Gastrointestinal Flashcards
What is Charcot’s triad
RUQ pain, fever, jaundice
Which inflammatory bowel disease invariably involves the rectum?
Ulcerative colitis- may extend proximally in a continuous fashion to involve part or all of the colon only. Crohn disease is characterized by patchy transmutation inflammation (skip lesions) involving any segment of the GI tract from the mouth to the anus.
What is Reynold’s pentad and why does it matter?
Charcot’s triad + hypotension + altered mental status. It indicates high risk of sepsis.
What disease is defined as an immunologic response to the gluten?
Celiac
Is peptic ulcer disease more common in the duodenum or the stomach?
Duodenum
What are the 5 points of Ranson’s criteria on admission?
Age > 55, WBC>16, glucose>200, AST>250, LDH>350 (acute pancreatitis)
Steatorrhea should make you think of what diagnosis?
Pancreatitis
Describe Courvoisier’s sign.
Nontender, palpable gallbladder which may indicate pancreatic neoplasm.
What tumor marker can be used to follow pancreatic cancer?
CA-19-9
What medication used in hepatitis B infection helps prevent the need for liver transplant?
Lamivudine
What is the recommended treatment for hepatitis C infection?
Pegylated interferon alpha-2
What is the most common cause of folate deficiency?
Alcoholism
Describe how to perform the psoas sign.
The patient is supine and attempts to raise right leg against resistance.
Describe how to perform the obturator sign
The patient is supine and attempts to flex and internally rotate right hip.
What two blood test can be used to diagnose celiac?
IgA endomysial antibody and IgA tTG antibody.
What class medication is first line to treat inflammatory bowel disease in the maintenance phase?
5-ASA products - sulfasalazine, mesalamine.
Currant jelly stool should make you think of what diagnosis?
Intussusception
Severe abdominal pain 30 minutes after a meal should make you think of what diagnosis?
Intestinal ischemia
What is the most common cause of lower GI bleed?
Diverticulosis
If you have heartburn that does not improve with medication what is the most likely diagnosis?
Gastrinoma
What tumor marker may be used for liver cancer?
alpha fetoprotein
Describe Cullen’s sign.
Umbilical ecchymosis secondary to retroperitoneal bleeding. (pancreatitis or ruptured ectopic pregnancy)
What is the leading cause of iron deficiency anemia?
Chronic GI bleed
At what age and how often should fecal occult blood test be performed as a screening tool?
Beginning at age 50 and they should be done every year.
Define Pellagra?
Niacin (B3) deficiency
How often should patients with pernicious anemia have a screening endoscopy performed?
Every 5 years looking for signs of gastric carcinoma.
What does Anti-HBs (hep B surface antibody) indicate?
Recovery from infection (or immunized)
A 15 year old boy presents complaining of night pain in the pelvis. The x-ray report comes back with the description of a mass with an “onion skin appearance”. What is the most likely diagnosis?
Ewing sarcoma (2nd MC cancer of bone in children and adolescents)
Describe Turner’s sign
Blue-black discoloration around the flanks, e.g. in acute hemorrhagic pancreatitis and other causes of retroperitoneal hemorrhage.
A patient complains of regurgitating undigested food several hours after a meal. What is the most likely diagnosis?
Zenker’s diverticulum
What does an Anti-HBc (hep B core antibody) indicate?
Previous or ongoing infection
What are the two most common causes of pancreatitis?
Cholelithiasis and ETOH
An endoscopy for presumed esophagitis shows multiple shallow ulcers. What is the most likely diagnosis?
Herpes simplex virus
An endoscopy for presumed esophagitis shows several solitary deep ulcers. What is the most likely diagnosis?
Cytomegalovirus
