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PANCE > GI 10% > Flashcards

GI 10% Flashcards

1
Q

HCl in the stomach is secreted by __ cells

Pepsin secreted by __ cells

A
  • Hcl - parietal cells
  • Pepsin - chief cells
  • ->HCl activates pepsinogen to pepsin
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2
Q

Medications that should be avoided in GERD b/c they lower esophageal sphincter pressure

A 
Beta agonists
alpha-adrenergic antagonists
Nitrates
CCB
Anticholinergics
Theophylline
Morphine
Meperidine
Diazepam
Barbiturates
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3
Q

Tx of CMV esophagitis

A

IV ganciclovir

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4
Q

T/F - Somatostatin stimulates the release of GI hormones

A

FALSE - suppresses

ex. suppress gastrin secretion from G cells in stomach
ex. suppress CCK, VIP, insulin, pancreatic enzymes

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5
Q

T/F - Lower GI series (aka barium enema) is the test of choice in acute ulcerative colitis

A

FALSE - contraindicated because may cause toxic megacolon

-also CI if perforation is suspected

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6
Q

MC cause of esophagitis

A

GERD (duh)

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7
Q

esophageal findings on endoscopy - what dx?

  1. large superficial shallow ulcers
  2. small, deep ulcers
  3. linear yellow-white plaques
A
  1. large superficial shallow ulcers = CMV
  2. small, deep ulcers = HSV
  3. linear yellow-white plaques = Candida
    All are infectious esophagitis, MC in immunocompromised pts
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8
Q

treatment of candida infectious esophagitis

A

oral fluconazole

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9
Q

Tx of HSV esophagitis

A

Acyclovir

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10
Q

medication classic for causing pill esophagitis

A

Bisphosphonates

others = NSAIDS, KCl, iron pills, BBs, CCBs

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11
Q

Multiple corrugated rings on endoscopy seen in ___

A

Eosinophilic esophagitis

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12
Q

gold standard to diagnose GERD

A

24 hr ambulatory pH monitoring

  • not usually done
  • 1st line = endoscopy
  • 2nd line = esophageal manometry
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13
Q

what should be done if GERD is presenting with alarm symptoms (dysphagia, odynophagia, wt loss, bleeding)

A

don’t just treat! Upper Endoscopy

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14
Q

loss of Auerbach’s plexus leading to increased LES pressure

Difficulty with ___

Dx gold standard:

Tx:

A

Achalasia

Both liquid and solids

Esophageal manometry

Botox injections (temporary relief)
Nitrates, CCB, pneumatic dilation of LES
Esophagomyomectomy

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15
Q

Neurogenic dysphagia causes difficulty with ___.

Caused by injury/disease of brain stem for CN ___.

A

Both liquid and solids

CN 9, 10

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16
Q

“corkscrew esophagus” seen on esophagram

A

diffuse esophageal spasm

-chest pain w/ hot or cold liquids, foods

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17
Q 
MC types Esophageal neoplasms in:
African Americans: 
Smoking/ETOH:
GERD/Barrett's esophagus:
Obesity:
A

African Americans: Squamous cell
Smoking/ETOH: Squamous cell
GERD/Barrett’s esophagus: Adenocarcinoma
Obesity: Adenocarcinoma

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18
Q

Squamous cell esophageal cancer MC in ___

Adenocarcinoma of esophagus MC in ___

A

SC: upper 1/3 of esophagus
AD: lower 1/3

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19
Q

Dx of esophageal neoplasm
Best initial:
Test of choice:
Staging:

A

Best initial: Biphasic barium esophagram
Test of choice: Endoscopy w/ bx
Staging: Endoscopic sonography, CT

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20
Q

pharyngoesophageal pouch is aka ___

A

Zenker’s diverticulum – dx via barium esophogram

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21
Q

T/F - Mallory Weiss tear can present with pneumomediastinum

A

FALSE - this is Boerhaave’s syndrome - FULL thickness rupture of distal esophagus

Crepitus on chest auscultation

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22
Q

Plummer-Vinson Syndrome consists of (3)

A
  1. dysphagia
  2. esophageal webs
  3. Fe def anemia
    * atrophic glossitis
    - -this is a congenital syndrome
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23
Q

