Gastrointestinal Flashcards
What disease has a corkscrew x-ray?
Esophageal spasm
What disease has an apple core x-ray?
Cancer
What disease has a stacked coin x-ray?
Intussuseption
What disease has a thumbprint x-ray?
Toxic megacolon
What disease has an abrupt cutt off x-ray?
Volvulous
What disease has a barium clumping x-ray?
Celiac sprue
What disease has a bird’s beak appearance?
Achalasia
What disease has a string sign x-ray?
Pyloric stenosis
What disease has a sold dysphagia?
Schatzki’s rings, strictures and cancer
What disease has solid and liquid dysphagia?
Esophageal spasm, scleroderma, achalasia
What is Barrett’s esophagus?
Metaplasia, increase adenocarcinoma risk
What are esophageal varices?
Vomit blood everywhere, portal HTN
What is Mallory Weiss?
Tear the LES mucosa, chronic vomiters
What is Boerhaave’s?
Tear all layers of the esophagus, left sided pneumo/pain/effusion
What is achalasia?
Loss of LES Auerbach’s, no meconium passage.
What is Hirschprung?
Loss rectum Auerbach, no meconium passage.
What is Zencker’s diverticulum?
Cough undigested food from above UES, halitosis.
What is traction diverticulum?
Eat big bolus, gets stuck above the LES.
What is Plummer Vinson syndrome?
Esophageal webs, spoon nails, Fe deficiency anemia.
What are Schatzki rings?
Esophageal webs in the lower esophagus.
What is a TE fistula?
Choke w each feeding.
What is an esophageal atresia w/ a TE fistula?
Vomit w/ first feeding, huge gastric bubble.
What is a duodenal atresia?
Bilious vomiting w/ 1st feeding, double bubble, Down’s
What is pyloric stenosis?
Projectile vomiting (3-4 wks old), RUQ olive mass.
How does choanal atresia present?
Turns blue w feeding.
How does the Tetralogy of Fallot presentation differ?
Turns blue w crying.
What makes Scleroderma unique?
Decrease LES pressure.
What makes esophageal spasm unique?
Increase peristalsis
What makes achalasia unique?
Decrease peristalsis and increase LES pressure.
What disease has a RUQ olive mass?
Pyloric stenosis
What disease has a RLQ sausage mass?
Intussuseption
What is a Bezoar?
Mass of hair or vegetables=> antrum obstruction
What is gastritis type A?
Upper GI bleed, anti Perietal cell-Ab.
What is Gastritis type B?
Upper GI bleed, spicy foods, H.pylori.
What is duodenal ulcer?
Too much acid: pain after meal/at night, type O blood, H.pylori, pan relieved by eating.
What is a gastric ulcer?
Broken mucus layer: pian during meal, NSAID’s, type A blood.
What is a sliding hiatal hernia?
Fundus slides to the esophageal hiatus to the thorax=> suck acid into the thorax
What is rolling hiatal hernia?
Fundus stick through hole in the diaphragm, strangulates bowel
What is Menetrier’s disease?
Protein losing, thick stomach rugal folds
What defines constipation?
< 3 BM per week
What defines diarrhea?
> 200g per day
What is osmotic diarrhea?
Watery
What is secretory diarrhea?
Laxative use
What is inflammatory diarrhea?
Blood, pus
What is celiac sprue?
Jejunum, wheat allergy, villous atrophy, anti-gliadian Ab, anti endomesyal Ab, anti reticulin Ab.
What is tropical sprue?
Ileum celiac sprue
What is mesenteric ischemia?
Pain out of proportion to exam.
What bugs cause bloody diarrhea?
"CASES" Campylobacter Amoeba Shigella E. coli Salmonella
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.
What is Ascending cholangitis?
Common duct stone gets infected.
What are the signs of alcoholic cirrhosis?
Spider angioma, palmar erythema, Dupuytren’s contractions, gynecomastia
What is hepatorenal syndrome?
