GI Flashcards
Increase serum fasting Gastrin levels is suggestive of:
Zollinger Ellison Syndrome
Scurvy is seen in
vit. C def
Bleeding from Mallory Weiss Tear is usually long lasting or self limiting?
Self Limiting
Virchow’s lymph node is located at and linked to what?
Left supraclavicular area
Associated with metastatic gastric adenocarcinoma
Pain that becomes worse with eating often corresponds to:
Gastric Ulcer
Hematochezia/bloody diarrhea with mucus is indicative of
UC
Gas w/i the wall of the small bowel seen on CT is a sign of
Strangulation
tx for uncomplicated small bowel obstructioin:
NG tube
bowel rest
IV fluids
Hep B window is defined as:
period of time when HBsAg and anti-HBsAg are bound together and therefor are not detectable.
Only anti-HBc are detectable
Pain that is reduced/improved with eating often corresponds to:
Duodenal ulcer
Bacterial cholangitis is often caused by what microrganisms?
E.Coli
Klebsiella
Enterococcus
Enterobacter
Diagnostic triad for anal fissure:
Fissure
Sentinel tag
hypertrophied anal papilla
Important complication of GERD is:
Barret’s Esophagus
Esophage Stricutre
weakness in the abdominal wall through Hesselbach’s Triangle corresponds to:
Direction Inguinal Hernia
Direction Hesselbach
Small bowel obstruction will production dilation of bowel greater than?
3 cm.
which polyps have malignant potential?
Adenomatous
Charcot’s triad + hypotension + altered mental status is known as:
Reynold’s pentad
Indicative of developing sepsis due to cholangitis
Adenocarcinoma of the Esophagus affects what portion of the esophagus?
lower 1/3
signs of vit K def. is:
bleeding
Alarm sx of GERD:
Refractory heartburn (despite medication use)
Dysphagia
Unintentional Weight Loss
GI bleed
important complication of IBD is:
Toxic Megacolon
Definition of bowel volvulus:
twisting of the bowel
Tx for autoimmune Hepatitis is:
Corticosteroids
+
Immunosuppressant
Esophageal Stricture is usually preceeded by:
Long lasting GERD or Esophagitis
Pancreatic CA marker is:
CA 19.9
Zollinger Elison Syndrome can be diagnosed with:
Somatostatin receptor scintigraphy
spams of the facial muscles in respons to taping on the angle of the jaw is known as:
Chvostek sign
multiple air levels in a stepladder patterns seen on upright supine abdominal film is indicative of
Small bowel obstruction
Pill induced esophagitis is caused by which meds:
Doxycycline
Tetracycline
NSAIDs
Bisphosphonates
Pottasium (KCl)
Jaundice + Puritis in a young male is notorious for:
Primary sclerosing cholangitis
Dilated esophagus
birds beak / rat tail sign
seen on barrium swallow study are indicative of:
Achalasia
Choledocholithiasis often causes?
Chalangitis
Thiamine is also known as:
vit B1
Gastric Bypass causes which vitamin def?
B12
Protrusion through the internal/deep inguinal ring into the scrotal sac is known as:
Indirect Inguinal Hernia
next step after diagnosing strangulation of small bowel
surgery
Most common causes of obstruction (large and small bowel)
Adhesion>small bowel
Neoplams>large bowel
Pyroxidine is also known as:
vit B6
Raised white plaque (which can be removed) seen on endoscopy is indicated of:
Candida esophagitis
tumor marker used to monitor colon cancer is:
CEA
Colon=CEA
Visual problems are caused by deficiancy in vit?
A
Esophageal Varices are often caused by:
Portal HTN
Liver Cirrhosis
Budd Chiary Syndrome (IVC thrombus)
Sister Mary Joseph nodule are located at:
umbilical regions
seen in GI cancers
Esophageal cancer caused by:
Obesity
Barret’s esophagus / GERD
is known as:
Adenocarcinoma
Radiation therapy to neck, chest, upper abdomen will often result in what?
