Gastrointestinal Flashcards
Which drug can discolor teeth?
tetracycline
What is myxedema?
severe hypothyroidism
What organ is known to hypertrophy during Myxedema?
tongue
Which four vitamin deficiencies can cause glossitis?
iron deficiency
B12
Niacin
Vitamin C
What two infections can cause glossitis?
Scarlet fever
EBV
Erythroplakia and leukoplakia are indicative of what type of hyperplasia?
squamous cell hyperplasia
Does leukoplakia or erythroplakia have a higher liklihood to transform into Squamous Cell Carcinoma?
erythroplakia
What is the most common cause of oral cavity tumors?
HPV
Where can oral cavity tumors metastisize?
jugular node
Where does Basal Cell Carcinoma occur in the oral cavity? What is the #1 risk factor for development of BCC?
Upper lip
UV light
What two glands in the head are affected by Sjogrens Syndrome?
salivary and lacrimal
What are the two components of pleomorphic Adenomas?
epithelial cells and stromal cartilage
What marks a Pleomorphic Adenoma transforming into a malignant tumor?
Involvement of facial nerve
What type of tissue makes up a Warthin tumor?
lymphoid
What is another name for a Warthin Tumor?
Papillary Cystadenoma Lymphomatosum
Is a Warthin tumor more found in males or females?
Males
What two cells make up a Mucoepidermoid Carcinoma?
epithelial and stromal
What is the most common TEF?
proximal esophageal atresia
distal tracho-esophageal fistula
What could be noticed on physical exam if an infant in utero has a TEF?
polyhydramnios
What does the R of VACTERL stand for?
renal defects and absent radius
What causes Plummer-Vinson Syndrome?
iron deficiency
Are hiatal hernias more common in men or women?
women
What drug could be discontinued to improve a sliding hernia?
CCBs
What part of the diaphragm is absent during a Bochdalek Hernia?
posterior-lateral
What is the test for LES abnormalitites?
Manomatery
What does the LES pressure have to be in order to diagnose GERD?
less than 10 mmHg
A pleural effusion with amylase would be indicative of what condition?
Boerhaave Syndrome
What type of age distribution does Achalasia have?
bimodal
What three drugs can be used for achalasia?
CCBs
long acting nitrates
botulinum
What is the most common type of Esophageal tumor?
Leimoyoma
Would squamous or adeno be more common in developing countries?
squamous
Which specific part of the esophagus would SCC be most common?
middle third
Which type of esophageal cancer is known for release a paraneoplastic syndrome pepritde? Which peptide is it?
Squamous
PTHrp
What is Hb converted into by stomach acid?
Hematin
BAO:MAO is normally what ratio?
0.2:1
What enzyme is deficient during Pyloric Stenosis?
NOS
What is the cause of gastroparesis?
autonomic neuropathy
What is the treatment of gastroparesis?
metoclopramide
Which worm can cause a stomach disorder? Which stomach disorder is it? How is this worm acquired?
Anisakis
Hemorrrhagic gastritis
eating raw fish
What are more common, duodenal or gastric ulcers?
duodenal
Which blood group is associated with Duodenal Ulcers?
Group O
Which blood group is associated with Gastric Ulcers?
Group A
Which type of ulcer has an increased BAO:MAO?
duodenal
Which family of tumors can Zollinger-Ellison Syndrome be associated with?
MEN Type I
A duodenal ulcer past the proximal duodenum could be suggestive of what disease?
ZE syndrome
What other two tumors could ZE Syndrome be associated with?
Parathyroid or pituitary
A gastrin level over what is indicative of ZE Syndrome?
1,000 pg/mL
What is used to localize a ZE Syndrome tumor?
radiolabeled octreotide
Where does gastric cancer commonly metastisize?
Virchow nodes
What parasite is known to cause an invasive diarrhea?
Entamoeba histolytica
Lactase deficiency clasically effects which two ethnic groups?
Asias and Native Americans
What is the most common cause of pancreatitis in adults?
alcohol
What is the most common cause of pancreatitis in children?
cystic fibrosis
What is the most common viral enteritis in AIDS patients? What is the treatment for this virus?
CMV
gangciclvir
What is the most common cause of viral enteritis in adults?
Norovirus
What is the most common virus on cruise ships?
Norovirus
What is the most common cause of viral enteritis in kids?
rotavirus
Why does rotavirus cause diarrhea?
rotavirus damages ion reuptake
Which gram positive rod can cause enteritis?
Bacillus cereus
Does B. cereus form a toxin or release a preformed toxin?
release preformed toxin
Which two foods is B. cereus associated with?
rice and tacos
What are the three reservoirs for Campylobacter jejuni?
cattle
chickens
puppies
Does C. jejuni produce bloody or non-bloody diarrhea?
bloody
How is C. jejuni treated?
erythromycin
What other GI tract disease can C, jejuni resemble?
Ulcerative Colitis
Guillain-Barre can be associated with what GI bug?
C. jejuni
What disease haplotype can C. jejuni similar symptoms to?
HLAB27
Is botulism a synthesized toxin or preformed toxin?
Preformed
What is the treatment for botulism?
anti-toxin
What three antibiotics cause pseudomembrane colitis?
Penicillin, Quinolones, Clindamycin
Which lab value can pseudomembrane colitis decrease?
albumin
Presence of what enzyme in stool could be indicatvie of pseudomembrane colitis?
Glutamate Dehydrogenase
What is the preferred antibiotic treatment for pseudomembrane colitis?
Metronidazole
Is C. difficile gram positive or negative?
positive
What is the treatment for C. difficile?
ciprofloxacin
What population does Mycobacterium Avium Intracellularle infect?
