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COMLEX 2 > GI > Flashcards

GI Flashcards

1
Q

Most common environmental factor assoc with pancreatic cancer?

A

Smoking

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2
Q

Courvoisier Sign

D/t?

A

Obstruction causing the gallbladder to become palpable

Often malignant neoplasm obstructing CBD

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3
Q

Pathogen responsible for most hepatic abscess

A

Klebsiella pneumoniae. (Also associate with infections of biliary tract, fatty liver disease, and DM pts.)

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4
Q

Gastritis

A

gnawing epigastric pain, anemia, extremity paresthesia

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5
Q

GERD

A

persistent hoarseness, dry cough, dysphagia

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6
Q

Gastric ulcer

A

Left sided chest pain and anorexia

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7
Q

Esophagitis

A

Severe chest pain, nausea, bitter “water brash”

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8
Q

Duodenal ulcer

A

Abdominal pain, dyspepsia, weight gain

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9
Q

Glycogen Storage Disorder I (Von Gierke’s disease)

A

Auto Rec deficiency in Glucose 6 Phosphatase
Doll Like Face
hypoglycemia when fasting –> lactic acidosis and Kussmaul resps

Tx: cornstarch feedings

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10
Q

What is the best test to evaluate biliary dilatation without gallstones on US?

A

CT of abd with contrast

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11
Q

What electrolyte abnormality is the hallmark of Refeeding syndrome?

A

HyPOPhosphatemia

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12
Q

Most effective treatment for Non-Alcoholic Steatohepatitis

A

Weight loss

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13
Q

Zenker’s diverticulum is due to what?

A

motor dysfunction of cricopharyngeus allowing for herniation between its muscle fibers

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14
Q

What are the surgical indications for diverticulitis?

Tx?

A

Presence of a fistula
perforation
2+ attacks in the same region

Tx: Partial colectomy

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15
Q

What is a common cause of GI blood loss (manifesting as iron deficiency anemia) in elderly patients who have no other obvious source of bleeding?

A

Angiodysplasia

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16
Q

What should you always do for a new onset dysphagia?

A

Upper endoscopy

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17
Q

Booerhaave v. Mallory Weiss

A

Boerhaave is esophageal perforation after excessive vomiting/bulimia

Mallory Weiss is superficial mucosal tear seen in a weekend warrior

18
Q

Dx. Boerhaave syndrome?

A

Gastrograffin swallow then Barium then EGD

19
Q

Dx. Mallory Weiss?

20
Q

Tx. Diffuse esophageal spasm?

A

CCB, Nitrates

21
Q

Dx. for achalsia and zenker’s diverticulum?

A

barium swallow

22
Q

Schatski’s ring keywords

A

steakhouse dysphagia
barium swallow
surgery to lyse ring

23
Q

Gold standard for confirming reflux?

A

24 hr esophageal pH monitoring

24
Q

Barret’s Esophagus has a risk of developing what ca?

A

Adenocarcinoma

25
Q

Ulcer types Curling v. Cushing

A

“burn from curling iron”

“cushion the brain”

26
Q

Gastric ca. keywords

A

Mucosal cell metaplasia
Signet ring cells
Virchow’s (left supraclavicular) node

27
Q

Most common location of a VIPoma? Keywords?

A

@ pancreatic tail
tea-colored watery diarrhea
hypOkalemia, hypochlorhydria

28
Q

Right sided colon ca. keywords

A

Bleed –> Iron Def. anemia

+ Melena

29
Q

Left sided colon ca. keywords

A

Apple core
Obstructing
Pencil stool
Hematochezia

30
Q

Angiodysplasia of colon is associated with?

A

Aortic Stenosis

Heyde’s syndrome

31
Q

If there’s Upper GI Bleed, what’s the next dx. step?

A

EGD if stable

NG tube and lavage

32
Q

If there’s Lower GI Bleed with no bleeding, what’s the next dx. step?

A

Colonoscopy

33
Q

If there’s Lower GI Bleed with medium amount of bleeding, what’s the next dx. step?

A

Tagged RBC scan

34
Q

If there’s Lower GI Bleed with high bleeding, what’s the next dx. step?

A

Arteriogram

35
Q

Labs in Biliary Tract obstruction

A

Increased ALKPHOS, GGT, Conjugated Bili

Jaundice, pruritus, clay stool, dark urine

36
Q

Ulcerative Colitis keywords

A 
Bloody diarrhea
Colon ca. (do annual colonoscopy after 8 yrs of disease)
Crypt Abscesses
Erythema nodosum
Lead Pipe
Mucosa and submucosa inflamm.
Primary Sclerosing cholangitis (pANCA, ANA)
Pseudopolyps
@ Rectum
Toxic Megacolon

Tx: 5ASA, Steroids

37
Q

Crohns keywords

A 
Anti-Saccharomyces-Cervisiae Abs (ASCA)
Cobblestone
Fistulas
Non-caseating granulomas
Perianal fissures
Skip lesions
Transmural
Watery diarrhea
Nephrolithiasis (IBD causes impaired fat absorption)

Tx: 5ASA, Corticosteroids, Infliximab IV (TNFa Ab), No NSAIDS.

38
Q

Primary Sclerosing Cholangitis (PSC) keywords

A 
HLA-DR52A
pANCA
Males with Ulcerative Colitis
Cholangiocarcinoma risk
Onion Skinning

Tx: Ursodiol, ERCP, Liver transplant

39
Q

Most common type of colonic polyps?

A

Adenomatous. Have malignant potential.

40
Q

Primary Biliary Cirrhosis (PBC) –> cholestasis

S&S

Dx

Tx

A

middle age woman
pruritus, skin hyperpigmentation,
hepatomegaly, fatigue, xanthelasma, steatorrhea
Increased ALKPHOS

+ Anti-mitochondrial Ab (AMA)

Tx: Ursodeoxycholic Acid

41
Q

Esophageal Varices Ppx?

A

Propranolol, Nadolol (non-selective BBs)

COMLEX 2 (19 decks)

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