Dx test of choice for esophageal webs

A

barium esophagram

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24
Q

abx prophylaxis in esophageal variceal bleed to prevent infectious complications

A

FQs (ex. Norfloxacin)
or
Ceftriaxone

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25
Q

treatment of choice in acutely bleeding esophageal varices

A 
endoscopic ligation 
(**after IV fluids via 2 lg bore IVs and stabilization of the pt of course)
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26
Q

pharmacologic drug of choice in acutely bleeding esophageal varices

A

octreotide

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27
Q

__% of esophageal variceal bleeds that RE-BLEED within 1 year
–preventative treatment?

A

70%!! (1/3 of re-bleeds are fatal)
TX = BB’s (nonselective - ex. propranolol, nadolol)
NOT used in acute bleeds

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28
Q

Budd-Chiari syndrome may cause ____

A

thrombosis of portal vein, leading to esophageal varices

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29
Q

MC type of hiatal hernia

A

Type 1 = sliding hernia

TX = same as GERD

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30
Q

How often and with what diagnostic tool should people with Barrett’s esophagus be screened for cancer?

A

Every 3-5 years with Endoscopy

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31
Q

MC cause of gastritis

A

H pylori

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32
Q

Gold standard to dx gastritis

A

Endoscopy (shows thick, edematous erosions <0.5cm)

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33
Q

H pylori treatment

A

“CAP”
Clarythromycin + amoxicillin + PPI
(If allergic to penicillin –> Metronidazole)

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34
Q

T/F - Gastric ulcers are 4x more common than duodenal ulcers

–Duodenal or gastric seen in younger population?

A

FALSE! - Duodenal 4x more common than gastric

–Duodenal seen in younger population (30-55yo)

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35
Q

Tx of delayed gastric emptying

A

Prokinetic medications:

Cisapride, metoclopramide

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36
Q

(Duodenal/gastric) ulcers worsen with food, whereas (duodenal/gastric) ulcers improve with food.

A

GASTRIC ulcers WORSEN with food, whereas DUODENAL ulcers IMPROVE with food.

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37
Q

Tests that can confirm cure of H. pylori PUD

A

Stool antigen testing
Urea breath test

Accurate after 4 weeks AFTER completion of treatment

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38
Q

Gold standard to dx H pylori infection

A

Endoscopy (with biopsy! to rule out malignancy especially with gastric ulcers if alarm sx)
–positive urease test of biopsy specimen

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39
Q

Which of the following should NOT be used to confirm eradication of H pylori infection
A. urea breath test
B. H pylori stool antigen
C. serologic antibodies

A

C - serologic antibodies only used to confirm infection, can stay elevated long after eradication

    • the other 2 can be used for dx and eradication
  • -make sure urea breath test, pt is OFF PPIs
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40
Q

(duodenal or gastric) ulcers are typically better with meals, worse at night

A

duodenal

-gastric ulcers are worse esp 1-2h post meals

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41
Q

H2 receptor antagonist with lots of drug interactions

A

cimetidine

-b/c inhibitors CYP450 (remember C for CYP inhibitor)

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42
Q

Side effect of H2 receptor antagonists (general)

Side effect of cimetidine specifically

A

Inc LFTs

– Cimetidine –> anti androgen (gynecomastia, impotence)

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43
Q

Side effect of PPIs

A

B12 deficiency

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44
Q

Prostaglandin E1 analog useful for preventing NSAID induced gastric ulcers

A

Misoprostol

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45
Q

Dx to suspect if: multiple peptic ulcers, “kissing ulcers”, refractory ulcers to tx

A

Zollinger Ellison Syndrome

gastrinoma

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46
Q

best screening test for Zollinger Ellison Syndrome

A

fasting gastrin levels

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47
Q

Secretin test used to help diagnose ___

A

Zollinger Ellison Syndrome

secretin normally inhibits gastrin secretion. With this test, increased gastrin levels (>200 pg/mL) regardless of secretin administration

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48
Q

Linitis plastica

A

diffuse thickening of stomach wall due to gastric cancer infiltration

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49
Q

Krukenberg tumor

A

a malignancy in the ovary that metastasized from a primary site, classically the GI Tract (gastric adenocarcinoma MC)

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50
Q

MC type of gastric carcinoma

A

adenocarcinoma

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51
Q

“string sign” seen on upper GI contrast study

A

pyloric stenosis

NOTE: String sign can also be seen in barium studies in Crohn’s

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52
Q

Budd Chiari Syndrome

  • what is it?
  • classic triad of sx?
A

Hepatic vein obstruction

SX = 1. ascites 2. hepatomegaly 3. RUQ abd pain

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53
Q

MC cause of gastroenteritis in US in adults? In kids?

