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PANCE > GI > Flashcards

GI Flashcards

1
Q

Drugs that can cause GERD

A

BB, CCB, nirates, anticholinergics

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2
Q

S/S of GERD

A

heartburn, dysphagia, cough, laryngitis

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3
Q

DX of GERD

A

pH monitoring, endoscopy w/ biopsy

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4
Q

TX of GERD

A

: lifestyle mod, antacids, metoclopramide,

H2 blockers, proton pump inhibitors

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5
Q

what type cancer is esophageal carcinoma usually

A

squamous cell carcinoma (du to smoking and ETOH)

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6
Q

what causes adenocarcinoma in the esophagus?

A

barretts esophagus

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7
Q

Risk factors for esophageal carcinoma

A

Vit A/C deficiency, achalasia, celiacs,

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8
Q

symptoms of esophageal carcinoma

A

progressive dysphagia for solid foods

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9
Q

found in upper 1/3 os esophagus, associated with iron deficiency anemia

A

Esophageal Webs

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10
Q

neural defect with fibrosis and
scarring with decreased peristalsis causing
dysphagia for solids & liquids, weight loss, chest
pain, nocturnal cough

A

Achalasia

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11
Q

how to Dx achalsia

A

manometry showing decreae peristalsis

radiography showing birds beak deformity

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12
Q

TX for achalasia

A

balloon dilatation, botox, nitrates , BB, CCB< prostaglandins

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13
Q

– systemic collagen vascular disease

with dysphagia for solids & liquids

A

scleroderma

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14
Q

Mucosal herniation causing regurgitation of undigested food

A

zenker’s diverticulum

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15
Q

– Mucosal tear causing significant hematemesis (but painless)
after initial nonbloody vomitus/retching

A

Mallory Weiss syndrome

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16
Q

– Mucosal tear causing significant hematemesis (but painless)
after initial nonbloody vomitus/retching

A

Boerhaave’s syndrome

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17
Q

Tx for boerhaave’s syndrome

A

surgery

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18
Q

does H. pylori more commonly cause duodenal ulcers or gastric ulcers?

A

duodenal

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19
Q

what type cancer of the stomach is H. pylori associated w/?

A

adenocarcinoma

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20
Q

Risk factors for gastroparesis

A

T1DM, systemic sclerosis, Parkinson’s, anticholinergics

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21
Q

Tx for gastroparesis

A

metroclopramide, domperidone, erythromycin

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22
Q

Constriction of the circular muscle of the

pylorus

A

pyloric stenosis

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23
Q

RF for pyloric stenosis

A

first born males, macrolides, maternal smoking during pregnancy

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24
Q

S/S of pyloric stenosis

A

projectile vomiting of nonbilious material, palpalbe olive sized mass in epigastrium

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25
Q

DX for pyrloci stenosis

A

Ultrasound > UGI contrast study

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26
Q

TX for pyloric stenosis

A

surgery (pyloromyotomy)

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27
Q

associated conditions with peptic ulcer disease

A

RA
COPD
hepatic/ renal failure
Type A personality

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28
Q

in what type ulcer does eatign diminish the pain?

A

duodenal ulcer

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29
Q

in what type ulcer does eating exacerbate the pain

A

gastric

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30
Q

gold standard for dx of PUD

A

endoscopy

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31
Q

Tx for H. pylori

A

PPI + amoxicillin _ clairthyromycin

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32
Q

• Gastrin hypersecreting tumor associated with PUD

A

Zollinger-Ellison syndrome

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33
Q

what other organs can zollinger-ellison syndrome involve?

A

pancreas

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34
Q

Symptosm w/ zollinger Ellison syndrome

A

Pain, diarrhea, increased parathyroidism

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35
Q

Dx of Zollinger Ellison syndrome

A

gastrin levels >150

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36
Q

Tx for Zollinger Ellison syndrome

A

H2 blockers, PPI, total gastrectomy

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37
Q

symptoms of gastric carcinoma

A

anorexia, weight loss, epigastric pain, vomiting, possible GI bleeding

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38
Q

what is a common water borne diarrhea that is treated with metronidazole?