Radiation induced esophagitis.
Hereditary non-polyposis syndrome requires colonoscopy at:
25 y.o every 2 years old.
Chronic liver cirrhosis is differentiated from acute liver cirhhosis by the presence of:
Spider Angiomata (due to high estrogen)
Portal HTN
Mucosal involvment lesion are indicative of
Ulcerative Collitis
Mucosal=Ulcerative Collitis
Pathophysiology of Celliac Dz:
Destruction of GI mucosa
IgA ednomysial antibodies - most specifi
Tissue transglutaminase antibodies
Pancreatic calcifications seen on x ray
Steatorrhea (fatty stool)
DMI II
are all signs of:
Chronic Pancreatits
isolated elevation of unconjugated bilirubin
w/o any additional sx is known as:
Gilbert syndrome
Abx of choice for acute cholecystitis are:
Ampicillin + aminoglycoside
Which IBD is associated with increased risk of colon CA?
UC > CA
severe acute abdominal pain which is out of proportion is often associated with:
Acute Mesenteric Ischemia
Tx for intussusception in kids is:
Barium enema
Most common location for Gastrinoma tumor is:
Duodenum
tx for PUK is:
strict control of protein intake
Transmural lesions are indicative of
Crohn’s dz
most common age for IBD is
20’s and 30’s
Internal and external hemorrhoids (painfull vs. non painful)
Internal > nonpainful
External > painful
Posterior esophageal outpouching in the area of hypopharynx is known as:
Zenker’s Diverticula
tx for Esophagial spasm is:
Ca channel blockers
hyoscyamine
Lead pipe appearance (loss of haustral markings) seen on barium enema is indicative of:
UC
Esophageal cancer likely caused by smoking and alcohol is:
Sqamous Cancer
(Sqamous=Smoking)
risk factors for Toxic Megacolon:
UC
Crohn’s Dz
Pseudomembranous colitis
Most common location for Diverticulitis is:
Sigmoid colon
Pain in the LLQ often corresponds to
Diverticulitis
Treatment for Esophageal Stricture is:
Endoscopic Dilatation
followed by PPI
followed by endoscopic triacinolone (if PPI fail)
Descibe appendicitis pain?
Starts at periumbilical regions
then radiates into RLQ
Epithelial problems and skin disorders are caused by def. in vit?
A
Charcot’s triad is indicative of:
Cholangitis
Abx for any colon conditions:
Ciprofloxacin and metronidazole
Pt with Sicle Cell Dz
Irrititable Bowel Syndrome
Hemolytic anemia are known
to have what kind of GB stones:
Bilirubin stone
Unique side effect of Cimetidine (H2 blocker) is:
Gynocomastia / importence in men
Galactorrhea in women.
in a pt with family history of colon cancer in a relative younger than 50 y.o colonoscopy should be perforemd at:
relative’s age minus 10 years old.
Tx options for Achalasia:
Calcium Channel Blockers
Nitrates
Botox injections
Surgical: myotomy, dilatation
Umbilical Ecchymosis (blueish collor) is known as:
Cullin sign
Definition of Murphy’s signs is:
Inhibition of inspiration due to pain during palpationg in the RUQ
RLQ pain vs LLQ pain in Cronh’s vs. UC DZ
Crohn’s > RLQ pain
UC > LLQ pain
Hematoemesis after extensive vomitting is usually a result of:
Mallory Weiss Tear
Medications known to cause pill induced esophagitis:
NSAID
Doxycycline
Tetracycline
Bisphosphonates
Most Common cause of Peptic Ulcer Dz (PUD):
H Pylori
Smoking
NSAID
Pharmacological tx of Zollinger Ellison Syndrome is:
PPI
Serum Ascites Albumin Gradient (SAAG) score is used to:
Diagnose portal HTN
SAAG>1 is indicative of portal HTN
The main pathological mechanism ofa Achalasia is:
Inability of lower esophageal sphincter to relax.