A

Adults - norovirus

Kids - rotavirus

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54
Q 
All of the following are causes of NON-invasive infectious diarrhea EXCEPT: 
A. Staphylococcus
B. Vibrio 
C. C. diff 
D. Shigella 
E. Enterotoxigenic E. Coli
A

D - Shigella causes invasive infectious diarrhea

Note: enterohemorrhagic E coli is a cause of invasive, NOT Enterotoxigenic

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55
Q

rice water stools leading to severe dehydration

Tx:

A 
Vibrio cholerae (non invasive diarrhea)
*Mainstay of tx = fluid replacement
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56
Q

MC cause traveler’s diarrhea

TX?

A

Enterotoxigenic E coli

TX = FQ (ex. cipro)

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57
Q

Abx notorious for causing C. diff

A

Clindamycin

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58
Q

diarrhea w/ very high lymphocytosis and pseudomembranous coliti

A

C. diff

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59
Q

TX of C diff (1st and 2nd line)

A

1st line = metronidazole

2nd line = vancomycin

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60
Q

key differentiating factor between invasive and noninvasive diarrhea

A

+ blood and fecal leukocytes w/ fever in invasive

—non invasive will have voluminous watery stools, vomiting

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61
Q

Tx of choice of Shigella

A

TMP-sulfa (Bactrim)

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62
Q

pea soup stools

A

Salmonella

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63
Q

diarrhea a kid gets after playing w/ pet turtle

A

Salmonella

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64
Q

treatment of typhoid fever/ salmonella gastroenteritis

A

FQs or ceftriaxone x 2 wks

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65
Q

pt w/ HA, pharyngitis –> progresses to diarrhea, intractable fever, bradycardia –> rose spots in 2nd week

A

Thyphoid (enteric) fever caused by Salmonella

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66
Q

MC cause of bacterial enteritis in US

A

Campylobacter (blood diarrhea)

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67
Q

“S or seagull shaped” organisms seen on stool culture

A

Campylobacter (GN bacteria) - also described as “comma shaped”

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68
Q

Tx of Campylobacter diarrhea

A

Erythromycin

FQs if severe

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69
Q

frothy, greasy diarrhea after camping

TX?

A

Giardia (protozoal infection)

TX = metronidazole

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70
Q

MC cause of chronic diarrhea in AIDS pts

A

Cryptosporidium

no proven treatments

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71
Q

PAS-positive macrophages on duodenal bx seen in __

A

Whipple’s ds

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72
Q

(osmotic / secretory) diarrhea will have a HIGH osmotic gap, dec diarrhea with fasting

A

Osmotic

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73
Q

2 stimulant laxatives that inc Ach GI motility

A

Bisacodyl

Senna

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74
Q

examples of osmotic laxatives (4)

A
  1. polyethylene glycol (Miralax)
  2. Lactulose
  3. sorbitol
  4. Milk of Mg or Mg Citrate
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75
Q

Peginterfera alpha for Hep C contraindicated if (4)

A
  1. autoimmune ds,
  2. pregnant,
  3. decompensated cirrhosis,
  4. profound cytopenias
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76
Q

salmon colored esophageal mucosa

A

Barrett’s esophagus

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77
Q

2 measurements of liver function

A
  1. albumin
  2. coagulation factors (prolonged PT)
    (ALT/ AST are not function tests!)
78
Q

MC cause of appendix obstruction? 2nd MC cause?

