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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
Q

How does choanale atresia present?
How does Tetrology of Fallot present differently

A
  • Turns blue with feeding
  • turns blue with crying
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26
Q

What makes scleroderma unique?

A

Decr LES pressure

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27
Q

What makes esophageal spasms unique?

A

Incr peristalsis

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28
Q

What makes Achalasia unique?

A

Decr peristalsis
Incr LES pressure

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29
Q

What disease has a RUQ olive mass?

A

Pyloric stenosis

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30
Q

What disease has a RLQ sausage mass?

A

Intussusception

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31
Q

What is a Bezoar?

A

Mass of hair or vegetables
- in antrum
- causes obstruction

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32
Q

What is gastritis type A?

A

Upper GI bleed
Anti-parietal cell Ab

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33
Q

What is gastritis type B?

A

Upper GI bleed
Spicy foods
H pylori

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34
Q

What is a duodenal ulcer?

A

Too much acid
Pain after meal/at night
Increased incidence w/ type O blood
Caused by H pylori
Pain relieved by eating

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35
Q

What is a gastric ulcer?

A

Broken mucus layer
Pain during meal
NSAIDs
Increased incidence w/ type A blood

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36
Q

What is a sliding hiatal hernia?

A

Fundus slides from esophageal hiatus to thorax
=> sucks acid into thorax

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37
Q

What is a rolling hiatal hernia?

A

Fundus sticks through hole in diaphragm
Strangulates bowel

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38
Q

What is Menetrier’s disease?

A

Protein-losing
Thick stomach rugal folds

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39
Q

What defines constipation?

A

<3 BM per week

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40
Q

What defines diarrhea?

A

> 200g per day

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41
Q

What is osmotic diarrhea?

A

Watery

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42
Q

What is iatrogenic/surreptitious cause of secretory diarrhea?

A

Laxative use

43
Q

What is seen in inflammatory diarrhea?

44
Q

What are specifics for celiac sprue?

A

Jejunum
Wheat allergy
Villous atrophy
Anti-gliadin Ab

45
Q

What is specific to tropical sprue?

A

Celiac sprue in ileum

46
Q

What is manifestation of mesenteric ischemia?

A

Pain out of proportion to exam

47
Q

What bugs cause bloody diarrhea?

A

“CASES”
Campylobacter
Amoeba (E histolytica)
Shigella
E. coli
Salmonella

48
Q

What is the difference b/w primary biliary cirrhosis and primary sclerosing cholangitis?

A

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
Q

What is ascending cholangitis?

A

Common duct stone gets infected

50
Q

What are the signs of alcoholic cirrhosis?

A

Spider angioma
Palmar erythema
Dupuytren’s contractures

51
Q

What is hepatorenal syndrome?

A

Patients w/ liver disease build up liver toxins that cause renal failure

52
Q

What is cholangitis?

A

Inflammation of bile duct
=> Charcot’s triad & Reynold’s Pentax

53
Q

What is Cholecystitis?

A

Inflammation of gall bladder
=> murphy’s sign

54
Q

What is cholelithiasis?

A

Formation of gallstones
=> RUQ colic

55
Q

What is choledocholithiasis?

A

Gallstone obstructs bile duct

56
Q

What is cholestasis?

A

Obstruction of bile duct
=> pruritis
=> elev alk phos
=> jaundice

57
Q

What is conjugated bilirubin?

A

Water-soluble
= direct bilirubin

58
Q

What is unconjugated bilirubin?

A

Fat soluble
= indirect bilirubin

59
Q

What is the most common type of gallstones?

A

Cholesterol
(Cannot see on x-ray)

60
Q

What type of gallstones can be seen on x-ray?

A

Calcium bilirubinate

61
Q

What is a xanthoma?

A

Cholesterol buildup
(Elbow or Achilles)

62
Q

What is a Xanthelasma?

A

Triglyceride buildup
(Under eye)

63
Q

What does high cholesterol cause?

A

Atherosclerosis

64
Q

What does high triglycerides cause?

A

Pancreatitis

65
Q

What is type I hyperlipidemia?