Ranson’s criteria is used for
evaluation of acute pancreotitis
Diagnostic method for infectious Esophagitis is:
Endoscopy with biopsy
marker of Celiac Dz is:
HLA-DQ2
Side effects of PPI:
CAP
CKD
Bone fractures
C-Diff
Acyclovir MoA
Nucloeside Analoges:
reduce viral DNA synthesis.
H2 blockers are more or less potent than PPI?
less
PPI > H2 blockers
CREST syndrome is seen in:
pt with Scleroderma:
Calcinosis
Raynaud’s phenomenon
Esophagial dysmotility
Sclerodactyly
Telangiectasias
What effect Scleroderma has on esophagus:
Thickening of esophagus leads to:
dysphagia to liquids and solids
Night blindness is caused by
Vit A def.
internal hip rotation of the bent knee (lateral rotation) is known as:
Obturator sign
Hepatitis that are self limiting and are fecal-oral transmission?
Hep A & E
Mouth to Anus lesions are knonw as:
Crohn’s
(mouth>anus>crhon’)
Abx tx for perforated appy:
ceftriaxone+metronidazole
Left supraclavicular lymph node enlargement is known as:
Virchow nodes
linked to adenocarcinoma
Risk Factors for Gastrinoma (Zillinger Ellison Syndrome)
Excessive acid production
Refractory PUD
Mainstay pharmacologic GERD tx is:
Proton Pump Inhibitors
Stomach adenocarcinoma has strong assosiation with
H Pylori
Hyperactive, high pitch bowel sounds are indicative of:
early stage of small bowel obstruction
Elevation of Alkaline Phosphate often corresponds to:
Billiary Obstruction
Most sensitive test of H Pylori is:
Urea breath test
(H pylori produces urease)
Highest rate of strangulation is among which types of hernia?
Femoral hernia
MoA PPI
Binds noncompleitively and irreversibly to H/K APAse and blocks H+ secretion by parietal cell.
Gilbert syndrome
underactivity of the conjugating enzyme bilirubin-uridine diphosphate glucuronyl transferase.
Corckscrew sign on barrium swallow test is indicative of:
Esophagial Spasm
Infection of the anal gland often produces:
Perianal abscess/fitsula
Predisposing factor for Infectious Esophagitis is:
Immunocompromised
HIV
Chemotherapy
Diabetis
Proloing steroid use
Tenesmus is:
urge to defecate when there is no stool
Schatski’s rings are caused by:
GERD/hiatal hernia
occure in distal esophagus
Encephalopathy caused by liver cirrhosis is treated with:
Lactulose
and
TIPPS procedure
RLQ pain with hip flexition is known as:
Psoas sign
Plummer Vinson syndrome consists of:
Iron Deficiancy Anemia
Glossitis
Esophageal Webs
Smoking is a risk factor for Crohn’s or UC
Crohn’s DZ
Cmoking=Crohn’s
smoking improves UC
Long use of PPI may lead to:
lack of B12 cause pericious anemia
sx of wet Beriberi
cardiac dysfunction and Wernicker’ encephalopathy
in a pt with a colon polyp, colonoscopy should be performed at:
every 5 years after the initial colonsocopy
most common location of bowel volvulus is:
segmoid
tx for Clostridium difficile / pseudomembraneous collitis is:
Oral Metronidazole
Flank Ecchymosis (bluesh sign) is known a
Grey Turner
Monometry findings in Achalasia and Esophagial Dysmotility caused by scleroderma:
Achalasia>Increased lower esophageal sphincter tone
Scleroderma>Decreased lower esophageal sphincter tone
MoA of Octreotide:
Used for Esophageal Varices:
reduces flow in the splenic vein
reduces portal HTN
tx of toxic megacolon:
IV fluids
Abx
decompression of colon
colectomy if indicated
sx of dry Beriberi:
neuropathy
poor coordination
sx of anal fissure:
recent constipation
recent opiod use
sever pain after bowel movement
Diverticulosis involves which layers of the collon?
mucosal and submucosal herniating through muscular layer
Palpable GB is known as
Courvoisier’s sign
Hep A and E are acute conditions therefore they will only develop which antibodies?
