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PANCE > GI > Flashcards

GI Flashcards

1
Q

Nephrolithiasis stone size for extraction

A

> = 5mm

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2
Q

IF for?

A

B12 absorption

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3
Q

parietal cells

A

HCl

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4
Q

chief cells

A

pepsin

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5
Q

parietal cells stim by? (3)

A

gastrin, histamine, ACh

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6
Q

beta cells

A

insulin

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7
Q

alpha cells

A

glucagon

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8
Q

PUD Dx test of choice

A

EGD

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9
Q

Achalasia Dx test of choice

A

Esophageal manometry

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10
Q

barium enema (lower GI series) contraindicated in?

A

acute UC

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11
Q

esophagitis: lg superficial shallow ulcers, Tx

A

CMV

Tx: ganciclovir

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12
Q

esophagitis: small deep ulcers, Tx

A

HSV

Tx: acyclovir

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13
Q

pill esophagitis causes (4)

A

NSAIDs, bisphosphonates, KCl, Fe, tetracycline

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14
Q

GERD alarm sx

A

dysphagia, odynophagia, wt loss, bleeding

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15
Q

Barrett’s

A

squamous-> columnar

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16
Q

GERD Dx progression

A

clinical-> endoscopy-> esoph manometry

gold std: 24hr ambulatory pH monitoring

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17
Q

Mallory-Weiss Dx test of choice

A

EGD

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18
Q

bird beak

A

achalasia - esophagram

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19
Q

dysphagia to both solids & liquids

A

achalasia

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20
Q

Tx achalasia

A

decr LES pressure

CCB, nitrates, botox

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21
Q

esophageal spasm sx

A

CP worse with hot/cold liquid/food

similar to angina

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22
Q

corkscrew on esophagram

A

esophageal spasm

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23
Q

boerhaave’s pathophysiology, sx

A

full thickness rupture, distal esophagus

CP worse with deep breaths/swallowing, crepitus, pneumomediastinum

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24
Q

Mallory-Weiss pathophysiology

A

Longitudinal superficial mucosal laceration, gastroesoph jxn

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25
Q

esophageal varices Tx of choice, prevention, etc.

A

Tx of choice: endoscopic ligation
Rx: octreotide
TIPS if refractory

prophylaxis: nonselective BB

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26
Q

hiatal hernia type I, II

A

type I: GE junction, stomach- sliding

type II: fundus- rolling

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27
Q

esophageal neoplasms: location of squamous cell, adenocarcinoma

A

squamous cell: upper 1/3

adenocarcinoma: lower 1/3

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28
Q

H. pylori Tx

A

PPI + clarithromycin + amox

metronidazole if allergic to PCN

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29
Q

PUD alarm sx

A

> 50y/o, dyspepsia, Hx gastric ulcer, anorexia, wt loss, anemia, dysphagia

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30
Q

MOA of PPI

A

block H+/K+ ATP-ase

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31
Q

PPI ADR

A

B12 def

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32
Q

MOA of H2 blocker

A

decr acid/pepsin secretion

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33
Q

H2 blocker (Cimetidine) ADR

A

gynecomastia, impotence

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34
Q

Rx prevention of NSAID-induced ulcers

A

misoprostol

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35
Q

MC esophageal, gastric CA

A

esoph: Squamous cell
gastric: Adenocarcinoma

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36
Q

RF gastric CA

A

H. pylori**, nitrites

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37
Q

test to confirm H. pylori eradication

A

urea breath test

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38
Q

NONbilious projectile vomiting

A

pyloric stenosis

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39
Q

string sign

A

pyloric stenosis, Crohns

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40
Q

Budd-Chiari syndrome sx

A

hepatic vein obstruction

ascites, hepatomegaly, RUQ pain

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41
Q

charcot’s triad

A

cholangitis

  1. F/C
  2. RUQ pain
  3. jaundice
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42
Q

Boas sign

A

cholecystitis
right subscapular pain
phrenic N. irritation

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43
Q

cholecystitis initial test, gold std

A

initial: US

gold std: HIDA

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44
Q

cholecystitis Dx

A

Murphy’s sx, R subscapular pain, fever, N/V

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45
Q

cholecystitis: pain control, Tx

A

pain control: meperidine

NPO, IVF, abx

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46
Q

incr indirect/unconj bili, no elevated LFTs

A

hemolytic/prehepatic

Hemolytic anemia, Crigler Najjar, Gilbert’s

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47
Q

ALT & AST markedly elevated. jaundice.

