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GI Flashcards

1
Q

Corkscrew X-Ray

A

Esophageal spasm, volvulus

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2
Q

Apple core X-Ray

A

Colorectal CA

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3
Q

“Stacked coin” X-Ray

A

Intussusception

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4
Q

Thumb Print on X Ray

A

Toxic Megacolon

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5
Q

Coffee Bean sign on X Ray

A

Sigmoid Volvulus

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6
Q

Bird’s Beak X Ray

A

Achalasia

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7
Q

String Sign on X Ray

A

Pyloric Stenosis
Crohn’s

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8
Q

Liquid Dysphagia causes

A

Scleroderma
Achalasia

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9
Q

Traction diverticulum

A

Out-pouching between UES and LES

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10
Q

Plummer Vinson

A

Esophageal webs at UES
Spoon nails from Fe-deficient anemia

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11
Q

H-Type TE Fistula

A

Chokes with each feeding, congenital

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12
Q

C-Type TE Fistula

A

Baby vomits with first feeding
Large gastric bubble
Distended abdomen
Failure of Apoptosis

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13
Q

Duodenal Atresia

A

Bilious vomiting with first feeding
Double bubble on XRay
Associated with Down’s

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14
Q

Choanal Atresia

A

Baby turns blue with feeding
Pinks when breast or bottle is removed
Blocked nasal passage

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15
Q

RLQ Sausage mass

A

Intussusception

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16
Q

Type A gastritis

A

Upper GI bleed
Auto-immune (Anti-parietal cell Abs)
Atrophic / Achlorhydria
Increased risk of Adeno in stomach body and fundus

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17
Q

Type B gastritis

A

Upper GI bleed
Associated with eating spicy foods
Loss of barrier protection, H. Pylori
Antrum of stomach

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18
Q

Menetrier’s Disease

A

Loss of protein through rural folds: General edema
CMV association in children, H. Pylori in adults

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19
Q

Celiac Sprue

A

Jejunum, villous atrophy
Anti-gliadin abs

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20
Q

Tropical Sprue

A

Distal ilium
Bacterial or viral, amoeba

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21
Q

Bugs of bloody diarrhea

A

Campylobacter
Entamoeba Histolytica
Shigella
E. coli
Salmonella

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22
Q

PBC

A

Anti-Mitochondrial Abs
Bile ducts destroyed
Xanthelasmas and pruritis

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23
Q

PSC

A

P-ANCA, maybe anti-SM
Bile ducts scarred from inflammation
Beading and onion skinning
UC association (rectum)

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24
Q

What kind of gallstone can be seen on X Ray

A

Calcium Bilirubinate

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25
Q

Type 1 hyperlipidemia

A

Defective LPL
Chylomicrons elevated

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26
Q

Type 2A hyperlipidemia

A

Defective LDL-Clathrin Pit or B-100
LDL elevated

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27
Q

Type 2B Hyperlipidemia

A

Deficiency of adipose receptors and LDL receptors
Increased LDL and VLDL

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28
Q

Type 3 Hyperlipidemia

A

Defective ApoE
Elevated IDL

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29
Q

Type 4 Hyperlipidemia

A

Defective Adipose LPL
Elevated VLDL

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30
Q

Type 5 Hyperlipidemia

A

Defective enzyme and co-receptor (C-II)
Elevated VLDL and chylomicrons
Associated with DM

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31
Q

Criggler-Najar I

A

Unconjugated bilirubin buildup
Newborn or infants
No UDP-GT
No change with phenobarbital

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32
Q

Gilbert’s syndrome

A

Stress induced unconjugated hyperbilirubinemia
Overwhelmed glucoronyl transferase

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33
Q

Currant jelly sputum vs stool

A

Sputum is klebsiella, stool is intussusception

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34
Q

Turcot’s Syndrome

A

FAP with brain tumors

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35
Q

Gardener’s syndrome

A

FAP with bone tumors

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36
Q

UC

A

Continuously Ascending from rectum
IBD with pseudo polyps
Hematochezia, lead pipe colon, toxic megacolon

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37
Q

Crohn’s

A

Transmural, cobblestoning, melena, creeping fat, fistulas, skip lesions

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38
Q

knees to chest for comfort in child

A

Intussusception

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39
Q

=IBS

A

Alternating diarrhea and constipation
Associated with stress, no abnormalities on colonoscopy