A
  1. lymphoid hyperplasia

2 fecalith

79
Q

what type of hernia might present with Howship-Romberg sign (aresthesias along medial thigh)

A

obturator

-d/t compression of obturator nerve

80
Q

triad of 1. vomiting 2. abd pain 3. currant jelly stools

A

intussusception

81
Q

___ sign = sausage shaped mass in RUQ. Associated with ___

A

Dance’s sign

-intussusception

82
Q

D-xylose test

A

Distinguishes maldigestion (pancreatic insufficiency, bile salt deficiency) from malabsorption

83
Q

Hydrogen breath test

A

Test of choice in dx of Lactose Intolerance

84
Q

2 Abs positive in celiac ds

A
  1. Endomysial IgA Ab

2. transglutaminase Ab

85
Q

skin disorder associated with celiac ds

A

dermatitis herpetiformis (pruritic, papulovesicular rash on extensor surfaces)

86
Q

“skip lesions” with cobblestone appearance

87
Q

stovepipe sign

A

ulcerative colitis (loss of haustral markings)

88
Q

(UC or Crohn’s) - transmural invovlement

A

Crohn’s

-UC is mucosa and submucosa only

89
Q

T/F - Barium enema is the diagnostic test of choice of UC (ulcerative colitis)

A

FALSE! contraindicated b/c might cause toxic megacolon

—> Flex sig is the dx test of choice

90
Q

(2) 5-ASA medications used to IBD

A
  1. mesalamine (oral or topical)
  2. sulfasalazine - more side effects
    - -used as maintenance therapy
91
Q

6-mercaptopurine, azathioprine, methotrexate are steroid-sparing agents in ___

92
Q

Dx of acute Crohns

A

Upper GI series w/ small bowel follow through

93
Q

Dx of intussusception in kids? In adults?

A

Kids: barium or air enema
Adults: CT, abd xray

94
Q

abx for diverticulitis

A

cipro (or Bactrim) + metronidazole x 14d

broad spectrum abx

95
Q

MC cause of acute lower GI bleeding

A

diverticulosis

96
Q

definitive diagnosis for acute mesenteric ischemia = “pain out of proportion to PE”

A

Angiogram

MC loss of blood to splenic flecture

97
Q

chronic dull abdominal pain WORSE after meals

A

chronic mesenteric ischemia

d/t atherosclerosis

98
Q

MC type of adenoma polyp

Type of colon polyp w/ highest risk of becoming cancerous

90% of all polyps are ___.

A

Tubulous adenoma

Villous adenoma

Hyperplastic ( lowest risk of malignancy)

99
Q

Tubular polyps require f/u ___

Villous polyps require f/u ___

A

Tubular polyps require f/u Q 5 years

Villous polyps require f/u Q 3 years

100
Q

mainstay of chemotherapy for colon cancer

101
Q

Peutz-Jehgers

A

Autosomal dominant, polyposis, mucocutaneous hypergigmentation (lips, buccal, hands)

RF for colorectal cancer

102
Q

R or L sided colon cancer lesion?

Chronic blood loss, iron deficiency anemia

A

Right

Left sided: obstructive symptoms

103
Q
  1. indirect hernias are (lateral/medial) to the inf epigastric aa’s and pass through ____
  2. direct hernias are (lateral/medial) to the inf epigastric aa’s and pass through ____
A
  1. indirect - LATERAL, through internal inguinal ring
    MOST COMMON
  2. direct - MEDIAL, through external inguinal ring at Hesselbach triangle
104
Q

(indirect/ direct) hernias go into the scrotum

A

indirect

-through persistent patent process vaginalis (MC in young children and adults)

105
Q

T/F: Tx of anoreectal abscess and fistula include I&D with abx.

A

False. NO abx.

106
Q

MC location for anal fissures

A

posterior midline

107
Q

Anal cancer is caused by ___

108
Q

MC cause of appendicitis

109
Q

Ranson Criteria

A

Poor prognosis for pancreatitis

Leukocyte >16,000
Blood glucose > 200
LDH > 350
AST > 250
Arterial PO2 <60
Base deficit > 4
HYPOcalcium
Increased BUN
110
Q

lab values in acute pancreatitis

  • (hypo/ hyper) calcemia
  • (inc/ dec) triglycerides
  • (hypo/ hyper) glycemia
A
  • HYPOcalcemia
  • INC TGs
  • HYPERglycemia
111
Q