A

intrahepatic

hepatitis (ETOH, acute/viral/drugs, chronic)

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48
Q

incr AST/ALT >2:1

ALT/AST

A

AST/ALT: ETOH

ALT/AST: viral, acute

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49
Q

acholic stool (pale). jaundice.

A

post hepatic

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50
Q

incr GGT and ALP. jaundice.

A

post hepatic

biliary obstruction, cholestasis, pancreatic CA, Dubin-Johnson

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51
Q

physiologic jaundice of NB: Timeframe

A

3-5 days s/p birth

52
Q

asterixis

A

flapping hand tremor

hepatic encephalopathy

53
Q

fulminant hepatitis: definition, MCC, labs

A

rapid liver failure + encephalopathy

MCC acetaminophen

sx: asterixis
labs: ammonia, incr PT/INR, hypoglycemia

54
Q

viral hepatitis: spiking fevers

A

Hep A

55
Q

screening test for hepatocellular CA

A

AFP, US

56
Q

HBsAg

A

infection (before sx)

57
Q

HBcAb

A

infection

58
Q

HBsAb

A

immunity

59
Q

HBeAg

A

incr infectivity

60
Q

HBeAb

A

decr infectivity

61
Q

Hep B vaccine: contraindications, schedule

A

CI: Baker’s yeast allergy

0, 1, 6 mo

62
Q

Tx hepatic encephalopathy

A

lactulose
neomycin
protein restriction

63
Q

Tx hepatic-related pruritis

A

Cholestyramine

64
Q

progressive jaundice, pruritis, hepatosplenomegaly. what am i?

A

primary sclerosing cholangitis

65
Q

primary sclerosing cholangitis assoc with what dz?

A

UC

66
Q

Dx Wilson’s dz

A

incr urine Cu excretion

decr ceruloplasmin

67
Q

MCC acute pancreatitis (and others)

A

2. ETOH

GALLSTONES

other: scorpion bite

68
Q

Ranson’s (admission) criteria

A

gluc >200, LDH >350, AST >250, age >55, WBC >16

> =3 is severe

69
Q

sentinel loop, colon cutoff sign

A

acute pancreatitis

70
Q

analgesia in acute pancreatitis

A

meperidine

71
Q

MCC chronic pancreatitis, and in kids

A

ETOH

Cystic fibrosis in kids

72
Q

Dx chronic pancreatitis (3)

A
  1. calcified pancreas (Xray)
  2. steatorrhea
  3. DM

amylase, lipase NORMAL

73
Q

RF pancreatic CA

A

smoking**

>60 y/o, chronic, DDT, coal tar, ETOH, DM, male

74
Q

pancreatic CA: MC location, sx

A

location: head, ductal
sx: PAINLESS JAUNDICE, wt loss, abdom/back pain

75
Q

pancreatic CA: initial test, labs

A

CT

incr CEA, CA 19-9

76
Q

Courvoisier’s sign

A

palpable NONtender GB, jaundice- associated with pancreatic CA

77
Q

persistent vitteline duct/yolk stalk

A

Meckel’s diverticulum

78
Q

Meckel’s diverticulum sx, rules

A

sx: painless rectal bleeding

rule of 2’s: 2ft from ileocecal valve, 2in length, 2y/o, boys

79
Q

intussusception age, Dx, Tx

A

age

80
Q

foods that cause/not cause celiac

A

yes: wheat, rye, barley
no: oats, rice, corn

81
Q

lactose intolerance: test of choice

A

hydrogen breath test

82
Q

Dx diverticular dz

A

CT

83
Q

Rovsing sign

A

RLQ pain with LLQ palpation

appendicitis

84
Q

relief with defecation

A

IBS

85
Q

acute vs. chronic mesenteric ischemia

A

acute: MCC occlusion, pain out of proportion
chronic: chronic, dull, worse after meals, “intestinal angina”