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40
Q

Whipple’s disease

A

T Whipplei destroys the GI tract
Malabsorption, arthralgia
PAS+

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41
Q

Charcot triad

A

Jaundice, fever (usually with rigors), RUQ pain

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42
Q

Common ERCP side effect

A

Pancreatitis from blocking the pancreatic duct during the procedure

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43
Q

Reynolds Pentad

A

Jaundice, fever (usually with rigors), RUQ pain, HPTN, change in mental status

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44
Q

Sudan black stain

A

Steatorrhea: it visualizes lipids

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45
Q

Colon cancer bugs

A

Clostridium melanogosepticus
Strep Bovis

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46
Q

H2 Blocker MOA

A

Blocking H2 blocks H+ secretion
AE: prolactin release, cimetidine inhibits P450
“-tidine”

47
Q

Misoprostol

A

PGE1 analog increases gastric mucous barrier
Protects against NSAID ulcers, induces labor, maintains PDA

48
Q

Octreotide

A

Somatostatin analog
Tx vatical bleeds, acromegaly, VIPoma, carcinoid

49
Q

Infliximab

A

binds TNF
Tx Crohn’s, RA
AE: respiratory infection (Tb reactivation), fever, HPTN

50
Q

Sulfsalazine

A

Antibacterial Sulfapyridine + 5-ASA (anti-inflammatory)
Activated by Colonic bacteria
Tx UC and Crohn’s
AE: Malaise, nausea, reversible oligospermia, sulfonimide

51
Q

Ondansetron

A

5-HT3 antagonist, powerful anti-emetic
Good for post-op, chemo

52
Q

The osmotic laxatives

A

Mag Hydroxide, Mag Citrate, PEG, lactulose

53
Q

Metoclopramide

A

D2 antagonist
Increases resting tone, contractility of LES, motility
Tx diabetic and post-surgery gastroparesis
AE: Parkinsonian, restlessness, drowsiness, fatigue, interacts with digoxin and DM drugs, c/I w/ SBO

54
Q

Electrolyte levels in hypovolemia

A

Increased net Na, decreased serum Na (dilution)
Decreased serum K+
Increased serum pH (From H/K exchanger)

55
Q

Vit A deficiency

A

Poor night vision
Hypoparathyriodism
Dry Skin

56
Q

B1 Deficiency

A

Thiamin
Beriberi, Wernicke, Korsakoff

57
Q

B2 Deficiency

A

Riboflavin
Angular cheilosis

58
Q

B3 Deficiency

A

Pellagra: Diarrhea, Dermatitis, Dementia, Death

59
Q

B4

A

Lipoic Acid
No deficiency syndrome

60
Q

B5

A

Pantothenic Acid
No deficiency syndrome

61
Q

B6 Deficiency

A

Pyridoxine
Peripheral neuropathy

62
Q

B9 Deficiency

A

Folate
Megaloblastic anemia
Hypersegmented Neutrophils
Neural Tube Defects

63
Q

B12 Deficiency

A

Cyanocobalamin
Megaloblastic anemia
Hypersegmented neutrophils
Neuropathy

64
Q

Vitamin E Deficiency

A

Increased free radical damage
Hemolytic anemia
Ataxia gait
Impaired position and vibration sense

65
Q

B7 deficiency

A

Biotin
Loss of carboxylase function

66
Q

Mg deficiency

A

Hypoparathyroidism
Loss of kinase function

67
Q

Zinc deficiency

A

Dysgeusia, anosmia, poor wound healing

68
Q

Cu deficiency

A

Monkey Kinky Hair syndrome

69
Q

Disease associated with chromium deficiency

70
Q

Disease associated with Selenium deficiency

A

Dilated cardiomyopathy

71
Q

Tin deficiency

A

Poor hair growth

72
Q

Deficiencies causing loss of xanthine oxidase function

A

Molybdenum and Manganese
Causes renal problems and kidney stones

73
Q

Fluoride deficiency

A

Poor teeth and bone growth

74
Q

Hunger

A

Lateral hypothalamus
Caused by ghrelin

75
Q

Temperature regulation

A

Cooling: Anterior hypothalamus
Warning: Posterior hypothalamus

76
Q

CFTR bugs

A

Staph aureus and Pseudomonas

77
Q

Nucleus ambiguous

A

Innervates UES
Efferent vagus (motor CN X)

