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0. PANCE Review > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

What is the term for difficulty swallowing?

A

Dysphagia

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2
Q

Bird-beak esophagus on barium swallow should make you think of what diagnosis?

A

Achalasia

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3
Q

What is the most common location for an anal fissure?

A

Posterior midline

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4
Q

Crohn’s is found where in the GI tract?

A

It can be from esophagus to anus.

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5
Q

How do you treat achalasia?

A

Loosen up the muscle - botox, dilation or surgery

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6
Q

A corkscrew appearance on barium study should make you think of what diagnosis?

A

Esophageal spasms

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7
Q

Epigastric abdominal pain which radiates to the back should make you think of what diagnosis?

A

Pancreatitis

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8
Q

In order to contract hepatitis D what must you already have?

A

Hepatitis B

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9
Q

Left lower quadrant pain and tenderness should make you think of what diagnosis?

A

Diverticulitis

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10
Q

What is the treatment for most Mallory-Weiss tears?

A

Watchful waiting, these will typically resolve within 48 hours.

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11
Q

A thumbprint sign on an abdominal film should make you think of what diagnosis?

A

Intestinal ischemia

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12
Q

What will the bowel sounds be early on in a small bowel obstruction? What will they be later on?

A

Early they are hyperactive. Late they are absent.

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13
Q

A patient has had GERD for years. Over the

past year he has noticed an increase in difficulty swallowing his food. This should make you think of what diagnosis?

A

Esophageal strictures

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14
Q

What are two treatments you should consider for esophageal strictures?

A

Dilation of the esophagus and long term PPIs.

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15
Q

What are two common predisposing factors for esophageal varices?

A

Portal HTN and cirrhosis often caused by alcoholism.

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16
Q

What is a common symptom that goes along with chest pain for GERD patients?

A

Dry cough

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17
Q

What medication is most commonly used for long term treatment of GERD?

A

Proton pump inhibitors - omeprazole, lansoprazole, pantoprazole

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18
Q

What is the imaging modality of choice for pancreatitis?

A

CT

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19
Q

What is the best test to check for H. pylori?

A

Urea breath test

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20
Q

Is peptic ulcer disease more common in the duodenum or the stomach?

A

Duodenum

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21
Q

What is the most common location for a pancreatic tumor?

A

75% occur in the head of the pancreas.

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22
Q

With a gastric ulcer are the patient’s symptoms exacerbated or relieved with food?

A

Exacerbated

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23
Q

Fasting gastrin will be above what level with gastrinoma?

A

> 150 pg/ml

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24
Q

Projectile vomiting should make you think of what diagnosis?

A

Pyloric stenosis

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25
Q

Most gallstones are made of what substance?

A

Cholesterol

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26
Q

What is the name of the sign when a patient shows inhibited inspiration with pressure over the RUQ? What diagnosis does it suggest?

A

Murphy’s sign, Cholecystitis

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27
Q

What is the most specific test for acute cholecystitis?

A

HIDA

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28
Q

What is the gold standard for diagnosis and treatment of bile duct stones

A

ERCP

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29
Q

What is Charcot’s triad?

A

RUQ pain, fever, jaundice

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30
Q

What is Reynold’s pentad and why does it matter?

A

Charcot’s triad + hypotension + altered mental status. It indicates high risk of sepsis.

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31
Q

What disease is defined as an immunologic response to gluten?

A

Celiac

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32
Q

What is the main risk factor for esophagitis?

A

Immunocompromised patient

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33
Q

An endoscopy for presumed esophagitis shows multiple shallow ulcers. What is the most likely diagnosis?

A

Herpes simplex virus

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34
Q

List two common offending agents for pill induced esophagitis?

A

NSAIDS, KCl, iron, antibiotics

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35
Q

A 30 year old African American woman presents with dysphagia. You notice she also has thickened skin. A barium swallow demonstrates the absence of peristalsis. What is the most likely diagnosis?

A

Scleroderma

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36
Q

A patient complains of regurgitating undigested food several hours after a meal. What is the most likely diagnosis?

A

Zenker’s diverticulum

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37
Q

What is the most common cause of peptic ulcer disease?

A

H. pylori

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38
Q

What is the most specific diagnostic test for peptic ulcer disease?

A

Endoscopy

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39
Q

What is the only curative therapy for gastric adenocarcinoma?

A

Surgical resection

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40
Q

A patient presents complaining of right upper quadrant pain 20 minutes after meals. What is the most likely diagnosis?

A

Cholecystitis

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41
Q

What does ERCP stand for?

A

Endoscopic retrograde cholangiopancreatography

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42
Q

What is the most common cause of acute cholangitis?

A

Choledocholithiasis

43
Q

Onion ring fibrosis from a bile duct biopsy should make you think of what diagnosis?

A

Primary sclerosing cholangitis

44
Q

What two viral hepatitis infections are self limiting?

A

Hepatitis A and hepatitis E

45
Q

Pica is often related to what type of anemia?

A

Iron deficiency anemia

46
Q

What does an Anti-HBc (hep B core antibody) indicate?

A

Previous or ongoing hepatitis B infection

47
Q

What does Anti-HBs (hep B surface antibody) indicate?

A

Recovery from infection or immunization to hepatitis B

48
Q

What it is the recommended treatment for hepatitis C infection?

What medication used in hepatitis B infection helps prevent the need for liver transplant?

A

Pegylated interferon alpha-2

Lamivudine

49
Q

There are vaccines for which two versions of hepatitis?

A

Hepatitis A and hepatitis B

50
Q

Will a patient with achalasia have dysphagia to liquids, solids or both?

A

Both

51
Q

If you have heartburn that does not improve with medication what is the most likely diagnosis?

