GI Flashcards
What are the borders of the Hesselbach triangle?
medial border: rectus abdominus, lateral border: inguinal ligament, superior border: inferior epigastric artery
Most common cause of painless rectal bleeding in peds?
polyps
Patient has slate colored skin indicates?
primary biliary cirrhosis
What is used to chelate in wilsons disease?
penicillamine
What is treatment for chronic hemachromatosis?
phlebotomy and deferoxamine chelation
Tx for chronic autoimmune hepatitis?
corticosteroids
Tx for chronic viral hep B and C?
pegylated interferon alpha
What serum gastric levels are found in zollinger ellison sx?
> 150 suggestive; >200 diagnostic
What level of eosinphillia is dx of eosinophilic esophagitis on bx?
> 15
What type of diarrhea is found with cholrea?
seceratory
What type of diarrhea is found with lactose intolerance?
osmotic
What are the 3 common sx of pellagra?
diarrhea, dermatitis, dementia
What bug is related to deli meat and miscarriages?
listeria
Niacin deficiency can cause?
pellagra
What congenital error of metabolism that requires avoidance of phenylalanine?
phenylketonuria
Abx to prevent travel diarrhea? Pregnant and children?
fluoroquinolone, azithromycin
How to dx lactose deficiency ?
lactose breath hydrogen test
Perifollicular petechial mean what type of vitamin deficiency?
Vita C-scurvy
What type of diarrhea can lead to meningitis in neonates and immunocomprised patients?
listria
What type of hernia can be felt on side of the finger on PE? tip?
side: direct, tip: indirect
How to tx giardia infxn?
metrodinazole
What are RF for ventral hernia?
age, surgery, obesity
Stomach herniated up to the thorax?
paraesophageal hernia
Sx of sliding hernia?
GERD
Adenomatous on colonoscopy should get how often colnoscopy?
3-5yrs
What does adenomatous mean?
benign polyps
What are thumb imprints on xray indicative of?
toxic megacolon, acute mesenteric ischemia
What is the most common CA?
adnocarcinoma
What does steatorrhea indicative of?
malabsorption
What is found on bx for celiac sprue?
villious atrophy
Abdominal pain that is out of proportion?
acute mesenteric ischemia
60yo male who is a smoker c/o recurrent abdominal dull ache within 1hr of eating?
chronic mesenteric ischemia
Inflammatory bowel disease + bloody diarrhea?
ulcerative colitis
What is the difference between ulcerative colitis and crohns?
ulcerative colitis only affects the colon, crohns has “skipped lesions”
What other sx can be assessed with patients who have ulcerative colitis?
pyoderma gangrenosum, ankloysing spondylitis, erthema nodosum, uvities
What irritable bowel disease affects the WHOLE GI tract, mouth and anus?
crohns
Newborn has double bubble on xray?
duodenal atresia
What are the 3 types of abx that can be used with diverticulotitis?
cipro + metronidazole, augmentin, bactrim DS
Positive anti-tissue transglutaminase, anti-gliadin, anti-endomysial AB suggests?
celiac sprue
What criteria is used to asses pancreatic CA?
ranson criteria
What genetic abnormality is associated with duodenal atresia?
hereditary spherocytosis
What heart condition will arise with mesenteric ischemia?
a fib, CHF, MI
What tumor marker is associated with pancreatic CA?
CA 19-9
What tumor marker is associated with liver CA?
Alpha fetoprotein
What does porcelain gall bladder suggest?
gallbladder CA
What is the sign called when patient has bleeding in the abdomen causing ecchymosis?
cullens sign
What is the most common type of pancreatic CA?
ductal adenocarcinoma
What does fever, RUQ, and jaundice indicate?
cholangitis
What is positive anti-mitochondrial AB indicate?
primary biliary cirrhosis
What lab results will indicate vaccination of Hep B?
Antigen neg., AB surface positive, AB core negative
What lab results will indicate immune from infxn of Hep B?
Antigen neg., AB surface positive, AB core positive
What lab results will indicate further testing of Hep B and what would you order?
Antigen is positive, IG anti-core
What lab results will indicate hep B chronic vs acute infnx?
chronic: antigen pos, surface neg, core positive, IG neg; acute: antigen pos, surface neg, core positive, IG pos
How to tx gastoparesis?
metocloparmide or IV erythromycin
How to tx gastritis?
PPI, sx relief
What drugs can increase risk of cholithiasis?
ceftraxoine and clofibrate
What hereditary disease can increase risk of cholithiasis?
sick cell dz and herediatry spherocytosis
What may result in a false negative in breath urea test?
PPI, antacids, abx, H2 blockers
What sx associated with GERD can indicate pulmonary disease?
wheezing, horseness
What is an important ADR to educate when giving metoclopramide?
tardive dyskinesia
What type of ulcer is relieved after eating?
duodenal ulcer
What motility disorder is caused by the degeneration of Auerbach plexus?
achalasia
What medication can be used to treat stable esophageal varices?
