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GI Flashcards

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1
Q

What is the best lab test for chronic pancreatitis?

A

Low fecal elastase

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2
Q

Tumor marker for hepatocellular carcinoma?

A

AFP

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3
Q

What are the two lymph node findings associated with gastric cancer (location and name)?

A
  • Left supraclavicular=Virchow’s

- Periumbilical=Sister Mary Joseph

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4
Q

Treatment for Ulcerative colitis?

A

5-ASA (Mesalamine for small bowel disease and Sulfasalazine for large bowel disease)

exacerbations=steroids

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5
Q

Bug associated with diarrhea and pseudo-appendicitis?

A

Yersinia

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6
Q

Marker for Primary Biliary Cholangitis? Who gets it?

A

-Anti-mitochondrial antibodies
-Bitches get it
(pBc=Bitches, ladies also carry the mitochondria, which helps with remembering the antibodies…you’re welcome)

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7
Q

What is the treatment for PBC?

A

Ursodeoxycholic acid

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8
Q

What marker is associated with PSC? What does imaging show?

A
  • pANCA.
  • beads on a string

(p=penis, beads=balls, men get this more)

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9
Q

What disease is associated with PSC?

A

Ulcerative colitis

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10
Q

What patient population is more likely to get fulminant hepatic failure if they have hepatitis E?

A

Preggos

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11
Q

What types of viral hepatitis increase your risk of hepatocellular carcinoma?

A

Hep B and C

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12
Q

What meds are used for outpatient treatment of diverticulitis?

A
  • Cipro and flagyl
  • Bactrim and flagyl
  • amoxicillin-clavulonate
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13
Q

Treatment for hepatic encephalopathy?

A

Lactulose and Rifaximin (kills bacteria that produce ammonia)

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14
Q

When are alcoholic cirrhosis patients eligible for liver transplant?

A

-abstinence from booze for 6 months

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15
Q

What is Budd-Chiari Syndrome? Symptoms? What is the most sensitive and specific test to diagnose it?

A
  • thrombosis and occlusion of the hepatic vein or supra hepatic portion of the IVC
  • Symptoms: ascites, jaundice, hepatomegaly +/- RUQ pain
  • Hepatic venography is the most sensitive and specific (Ultrasound is the best initial test)
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16
Q

What SAAG score indicates portal HTN?

A

SAAG >= 1.1

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17
Q

Treatment of SBP?

A
  • Cefotaxime or third generation cephalosporin x 5 days.

- Albumin =helps prevent hepatorenal

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18
Q

Lab test for suspected hemochromatosis (bronze diabetes)? Tx?

A
  • Ferritin and Transferrin

- Tx: phlebotomy

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19
Q

Lab test for Wilson’s? What foods should these people avoid?

A
  • Low ceruloplasmin

- high copper food: shellfish, organ meats, chocolate, nuts, mushrooms

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20
Q

Markers associated with autoimmune hepatitis?

A

-Anti-smooth muscle Ab, Liver kidney microsomal (LKM) antibodies

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21
Q

Risk for hepatic adenoma?

A

OCP

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22
Q

Ranson criteria?

A 
GA LAW, C HOBBS
Glucose
AST
LDH
Age
WBC
Ca2+
Hematocrit
Oxygen
BUN 
Base deficit
Sequestration of fluid
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23
Q

What is the treatment for Entamoeba histolytica?

A

Metronidazole or paromomycin

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24
Q

What is the treatment for Giardia lamblia?

A

Metronidazole

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25
Q

What is the treatment for Trichinella spiralis

A

Albendazole or mebendazole

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26
Q

What is the treatment for Cryptosporidium parvum?

A

Nitazoxanide

27
Q

What tests are used to evaluate for celiac disease?

A
  • anti-tissue transglutaminase Ab
  • Anti-gliadin Ab
  • Anti-endomysial Ab

-EGD with duodenal biopsy–> blunting of villi and hypertrophic crypts

28
Q

What is the triad associated with Plummer-vinson syndrome?

A

Esophageal webs, dysphagia, and iron deficiency anemia

29
Q

“Corkscrew” on Barium Swallow? Tx?

A

Diffuse Esophageal Spasm

-Tx: CCB and nitrates or TCA

30
Q

What is Barrett’s esophagus?

A

Metaplasia of the columnar cells of the distal esophagus

31
Q

Pt with bad breath and regurgitating food that was eaten several days ago?