(amylase/ lipase) more specific for acute pancreatitis

112
Q

Cullen and Turner’s signs

A

signs of necrotizing hemorrhagic pancreatitis

  • Cullins = periumbilical bruise
  • Turners = flank bruise
113
Q

colon cutoff sign and sentinel loop seen on abd xray

A

Pancreatitis

  • colon cutoff = abrupt collapse of colon near pancreas
  • sentinel loop = dilated small bowel loop in LUQ
114
Q

Triad of chronic pancreatitis

A
  1. calcifications 2. steatorrhea 3. DM

* calcifications seen on abd Xray

115
Q

70% of pancreatic adenocarcinoma are found in the (head, body, tail)?

MC type of adenocarcinoma

A

head

Ductal

116
Q

painless jaundice = ___

A

pancreatic cancer

117
Q

___ sign = palpable, NONtender distended gallbladder associated w/ jaundice. Associated with _____

A

Courvoisier’s sign

-pancreatic cancer

118
Q
  1. MC cause of small bowel obstruction

2. MC cause of large bowel obstruction

A
  1. SBO - post surgical adhesions

2. LBO - cancer

119
Q

Abd X-ray with air fluid levels in Step ladder pattern

A

Small bowel obstruction

120
Q

Pancreatic tumor markers in pancreatic carcinoma

A

CEA

CA 19-9

121
Q

Charcot’s triad (3)
+
Reynolds’ pentad (+2)

A

For Cholangitis

  1. Fevers/ chills
  2. RUQ pain
  3. Jaundice
    - –> Reynolds
  4. Shock (hypotension)
  5. Altered mental status
122
Q

Boas sign

A
  • referred pain to right sub scapular area due to phrenic nerve irritation

seen in acute cholecysitis

123
Q

porcelain gallbladder seen when?

A

chronic cholecystitis

  • cholesterol submucosal aggregation
  • premalignant
124
Q

Gold standard to dx cholecysitis

A

HIDA scan

-although RUQ US is initial test of choice

125
Q

Abx used in cholecsytitis (2)

A

3rd gen cephalosporin + metronidazole

126
Q

Abx used in cholangitis (2)

A

penicillin + aminoglycoside (-mycins)

127
Q

T/F - morphine is the pain med of choice for acute cholecysitis

A

False! Ass w/ sphincter of Oddi spasm

–Meperidine (Demerol) is preferred

128
Q

Treatment of cholangitis

A

decompression of biliary tree via ERCP stone extraction

129
Q

hereditary disorder with mildly reduced UGT (glucuronosyltransferase) enzyme activity

A

Gilbert’s
-increased INDIRECT bilirubin w/ nml LFTs
(UGT normally conjugates indirect –> direct bill)
-no tx needed

130
Q

“more severe form of Gilbert’s disease”

A

Crigler Najjar Syndrome - no or little UGT activity

INDIRECT bilirubin

131
Q

grossly black liver and isolated mild conjugated hyperbilirubinemia

A

Dubin Johnson Syndrome
-hepatocytes can’t secrete conjugated bilirubin (gene mutation)
Increased DIRECT bilirubin
-no tx needed

132
Q

echoic (clay colored) stools suggests ___

-would see inc (indirect/ direct) bilirubin

A

Biliary obstruction

  • increased DIRECT (conjugated) bili
  • also increased ALP and GGT
133
Q

Most sensitive indicator of biliary injury

134
Q

Increased ALP w/ normal GGT =

A

bone disease

135
Q

Definitive tx of Primary sclerosing cholangitis

A

liver transplant

136
Q

Primary sclerosing cholangitis mc associated w/ ___

Gold standard Dx:

Clinical presentation:

A

Ulcerative colitis

ERCP

Progressive jaundice, pruritis

137
Q

Pattern of liver injury seen in alcoholic hepatitis

A

AST: ALT >2:1

*think S for SHOTS!

