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PANCE Prep Pearls > Gastrointestinal/Nutrition > Flashcards

Gastrointestinal/Nutrition Flashcards

1
Q

What is the condition associated with vitamin C deficiency?

A

Scurvy

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2
Q

Scurvy clinical manifestations (6)

A
  • Malaise
  • Weakness
  • Vascular fragility (due to abnormal collagen production)
  • Recurrent hemorrhages in gums, skin (perifollicular)* and joints
  • Impaired wound healing
  • Hyperkeratotic papules
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3
Q

3 “H’s” of scurvy

A
  1. Hyperkeratosis
  2. Hemorrhage
  3. Hematologic (anemia)
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4
Q

What is the name of the condition(s) associated with vitamin D deficiency?

A
  • Rickets (children)

- Osteomalacia (adults)

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5
Q

Management of vitamin D deficiency

A

Ergocalciferol (vitamin D)

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6
Q

Vitamin A deficiency clinical manifestations (7)

A
  1. visual changes (especially night blindness)
  2. Impaired immunity
  3. Squamous metaplasia (conjunctiva, respiratory epithelium, urinary tract)
  4. Bitot spots (white spots on conjunctiva)
  5. Xeropthalmia (dry eye)
  6. Alopecia
  7. Taste loss
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7
Q

What are the three conditions associated with vitamin B1 (thiamine) deficiency?

A
  1. Beriberi
  2. Wernicke’s encephalopathy
  3. Korsakoff’s dementia
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8
Q

“Dry” Beriberi symptoms (4)

A
  1. Peripheral neuropathy
  2. Symmetric impairment of sensory, motor & reflexes
  3. Anorexia
  4. Muscle cramps and wasting
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9
Q

“Wet” Beriberi symptoms (3)

A
  1. High output failure
  2. Dilated cardiomyopathy
  3. Edema
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10
Q

Triad of Wernicke’s encephalopathy

A
  1. Ophthalmoplegia
  2. Ataxia
  3. Global confusion
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11
Q

Korsakoff’s dementia

A
  • Memory loss (especially short-term)
  • Confabulation
  • IRREVERSIBLE
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12
Q

What is the name of the condition associated with vitamin B2 (Riboflavin) deficiency?

A

Oral-ocular-genital syndrome

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13
Q

Oral-ocular-genital syndrome: Oral (4)

A
  1. Lesions of the mouth
  2. Magneta colored tongue
  3. Angular cheilitis
  4. Pharyngitis
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14
Q

Oral-ocular-genital syndrome: Ocular (2)

A
  1. Photophobia

2. Corneal lesions

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15
Q

Oral-ocular-genital syndrome: Genital (1)

A
  1. Scrotal dermatitis
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16
Q

What is the name of the condition associated with niacin/nicotinic acid (B3) deficiency?

A

Pellagra

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17
Q

“3 D’s” of Pellagra

A
  1. Diarrhea
  2. Dementia
  3. Dermatitis
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18
Q

Etiologies of Pyridoxine B6 deficiency

A

Alcoholism, isoniazid, OCPs

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19
Q

Clinical manifestations of Vitamin B6 (Pyridoxine) deficiency) (7)

A
  1. Peripheral neuropathy*
  2. flaky skin
  3. HA
  4. Anemia
  5. Sore tongue
  6. Stomatitis
  7. Seizures
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20
Q

What type of genetic disorder is PKU?

A

Autosomal recessive

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21
Q

Children with PKU typically have what characteristics?

A

Blonde, blue-eyed with fair skin

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22
Q

Which foods are high in phenylalanine?

A

Cheese, nuts, fish, meats, eggs, chicken, milk, legumes, aspartame

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23
Q

Opioid agonists used in diarrhea (but not with acute dysentary)

A
  1. Diphenoxylate/Atropine (Lomotil)

2. Loperamide (Immodium)

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24
Q

Anticholinergic used in diarrhea

A

Phenoarbital/hyoscyamine/Atropine/scopolamine (Donnatal)

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25
Q

What is the most common cause of gastroenteritis in adults?

A

Norovirus

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26
Q

What is the most common cause of gastroenteritis in children?

A

Rotavirus

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27
Q

What are the most common sources of food seen with staphylococcus infection?

A

Dairy products, meats, eggs, mayonnaise

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28
Q

Bacillus Cereus incubation period

A

1-6 hours

29
Q

What type of food is most associated with bacillus cereus infection?

A

Fried rice

30
Q

Clinical manifestations of bacillus cereus infection

A

Vomiting*, cramps, diarrhea

31
Q

Vibrio cholera characteristics (3)

A
  1. Transmitted via contaminated food and water esp. abroad
  2. Gram negative rod
  3. May be associated with outbreaks during poor sanitation and overcrowding conditions
32
Q

Vibrio parahemolyticus and V. vulnificus characteristics (2)

A
  1. Associated with raw shellfish esp. in Gulf of Mexico

2. Exotoxin causes hyper secretion of water and chloride ions leading to severe dehydration

33
Q

Virbrio cholerae and vibrio parahemolyticus clinical manifesetations (2)

A
  1. Copious watery diarrhea “rice water stools” that may rapidly produce severe dehydration
  2. If fatal it usually results from hypovolemia
34
Q

Vibrio cholerae and vibrio parahemolyticus management (3)

A
  1. Often self-limited
  2. Fluid-replacement mainstay*
  3. If ill, high fevers, medical problems –> Fluoroquinolones (Cipro), doxycline, bactrim, choramphenicol
35
Q

What is the most common cause of traveler’s diarrhea?