IgM
absence of parasympathetic ganglion cells in the submucosal and myenteric plexuses in the affected segment of the large intestine
Hirschprung’s disease
Most common cause of Upper GI bleed are:
Esophageal Varices
Tx for Herpes Esophagitis is:
Acyclovir (antiviral)
Which hemorrhoid grade requires surgery?
grade IV
Lactulose is used in:
Hepatic Encephalopathy:
it removes amonia from the blood
Most common anal cancer is
Squamous cell
Most common GI organ affected by Scleroderma is:
Esophagus
Definition of Intussusception is:
Invagination of proximal segment of the colon into distal
Risk factors for Intussusceoption in adults:
Neoplasm
Pharmacologycal tx of esophagial varices:
Octreotide (vasoactive)
Vitamin K (corrects PT)
Lactulose (corrects encephalopathy)
Most specific marker for acute pancreotitis is:
Lipase
Most common location of anal fissure is:
posteir midline
Dentate line:
divides internal and external hemorrhoids
Ulcerative Colitits (UC) can or can not be cured with surgery?
sUrgery is cUrrative
UC = sUrgery/cUrrative
Zollinger Ellison Syndrome is also known as:
Gastrinoma: gastrin secreting tumor
replacement of squamous epithelium by columnar in the esophagus is known as:
Barrets esophagus
Primary sclerosing cholangitis is linked to:
Ulcerative Collitis
GI/Bill Cancers
hemolytic anemia in premature infants is caused by:
vit E def.
E=anEmia
Skip lesions with Cobble Stone appearance is indicative of:
Crohn’s dz
Skip=Cobble=Crohn
Pharm tx for mild GERD is:
Antacids
H2 blockers
-tidine-
Palpable sausage mass in the abdomen is indicative of:
intussusception
Risk factors for Intussusceoption in kids:
Viral enteritis
Cystic Fibrosis
Meckel’s diverticulum
which hernia is more common direct or indirect?
Indirect
Pt with IBD x more than 10 years should get colonosopy every
2 years due to increased risk of colon CA
Birds’ beak or rat tail sign seen on barrium swallowing tests is suggestive of:
Achalasia
Hep C is what type of virus?
Single stranded RNA
Dermatitis herpetiformis is related to:
Celiac Disease
inability to convert phenylalanine to tyrosine is known as:
PKU
Misoprostol:
Prostaglandin analog
may be used to treat PUD
stimulates mcous and bicarbonate secretions
Golden standard for diagnosing/confirming Celiac Dz is:
Serology with mucosal biopsy
Example of H2 blockers are:
-TIDINE-
Most common cause of large bowel obstruction is:
neoplasm
Tx for anal fissure:
topical nitroglicerin
topical diltiazem
Anal cancer is closed linked to which virus?
