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Surgery > GI > Flashcards

GI Flashcards

1
Q

Symptoms including:

  • Arthralgias, myalgias
  • Waxing and waning transaminase levels
  • Mixed cryogloblulinemia
  • Porphyria cutanea tarda
  • Membranoproliferative glomerulonpehritis

may indicate…

A

Hep C

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2
Q

Patient presenting with hematemesis and abdominal pain after consuming alcohol and aspiring likely has…

A

acute erosive gastritis

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3
Q

54 year old man complains of substernal burning after meals, unintentional weight loss, and burning worse when supine. What test should evaluate him?

A

Upper GI endoscopy

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4
Q

What screen is used for pancreatic cancer in asymptomatic individuals with risk factors?

A

None has been developed as of yet!

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5
Q

What is the rx for upper GI bleed if hemoglobin

A

Packed red blood cells

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6
Q

Low serum iron and ferritin with an elevated total iron binding capacity indicates what kind of anemia?

A

Iron deficiency anemia

- Evaluate for GI bleed (colonoscopy, endoscopy)

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7
Q

What imaging establishes the dx of chronic pancreatitis?

A

Pancreatic calcifications seen on CT or plain film

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8
Q

What are the stages of alcoholic liver disease?

A

1) Fatty liver (steatosis)
2) Alcoholic hepatitis
3) Alcoholic fibrosis/cirrhosis

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9
Q

At what stages is alcoholic liver disease reversible?

A

Through alcoholic hepatitis and even early fibrosis in some cases, if alcohol consumption is ceased

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10
Q

Histological findings such as:

  • Mallory bodies
  • Infiltration by neutrophils
  • Liver cell necrosis
  • Perivenular inflammation

indicate what stage of alcoholic liver disease?

A

Stage 2) alcoholic hepatitis

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11
Q

What is the rx for nonbleeding esophageal varices?

A

Nonselective beta blockers (propanolol, nadolol)

Mechanism: decrease adrenergic tone in mesenteric arterioles, which leads to unopposed alpha-mediated vasoconstriction, preventing the varices from growing/bleeding

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12
Q

What syndrome is indicated by vomiting, retrosternal pain, and crepitus in the suprasternal notch?

A

Boerhaave syndrome, spontaneous rupture of the esophagus

- Rupture into the mediastinum causes pneumomediastinum

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13
Q

What syndrome results from protracted vomiting and does not involve crepitus/pneumomediastinum?

A

Mallory Weiss tear

- Incomplete mucosal tear at GE jx

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14
Q

What is post-cholecystectomy syndrome (PCS)?

A

Postoperative pain (early = months, or late = years) after cholecystectomy that resembles original abdominal pain/dyspepsia

Causes include:

  • Biliary = retained stones, cyst
  • Extrabiliary = pancreatitis, peptic ulcer disease, coronary artery disease
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15
Q

What is the imaging done to evaluate post-cholecystectomy syndrome (PCS)?

A

US followed by ERCP

- Rx depends on cause

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16
Q

What medications cause drug induced esophagitis?

A 
Tetracyclines
Aspirin and other NSAIDs
Alendronate (bisphosphonate)
KCl
Quinidine
Fe
17
Q

How long after diagnosis of UC should patients begin colonoscopy surveillance for colorectal ca?

A

8 years, and repeat q1-2 years to assess for colonic dysplasia

18
Q

Why is the BUN/Cr ratio elevated with GI bleed?

A

2 to reabsorption of blood from the GI tract

bacterial breakdown of hemoglobin in the GI tract with resultant urea absorption

19
Q

A patient with history of constipation and low fiber diet presents with days of LLQ abdominal pain that does not resolve with antibiotic treatment. What is the likely diagnosis?

A

Diverticulitis

20
Q

What is the best imaging for complications from diverticulitis?

A

CT scan

21
Q

IBD has a bimodal distribution that means the disease affects what age groups primarily?

A

Usually presents in the 20-30s or the 60s

22
Q

Neutrophilic crypts is found in what GI condition(s)?

A

IBD: both UC and Crohn’s

23
Q

What inflammatory changes are seen in the blood and indicated inflammatory diarrhea due to IBD?

A
  • Anemia
  • Elevated ESR
  • Acute phase reactants
  • Reactive thrombocytosis
24
Q

What are risk factors for SIBO, small intestine bacterial overgrowth?

A

Anatomical issues or dysmotility syndromes (scleroderma, DM)

Presents with abdominal boating, flatulence, diarrhea
Endoscopy with jejunal aspirate showing >10^5 organisms is diagnostic

25
Q

Patient presents with recurrent PUD and ulcers in the jejunum, with endoscopy showing thickened gastric folds. What is the suspected diagnosis and what would confirm?

A

Z-E syndrome (gastrinoma), confirmed with serum gastrin level > 1000

Note: strongly associated with MEN-1 in 20% of cases, not associated with H. pylori!

26
Q

Where do H. pylori ulcers form?

A

Stomach and duodenum, NOT jejunum

27
Q

What does the “double duct” sign (compressed pancreatic duct and common bile duct) and non-tender, distended gallbladder signify?

A

Pancreatic cancer that is large enough to cause biliary obstruction

28
Q

What two watershed areas of the colon are most vulnerable to ischemia during surgery (hypotensive state)?

A 
Splenic flexure (SMA)
Recto-sigmoid junction (IMA)
29
Q

What is the rx for Primary Biliary Cirrhosis?

A

Ursodeoxycholic acid

30
Q

What is the most common complication of peptic ulcer disease?

A

Hemorrhage

31
Q

What test is recommended for motility disorders of the esophagus?

A

Barium swallow (followed by motility studies like manometry)

32
Q

What is the appropriate imaging for esophageal perforation?

A

Water soluble contrast esophogram

33
Q

Patient presents with progressive destruction of the intrahepatic bile ducts, leading to ductopenia. What is the most likely cause/diagnosis?

A

Primary biliary cirrhosis

34
Q

What is the most common cause of lower GI bleed in an elderly patient?

A

Divericulosis (not hemorrhoids)

  • Causes painless massive bleeding
  • Distinguish from diverticulitis, which is assoc. w infection and is painful!
35
Q

What is the rx for acute pancreatitis?

A

Treat conservatively:

  • Analgesia
  • IVF
  • NPO

Usually resolves in 4-7d

Surgery (3 decks)

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