BB
What bugs can cause esophagitis?
HSV and CMV
Vitamin B1 is associated with what prob?
beriberi, wernickes
Vitamin B6 is associated with what prob?
anemia
Vitamin K def can lead to what lab result?
increased PT
Vitamin E def can lead to?
hemolytic anemia
What is therapeutic and diagnostic for intussusception?
barium enema
What to expect on the imaging results for pyloric stenosis?
string sign
Sausage mass + red currant jelly stools indicates?
intussusception
Drinking from water stream + diarrhea is caused by what bug?
giardia
Newborn has very foul smelling urine suggests?
phenylketonuria
Longterm, untreated phenylketonuria can cause what complication?
mental retardation
Diarrhea on a cruise ship is d/t what bug?
norovirus
Diarrhea at daycares?
rotavirus
Diarrhea at picnics and egg salad?
s. aureus
Diarrhea with undercooked pork?
salmonella
Diarrhea with traveling?
e. coli
Diarrhea with shellfish?
vibrio
Obesity and recent surgery causes ventral herniation, treatment?
observe
Congenital inguinal hernia,
indirect
Treatment for perianal cyst?
I&D
What type of hernia worsens with GERD?
hiatal hernia
Painful defecation, occasional blood, pruritis of the anus?
external hemmoroids
Which anal cyst is cancerous?
teratoma
How to differeniate between mesenteric ischemia and toxic megacolon?
mesenteric has a soft abdomen, toxic has a rigid abdomen
Common area for large bowel obstruction?
sigmoid colon
Barium study reveals an apple core lesion, what should you expect?
colon CA
Celiac would reveal what lab results?
Positive anti-tissue transglutaminase, anti-gliadin, anti-endomysial AB
What med should be given to patient with acute mesentaric ischemia while patient is waiting for surgery?
papaverine via angiogram
What is gold standard for acute mesentaric ischemia?
angiogram
What are the complications for ulcerative colitis?
primary sclerosing cholangitis, toxic megacolon, colorectal CA
What labs should be positive with ulcerative colitis?
pANCA
What labs should be positive in crohn’s dz?
ASCA
What two meds should patients with chronic pancreatitis be on?
insulin and pancreatic enzymes
What is the gold standard for primary biliary cirrhosis?
liver bx revealing antimitochondrial AB
Family hx of cirrhosis, hyperpigmentation, DM, pseudogout, cardiomyopathy can suggest what dz?
hereditary hemachromatosis
45yo male alcoholic has epigastric pain raditating to back has ARDS?
acute pancreatitis and sepsis
How to medically treat ascities in cirrhosis?
PO AM spirinolactone and furosemide
Primary biliary cirrhosis is associated with?
celiac
Which hepatitis is DNA?
hep B; rest are RNA
Which hep causes high infant mortality in pregnant women?
hep E
How to tell between chronic and acute hep B?
IGM
Patient has wt loss, jaundice, and palpable RUQ mass?
pancreatic CA or gallbladder CA
What is the next step after patient has an inconclusive US for cholecystitis?
HIDA
Patient has cholangitis with confusion and HTN?
acute obstructive suppurative cholangitis
Patient has jaundice, RUQ pain, fever?
cholangitis
Which MEN I tumor causes excess gastric acid?
zollinger ellison
Diabetic patient checks his glucose level after meals and it’s consistently low, what to suspect?
gastroperesis
Patient has L supraclavicular and umbilical swollen lymph node?
gastric CA
What abx is major cause of biliary sludge?
ceftriaxone
Patient has discomfort with eating, better after eating?
gastric ulcer
Patient does not have discomfort with eating, worse after eating?
duodenal ulcer
What surgical procedure is indicated with for refractory GERD?
nissen fundoplication
Patient presents with esophageal bleeding, what IV medication should be used?
vasopressin
What meds to prevent esophageal varices?
BB
What is the treatment for plummer vinson dz?
dilation and iron supplementation
Female patient presents dysphagia to solid foods and anemia; what to expect on endoscopy?
esophageal webs for plummer vinson dz
Stroke patients have dysphagia with solid, liquid, or both?
both
Patient with dysphagia for solid and liquid food, and shiny tight skin?
scleroderma
Schatzki ring has dysphagia with solid or liquid food?
solid
What to expect on barium swallow on patient that has esophageal spasm?
corckscrew
Bird beak on barium swallow indicates patient cannot swallow solid, liquid, both?
both
Patient has severe sore throat after bone marrow transplant, on exam: multiple vesicles; what to suspect?
HSV as it is common in transplant patients
Most likely bug that is causing deep vesicular oral lesions in HIV patient?
CMV
What treatment should be used with patient’s family of active Hep A?
immunoglobulin