HPV
Incarcerated hernia:
Non reducable
Blood flow is intact
Hepatic Encephalopathy is caused by:
Liver cirrhosis:
Liver does not remove amonia from the blood
vit E def. is seen in children with:
CF
Gradual disphagia and regurgitation of undigested foods seen when lower esophagial spincter fails to relax is known as:
Achalasia
Tx for long lasting bleeding from Mallory Weiss Tear is:
Epinephrine injections
Thermal Coagulation
painless rectal bleeding in 2 y.o pt is usualy indicative of
Meckel diverticulum
Majority of GB stones are made of:
cholesterol
Ranson criteria for admission includes:
age > 55
glucose > 200
WBC > 16,000
LDH > 350
AST > 250
sx of Esophagitis:
Odonophasia
Dysphasia
Diffuse rectal erythema is indicative of
UC
Abx for non perforated acute appy:
Timentin
Pain in the RLQ during LLQ pressure is known as:
Rebound Tenderness / Rovsing’s signs
(R=R)
indicative of acute appy
LFT marker which is elevated in Viral Hepatitis is:
ALT
Esophagial Food Impaction is suggestive of:
Esophageal Webs
or
Schatzi’s ring
Gold standard test for: Cholycystitis and Cholagitis
HIDA>Cholecystitis
ERCP>Cholegitis
B12 and Iron absorption are _____ after a prolonged use of PPI
reduced
Tx fir Candida Esophagitis is:
Amphotericin
Fluconazole
Ketoconazole
Most common etiology of acute appendicitis is?
Fecolith
Most effect treatment of GERD is:
weight loss
Most common non GI manifistation of IBD is:
Arthritis (joint pain)
Most Gastric Lymphomas are:
Non Hodgkins
Risk population for Hep C:
IV drug use
organ transplant / blood transfusion prior to 1992
HemoDialasis
HIV
children born to infected mothers
Niacin toxicity sx is:
flushing
Tx for Hep C is:
Ribavirin + Pegylated Interferon
Ulceerative Colitits can be treated with
Surgery
Celliac dz in children under 2 y.o is manifested by:
malabsorption sx:
Diarrhea, weight loss, abd distention, growth retardation.
The Gold Standard for diagnosis GERD is:
24 hour pH monitorising
(probe left 6 cm above the LES)
Acute phase of Hep B will test positive for:
Hep B surface antigen
Hep B core antigen
Antibody to Hep B core (IgM)
Best test to diagnose Achalasia is:
Monotomy study
complication of phenylketonuria (PKU) is
mental retardation
Colonoscopy screening should start at:
50 y.o ever 10 years.
A person who recovered from Hep B will test positive for:
Antibodies to Hep B surface antigen
and
Antibodies to Hep B core antigen (G type)
Risk factors for Gastric Adenocarcinoma
H Pylori
Smoking
Blood Group A
Biomarker for Hepatocellular carcinoma?
Alpha-fetoprotein.
moans, groans, bones are indicative of:
HyperCalcemia
Extraintestinal manifistation of IBD:
Pyoderma gangrenosum, Erythema Nodosum
Iritis, Conjunctivitis, Uveitis
Arthritis
Sclerosing cholangitis, Hepat, GB stones
Currant jelly stool is indicative of
Intussusception
Treatment Protocal of H Poliry?
Tipple Therapy x 2 weeks
PPI+Clarithromycin+Amoxicilin
or
Quadruple Theraphy x 2 weeks
PPI + Bisthmus + 2 abx
sx of Zenker’s Diverticula:
Regurgitation, bad breath (halitosis), dysphagia
h/o: hiatal hernia, esophageal spasm
IgA ednomysial antibodies are indicative of
Celliac Dz
painfull McBurney’s point is a signs of:
acute Appy
tx for acute IBD:
Corticosteroids
Best tx for acute pancreatitis
IV fluids
most common cause of small bowel obstruction:
adhesions
Bird’s beak volvulus seen on abd film is a sign of
Large bowel obstruction
risk factors for acute mesenteric ischemia:
a fib
PAD or CAD
hx of hypercoagulability
Familial Adenomatous Polyposis
Tenesmus + mucus passage is often seen in:
UC
Abx for diverticulitis include:
Ciproflaxin + metronidazole
Enterochromaffin cells (ECL) in the stomach produce:
Histamine
Abscess in the sacrococcygeal (natal) cleft is known as:
Pilonidal Disease
Esophageal Cancer caused by obesity and Barrett’s esophagus is known as:
Adenocarcinoma
alchoholics have which vitamin def.