Pts w/ liver disease build up liver toxins that cause renal failure.
What is cholangitis?
Inflammation of bile duct => Charcot’s triad, Reynaud’s pentad
What is cholescystitis?
Infammation of the gallbladder=> Murphy’s sign
What is cholelithiasis?
Formation of gallstones=> RUQ colic
What is choledocholithiasis?
Gallstone obstructs the bile duct
What is cholestasis?
Obstruction of bile duct, => pruritus, increase alkaline phosphatase, jaundice.
What is conjugated bilirubin?
Water soluble, direct
What is unconjugated bilirubin?
Fat soluble, indirect
What is the most common type of gallstone?
Cholesterol (can’t see on x-ray)
What type of gallstone can be seen on x-ray?
Ca-bilirubinate
What is a xanthoma?
Cholesterol buildup (elbow or achilles)
What is a xanthelesma?
Triglyceride buildup, under the eye
What does high cholesterol cause?
Atherosclerosis
What do high triglycerides cause?
Pancreatitis
What is type I hyperlipidemia?
Bad liver LL (CM)
What is type 2A hyperlipidemia?
Bad LDL or B-100 receptor: trapped in the ER (LDL only)
What is type 2B hyperlipidemia?
Less LDL/VLDL receptors (LDL/VLDL)
What is type 3 hyperlipidemia?
Bad Apo E (IDL/VLDL)
What is type 4 hyperlipidemia?
Bad adipose LL (VLDL only)
What is type 5 hyperlipidemia?
Bad C2 (VLDL/CM) b/c C2 stimulates LL
What is Criggler Najjar?
Unconjugated bilirubin, usually in infants
What is Gilbert syndrome?
Glucoronyl transferase in saturated=> stress unconjugated bilirubin
What is Rotor’s?
Bad bilirubin storage: conjugated bilirubin
What is Dubin Johnson?
Bad bilirubin excretion=> black liver
What is Cullen sign?
Bleed around the umbilicus=> hemorrhagic pancreatitis
What is Turne’s sign?
Bleed into flank=> hemorrhagic pancreatitis
What tests are used for following pancretitis?
Amylase: sensitive, breaks down carbs
Lipase: specific, breaks down triglycerides
What does Ranson’s criteria tell you?
Poor prognosisi for pancreatitis pts
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)
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)
What is carcinoid syndrome?
Diarrhea, flushing and wheezing
What produces currant jelly sputum?
Klebsiella
What currant jelly stool?
Intussuseption
What is Gardener’s syndrome?
Familial polyposis w/ bone tumors
What is Turcot’s syndrome?
Familial polyposis w/ brain tumors
What is familial polyposis?
100% risk of colon cancer, APC defect, => annual colonoscopy at 5 y.o.
What is Peutz-Jagher syndrome?
Hyperpigmented mucosa=> dark gums and vagina
What is Crohn’s?
IBD w/ cobblestones, melena creeping fat and fistulas.
What is ulcerative colitis?
IBD w/ pseudoolyps, hematochezia, lead pipe colon, toxic megacolon
What is intussuseption?
Currant jelly stool, stacked coin enema, sx come and go.
What does diverticulosis present?
Bleeds
What does diverticulitis presents?
Hurts
How does spastic colon present?
Intermittent severe cramps?
How does IBS present?
Alternating diarrhea/contipation
How does external hemorrhoids presents?
Pain
How does internal hemorrhoids presents?
No pain
What is pseudomembranous colitis?
Overgrowth od C. difficile due to normal flora being killed off, usually by Clindamycin use
What Whipple’s disease?
T. whipplei destroys GI tract, then spreads, causing malabsorption, atrhralgia
What color in an upper GI bleed?
Black
What color is lower GI bleed?
Red
What adds color to stool?
Bilirubin
What is the default color of stool?
Clay-color
What is the default color of urine?
Tea-color