138
Q

Pattern of liver injury: AST/ ALT >1,000

A
  • acute viral hepatitis
  • Usually active hep A, B, rarely C
  • (ALT usually > AST)
139
Q

Pattern of liver injury: ALT >1,000, + smooth mm Abs, + ANA

A

autoimmune hepatitis

140
Q

Pattern of liver injury: inc AST/ ALT (but <400)

A
  • chronic viral hepatitis
  • Hep B, C, D
  • (ALT usually > AST)
141
Q

MC cause of fulminant hepatitis

A

acetaminophen

142
Q

fulminant hepatitis in children w/ aspirin use during viral infection

  • -other sx?
  • -Tx?
A

Reye’s syndrome

  • rash, vomiting, encephalopathy, dilated pupils, multi-organ failure
  • TX = lower ICP w/ mannitol
143
Q

only viral hepatitis associated with spiking fevers

A

Hepatitis A

144
Q

T/F: HAV, HBV, HEV are the only ones associated w/ chronic hepatitis

A

False. Hepatitis B, C, D

145
Q 
Transmission of 
Hep A: 
Hep B:
Hep C:
Hep D:
Hep E:
A

Hep A: feco-oral
Hep B: sexual, perinatal, percutaneous, perenteral
Hep C: parenteral (IVDU)&raquo_space; sex
Hep D: parenteral, mucous membrane contact requires HBV
Hep E: feco-oral

146
Q

Positive IgG HAV Ab with negative IgM HAV Ab indicates what?

A

Past exposure to hep A

In acute hepatitis –> IgM HAV will be positive

147
Q

Diagnostic test for acute and chronic hepatitis C

A

HCV-RNA
(anti-HCV may be pos or neg in acute. in chronic, anti-HCV is pos)
(neg HCV-RNA = resolved infection)

148
Q

treatment of chronic hep C (2)

A

pegylated interferon alpha-2b AND ribavirin

149
Q

screening for HCC (hepatocellular carcinoma) if chronic Hep C with (2)

A

AFP

ultrasound

150
Q

Hepatitis B serologies:

if HbsAb is present, it indicates what?

A

distant resolved infection OR vaccination

151
Q 
Hepatitis B serologies: 
HBsAg - neg
anti-HBs Ab - neg 
anti-HBc Ab - *pos (IgM)*
HBeAg - neg 
Anti-HBe Ab - neg
A

window period of acute infection

152
Q 
Hepatitis B serologies: 
HBsAg - *pos*
anti-HBs Ab - neg
anti-HBc Ab - *pos (IgM)*
HBeAg - pos/neg
Anti-HBe Ab - pos/neg
A

Acute hepatitis

153
Q 
Hepatitis B serologies: 
HBsAg - neg
anti-HBs Ab - *pos* 
anti-HBc Ab - *pos (IgG)*
HBeAg - neg
Anti-HBe Ab - neg
A

recovery /resolved infection

- if pt hasn’t developed anti- HBs Ab in 6 months, the patient has a chronic infection

154
Q 
Hepatitis B serologies: 
HBsAg -*pos* 
anti-HBs Ab - neg 
anti-HBc Ab - *pos (IgG)*
HBeAg - *pos*
Anti-HBe Ab - neg
A

Chronic replicative hepatitis

  • If HBeAg were negative and anti-HBe Ab were positive –> This indicates chronic infection (non replicative) –> waning viral replication and decreased infectivity
155
Q

MELD score for end stage liver disease is calculated using (3)

A
  1. bilirubin
  2. INR
  3. creatinine
    * measures 3 mo mortality
156
Q

HCC is MC caused by chronic hepatitis, but can also be due to ___ exposure from ___ infection

A

aflatoxin exposure from Aspergillus infection

157
Q

treatment for hepatic encephalopathy (2)

A
  1. lactulose (converted to lactic acid by intestinal bacteria, pulls ammonia into gut)
  2. neomycin (abx that decreases ammonia producing flora)
158
Q

treatment for pruritus is cirrhosis

A

cholestryamine (bile acid sequestrant)

159
Q

autosomal recessive disorder with Copper accumulation

A

Wilson’s disease

160
Q

cholestasis disease associated with ulcerative colitis

A

PSC (primary sclerosing cholangitis)

161
Q

Hallmark antibody for PBC (primary biliary cirrhosis)

A

Anti-mitochondrial Ab

162
Q

1st line treatment for PBC (primary biliary cirrhosis)

