GI 1

Question 0

Melena

Answer 0

Tarry stool, blood from upper GI

Question 1

Hematochezia

Answer 1

Fresh blood in stool, lower GI problem

Question 2

Gall bladder test

Answer 2

Murphy’s sign

Question 3

Appendicitis tests

Answer 3

McBurney’s pt tenderness, rovsings, psoas sign, obturator sign

Question 4

3 tests to order if upper GI issue…

Answer 4

Endoscopy (to rule out cancer)
Manometry
Barium swallow

Question 5

Oropharyngeal dysphagia Sxs

Answer 5

Hard to initiate swallowing, nasal regurg, recurrent pneumonia

Question 6

Oropharyngeal dysphagia causes

Answer 6

Neuro: stroke, MS, Parkinson’s

Muscular: myasthenia gravis, muscular dystrophy, cricopharyngeal incoordination

Question 7

Esophageal dysphagia Sxs

Answer 7

Oral regurg, drooling. Hard to pass down esophagus

Question 8

Esophageal dysphagia causes

Answer 8

Motility: achalasia, diffuse esophageal spasm

Mechanical: ca, lower esophageal rings, aberrant subclavian, peptic stricture, huge thyroid

Question 9

Dysphagia red flags

Answer 9

Drooling, Sxs of complete obstruction, weight loss, new neurological deficit

Question 10

Schatski’s rings

Answer 10

Obstructive disorder of esophagus. Distal. Dysphagia for solids.

Question 11

Plummer Vinson syndrome

Answer 11

Obstructive webby disorder of esophagus. Upper. Dysphagia for solids

Question 12

Dysphagia lusoria

Answer 12

Aberrant right subclavian artery

Question 13

Achalasia

Answer 13

Sxs: dysphagia for both solids and liquids, nocturnal regurg

Aperistalsis–> narrow and beak like at LES, dilated esophagus

Ddx: carcinoma, peptic stricture

Question 14

Corkscrew esophagus

Answer 14

Diffuse esophageal spasm. Random contractions, elevated LES pressure.

Sxs: sub sternal chest pain, dysphagia for both solids and liquids

Question 15

Zenkers diverticula

Answer 15

Outpourings through cricopharyngeal muscle. Fill w food may regurg when bend/lie down…aspiration pneumonitis.

Question 16

GERD

Answer 16

LES incompetence dt…weight gain, fatty foods, caffeinated beverages, alcohol, tobacco, drugs (anticholinergics, nitrates, Ca channel blockers)

Question 17

GERD complications

Answer 17

Esophagitis, peptic esophageal ulcer, esophageal stricture, Barrett esophagus (which can –> adenocarcinoma)

Question 18

7 Fs

Answer 18

Fat, fatal growth, fetus, feces, flatus, fluid, fibroid

Question 19

Hiatal hernia

Answer 19

Stretching of fascia bet esophagus and diaphragm

Common=sliding. Work up–barium swallow

Question 20

Infectious esophageal disorders

Answer 20

Candida, HSV, CMV

Work up– endoscopy and culture

Question 21

Esophageal rupture

Answer 21

Emergency! Dt iatrogenic/endoscopy, etc; spontaneous dt huge bolus of food; GERD

Chest pain, vomiting, hematemesis