A

giardia lamblia

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39
Q

diarrhea found in AIDS patients that is watery and profuse

A

cryptosporidium

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40
Q

DX of a small bowel obstruction

A

air fluid levels above the obstruction on x-ray

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41
Q

TX for SBO

A

IV fluids, NG decompression, surgery

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42
Q

where is Meckel’s diverticulum found

A

terminal ileium

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43
Q

Inflammatory bowel disease with an abnormal
sensitivity to gluten
• S/Sx : diarrhea, steatorrhea, weight loss, IDA,
abdominal bloating

A

celiac sprue

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44
Q

Dx of celiac

A

– Small bowel biopsy on gluten : villous atrophy

– Antigliadin antibodies (90%)

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45
Q

Chronic granulomatous disease occurring
anywhere from mouth to anus with ileum most
often involved

A

Crohns disease

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46
Q

what will be seen on colonoscopy with crohn’s

A 
Cobblestone filling defects with segmental areas of
involvement
– Deep ulcerations (collar button)
– Long strictured segments (string sign)
– Skip areas
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47
Q

most common type of small bowel tumor

A

adenocarcinoma

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48
Q

Chronic inflammatory disease of colon that
starts distally at the rectum and gradually
progresses proximally
• Continuous lesion

A

ulcerative colitis

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49
Q

Tx for ulcerative colitis

A

– Mesalamines > Sulfasalazine > Corticosteroids

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50
Q

most common type of colon cancer

A

adenocarcinoma

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51
Q

s/s colon cancer

A

fatigue, pain, change in stool size, blood in stool

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52
Q

lab used to monitor colon caner

A

CEA (carcinoembryonic antigen) –

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53
Q

perianal pruritus, rectal bleeding, anal pain

& palpable mass in the anal region

A

hemorrhoids

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54
Q

tx for hemorrhoids

A

stool softeners, sitz bath, surgery

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55
Q

4 drugs that can cause acute pancreatitis

A

azathioprine, furosemide, estrogens, steroids

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56
Q

symptoms of acute pancreatitis

A

epigastric or periumbilical pan radiates to back. Worse with walking, lying supine. Better sitting and leaning forward

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57
Q

PE signs with acute pancreatitis

A

Cullen’s sign, Gray turner’s sign

58
Q

DX of acute pancreatitis

A

upper EUS, CT scan

59
Q

Tx for acute pancreatitis

A

NPO, bowel rest, IV fluids, NG suction, TPN

60
Q

what will ERCP show with chronic pancreatitis

A

irregular beading

61
Q

what may an abdominal film show with chronic pancreatitis

A

pancreatic calcification

62
Q

what type carcinoma are most pancreatic carcinomas?

A

adenocarcinoma

63
Q

S/S of pancreatic adenocarcinoma

A

post prandial epigastric pain for 3-4 months, radiate to back. relieved by sitting or bending both knees Jaundice, weight loss

64
Q

RF for gallstones

A

OCPs, pregnancy, rapid weight loss, FMHx DM< crohn’s TPN

65
Q

what drugs can cause cholesterol gallstones

A

clofibrate, cetriaxone, octerotide

66
Q

who are pigment gallstone found ine (made of calcium bilirubinate)

A

chronic hemolysis (SS diseae) and asians

67
Q

crampy postprandial pain in epigastrium or
RUQ that may radiate to back near right scapular
tip, fever, N/V, ileus,↑WBC

A

acute cholecystitis

68
Q

what percent of gallstones are radiopque?

69
Q

Tx for acute cholecystitis

A

IV fluid, NG suction , surgery

70
Q

Gallstone stuck in the common bile duct
• Sx : intermittent colicky pain in RUQ, fevers,
chills, jaundice, possible sepsis

A

choledocholithiasis

71
Q

Tx for choledocholithiais

A

ABX conrol, surgical extraction of stone

72
Q

What is Charcot’s triad

A

Fever >40, RUQ pain, jaundice

73
Q

Rare disease causing progressive narrowing of

the bile ducts, M > F, dx in 3rd to 4th decade

A

sclerosing cholangitis

74
Q

70% of people with sclerosing cholangitis also have what?