A 
ursodeoxycholic acid (reduces progression)
-cure = liver transplant
163
Q

Kayser Fleischer rings

A

corneal copper deposits seen in Wilson’s ds

164
Q

inc ALP and GGT indicate __

A

cholestasis

-can be seen in PBC, PSC, biliary obstruction

165
Q

Vit D deficiency is called ___ in kids and ___ in adults

TX = ___

A

Rickets in kids, osteomalacia in adults

TX = Ergocalciferol (vit D)

166
Q

vitamin __ deficiency - night blindness, squamous metaplasia

167
Q

Wernicke-Korsakoff’s syndrome is caused by __ deficiency

A

Thiamin (B1) def

–alcoholics

168
Q

3 D’s of Pellagra (aka __ deficiency)

A
  1. Diarrhea
  2. Dementia
  3. Dermatitis
    aka Niacin (B3) deficiency
169
Q

__ deficiency presents w/ oral-ocular-genital syndrome

A

Riboflavin (B2)

  1. Oral - magenta colored tongue, angular cheilitis
  2. Ocular - photophobia, corneal lesions
  3. Genital - scrotal dermatitis
170
Q

pernicious anemia

A

lack of gastric parietal cells = lack of intrinsic factor —> B12 deficiency

171
Q

sx of parasthesias, gait abnl, dementia, glossitis, GI problems, macrocytic anemia

A

B12 deficiency

172
Q

PKU = reduced ability to metabolize ___ to ___

A

phenylalanine to tyrosine

173
Q

infant presenting with vomiting, retardation, inc DTR, convulsions

174
Q

mechanism of action of loperamide (Immodium) and diphenoxylate (Lomotil)

A

opioid agonists

-anti diarrheals

175
Q

T/F - Bismuth salicylate (Pepto-Bismol) is safe in dysentery (fever, bloody diarrhea)

A

True

–loperamide (another anti-diarrheal) is NOT

176
Q

cardiac side effect of anti emetics (ex. ondansetron, prochlorperazine)

A

QT prolongation

177
Q

what type of hernia might present with Howship-Romberg sign (aresthesias along medial thigh)

A

obturator

-d/t compression of obturator nerve

178
Q

Dilation of lacteals seen in ___

Caused by ____

Clinical manifestation:

Tx:

A

Whipple’s disease

Tropheryma whipplei: MC in farmers around contaminated soils

Malabsorption**: weight loss, fever, lymphadenopathy, arthritis, steatorrhea

Rhythmic motion of eye muscles while chewing

PCN or tetracycline for 1-2 YEARS

179
Q

Roux-en-Y gastric bypass sx should be given prophylactic ____ for 6 months to reduce risk of ____.

A 
Ursodeoxycholic acid (UDCA)
gallstone
180
Q

Nephrocalcinosis is common in pts with ____

A

Cystic fibrosis

181
Q

Initial diagnostic test for C. dif

A

Rapid enzyme immunoassay (EIA)

182
Q

LEFT supraclavicular adenopathy suggests ___

A

Intraabdominal cancer: kidney, ovary, testies, prostate

183
Q

Celiac disease is associated with ___(2)

A 
Down Syndrome (15%)
DM1
184
Q

T/F: Urethritis caused by Chlamydia will have urinalysis that shows pyuria with bacteriuria on gram stain. Ucx will show bacterial growth.

A

FALSE. Chlaymdia will show pyuria WITHOUT bacteriuria on gram stain. NO growth on ucx.

185
Q

Men with ED should be evaluated for ____ via ____

A

coronary artery disease

Thallium cardiac scintigraphy

186
Q

Initial diagnosis of intussusception

A

US of abdomen

187
Q

Rice water stool from improperly cooked shellfish

Caused by ___

A

Cholera

Enterotoxin actively secreted by pathogen

188
Q

Screening recommendation of dysplasia or adenocarcinoma in pts with Barrett esophagus

A

Upper endoscopy q 3-5 years

189
Q

MC presentation of Crohn disease

A

RLQ pain
diarrhea
weight loss

190
Q

Newborn screening for Cystic Fibrosis uses ___

A

assay for immunoreactive trypsin (IRT)

PANCE (20 decks)

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