A

Gastrinoma

52
Q

What are the two main complications of cirrhosis?

A

Portal HTN & liver insufficiency

53
Q

What is a good beta blocker to reduce portal HTN?

A

Propranolol

54
Q

What tumor marker may be used for liver cancer?

A

alpha-Fetoprotein

55
Q

What are the two most common causes of pancreatitis?

A

Cholelithiasis and ETOH

56
Q

Describe Cullen’s sign?

A

Umbilical ecchymosis often related to pancreatitis.

57
Q

What are the 5 points of Ranson’s criteria on admission?

A
  • older than 55,
  • WBC>16,
  • glucose>200,
  • LDH>350,
  • AST>250
58
Q

What is the first step in treating GERD?

A

Lifestyle modification

59
Q

Steatorrhea should make you think of what diagnosis?

A

Pancreatitis

60
Q

Describe Courvoisier’s sign.

A

Nontender, palpable gallbladder which may indicate pancreatic neoplasm.

61
Q

What tumor marker can be used to follow pancreatic cancer?

A

CA-19-9

62
Q

A patient complains of periumbilical pain which has now moved over McBurney’s point. What is the most likely diagnosis?

A

Appendicitis

63
Q

Describe how to perform the psoas sign?

A

The patient is supine and attempts to raise the right leg against resistance.

64
Q

What is the term for painful swallowing?

A

Odynophagia

65
Q

Describe how to perform the obturator sign?

A

The patient is supine and attempts to flex and internally rotate right hip.

66
Q

What is the best imaging study for acute appendicitis?

A

CT

67
Q

What two blood test can be used to diagnose celiac?

A

IgA endomysial antibody and IgA tTG antibody

68
Q

How much fiber should you normally get in a day?

A

About 30 grams

69
Q

What treatment should be started for asymptomatic diverticulosis?

A

None

70
Q

Is surgery curative for Crohn’s or ulcerative colitis?

A

Ulcerative colitis

71
Q

What causes Mallory-Weiss tears?

A

Forced vomiting or retching (often involving alcohol)

72
Q

A colonoscopy that shows cobblestone or skip lesions should make you think of what diagnosis?

A

Crohn’s disease

73
Q

What class of medication is first line to treat inflammatory bowel disease in the maintenance phase?

A

5-ASA products

  • sulfasalazine,
  • mesalamine
74
Q

Currant jelly stool should make you think of what diagnosis?

A

Intussusception

75
Q

Severe abdominal pain 30 minutes after a meal should make you think of what diagnosis?

A

Intestinal ischemia

76
Q

What is the most common cause of lower GI bleed?

A

Diverticulosis

77
Q

What is the most common location of colorectal cancer?

A

Cecum about 38%

78
Q

Colorectal cancer patients are almost all older than what age?

A

90% of patients are older than 50.

79
Q

An epigastric olive-shaped mass should make you think of what diagnosis?

A

Pyloric stenosis

80
Q

An elevated serum amylase and lipase should make you think of what diagnosis?

A

Pancreatitis

81
Q

Under routine circumstances when should patients begin getting screening colonoscopies?

A

Age 50

82
Q

What is the #1 cause of small bowel obstruction?

A

Postoperative adhesions

83
Q

Air fluid levels on abdominal x-ray should make you think of what diagnosis?

A

Bowel obstruction

84
Q

Which is more likely to pass into the scrotum, a direct or indirect hernia?

A

Indirect

85
Q

A string sign on barium swallow should make you think of what diagnosis?

A

Pyloric stenosis

86
Q

What is the first line of treatment for an anal fissure?

A

Fluid and fiber

87
Q

What are two things that an anal fissure off midline might suggest?

A

Crohn’s, syphilis, HIV, neoplasm

88
Q

What medical treatment is given for a gastrinoma?

A

Proton pump inhibitors

89
Q

What is the term for an abscess in the sacrococcygeal cleft?

A

Pilonidal disease

90
Q

Should diverticulitis always be admitted?

A

No, mild cases can be treated as outpatients with rest and clear fluids.

91
Q

Which NSAID has the highest rate of peptic ulceration?

A

Naproxen

92
Q

What is the diagnostic test of choice for Zenker’s diverticulum?

A

Barium swallow will show the diverticulum.

93
Q

What is the leading cause of iron deficiency anemia?

A

Chronic GI bleed

94
Q

At what age and how often should fecal occult blood tests be performed as a screening tool?

A

Beginning at age 50, and they should be done every year.

95
Q

How often should patients with pernicious anemia have a screening endoscopy performed?

A

Every 5 years looking for signs of gastric carcinoma.

96
Q

Are one half of all adult hernias direct or indirect inguinal hernias?

A

Indirect inguinal hernias makeup 50% of all adult hernias.

97
Q

How is celiac disease most commonly diagnosed?

A

Endoscopic biopsy

98
Q

Define pellagra?

A

Niacin (B3) deficiency

99
Q

An endoscopy for presumed esophagitis shows several solitary deep ulcers. What is the most likely diagnosis?

A

Cytomegalovirus

100
Q

Which are more painful, hemorrhoids above or below the dentate line?

A

Below, internal hemorrhoids are not painful.

101
Q

An abdominal exam with pain out of proportion to the exam should make you think of what diagnosis?

A

Intestinal ischemia

102
Q

Does adenocarcinoma arise from the proximal or distal esophagus?

A

Distal

103
Q

What does HBsAg (hep B surface antigen) indicate?

A

Active Hep B infection

104
Q

Jaundice with very high Alk Phos should make you think of what condition?

A

Cholangitis

0. PANCE Review (15 decks)

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