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PP Clues > Gastrointestinal > Flashcards

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
Q

How does choanal atresia present?

A

Turns blue with feeding

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25
Q

How is the tetralogy of fallot presentation different?

A

Turns blue with crying

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26
Q

What makes scleroderma unique?

A

Decrease LES pressure

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27
Q

What makes esophageal spasms unique?

A

Increase peristalsis

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28
Q

What makes achalasia unique?

A

Decrease peristalsis and increase 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

Cause antrum 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 duodenal ulcer?

A

Too much acid: pain after meal/at night
Type O blood
H.pylori
Pain relieved by eating

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35
Q

What is a gastric ulcer?

A

Broken mucus layer: pain during meal
Type A blood
Caused or worsened with NSAID’s (aspirin, ibuprofen, diclofenac and naproxen)

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36
Q

What is hiatal hernia?

A

Herniation of upper part of stomach into thorax

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37
Q

What is a sliding hiatal hernia?

A

Most common hernia
Type I hernia
Upward dislocation of cardia
Sucks acid into thorax

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38
Q

What is rolling hiatal hernia?

A

Fundus stick through hole in diaphragm
Type II hernia
Upward dislocation of gastric fundus

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39
Q

What is menetrier’s disease?

A

Protein loss
Stomach rugal folds
Associated w/excessive secretion of TGF-alpha

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40
Q

What defines constipation?

A

Common cause of painful defecation
<3 bowel movement per week
Fecal impaction which can progress to bowel obstruction

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41
Q

What defines diarrhea?

A

Condition of having 3 or more loose or liquid stools per day
Most common cause is gastroenteritis
>200g per day

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42
Q

What is osmotic diarrhea?

43
Q

What is secretory diarrhea?

A

Laxative use

44
Q

What is inflammatory diarrhea?

45
Q

What is celiac sprue?

A

Disorder of small intestine
Jejunum
Wheat allergy
Villous atrophy

46
Q

What is tropical sprue?

A

Ileum celiac sprue

47
Q

What is mesenteric ischemia?

A 
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
Q

What bugs cause bloody diarrhea?

A

“CASES”:

  • campylobacter
  • amoeba (E.histolytica)
  • shigella
  • e-coli
  • salmonella
49
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 (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
Q

What is ascending cholangitis?

A

Common duct stone gets infected

51
Q

What are the signs of alcoholic cirrhosis?

A

Spider angioma
Palmar erythema
Gynecomastia
Dupuytren’s contraction= fingers bend towards the palm and cannot
be fully extended (straightened)

52
Q

What is hepatorenal syndrome?

A

Is the development of renal failure in patients with advanced chronic liver disease

53
Q

What is cholangitis?

A

Inflammation of bile duct
Charcot’s triad= three common findings in cholangitis: abdominal pain,
jaundice and fever

54
Q

What is cholecystitis?

A

Inflammation of gallbladder

Murphy’s sign

55
Q

What is cholelithiasis?

A

Formation of gallstones

Right upper quadrant colic

56
Q

What is choledocholithiasis?

A

Gallstone obstructs bile duct

57
Q

What is cholestasis?

A 
Obstruction of bile duct
Cause:
*pruritus
*elevation of alkaline phosphatase
*jaundice
58
Q

What is conjugated bilirubin?

A

Water soluble “direct”

59
Q

What is unconjugated bilirubin?

A

Fat soluble “Indirect”

60
Q

What is the most common type of gallstone?

A

Cholesterol (can’t see on x-ray)

61
Q

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

A

Ca-bilirubinate

62
Q

What is a xanthoma?

A

Cholesterol buildup (elbow and achilles)

63
Q

What is xanthelasma?

A

Triglyceride buildup (under eye)

64
Q

HDL cholesterol?

A

Good cholesterol

65
Q

LDL cholesterol?

A

Bad cholesterol

66
Q

What does high cholesterol cause?

A

Atherosclerosis

67
Q

What do high triglycerides cause?