AIDS
What other disease can MAC mimmic on histology?
Whipple disease
Which non-reptile can Salmonella reside in?
Hamsters
What two drugs are used to treat Salmonella?
Ciprofloxacin and levofloxacin
What is the classic triad of S. typhi?
neutropenia/splenomegaly/bradycardia
Is Typhus treated with antibiotics?
no
In what organ can salmonella establish a carrier state?
gallbladder
What drug is used to treat Vibrio cholerae?
doxycycline or fluroquinolone
How is Yersinia enterocolitica treated?
TMP-SMX
What protozoa can cause colonic ulcers and rectal bleeding?
Balantidium coli
Which protozoa is known to cause diarrhea in AIDS patients?
Cryptosporidium parvum
Which protozoa is known to cause diarrhea from swimming pools?
Cryptosporidium parvum
Which protozoa produces flask shaped lesions?
Entamoeba histolytica
Does Entamoeba histolyticum cause bloody or non-bloody diarrhea?
bloody
Where can Entamoeba histolytica traver to and establish an abscess?
Liver
Which protozoa can phagocytose RBCs?
entamoeba histolytica
Which intestinal parasite can arise during IgA Deficiency?
Giardia
What is the scientific name for Whip Worm?
Trichuris trichuria
Which nematode can produce rectal prolapse in children?
Trichuris trichiura
Which nematode does not produce Eosinophilia?
Ascaris
Which apolipoprotein mediates the secretion of chylomicrons into the lymphatics?
B48
How much fat has to be secreted into the stool in a 24 hours period to diagnose malabsorption?
greater than 7 grams
β-carotene is a precursor for what vitamin?
Vitamin A
When is trypsin concentrtion elevated?
early cystic fibrosis
What is the bentiromide test used for?
chymotrypsin insufficiency
What does chymotrypsin cleave bentiromide into?
PABA
What is C14-Xylose test used for?
bacterial growth in GI tract
What is the substrate used for Bile Breath Test?
Cholyglycine
What immune disease is celiac disease associated with?
IgA Deficiency
What two genetic diseases is Celiac Disease associated with?
Downs and Turner
Which auto-antibody is the best for diagnosing Celiac Disease?
anti-endomysium
How is Whipple Disease diagnosed?
PCR
In what layer of the GI tract do Trypopherma whippeli accumulate?
Lamina propria
What is the classic patient to present with a gallstone ileus?
Elderly woman
Which type of hernia has the highest rate of bowel incarceration?
femoral
What is the most common hernia in adults with ascites?
Umbilical
What does Antiphospholipid Syndrome Produce?
Hypercoaguable state
What immune cell invades during the early stages of a bowel infarction?
neutrophil
What is the radiologic sign for Bowel Ischemic necrosis?
thumb printing
What is the treatment for angiodysplasia?
colonoscopy
What is the most common finding of a Meckels Diverticulum?
bleeding
What causes a pulsion diverticula?
increased transluminal force
Where is the most common site for a pulsion diverticula in the small bowel?
Duodenum
A wide-mouthed diverticula suggests what other disease?
systemic sclerosis
Meckels diverticulitis mimmics what other disease?
appendicitis
What are the three associations for a sigmoid diverticulum?
ED
Marfan
ADPKD
What is diverticulosis?
painless bleeding
Does IBS have normal or abnormal CRP?
normal
What is the mainstay of IBS Treatment?
Fiber
What is THE most common site for a carcinoid tumor?
vermiform appendix
What can carcinoid syndrome do to the face?
Telangiectasia
What is avoided during Carcinoid Syndrome?
alcohol
What type of drug can be used to treat a carcinoid tumor?
somatostatin analogue
Where are the majority of hamartomous polyps found?
Sigmoid
Where are the majority of Juvenile polyps found?
rectum
What is the mode of inheritance for juvenile polyposis?
autosomal dominant
What are the two features of Cronkhite-Canada Syndrome?
nonhereditary polyposis
abnormalities of fingernails
What is the Mode of Inheritance for Peutz Jeghers?
autosomal dominant
Which gene is Peutz Jeghers associated with? Is this gene activated or inactivated?
STK11
inactivated
Large sessile polyps can produce what two metabolic abnormalities?
hypoalbuminemia and hypokalemia
What is the mode of inheritace for lynch syndrome?
autosomal dominant
What type of drug can inhibit the growth of colon cancer cell lines?
statins
What is the best screening molecule for colon cancer?
CEA
Which two bacteria are the most common cause of appendicitis?
E. coli
Bacteroides fragilis
Which fiber initially carries the pain sensation of appendicitis? Where are these fibers located?
C fibers
visceral peritoneum
What is the level of cutaneous hyperesthesia of acute appendicitis?
T12
After appendicitis shift to RLQ, what fibers carry the pain sensation? Which layer?
A-delta
parietal peritoneum
What is the Blumberg sign?
rebound tenderness at McBurney point
What is the Psoas sign?
RLQ pain with right leg extension
What is Rovsing sign?
RLQ pain with LLQ palpation
What would be most abnormal on a heme workup for a patient with acute appendicitis?
neutrophilic leukocytosis
Formation of a periappendiceal abscess is indicative of what bacteria?
Bacteriodes fragilis
What is pyelophlebitis?
thrombophlebitis of portal vein caused by infection
What is the best method to diagnose acute appendicitis?
spiral CT after gastrografin enema
What is the antibiotic treatment of acute appendicitis?
Cefoxitin
What are the three most common cause of rectal prolapse in children?
Whip worm (Trichuris trichiura)
Whooping cough
cystic fibrosis
What are the two most common causes of anal SCC?
HPV 16 and HPV 18