A

IBD (usually ulcerative colitis)

75
Q

Tx for sclerosing cholangitis

A

steroids, methotreate, long term abx, stens, surgery

76
Q

what type cancer is found in the gallbladder (typically older women)

A

adenocarcinoma

77
Q

genetic & rather benign
condition that affects 7% of US population,
decreased uridine diphosphate (UDP)
glucuronyl transferase activity leads to mild
unconjugated hyperbilirubinemia

A

Gilbert’s syndrome

78
Q

genetic absence of
hepatic UDP enzyme activity. Pts usually die in
infancy with Type I.

A

Crigler-Najjar syndrome

79
Q

what type of hepatitis is post-transufion, lead sto chronic hepatitis and cirrhosis and puts an individual at an increased risk of hepatocellular carcnioma

A

Hepatitis C

80
Q

symptoms of hepatitis

A

malaise, anorexia, fatigue, abd pain, arthritis, urticaria, flu like syndrome, juandice, heaptic enlargement, splenomegaly, tea colored urine

81
Q

Dx of hepatitis

A

increase in ALT>AST, increased bilirubin, i> ALP

82
Q

with hepatitis A which Ig rises quickly

83
Q

What is diagnostic of hepatitis B?

A

positive surface antigen

84
Q

what is diagnostic for hepatitis C

A

positive antibiotics to hepatitis C

85
Q

Tx for hepatitis (supportive)

A

supportive, IV fluitds, correct electrolyte abnormalitites, claories for N/V, Vitamin K for elevated Pt/INR

86
Q

Drug treatment for hepatitis B

A

interferon in combination with lamivudine (HBV) and

87
Q

drug treatment for hepatitis C?

A

interferon in combination with ribavirin

88
Q

progressive jaundice, hepatic
encephalopathy and ascites. Mortality rate varies
with age and approaches 90‐100% in patients older
than 60 years of age (HBV, HCV and rarely HAV)

A

fulminant hepatitis

89
Q

complication of HBV,HCV, & HDV,
with liver enzymes elevated for > 6 months.
Inflammation , necrosis, fibrosis bridge portal areas
and disease may progress to cirrhosis.

A

chronic hepatitis

90
Q

what hepatitis’ can lead to hepatocellular carcinoma?

A

HBV, HCV, HDV

91
Q

what will be seen on PE with hepatitis complications

A

splenomegaly, spider angiomas, caput medusa

92
Q

how is hepatitis A transmitted?

A

RNA virus, fecal oral

93
Q

incubation time for hepatitis A?

94
Q

when will jaundice appear with hepatitis A?

A

after 5-10 days

95
Q

What lab will be positive with hepatitis A?

A

+IgM anti-HAV

96
Q

incubation period for hepatitis b?

A

6 weeks-6 months

97
Q

what serology will an individual vaccinated with hepatitis B have?

98
Q

RNA virus spread by IV drug users, sex, tattoos. Incubation time of 6-7 weeks

A

hepatitis C

99
Q

what drugs can cause liver disease through direct toxicity?

A

APAP, amiodarone, aspirin, ETOH, niacin, phosphorus, heavy metals

100
Q

what drugs can cause viral like hepatitis?

A

isoniazid, dilantin, sulfonamides, halothane

101
Q

lab values with cirrhosis of the liver

A

anemia (macroctic), thrombocytopenia (alcoholic BM suppression), increased LFTs, prolonged INR, decreased albumin

102
Q

drug tx for hepatic encephalopathy

103
Q

what causes a liver abscess

A

entamoeba histolytica

104
Q

who are liver abscess common in

A

homosexual men, institutionalized individuals

105
Q

Tx for liver abscess

A

metronidazole

106
Q

– genetic defect, homozygotes
usually have liver disease in childhood, no effective
therapy but transplant

A

A1 antitrypsin deficiency

107
Q

genetic disorder with increased abosprtion of iron and deposition. Will have increased serum ferritin.

