GI Flashcards
(115 cards)
1
Q
With achalasia will the patient have dysphagia to liquids, solids or both?
A
Both
2
Q
With a gastric ulcer are the patient’s exacerbated or relieved with food?
A
Exacerbated
3
Q
Which NSAID has the highest rate of peptic ulceration?
A
Naproxen
4
Q
Which is more likely to pass into the scrotum, a direct or indirect hernia?
A
Indirect
5
Q
Which are more painful, hemorrhoids above or below the dentate line?
A
Below, internal hemorrhoids are not painful.
6
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
7
Q
What two viral hepatitis infections are self limiting?
A
A and E
8
Q
What two blood test can be used to diagnose celiac?
A
IgA endomysial antibody and IgA tTG antibody
9
Q
What tumor marker may be used for liver cancer?
A
alpha-Fetoprotein
10
Q
What tumor maker can be used to follow pancreatic cancer?
A
CA-19-9
11
Q
What treatment should be started for asymptomatic diverticulosis?
A
None
12
Q
What medication used in Hep B infection helps prevent the need for liver transplant?
A
Lamivudine
13
Q
What medication is most commonly used for long term treatment of GERD?
A
PPIs - omeprazole, lansoprazole, pantoprazole
14
Q
What medical treatment is given for a gastrinoma?
A
PPIs
15
Q
What it is the recommended treatment for Hep C infection?
A
Pegylated interferon alpa-2a
16
Q
What is the treatment for most Mallory-Weiss tears?
A
Self limiting, typically within 48 hours
17
Q
What is the term for painful swallowing?
A
Odynophagia
18
Q
What is the term for difficulty swallowing?
A
Dysphagia
19
Q
What is the term for an abscess in the sacrococcygeal cleft?
A
Pilonidal disease
20
Q
What is the only curative therapy for gastric adenocarcinoma?
A
Surgical resection
21
Q
What is the most specific test for acute cholecystitis?
A
HIDA
22
Q
What is the most common vessel blocked with intestinal ischemia?
A
Superior mesenteric artery
23
Q
What is the most common location of colorectal cancer?
A
Cecum 38%
24
Q
What is the most common location for an anal fissure?
A
Posterior midline
25
What is the most common location for a pancreatic tumor?
75% occur in the head of the pancreas
26
What is the most common cause of peptic ulcer disease?
H. pylori
27
What is the most common cause of lower GI bleed?
Diverticulosis
28
What is the most common cause of folate deficiency?
Alcoholism
29
What is the most common cause of acute bacterial cholangitis?
Choledocholitaisis
30
What is the most common anorectal problem affecting patients over 50?
Hemorrhoids
31
What is the medical term for feeling like there is a lump in your throat?
Globus
32
What is the main risk factor for esophagitis?
Immunocompromised patient
33
What is the leading cause of iron deficiency anemia?
Chronic GI bleed
34
What is the imaging modality of choice for pancreatitis?
CT
35
What is the gold standard for diagnosis and treatment of bile duct stones?
ERCP
36
What is the first step in treating GERD?
Lifestyle modification
37
What is the diagnostic test of choice for Zenker's diverticulum?
Barium swallow will show the diverticulum
38
What is the best test to check for H. pylori?
Urea breath test
39
What is the best imaging study for acute appendicitis?
CT
40
What is the #1 cause of small bowel obstruction?
Postoperative adhesions
41
What is Reynold's pentad and why does it matter?
Charcot's triad + hypotension + altered mental status. It indicates high risk of sepsis
42
What is most specific diagnostic test for peptic ulcer disease?
Endoscopy
43
What is Charcot's triad?
RUQ pain, fever, jaundice
44
What is a good beta blocker to reduce portal HTN?
Propranolol
45
What is a common symptom that goes along with chest pain for GERD patients?
Dry cough
46
What does HBsAG (Hep B surface antigen) indicate?
Active Hep B infection
47
What does ERCP stand for?
Endoscopic retrograde cholangiopancreatography
48
What does Anti-HBs (Hep B surface antibody) indicate?
Recovery from infection or immunization to Hep B
49
What does an Anti-HBc (hepB core antibody) indicate?
Previous or ongoing infection Hep B infection
50
What disease is defined as an immunologic response to gluten?
Celiac
51
What class of medication is first line to treat inflammatory bowel disease in the maintenance phase?
5-ASA products - sulfasalazine, mesalamine
52
What causes Mallory-Weiss tears?
Forced vomiting or retching (Often involving alcohol)
53
What are two treatments you should consider for esophageal strictures?
Dilation of the esophagus and long term PPIs
54
What are two things that an anal fissure off midline might suggest?
Crohn's, syphilis, HIV, neoplasm
55
What are two common predisposing factors for esophageal varices?
Portal HTN and cirrhosis often caused by alcoholism
56
What are the two most common causes of pancreatitis?
Cholelithiasis and ETOH
57
What are the two main complications of cirrhosis?
Portal HTN & liver insufficiency
58
What are the first three steps of managing pancreatitis?
NPO, pain control, fluids
59
What are the 5 points of Ranson's criteria on admission?
older than 55, WBC>16, glucose>200, LDH>350, AST>250
60
Under routine circumstances when should patients begin getting screening colonoscopies?
Age 50
61
Thumbprint sign on abdominal film should make you think of what diagnosis?
