirubin excretion => black liver
75
What is Cullen’s sign?
Bleeding around the umbilicus => hemorrhagic pancreatitis
76
What is Turner’s sign?
Bleeding into flank => hemorrhagic pancreatitis
77
What tests are used for following pancreatitis?
Amylase-sensitive Breaks down carbs
78
What does Ranson’s criteria tell you?
Poor prognosis for pancreatitis patients
79
What is Ranson’s criteria at presentation?
“WAGLA” - WBC: >16K/microL (infection) - Age: >55yo (usually multiple illnesses) - Glucose: >200 mg/dL (islet cells are fried) - LDH: >350 IU/L (cell death) - AST: >250 IU/L (cell death)
80
What is Ranson’s criteria at 48 hr?
“BuCH was a SOB” - BUN: elevated >5 mg/dL (decr renal blood flow) - Ca: <8 mg/dL (saponification) - Hct: drops >10% (bleed into pancreas) - Sequester: >6 L fluid => 3rd spacing - pO2: <60 mmHg (fluid/protein leak -> ARDS) - Base deficit: >4 mEq/L (diarrhea => pancreatic enzymes are dead)
81
What is carcinoid syndrome?
Diarrhea Flushing Wheezing
82
What produces currant jelly sputum?
Klebsiella
83
What produces Currant jelly stool?
Intussusception
84
What is Gardener’s syndrome?
Familial polyposis w/ bone tumors
85
What is Turcot’s syndrome?
Familial polyposis w/ brain tumors
86
What is familial polyposis?
100% risk of colon cancer APC defect Annual colonoscopy at 5yo
87
What is Peutz-Jegher’s syndrome?
Hyperpigmented mucosa => Dark gums/vagina W/ Hyperplastic polyps
88
What is Crohn’s disease?
IBD w/ - cobblestones - melena - creeping fat - fistulas
89
What is ulcerative colitis?
IBD w/: - pseudopolyps - hematochezia - lead pipe colon - toxic megacolon
90
What are manifestations of intussusception?
- currant jelly stool - stacked coin appearance on enema - sx come and go
91
How does diverticulosis present?
Bleeds
92
How does diverticulitis present?
Hurts
93
How does spastic colon present?
Intermittent severe cramps
94
How does IBS present?
Alternating diarrhea/constipation
95
How do external hemorrhoids present?
Pain
96
How do internal hemorrhoids present?
No pain
97
What is pseudomembranous colitis?
Overgrowth of C. difficile d/t normal flor being killed off Usually after Clindamycin use
98
What is Whipple’s disease?
T whipplei destroy GI tract => malabsorption
99
What color is an upper GI bleed?
Black
100
What color is a lower GI bleed?
Red
101
What adds color to stool?
Bilirubin
102
What is the default color of stool
Clay-colored
103
What is the default color of urine?
Tea-colored

PP Clues (31 decks)

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