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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

Intussuseption

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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 cutt off x-ray?

A

Volvulous

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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 appearance?

A

Achalasia

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8
Q

What disease has a string sign x-ray?

A

Pyloric stenosis

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9
Q

What disease has a sold dysphagia?

A

Schatzki’s rings, strictures and cancer

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10
Q

What disease has solid and liquid dysphagia?

A

Esophageal spasm, scleroderma, achalasia

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11
Q

What is Barrett’s esophagus?

A

Metaplasia, increase adenocarcinoma risk

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12
Q

What are esophageal varices?

A

Vomit blood everywhere, portal HTN

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13
Q

What is Mallory Weiss?

A

Tear the LES mucosa, chronic vomiters

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14
Q

What is Boerhaave’s?

A

Tear all layers of the esophagus, left sided pneumo/pain/effusion

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15
Q

What is achalasia?

A

Loss of LES Auerbach’s, no meconium passage.

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16
Q

What is Hirschprung?

A

Loss rectum Auerbach, no meconium passage.

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17
Q

What is Zencker’s diverticulum?

A

Cough undigested food from above UES, halitosis.

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18
Q

What is traction diverticulum?

A

Eat big bolus, gets stuck above the LES.

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19
Q

What is Plummer Vinson syndrome?

A

Esophageal webs, spoon nails, Fe deficiency anemia.

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20
Q

What are Schatzki rings?

A

Esophageal webs in the lower esophagus.

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21
Q

What is a TE fistula?

A

Choke w each feeding.

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22
Q

What is an esophageal atresia w/ a TE fistula?

A

Vomit w/ first feeding, huge gastric bubble.

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23
Q

What is a duodenal atresia?

A

Bilious vomiting w/ 1st feeding, double bubble, Down’s

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24
Q

What is pyloric stenosis?

A

Projectile vomiting (3-4 wks old), RUQ olive mass.

