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Casey: Panre > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

1
Q

Term for difficulty swallowing

A

Dysphagia

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2
Q

Bird beak esophagus on barium swallow should make you think of what dx

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 disease is found where in the GI tract?

A

It can be from the esophagus to the anus

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5
Q

What does HBsAg (hep B surface antigen) indicate?

A

Active hep B infection

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6
Q

How do you treat achalasia?

A

Loosen up the muscle–Botox, dilation or surgery

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7
Q

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

A

Esophageal spasms

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8
Q

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

A

Pancreatitis

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9
Q

IOT contract hepatitis D what must you already have?

A

Hep B

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10
Q

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

A

Diverticulitis

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11
Q

What is the treatment for most Mallory-Weiss tears?

A

Watchful waiting, these will typically resolve within 48 hours

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12
Q

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

A

Intestinal ischemia

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13
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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14
Q

A pt has had GERD for yrs. over the past year, he has noticed an increase in difficulty swallowing his food. This should make you think of what dx?

A

Esophageal strictures

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15
Q

What are two tx you should consider for esophageal strictures?

A

Dilation of the esophagus and long term PPIs

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16
Q

What are 2 common predisposing factors for esophageal varices?

A

Portal HTN and cirrhosis often caused by alcoholism

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17
Q

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

A

Dry cough

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18
Q

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

A

Proton pump inhibitors
Omeprazole
Lansoprazole
Pantoprazole

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19
Q

What is the imaging modality of choice for pancreatitis?

A

CT

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20
Q

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

A

Urea breath test

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21
Q

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

A

Duodenum

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22
Q

What is the most common location for a pancreatic tumor?

A

75% occur in the head of the pancreas

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23
Q

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

A

Exacerbated

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24
Q

Projectile vomiting should make you think of what dx?

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 pt shows inhibited inspiration with pressure over the RUQ? What dx 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 dx of and tx 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 plus
Hypotension
Altered mental status
It indicates sepsis and is endoscopic emergency

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31
Q

What diseas 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 pt

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33
Q

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

A

Herpes simplex virus

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34
Q

List 2 common offending agents for pill induced esophagitis?

A

NSAIDS, KCl, iron, antibiotics

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35
Q

A 30 yr old AA woman presents with dysphagia. You notice she also has thickened skin. A barium swallow demonstrates the absence of peristalsis. What is the most likely dx?

A

Scleroderma

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36
Q

What is the most common cause of peptic ulcer disease?

A

H. Pylori

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37
Q

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

A

Endoscopy

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38
Q

What is the only curative tx for gastric adenocarcinoma?

A

Surgical resection

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39
Q

A pt c/o right upper quadrant pain :20 after meals. What is the most likely dx?

A

Cholecystitis

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40
Q

What does ERCP stand for?

A

Endoscopic retrograde cholangiopancreatography

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41
Q

What is the most cause of acute bacterial cholangitis?

A

Choledocolithiasis

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42
Q

Onion ring fibrosis from a bile duct bx should make you think of what dx?

A

Primary sclerosing cholangitis

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43
Q

What two viral hepatitis infections are self limiting?

A

Hepatitis A & E

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44
Q

Pica is often related to what type of anemia?

A

Iron deficiency

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45
Q

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

A

Previous or ongoing hepatitis B infection

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46
Q

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

A

Recovery from infection or immunization to hepatitis B

47
Q

What is the recommended tx for hepatitis C infection?

A

Pegylated interferon alpha-2

48
Q

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

A

Lamivudine

49
Q

There are vaccines for which 2 versions of hepatitis?

A

Hepatitis A and B

50
Q

Will a pt c 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 dx?

A

Gastrinoma

52
Q

What are the 2 main complications of cirrhosis?

A

Portal HTN and 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

Acute/chronic pancreatitis

58
Q

What is the first step in treating GERD?

A

Lifestyle modification

59
Q

Steatorrhea should make you think of what dx?

