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Gastrointestinal Flashcards

0
Q

What disease has an apple core x-ray?

A

Cancer

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1
Q

What disease has a corkscrew x-ray?

A

Esophageal spasm

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2
Q

What disease has a stacked coin x-ray?

A

Intussusception

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3
Q

What disease has a thumbprint x-ray?

A

Toxic megacolon

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4
Q

What disease has an abrupt cutoff x-ray?

A

Volvulus

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5
Q

What disease has a barium clumping x-ray?

A

Celiac sprue

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6
Q

What disease has a bird’s beak x-ray?

A

Achalasia

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7
Q

What disease has a string sign x-ray?

A

Pyloric stenosis

Chron’s disease

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8
Q

What diseases have solid dysphagia?

A

Schatzki’s rings
Stricture
Cancer

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9
Q

What diseases have solid and liquid dysphagia?

A

Esophageal spasm
Scleroderma (systemic sclerosis)
Achalasia

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10
Q

What is barret’s esophagus?

A

Metaplasia

Increase risk of adenocarcinoma

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11
Q

What are esophageal varices?

A

Vomit blood everywhere

Portal HTN

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12
Q

What is mallory-weiss?

A

Tear LES mucosa

Chronic vomiters

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13
Q

What is boerhaave’s syndrome?

A 
Esophageal wall rupture
*tear all layers of esophagus
*left-sided pneumo
*abdominal pain
*pleural effusion
*vomiting
*retrosternal pain
Retrosternal pain
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14
Q

What is achalasia?

A

Lost lower esophageal sphincter auerbach’s plexus
Bird’s beak
Chaga’s

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15
Q

What is hirschsprung’s disease?

A

This disease cause obstruction in colon

*Lost rectum auerbach’s plexus

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16
Q

What is zenker’s diverticulum?

A

Diverticulum of the mucosa of the pharynx
False diverticulum (involve all layers of structure)
*cough undigested food
*halitosis

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17
Q

What is traction diverticulum?

A

Esophageal diverticulum
True diverticulum (only involve submucosa and mucosa)
*eat big bolus

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18
Q

What is plummer-vinson syndrome?

A
  • Esophageal webs (dysphagia-difficulty in swallow and odynophagia- painful swallow)
  • Iron deficiency (anemia)
  • Glossitis
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19
Q

What is schatzki rings?

A

Esophageal webs in lower esophagus (cause dysphagia)

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20
Q

What is TE fistula?

A

Tracheoesophageal fistula
Fistula between esophagus and trachea
*Choke w/each feeding

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21
Q

What is an esophageal atresia w/ TE fistula?

A

Vomit w/ first feeding

Huge gastric bubble

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22
Q

What is duodenal atresia?

A

Bilious vomiting w/ first feed
Double bubble
All infants with Down’s syndrome have duodenal atresia

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23
Q

What is pyloric stenosis?