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25
How does choanal atresia present?
Turns blue w feeding.
26
How does the Tetralogy of Fallot presentation differ?
Turns blue w crying.
27
What makes Scleroderma unique?
Decrease LES pressure.
28
What makes esophageal spasm unique?
Increase peristalsis
29
What makes achalasia unique?
Decrease peristalsis and increase LES pressure.
30
What disease has a RUQ olive mass?
Pyloric stenosis
31
What disease has a RLQ sausage mass?
Intussuseption
32
What is a Bezoar?
Mass of hair or vegetables=> antrum obstruction
33
What is gastritis type A?
Upper GI bleed, anti Perietal cell-Ab.
34
What is Gastritis type B?
Upper GI bleed, spicy foods, H.pylori.
35
What is duodenal ulcer?
Too much acid: pain after meal/at night, type O blood, H.pylori, pan relieved by eating.
36
What is a gastric ulcer?
Broken mucus layer: pian during meal, NSAID's, type A blood.
37
What is a sliding hiatal hernia?
Fundus slides to the esophageal hiatus to the thorax=> suck acid into the thorax
38
What is rolling hiatal hernia?
Fundus stick through hole in the diaphragm, strangulates bowel
39
What is Menetrier's disease?
Protein losing, thick stomach rugal folds
40
What defines constipation?
< 3 BM per week
41
What defines diarrhea?
> 200g per day
42
What is osmotic diarrhea?
Watery
43
What is secretory diarrhea?
Laxative use
44
What is inflammatory diarrhea?
Blood, pus
45
What is celiac sprue?
Jejunum, wheat allergy, villous atrophy, anti-gliadian Ab, anti endomesyal Ab, anti reticulin Ab.
46
What is tropical sprue?
Ileum celiac sprue
47
What is mesenteric ischemia?
Pain out of proportion to exam.
48
What bugs cause bloody diarrhea?
``` "CASES" Campylobacter Amoeba Shigella E. coli Salmonella ```
49
What is difference b/w 1ry Biliary Cirrhosis and Sclerosing Cholangitis?
1ry Biliary Cirrhosis: anti-mitochondrial Ab, bile ductules destroyed, xanthelesma. 1ry Sclerosing Cholangitis: p-ANCA Ab, bile duct inflammation, beading, onion skinning, associated w/ UC.
50
What is Ascending cholangitis?
Common duct stone gets infected.
51
What are the signs of alcoholic cirrhosis?
Spider angioma, palmar erythema, Dupuytren's contractions, gynecomastia
52
What is hepatorenal syndrome?
Pts w/ liver disease build up liver toxins that cause renal failure.
53
What is cholangitis?
Inflammation of bile duct => Charcot's triad, Reynaud's pentad
54
What is cholescystitis?
Infammation of the gallbladder=> Murphy's sign
55
What is cholelithiasis?
Formation of gallstones=> RUQ colic
56
What is choledocholithiasis?
Gallstone obstructs the bile duct
57
What is cholestasis?
Obstruction of bile duct, => pruritus, increase alkaline phosphatase, jaundice.
58
What is conjugated bilirubin?
Water soluble, direct
59
What is unconjugated bilirubin?
Fat soluble, indirect
60
What is the most common type of gallstone?
Cholesterol (can't see on x-ray)
61
What type of gallstone can be seen on x-ray?
Ca-bilirubinate
62
What is a xanthoma?
Cholesterol buildup (elbow or achilles)
63
What is a xanthelesma?
Triglyceride buildup, under the eye
64
What does high cholesterol cause?
Atherosclerosis
65
What do high triglycerides cause?
Pancreatitis
66
What is type I hyperlipidemia?
Bad liver LL (CM)
67
What is type 2A hyperlipidemia?
Bad LDL or B-100 receptor: trapped in the ER (LDL only)
68
What is type 2B hyperlipidemia?
Less LDL/VLDL receptors (LDL/VLDL)
69
What is type 3 hyperlipidemia?
Bad Apo E (IDL/VLDL)
70
What is type 4 hyperlipidemia?
Bad adipose LL (VLDL only)
71
What is type 5 hyperlipidemia?
Bad C2 (VLDL/CM) b/c C2 stimulates LL
72
What is Criggler Najjar?
Unconjugated bilirubin, usually in infants
73
What is Gilbert syndrome?
Glucoronyl transferase in saturated=> stress unconjugated bilirubin
74
What is Rotor's?
Bad bilirubin storage: conjugated bilirubin
75
What is Dubin Johnson?
Bad bilirubin excretion=> black liver
76
What is Cullen sign?
Bleed around the umbilicus=> hemorrhagic pancreatitis
77
What is Turne's sign?
Bleed into flank=> hemorrhagic pancreatitis
78
What tests are used for following pancretitis?
Amylase: sensitive, breaks down carbs Lipase: specific, breaks down triglycerides
79
What does Ranson's criteria tell you?
Poor prognosisi for pancreatitis pts
80
What is Ranson's criteria at presentation?
``` "WAGLA" WBC > 16k: infection Age > 55 (multiple comorbidities) Gucose > 200 (islet cells are fried) LDH > 350 (cell death) AST > 250 (cell death) ```
81
What is Ranson's criteria at 48 hrs?
"BuCH SOB" BUN > 5 mg (decrease renal blood flow) Ca < 8 mg (saponification) Hct drops > 10% (bleed into pancreas) Sequester > 6L fluid=> 3rd spacing pO2: < 60 mmHg (fluid/protein leak=> ARDS) Base deficit > 4 (diarrhea=> pancreatic enzymes are dead)
82
What is carcinoid syndrome?
Diarrhea, flushing and wheezing
83
What produces currant jelly sputum?
Klebsiella
84
What currant jelly stool?
Intussuseption
85
What is Gardener's syndrome?
Familial polyposis w/ bone tumors
86
What is Turcot's syndrome?
Familial polyposis w/ brain tumors
87
What is familial polyposis?
100% risk of colon cancer, APC defect, => annual colonoscopy at 5 y.o.
88
What is Peutz-Jagher syndrome?
Hyperpigmented mucosa=> dark gums and vagina
89
What is Crohn's?
IBD w/ cobblestones, melena creeping fat and fistulas.
90
What is ulcerative colitis?
IBD w/ pseudoolyps, hematochezia, lead pipe colon, toxic megacolon
91
What is intussuseption?
Currant jelly stool, stacked coin enema, sx come and go.
92
What does diverticulosis present?
Bleeds
93
What does diverticulitis presents?
Hurts
94
How does spastic colon present?
Intermittent severe cramps?
95
How does IBS present?
Alternating diarrhea/contipation
96
How does external hemorrhoids presents?
Pain
97
How does internal hemorrhoids presents?
No pain
98
What is pseudomembranous colitis?
Overgrowth od C. difficile due to normal flora being killed off, usually by Clindamycin use
99
What Whipple's disease?
T. whipplei destroys GI tract, then spreads, causing malabsorption, atrhralgia
100
What color in an upper GI bleed?
Black
101
What color is lower GI bleed?
Red
102
What adds color to stool?
Bilirubin
103
What is the default color of stool?
Clay-color
104
What is the default color of urine?
Tea-color

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