A

Bad Liver LL (CM)

  • LPL deficiency
  • TG accumulation
  • pancreatitis
66
Q

What is a type 2a hyperlipidemia?

A

Bad LDL or B-100 receptors
Trapped in ER (LDL only)

  • LDL receptor deficiency
  • LDL buildup
  • Tendon xanthoma
67
Q

What is a type 2b hyperlipidemia?

A

2a + VLDL
Less LDL/VLDL receptors

68
Q

What is type 3 hyperlipidemia?

A

Bad apoE
(IDL/VLDL)

  • ApoE deficiency
  • remnant buildup (chylo & VLDL)
  • palmar xanthoma
69
Q

What is type 4 hyperlipidemia?

A

“4 gets more”
Bad adipose LL
(VLDL only)

  • VLDL overproduction
    (VLDL has more letters)
  • TG accumulation
  • pancreatitis
70
Q

What is type 5 hyperlipidemia?

A

Bad C2
(VLDL/chylomicrons)
B/c C2 stimulates LL

5 = 1 + 4

71
Q

What is Crigler-Najjar?

A

Unconjugated bilirubin
Usually in infants

72
Q

What is Gilbert’s syndrome?

A

Stress jaundice

Glucoronyl transferase is saturated
=> unconjugated hyperbilirubinemia

73
Q

What is Rotor’s syndrome?

A

Bad bilirubin storage
=> conjugated hyperbilirubinemia

74
Q

What is Dublin-Johnson syndrome?

A

Bad bilirubin excretion
=> black liver

75
Q

What is Cullen’s sign?

A

Bleeding around the umbilicus
=> hemorrhagic pancreatitis

76
Q

What is Turner’s sign?

A

Bleeding into flank
=> hemorrhagic pancreatitis

77
Q

What tests are used for following pancreatitis?

A

Amylase-sensitive
Breaks down carbs

78
Q

What does Ranson’s criteria tell you?

A

Poor prognosis for pancreatitis patients

79
Q

What is Ranson’s criteria at presentation?

A

“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
Q

What is Ranson’s criteria at 48 hr?

A

“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
Q

What is carcinoid syndrome?

A

Diarrhea
Flushing
Wheezing

82
Q

What produces currant jelly sputum?

A

Klebsiella

83
Q

What produces Currant jelly stool?

A

Intussusception

84
Q

What is Gardener’s syndrome?

A

Familial polyposis w/ bone tumors

85
Q

What is Turcot’s syndrome?

A

Familial polyposis w/ brain tumors

86
Q

What is familial polyposis?

A

100% risk of colon cancer
APC defect
Annual colonoscopy at 5yo

87
Q

What is Peutz-Jegher’s syndrome?

A

Hyperpigmented mucosa
=> Dark gums/vagina
W/ Hyperplastic polyps

88
Q

What is Crohn’s disease?

A

IBD w/
- cobblestones
- melena
- creeping fat
- fistulas

89
Q

What is ulcerative colitis?

A

IBD w/:
- pseudopolyps
- hematochezia
- lead pipe colon
- toxic megacolon

90
Q

What are manifestations of intussusception?

A
  • currant jelly stool
  • stacked coin appearance on enema
  • sx come and go
91
Q

How does diverticulosis present?

92
Q

How does diverticulitis present?

93
Q

How does spastic colon present?

A

Intermittent severe cramps

94
Q

How does IBS present?

A

Alternating diarrhea/constipation

95
Q

How do external hemorrhoids present?

96
Q

How do internal hemorrhoids present?

97
Q

What is pseudomembranous colitis?

A

Overgrowth of C. difficile d/t normal flor being killed off
Usually after Clindamycin use

98
Q

What is Whipple’s disease?

A

T whipplei destroy GI tract
=> malabsorption

99
Q

What color is an upper GI bleed?

100
Q

What color is a lower GI bleed?

101
Q

What adds color to stool?

102
Q

What is the default color of stool

A

Clay-colored

103
Q

What is the default color of urine?

A

Tea-colored

PP Clues (27 decks)

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