A

hemochromatotisis

108
Q

tx for hemochromatosis

A

phelbotomy

109
Q

how does sarcoidosis present in the liver

A

liver granulomas

110
Q

genetic disorder of excess copper deposition (cornea will have Kayser Fleischer rings)

A

wilson’s disease

111
Q

treatment for wilson’s disease

A

penicillamine

112
Q

benign pruritus and jaundice in the third timester that goes away after delivery

A

cholestasis

113
Q

pregnancy- hemolysis, increased liver enzymes, low platelets in the third trimester. tx is delivery

A

HELLP syndrome

114
Q

rare liver condition in pregnancy- seen in eclamptic patients

A

hepatic rupture

115
Q

common liver tumor in patients using OCPs. occasional RUQ fullness and if adenoma ruptures hemorrhage is fatal in 1/4 of patients

A

hepatic adenoma

116
Q

dx of hepatic adenoma

A

CT scan and cold spot on liver scanning

117
Q

Tx for hepatic adenomas

A

D/C OCPs and if regression doesn’t occur do surgery

118
Q

most common benign liver tumor, usually no symptoms, but can have decreased platelets

A

hemangiomas

119
Q

Dx of hemangiomas

A

angiography, Ct/MRI

120
Q

Tx for hemangioma

A

usually not needed , can do steroids, radiotherapy, embolization

121
Q

associated with HBV, HCV, chronic hepatitis, alcoholic cirrhosis, hemochromatosis, gallbladder ancer

A

hepatocelluclar carcinoma

122
Q

S/Sxs with hepatocellular carcinoma

A

pain, obstructive jaundice, anorexia, weiht loss, anemia

123
Q

Lab present in hepatocellular carcinoma

A

alpha fetoprotein (AFP) serum trumor marker

124
Q

etiology of ascitites

A

increase hydrostatis pressure, decreased colloid osmotic pressure (decrease proteins), increased permeability of peritoneal capillaries, leakage of fluid into peritoneal cavity

125
Q

PE with ascitites

A

dullness to percussion + fluid wave . Diagnose by ultrasound

126
Q

Gonococcal peritonitis typically in young women due to ascending infection originating in the pelvis

A

Fitz-Hugh-Curtis syndrome

127
Q

Tx for gonococcal peritonitis

A

ceftriaxone, add tetracycline if chlamydia present

128
Q

what are the most common peritoneal tumors

A

metastatic lesions

129
Q

Decreased blood supply usually involving the

superior mesenteric artery. RF include atherosclerosis, CHF, AMI.

A

acute mesenteric ischemia

130
Q

Tx for acute mesenteric ischemia

A

surgical removal of embolusor thrombus, stent or angioplasty

131
Q

most common type of hernia

A

indirect in guinal hernia

132
Q

most common vitamin deficiency, commonc ause of blindness (starting with night blindness)

A

vitamin A deficiency

133
Q

Signs of vitamin A toxicity

A

dry, scaly skin, hair loss, vomiting, hypercalcemia, papilledema, HA, hepatomegaly

134
Q

deficiency due to chronic alcoholism. ANorexia, muscle cramps, paresthesias, irritability

A

B1 thiamine

135
Q

deficiency that presents with cheilosis, angular stomatitis, glossitis, seborrheic dermatitis, corneal vascularization and anemia

A

Riboflavin B2

136
Q

Deficiency with pellagra (dermatitis, diarrhea, dementia)

A

niacin deficiency 9B3)

137
Q

Deficiency that is common with ETHO and isoniazid, cycloserine, penicillamine, and OCPs. will have mouth soreness, glossitis, cheilosis, weakness, irritability

A

Vitamin B6 deficieicny (pyridoxine)

138
Q

Advanced deficiency presents with scurvy- parafollicular hemorrhages, petechiae, purpura, bleeding gums, impaired wound healing

139
Q

Vitamin D deficiency presents as what?

A

oteomalacia

140
Q

Symptoms of vitamin E deficiency

A

areflexia, gait disturbance, decreased proprioception, fibration, ophthalmoplegia

141
Q

Symptom of vitamin K deficiency

A

bleeding dyscrasia

PANCE (14 decks)

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