A

Pancreatitis

60
Q

Describe Courvoisier’s sign

A

Nontender palpable gallbladder which may indicate pancreatic neoplasm

61
Q

What tumor marker may be used to follow pancreatic cancer?

A

CA-19-9

62
Q

A pt c/o periumbilical pain which has now moved over McBurney’s point. What is the most likely dx?

A

Appendicitis

63
Q

Describe the psoas sign

A

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

64
Q

What is the term for painful swallowing?

A

Odynophahia

65
Q

Describe how to perform the obturator sign.

A

The pt is supine and attempts to flex and internally rotate the right hip

66
Q

What is the best imaging study for acute appendicitis?

A

CT

67
Q

What 2 blood tests can be used to dx 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 tx 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 dx?

A

Crohn’s disease

73
Q

What class of medication is the first line to tx inflammatory bowl disease in the maintenance phase?

A

5-ASA products:
Sulfasalazine
Mesalamine

74
Q

Currant jelly stool should make you think of what dx?

A

Intussusception

75
Q

Severe abdominal pain :30 after a meal should make you think of what dx?

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 pts are almost all older than what age?

A

90% are older than 50

79
Q

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

A

Pyloric stenosis

80
Q

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

A

Pancreatitis

81
Q

Under routine circumstances when should pts 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 dx?

A

Bowel obstruction

84
Q

What 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 dx?

A

Pyloric stenosis

86
Q

What is the first line tx for an anal fissure?

A

Fluid and fiber

87
Q

What 2 things that an anal fissure off midline might suggest?

A

Crohn’s, syphilis, HIV, neoplasm

88
Q

What medical tx 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

How do you tretH. Pylori infection?

A

PPI + 2 antibiotics,
Commonly omeprazole & clarithromycin & amoxicillin

Or
PPI & metronidazole & TCN

91
Q

Painless bright red blood per rectum should make you think of what dx?

A

Hemorrhoids

92
Q

A pt on sulfasalazine for an inflammatory bowel disease should be supplemented with what vitamin?

A

Folate

93
Q

What is the most common anorectal problem affecting pts over 50?

A

Hemorrhoids

94
Q

A gastrinoma is also known as what syndrome?

A

Zollinger-Ellison syndrome

95
Q

Salivary amylase breaks down what macronutrient?

A

Carbohydrates

96
Q

What is the medical term for feeling like there is a lump in your throat?

A

Globus

97
Q

What is the most common vessel blocked with intestinal ischemia?

A

Superior mesenteric artery

98
Q

Describe Grey-Turner’s sign

A

Flank ecchymosis often related to pancreatitis

99
Q

What are the first 3 steps of managing pancreatitis?

A

NPO
Pain control
Fluids

100
Q

A pt presents with unproductive retching, acute localized epigastric distention and inability to pass a nasogastric tube. What is the most likely dx?

A

Gastric volvulus

101
Q

What is the most common cause of a folate deficiency?

A

Alcoholism

102
Q

Should diverticulitis always be admitted?

A

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

103
Q

Which NSAID has the highest rate of peptic ulceration?

A

Naproxen

104
Q

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

A

Barium swallow will show the diverticulum

105
Q

What is the leading cause of iron deficiency anemia?

A

Chronic GI bleed

106
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 performed annually.

107
Q

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

A

Every 5 yrs looking for signs of gastric carcinoma

108
Q

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

A

Indirect inguinal hernias make up 50% of all adult hernias.

109
Q

How is celiac disease most commonly diagnosed?

A

Endoscopic biopsy

110
Q

Define pellagra

A

Niacin (B3) deficiency

111
Q

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

A

Cytomegalovirus

112
Q

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

A

Below, internal hemorrhoids are not painful.

113
Q

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

A

Intestinal ischemia

114
Q

Does adenocarcinoma arise from the proximal or distal esophagus

A

Distal

Casey: Panre (12 decks)

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