78
Q

Dorsal motor nucleus

A

Innervates the rest of GI after UES (Motor CN X)

79
Q

Treat Zenker’s

A

Craico-pharyngeal myotomy

80
Q

Screening in Barrets

A

PPI, Upper endoscopy every 2-3 years

81
Q

When to use pH monitor

A

Persistent GERD after 4 week PPI trial

82
Q

Testing for Dysphagia (painless)

A

Barium Esophagram

83
Q

Corkscrew barium esophagram

A

Diffuse esophageal spasm

84
Q

Gastric ulcer management

A

CLO (H Pylori) test
Endoscopy on all

85
Q

Peptic Ulcer Dz management

A

Triple: PPI + Amox/metro + Clarythro/tetracycline
Positive CLO? Add bismuth or sucralfate

86
Q

Pancreatic Pseudocyst

A

No epithelial lining
0-5cm, observe. Bigger? Drain it.

87
Q

Virchow’s Triad

A

Cholesterol gall stones
Cholesterol high
Bile Salts and Lethicin down

88
Q

Dx Gallstones

A

U/S, HIDA scan (most specific)

89
Q

Gallstone treatment

A

Symptomatic? Schedule a surgery
ASx? Ursodeoxycolic acid

90
Q

Where are things absorbed in the small intestine?

A

Jejunum except for iron (duodenum), ADEKB12 (Ileum)

91
Q

Screen for Celiac

A

Anti-tTG or anti-endomysium

92
Q

Treat celiac sprue

A

Folate and abx for 6 mo

93
Q

Treat Crohn’s

A

Mild and on the Left: Prednisone
Ileum or on the Right: Budesinide
Moderate - severe: AZT or 6MP

94
Q

Treat UC

A

Distal? Sulfsalazine
Becoming proximal? Mesalamine
Fails? Glucocorticoids. Fail? Infliximab
Surgery is curative

95
Q

Head cancer types

A

Jaw and down: squamous
mouth and up: Basal

96
Q

Ilium lymphoma

A

Early upper GI obstruction
Napkin ring lesion (Apple Core)
Melena, pencil-thin stools

97
Q

Appendix cancer

A

Most common is leiomyoma, carcinoid
Causes tricuspid damage, does not metastasize

98
Q

When to get FAP colectomy

A
  1. It is 100% cancer by age 20.
99
Q

Gardener syndrome

A

FAP and osteomas and sebaceous adenomas

100
Q

Turcot syndrome

A

FAP and brain tumor (glioblastomas)

101
Q

Hydatid liver cyst

A

From dogs
find eggshell calcifications, septations after a GI upset

102
Q

Klebsiella liver cyst

A

Has air in it, travel

103
Q

VACTRL

A

Vertebral abnormalities
Imperforate Anus
Cardiac defects
TE Fistula
Renal abnormalities
Limb abnormalities

104
Q

Beckwith-Weideman

A

Omphalocele
Hemihypertrophy
Wilm’s Tumor
Enlarged tongue
Insulinoma

105
Q

Colonoscopy screening

A

10 years before direct family relative was dx
OR age 40, whichever comes first

106
Q

Treat DM gastroparesis

A

Metaclopramide
Second line Erythromycin

107
Q

Where does a carcinoid tumor come from

A

Small intestine

108
Q

Biliary atresia

A

Cholestasis + Hepatomegaly + Direct hyperbilirubinemia
Tx w/ Kasai procedure (hepato-porto-enterostomy)

109
Q

Manage gout

A

Acute: 1. NSAID 2. Colchicine 3. Glucocorticoids
Chronic: Allopurinol

110
Q

Veins involved in hemorrhoids

A

Internal: superior rectal vein
External: Inferior rectal vein

111
Q

Treat Fitz-Hugh-Curtis

A

Cefoxitin and Doxy IV

112
Q

Acute Cholecystitis imaging

A

Wall thickening with fluid and stones

113
Q

Labs by bile duct geography

A

Cystic duct: gallbladder only, nothing.
Alk phos: entire duct. Isolated elevation means Common bile duct
GGT: only above the gallbladder: Common hepatic duct.

Clues (14 decks)

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