A

Pancreatitis

68
Q

What is type 1 hyperlipidemia?

A

Bad liver LL (lipoprotein lipase)

69
Q

What is type 2a hyperlipidemia?

A

Bad LDL or B-100 receptors

70
Q

What is type 2b hyperlipidemia?

A

Less LDL/VLDL receptors

71
Q

What is type 3 hyperlipidemia?

A

Bad Apo E (IDL/VLDL)

72
Q

What is type 4 hyperlipidemia?

A

Bad adipose LL (VLDL only)

73
Q

What is type 5 hyperlipidemia?

A 
Bad C2 (VLDL/CM)
Because C2 stimulates LL (lipoprotein lipase)
74
Q

What is Crigler-Najjar syndrome?

A

Is a disorder affecting metabolism of bilirubin
Unconjugated bilirubin
Usually in infants

75
Q

What is Gilbert’s syndrome?

A 
Is a genetic liver disorder
Glucuronyl transferase is saturated 
Cause:
*increase unconjugated bilirubin in bloodstream
*jaundice
76
Q

What is Rotor’s syndrome?

A

Is a bilirubin disorder

Bad bilirubin storage-conjugated bilirubin

77
Q

What is Dubin-Johnson syndrome?

A

Is a disorder that causes increase of conjugated bilirubin

Bad bilirubin excretion-black liver

78
Q

What is Cullen’s sign?

A

Is a superficial edema and bruising around umbilicus

Bleed around umbilicus-hemorrhagic pancreatitis

79
Q

What is Turner’s sign?

A

Is a bruising of the flanks (blue discoloration)

Bleed into flank-hemorrhagic pancreatitis

80
Q

What test are used for following pancreatitis?

A
  • Amylase- sensitive, breaks down carbs

* Lipase- specific, breaks down TGs

81
Q

What does Ranson’s criteria tell you?

A

Poor prognosis for pancreatitis ptes

82
Q

What is Ranson’s Criteria at presentation?

A

“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
Q

What is Ranson’s Criteria at 48 hrs?

A

“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
Q

What is carcinoid syndrome?

A

Diarrhea
Flushing
Wheezing

85
Q

What produces currant jelly sputum?

A

Klebsiella

86
Q

What produces currant jelly stool?

A

Intussusception

Part of intestine invaginated another section of intestine

87
Q

What is gardener’s syndrome?

A

Familial polyposis w/ bone tumors

88
Q

What is turcot’s syndrome?

A

Familial polyposis w/ brain tumors

89
Q

What is familial polyposis?

A

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

90
Q

What is peutz-jegher syndrome?

A

Hyperpigmented mucosa

Dark gums/vagina

91
Q

What is crohn’s disease?

A
  • 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
Q

What is ulcerative colitis?

A

*IBD (inflammatory bowel disease) w/ pseudopolyps, hematochezia, lead pipe colon, toxic megacolon

93
Q

What is intussusception?

A

Currant jelly stool
Stacked coin enema
Sx. come and go

94
Q

How does diverticulosis present?

95
Q

How does diverticulitis present?

96
Q

How does spastic colon present?

A

Intermittent severe cramps

97
Q

How does IBS (inflammatory bowel syndrome) present?

A

Alternating diarrhea

Constipation

98
Q

How do external hemorrhoids present?

99
Q

How do internal hemorrhoids present?

100
Q

What is pseudomembranous colitis?

A

Overgrowth of C.difficile due to normal flora being killed off
Usually by clindamycin use

101
Q

What is whipple’s disease?

A

T.whippleii destroy GI tract
Spread causing malabsorption
Arthralgia (joint pain)

102
Q

What color is an upper GI bleed?

103
Q

What color is a lower GI bleed?

104
Q

What adds color to stool?

105
Q

What is the default color of stool?

A

Clay-colored

106
Q

What is the default color of urine?

A

Tea-colored

PP Clues (6 decks)

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