A

Enterotoxogenic E. coli

36
Q

Enterotoxogenic E. coli treatment

A

Fluoroquinolone (BID x 3 d) to shorten the course; Bactrim, doxycycline, bismuths

37
Q

Shigella clinical manifestations (5)

A
  1. Crampy, lower abdominal pain
  2. Explosive, watery diarrhea –> mucoid, bloody*
  3. Severe cases may lead to toxic megacolon
  4. Neurologic manifestations esp. in young children (FEBRILE SEIZURES)
  5. May cause Leukemoid reaction* (WBC >50,000)
38
Q

What does a sigmoidoscopy show with shigella?

A

Punctate areas of ulceration

39
Q

Shigella treatment

A

Bactrim is the treatment of choice, fluoroquinolones

40
Q

A yersinia enterocolitica infection may mimic what other condition?

A

Acute appendicitis (can cause mesenteric adenitis producing abdominal tenderness, guarding)

41
Q

Yersinia enterocolitica management

A

Fluoroquinolones

42
Q

Which organism causes mucous diarrhea “Pea soup stools”?

A

Salmonella typhimurium

43
Q

Typhoid (enteric) fever clinical manifestations (3)

A
  1. Caused by salmonella typhi.
  2. Cephalic phase: HA, constipation, pharyngitis, cough
  3. 2nd week: Diarrhea (PEA SOUP STOOLS)*, intractable fever, relative bradycardia, rose spots
44
Q

Salmonella management

A

Fluoroquinolones, ceftriaxone x 2 weeks if severe

45
Q

Enterohemorrhagic E coli 0157:H7 management (2)

A
  1. Supportive

2. Abx are controversial (increases risk of HUS in children)

46
Q

What is the most common cause of bacterial enteritis in the United States?

A

Campylobacter Enteritis

47
Q

Campylobacter diarrhea

A

Initially watery and then turns bloody

48
Q

Campylobacter stool culture

A

Gram negative “S or Seagull shaped” organisms

49
Q

Campylobacter management

A

Erythromycin*, fluoroquinolones, or doxycycline if severe

50
Q

What is the usual cause of Giardia infection?

A

Ingestion of contaminated water from remote streams/wells* aka Beaver’s fever or “Backpacker’s diarrhea”

51
Q

Giardia diarrhea description

A

Frothy, greasy, foul diarrhea* (no blood or pus)

52
Q

What does a stool culture show with giardia?

A

Trophozites/cysts in stool

53
Q

Giardia management

A
  1. Metronidazole*, tinidazole, albendazole, quinacrine

2. FURAZOLIDONE in children

54
Q

Amebiasis (Entamoeba histolytica) clinical manifesations (3)

A
  1. GI colitis
  2. Dysentary
  3. Amebic liver abscess*
55
Q

Amebiasis (Entamoeba histolytica) treatment

A

Metronidazole (Flagyl), tinidazole, paromycin

56
Q

What is the most common cause of chronic diarrhea in AIDS patients?

A

Cryptosporidium

57
Q

Isospora belli (3)

A
  1. MC in homosexual men, pts with AIDS
  2. Transmitted feco-oral
  3. Treatment: bactrim
58
Q

Non-invasive diarrhea: affected area

A

Small bowel –>large voluminous stools

59
Q

Non-invasive diarrhea: vomiting

A

Vomiting predominant symptoms

60
Q

Non-invasive diarrhea: examples

A

Viral, S. aureus, B. Cereus, V. cholera, Enterotoxogenic E. coli

61
Q

Invasive diarrhea: affected area

A

large bowel–> many small-volume stools, high fevers

62
Q

Invasive diarrhea: vomiting

A

vomiting not as common

63
Q

Invasive diarrhea: examples

A

Shigella, salmonella, IBD (UC & CD), enterohemorrhagic E. coli

64
Q

Whipple disease MC in what type of population?

A

Farmers around contaminated soil

65
Q

Whipple disease clinical manifestations (2)

A
  1. Malabsorption symptoms

2. Rhythmic motion of eye muscles while chewing

66
Q

Whipple disease diagnosis

A

-Duodenal bx: periodic acid-schiff (PAS)-positive macrophages, non acid fast bacilli, dilation of lacteals

67
Q

Whipple disease management

A

Penicillin** or tetracycline for 1-2 years

68
Q

What is the side effect of osmotic laxatives?

A

Hypermagnesemia (especially in patients with chronic renal disease)*

69
Q

Stimulant laxatives

A
  1. Bisacodyl (Dulcolax)

2. Senna

PANCE Prep Pearls (7 decks)

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