86
Q

Toxic megacolon: definition, Tx

A

colon dilation >6cm, systemic toxicity

Tx: bowel decompression

87
Q

UC: complications

A

complications: primary sclerosing cholangitis, toxic megacolon

both UC and Chrohns: arthritis (seronegative)

88
Q

Crohn’s: complications

A

complications: B12 def

both UC and Chrohns: arthritis (seronegative)

89
Q

UC: Dx, contraindications

A

Dx: flex sigmoidoscopy

CI: colonoscopy, barium enema

90
Q

Crohn’s: Dx

A

upper GI series

91
Q

colon polyps- hyperplastic, adenomatous, villous adenoma

A

hyperplastic: low risk
adenomatous: cancerous in 10-20yrs
villous adenoma: highest risk

92
Q

colorectal CA screening

A

50y/o Q10yrs

1st degree relative >60y/o: 40y/o Q10yrs

1st degree relative

93
Q

colorectal CA Tx

A

chemo (5FU)

94
Q

hernia below the inguinal ligament

A

femoral

95
Q

when to repair umbilical hernia

A

present >5y/o

96
Q

BRBPR

A

internal hemorrhoid, anal fissures

97
Q

location, Tx anorectal abscess

A

post wall

I&D, NO ABX

98
Q

MC location anal fissures

A

post midline

99
Q

vit A def

A 
squamous metaplasia
Bitot spots (white spots on conjunctiva)
100
Q

Thiamin def, aka

A

Beriberi
paresthesias
Wernicke’s: opthalmoplegia, ataxia, confusion
Korsakoff’s: dementia

101
Q

Niacin def, aka

A

Pellagra

3 D’s: dementia, dermatitis, diarrhea

102
Q

B12 def

A

NEURO SX
hypersegs

vegans

103
Q

Schilling test

A

B12 def

104
Q

Phenylketonuria: sx, Dx

A

sx: after birth, vomit, MR
blonde, blue eyes, fair skin

Dx: mousy odor urine

Tx: NO (phenylalanine) cheese, nuts, fish, meat, eggs, chicken, milk, legumes, aspartame

105
Q

Zofran MOA

A

block serotonin receptors (5-HT3)

106
Q

Reglan (metoclopramide), Phenergan MOA, ADR

A

MOA: block CNS dopamine receptors

ADR: QT prolong, EPS

107
Q

MC gastroenteritis adults, kids

A

adults: Norovirus
kids: Rotavirus

108
Q

fried rice, diarrhea

A

Bacillus cereus

109
Q

dairy, diarrhea

A

Staph

110
Q

grey, no fecal odor- stools

A

Vibrio cholerae

111
Q

Tx C. diff

A

Flagyl

112
Q

Tx Shigella

A

Bactrim

113
Q

febrile seizures, diarrhea

A

Shigella

114
Q

sickle cell disease, diarrhea

A

Salmonella

115
Q

AIDS, diarrhea

A

Isospora belli, Cryptosporidium

116
Q

Tx Giardia

A

Flagyl

117
Q

frothy, greasy, foul diarrhea

A

Giardia

118
Q

HA-> fever, diarrhea, blanching rose spots

A

Typhoid fever (Salmonella)

119
Q

Bulk laxatives

A

Psyllium, Citrucel, Fibercon, Benefiber

120
Q

Osmotic laxatives

A

PEG (Golytely, Miralax), sorbitol, lactulose, MOM, Mg citrate

121
Q

Stimulant laxatives

A

Dulcolax, Senna

122
Q

Whipple’s disease

A

malabsorption, fever

farmers (soil)

123
Q

dermatitis herpetiformis assoc with what?

A

Celiac

pruritic, papulovesicular rash- extensor surfaces

124
Q

Celiac Dx, definitive Dx

A

IgA, transglutaminase

definitive Dx: small bowel Bx

125
Q

Vit B1

A

thiamine

126
Q

Vit B3

A

niacin

PANCE (9 decks)

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