Intestinal ischemia
62
There are vaccines for which two versions of hepatitis?
Hep A and Hep B
63
Steatorrhea should make you think of what diagnosis?
Pancreatitis
64
Should diverticulitis always be admitted?
No mild cases can be treated as outpatients with rest and clear fluids.
65
Severe abdominal pain 30 minutes after a meal should make you think of what diagnosis?
Intestinal ischemia
66
Salivary amylase breaks down what macronutrient?
Carbohydrates
67
Projectile vomiting should make you think of what diagnosis?
Pyloric stenosis
68
Pica is often related to what type of anemia?
Iron deficiency anemia
69
Patient complains of RUQ pain 20 minutes after a meal. What diagnosis should you be thinking of?
Cholecystitis
70
Patient complains of regurgitating undigested food several hours after a meal. What diagnosis should you be thinking of?
Zenker's diverticulum
71
Patient complains of periumbilical pain which has now moved over McBurney's point. What diagnosis should you be thinking of?
Appendicitis
72
Painless bright red blood per rectum should make you think of what diagnosis?
Hemorrhoids
73
Onion ring fibrosis from a bile duct biopsy should make you think of what diagnosis?
Primary sclerosing cholangitis
74
One half of all adult hernias are direct or indirect?
Indirect inguinal hernias makeup 50% of all adult hernias
75
Name the sign. Patient is supine and attempts to raise right leg against resistance.
Psoas sign
76
Name the sign. Patient is supine and attempts to flex and internally rotate right hip
Obturator sign
77
Most gallstones are made of what substance?
Cholesterol
78
LLQ pain and tenderness should make you think of what diagnosis?
Diverticulitis
79
List two common offending agents for pill induced esophagitis?
NSAIDS, KCL, iron, Abx
80
Is surgery curative for Crohn's or ulcerative colitis?
Ulcerative colitis
81
Is peptic ulcer disease more common in the duodenum or the stomach?
Duodenum
82
Inhibited inspiration with pressure over the RUQ is called what? What diagnosis does it suggest?
Murphy's sign, Cholecystitis
83
In order to contract Hep D what must you already have?
Hep B
84
If you have heartburn that does not improve with medication what diagnosis should you be thinking about?
Gastrinoma
85
How often should patients with pernicious anemia have a screening endoscopy performed?
Every 5 years looking for signs of gastric carcinoma
86
How much fiber should you get in a day?
30 grams
87
How is celiac most commonly diagnosed?
Endoscopic biopsy
88
How do you treat an H. pylori infection?
PPI + 2 Abx, commonly omeprazole + clarithromycin and amoxicillin or PPI +metronidazole + tetracycline
89
How do you treat achalasia?
Loosen up the muscle - botox, dilation or surgery
90
First line of treatment for an anal fissure?
Fluid and fiber
91
Fasting gastrin will be above what level with gastrinoma?
>150 pg/ml
92
Epigastric abdominal pain which radiates to the back should make you think of what diagnosis?
Pancreatitis
93
Describe Grey-Turner's sign.
Flank ecchymosis often related to pancreatitis
94
Describe Cullen's sign
Umbilical ecchymosis often related to pancreatitis
95
Describe Courvoisier's sign
Nontender, palpable gall bladder may indicate pancreatic neoplasm
96
Define pellagra?
Niacin (B3) deficiency
97
Currant jelly stool should make you think of what diagnosis?
Intussusception
98
Crohn's is found where in the GI tract?
It can be from esophagus to anus
99
Colorectal cancer patients are almost all older than what age?
90% of patients are older than 50
100
Birds beak esophagus on barium swallow should make you think of what diagnosis?
Achalasia
101
At what age and how often should fecal occult blood tests be performed as a screening tool?
Beginning at age 50 and they should be done every year.
102
An epigastric olive shaped mass should make you think of what diagnosis?
Pyloric stenosis
103
An endoscopy for presumed esophagitis shows several solitary deep ulcers. What diagnosis should you be thinking of?
CMV
104
An endoscopy for presumed esophagitis shows multiple shallow ulcers. What diagnosis should you be thinking of?
Herpes simplex virus
105
An elevated serum amylase and lipase should make you think of what diagnosis?
Pancreatitis
106
An abdominal exam with pain out of proportion to the exam should make you think of what diagnosis?
Intestinal ischemia
107
Air fluid levels on abdominal x-ray should make you think of what diagnosis?
Bowel obstruction
108
A string sign on barium swallow should make you think of what diagnosis?
Pyloric stenosis
109
A patient presents with unproductive retching, acute localized epigastric distention and inability to pass a nasogastric tube. What diagnosis should you be thinking of?
Gastric volvulus
110
A patient on sulfasalazine for an inflammatory bowel disease should be supplemented with what vitamin?
Folate
111
A patient has had GERD for years. Over the past year he has noticed an increase in difficulty swallowing his food. This should make you think of what diagnosis?
Esophageal strictures
112
A gastrinoma is also known as what syndrome?
Zollinger-Ellison syndrome
113
A corkscrew appearance on barium study should make you think of what diagnosis?
Esophageal spasms
114
A colonoscopy that shows cobblestone or skip lesions should make you think of what diagnosis?
Crohn's disease
115
30 year old African American woman presents with dysphagia. You notice she also has thickened skin. A barium swallow demonstrates the absence of peristalsis. What diagnosis should you be thinking of?
Scleroderma