B6 (pyroxidine)
tx for intestinal ischemia is:
IV fluids
Trousseau and Chvostek signs are indicative of:
hypoCalcemia.
Loss of esophageal compliance and esophagial fibrosis caused by chronic inflammation is known as:
Esophageal Stricture
B1 (Thyiamine) def. produces:
Beriberi
Most common stomach cancer is:
Adenocarcinoma
H Pylori mophology is:
Grem -
Spiral
Bacilus
RUQ pain
Fever
Jaundice
correspond to:
Charcot’s triad
indicative of Cholangitis
Imaging modality of choice in the setting of acute diverticulitis is:
CT with oral contrast
spasm of the fingers caused by inflating a blood pressure cuf is known as:
Trousseau sign
Niacin Deficiency is known as:
Pellagra
The presence of antibodies to Hep B surface antigen (antiHBsAg) only is indicative of:
previous immunization
Colon fistual are seen in:
Crohn’s Dz
Crohn’s fistula
Apple Core appearnace on barium anema abdominal x ray should make you suspect:
colon cancer
Onion skin pattern on a liver biopsy is indicative of:
Primary sclerosing cholangitis.
Large esophagial ulcers seen on endoscopy are indicative of:
CMV esophagitis.
large CMV
Most common type of colon cancer is:
adenocarcinoma
Transverse proximal esophageal Webs that appear like “shelfs” are known as:
Esophageal Webs
Aspergillus is associated with:
Hepatocellular CA
Sqamous Esophageal Cancer affects what portion of the esophagus?
upper 2/3
Strangulated hernia
can not be reduced
compromised blood supply
Distal onset with progressive continuous proximal invovlment of the colon is indicative of
Ulcerative Colitis
pt. with Celliac Dz require supplementation of which vitamins/minnerals:
B12, folate, Ca, vitamin D
Pseudomembranous colitis is caused by
C diff
Asterixis is?
hand tremor when the werist is extended
seen in cirrhosis patients.
Cullen signs and Grey-Turner signs are indicative of:
Acute Pancreatitis
Autoimmune reaction to gluten (gliadin) products is known as:
Celiac Disease
Valganciclovir is used to treat CMV esophagitis.
What is the important side effect of this medication?
Neutrophenia
Thrombocytopenia
example of PPI:
-ZOLE-
The best test to diagnoses GB stones is:
HIDA
not US
Inability of lower esophageal sphincter to relax leads to:
Achalasia
maintenance tx of IBD
mesalamine (5 ASA)
meaintenance=mesalamine
Penesa
Asacol
Rowasa
Villous polyps are:
have very high malignant potential
Ridig abdomen
Distention
Rebound tenderness
are possible signs of:
Toxic megacolon
Thurmb print sign of abdominal X ray is indicative of:
Bowel edema (often seen in collon ischemia)
Colon distention greater than 6 cm is indicative of
Toxic Megacolon
Most common location of colon cancer is:
cecum
risk factors for umbilical hernia:
female infants
pregnancy
obesity
Tx for CMV esophagitis is:
Valgancyclovir
MoA of H2 blockers:
Step 1. Blocks Histamine from binding to H2 receptors on paietal cells
Step 2. Reduces Acid secretion by slowin down H/K ATPase
Colonoscopy or barium enema in the settings of diverticulitis is:
contraindicated cause of the high risk of bowel performation
golden standard for diagnosis IBD is:
Colonoscopy with biopsy
Ursodeoxycholic acid (UDCA) is used for:
Dissolution of cholesterole GB stone in pt who can not proceed with chelycystectomy
Multiple shallow esophagial ulcers seen on endoscopy is indicated of:
Herpes esophagitis
(shallow herpes)
High levels of gastrin are caused by:
Perenicious Anemia
or Zollinger-Ellison syndrome
which antibody is indicative for primary biliary cirrhosis?
Antimitochondrial
in alcoholic hepatitis AST/ALT will be:
AST/ALT>2:1