A 
Projectil vomiting (3-4 week old)
Right upper quadrant olive mass
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24
How does choanal atresia present?
Turns blue with feeding
25
How is the tetralogy of fallot presentation different?
Turns blue with crying
26
What makes scleroderma unique?
Decrease LES pressure
27
What makes esophageal spasms unique?
Increase peristalsis
28
What makes achalasia unique?
Decrease peristalsis and increase 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 | Cause antrum 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 duodenal ulcer?
Too much acid: pain after meal/at night Type O blood H.pylori Pain relieved by eating
35
What is a gastric ulcer?
Broken mucus layer: pain during meal Type A blood Caused or worsened with NSAID's (aspirin, ibuprofen, diclofenac and naproxen)
36
What is hiatal hernia?
Herniation of upper part of stomach into thorax
37
What is a sliding hiatal hernia?
Most common hernia Type I hernia Upward dislocation of cardia Sucks acid into thorax
38
What is rolling hiatal hernia?
Fundus stick through hole in diaphragm Type II hernia Upward dislocation of gastric fundus
39
What is menetrier's disease?
Protein loss Stomach rugal folds Associated w/excessive secretion of TGF-alpha
40
What defines constipation?
Common cause of painful defecation <3 bowel movement per week Fecal impaction which can progress to bowel obstruction
41
What defines diarrhea?
Condition of having 3 or more loose or liquid stools per day Most common cause is gastroenteritis >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?
Disorder of small intestine Jejunum Wheat allergy Villous atrophy
46
What is tropical sprue?
Ileum celiac sprue
47
What is mesenteric ischemia?
``` Inflammation and injury of small intestine Result from inadequate blood supply Pain out of proportion to exam Cause: (decrease blood flow) *low blood pressure *constriction of blood vessels *blood clot ```
48
What bugs cause bloody diarrhea?
"CASES": * campylobacter * amoeba (E.histolytica) * shigella * e-coli * salmonella
49
What is the difference b/w primary biliary cirrhosis and primary sclerosing cholangitis?
*Primary biliary cirrhosis= anti-mitochondrial Ab, bile ductules destroyed, xanthelasma (yellowish deposit of fat in the skin) *Primary sclerosing cholangitis= p-anca Ab (Perinuclear Anti- Neutrophil Cytoplasmic Antibodies), bile duct inflammation, beading, onion skinning, assoc. w/ UC
50
What is ascending cholangitis?
Common duct stone gets infected
51
What are the signs of alcoholic cirrhosis?
Spider angioma Palmar erythema Gynecomastia Dupuytren's contraction= fingers bend towards the palm and cannot be fully extended (straightened)
52
What is hepatorenal syndrome?
Is the development of renal failure in patients with advanced chronic liver disease
53
What is cholangitis?
Inflammation of bile duct Charcot's triad= three common findings in cholangitis: abdominal pain, jaundice and fever
54
What is cholecystitis?
Inflammation of gallbladder | Murphy's sign
55
What is cholelithiasis?
Formation of gallstones | Right upper quadrant colic
56
What is choledocholithiasis?
Gallstone obstructs bile duct
57
What is cholestasis?
``` Obstruction of bile duct Cause: *pruritus *elevation of 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 gallstones can be seen on x-ray?
Ca-bilirubinate
62
What is a xanthoma?
Cholesterol buildup (elbow and achilles)
63
What is xanthelasma?
Triglyceride buildup (under eye)
64
HDL cholesterol?
Good cholesterol
65
LDL cholesterol?
Bad cholesterol
66
What does high cholesterol cause?
Atherosclerosis
67
What do high triglycerides cause?
Pancreatitis
68
What is type 1 hyperlipidemia?
Bad liver LL (lipoprotein lipase)
69
What is type 2a hyperlipidemia?
Bad LDL or B-100 receptors
70
What is type 2b hyperlipidemia?
Less LDL/VLDL receptors
71
What is type 3 hyperlipidemia?
Bad Apo E (IDL/VLDL)
72
What is type 4 hyperlipidemia?
Bad adipose LL (VLDL only)
73
What is type 5 hyperlipidemia?
``` Bad C2 (VLDL/CM) Because C2 stimulates LL (lipoprotein lipase) ```
74
What is Crigler-Najjar syndrome?
Is a disorder affecting metabolism of bilirubin Unconjugated bilirubin Usually in infants
75
What is Gilbert's syndrome?
``` Is a genetic liver disorder Glucuronyl transferase is saturated Cause: *increase unconjugated bilirubin in bloodstream *jaundice ```
76
What is Rotor's syndrome?
Is a bilirubin disorder | Bad bilirubin storage-conjugated bilirubin
77
What is Dubin-Johnson syndrome?
Is a disorder that causes increase of conjugated bilirubin | Bad bilirubin excretion-black liver
78
What is Cullen's sign?
Is a superficial edema and bruising around umbilicus | Bleed around umbilicus-hemorrhagic pancreatitis
79
What is Turner's sign?
Is a bruising of the flanks (blue discoloration) | Bleed into flank-hemorrhagic pancreatitis
80
What test are used for following pancreatitis?
* Amylase- sensitive, breaks down carbs | * Lipase- specific, breaks down TGs
81
What does Ranson's criteria tell you?
Poor prognosis for pancreatitis ptes
82
What is Ranson's Criteria at presentation?
"WAGLA": * WBC: > 16K/uL (infection) * Age: > 55 (usually multiple illnesses) * Glucose: > 200 mg/dL (islet cells are fried) * LDH: > 350 IU/L (cell death) * AST: > 250 IU/L (cell death)
83
What is Ranson's Criteria at 48 hrs?
"BuCH was a SOB": * BUN: > 5mg/dL (decrease renal blood flow) * Ca: < 8mg/dL (saponification) * Hct: drops > 10% (bleed into pancreas) * Sequester: > 6L fluid= > 3rd spacing * pO2: < 60mm Hg (fluid/protein leak-ARDS) * Base deficit: > 4 mEq/L (diarrhea-pancreatic enzymes are dead)
84
What is carcinoid syndrome?
Diarrhea Flushing Wheezing
85
What produces currant jelly sputum?
Klebsiella
86
What produces currant jelly stool?
Intussusception | Part of intestine invaginated another section of intestine
87
What is gardener's syndrome?
Familial polyposis w/ bone tumors
88
What is turcot's syndrome?
Familial polyposis w/ brain tumors
89
What is familial polyposis?
100% risk of colon cancer APC defect Annual colonoscopy at 5yrs
90
What is peutz-jegher syndrome?
Hyperpigmented mucosa | Dark gums/vagina
91
What is crohn's disease?
* IBD (inflammatory bowel disease) w/ cobblestones, melena, creeping fat, fistulas * Autoimmune disorder * Most often involve lower end of small intestine and the beginning of large intestine
92
What is ulcerative colitis?
*IBD (inflammatory bowel disease) w/ pseudopolyps, hematochezia, lead pipe colon, toxic megacolon
93
What is intussusception?
Currant jelly stool Stacked coin enema Sx. come and go
94
How does diverticulosis present?
Bleeds
95
How does diverticulitis present?
Hurts
96
How does spastic colon present?
Intermittent severe cramps
97
How does IBS (inflammatory bowel syndrome) present?
Alternating diarrhea | Constipation
98
How do external hemorrhoids present?
Pain
99
How do internal hemorrhoids present?
No pain
100
What is pseudomembranous colitis?
Overgrowth of C.difficile due to normal flora being killed off Usually by clindamycin use
101
What is whipple's disease?
T.whippleii destroy GI tract Spread causing malabsorption Arthralgia (joint pain)
102
What color is an upper GI bleed?
Black
103
What color is a lower GI bleed?
Red
104
What adds color to stool?
Bilirubin
105
What is the default color of stool?
Clay-colored
106
What is the default color of urine?
Tea-colored

PP Clues (6 decks)

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