A

Zener’s Diverticulum (right above the UES)

32
Q

Treatment of H. pylori?

A

-PPI, amoxicillin, clarithromycin

33
Q

What is a Cushing ulcer associated with?

A

Increased intracranial pressure -> increased gastric acid secretion

34
Q

How can you determine if a GI bleed is upper or lower?

A

NG lavage

35
Q

Medication for GI bleed if varices are suspected?

A

Octreotide (decrease splanchnic blood flow)

36
Q

Most common causes of SBO?

A
  • Adhesions
  • Bulge (incarcerated hernia)
  • Cancer
37
Q

Old man with abdominal pain, diarrhea, weight loss, arthralgia and neurological problems….diagnosis?

A

Whipple disease (Tropheryma whipplei)

38
Q

Intestinal biopsy showing lamina propria filled with fat droplets and PAS + foamy macrophages? Tx?

A

Whipple disease

-IV ceftriaxone then oral Bactrim for 12 months

39
Q

What is the D-Xylose test used for?

A

To test for passive absorption of carbohydrates.

  • Will be NORMAL in pancreatic insufficiency (does not need pancreatic enzymes to absorb).
  • Will be abnormal in celiac disease
40
Q

How do you calculate a stool osmotic gap? What value is osmotic diarrhea? Secretory?

A
  • Osmotic gap= 290 - 2(Na+stool + K+stool)
  • > 125–> osmotic diarrhea
  • secretory diarrhea
41
Q

Cause of a caucasian with foul-smelling diarrhea and iron deficiency anemia?

A

Celiac disease

42
Q

Recent immigrant from the Dominican Republic with foul-smelling chronic diarrhea with macrocytic anemia?

A

Tropical Sprue

43
Q

Chronic diarrhea + arthralgia + ataxia

A

Whipple Disease

44
Q

What skin finding is associated with Celiac?

A

Dermatitis herpetiformis

45
Q

Chronic diarrhea with a positive stool sudan stain and a normal D-xylose test. Cause?

A

Pancreatic insufficiency

46
Q

Most common food borne bacterial GI infection?

A

Salmonella

47
Q

“bacterial dysentery”? Treatment?

A
  • Shigella

- FQ, bactrim

48
Q

When should you do further studies for acute diarrhea? What is the workup?

A

Severe diarrhea: hypovolemia, bloody stools, fever, >6 stools/day, duration >1 week, severe abdominal pain, older age, immunocompromised.
-workup: fecal leukocytes, stool culture, +/- ova and parasites if immunocompromised, +/- giardia and E. histolytic if associated with surface water, c. diff toxin

49
Q

Rice water diarrhea

A

vibrio cholera. Agressive rehydration!!

50
Q

What parasitic infection can cause liver abscesses?

A

Entamoeba histolytica. Tx: metronidazole

51
Q

Rome Criteria for IBS?

A
  • recurrent abd pain for 3+ days/month/3months and 2 of the following:
  • Relief with defecation
  • onset associated with change in frequency of stool
  • onset associated with change of form of stool
52
Q

What serum lab findings can distinguish Crohn’s from UC?

A

Crohns=ASCA +

UC= pANCA +

53
Q

What unique image can you see on a plain film of a patient with ovules?

A

Double bubble

54
Q

How can a gallstone obstruct the normal propulsive ability of the bowel?

A

-can pass through a biliary-enteric fistula and become impacted in the ileum

55
Q

Carcinoid syndrome symptoms?

A

“Be FDR”

  • bronchospasm
  • flushing
  • diarrhea
  • right sided valvular disease
56
Q

Outpatient treatment of diverticulitis?

A
  • NPO

- FQ + metronidazole

57
Q

APC gene mutation?

A

Lynch syndrome (hereditary non-polyposis colon cancer)

58
Q

What is the best initial lab test in a suspected ZES? Then what?

A

-gastrin level –> if >1000 then do a secretin stimulation test

59
Q

Migratory thrombophlebitis (Trousseaus sign)?

A

can be a complication of pancreatic adenocarcinoma

60
Q

What is necrolytic migratory erythema associated with?

A

Glucagonoma

61
Q

What meds can stop insulin production in an insulinoma

A

Diazoxide and octreotide

62
Q

Best test for acute cholangitis?

A

ERCP

63
Q

“porcelain gall bladder” (with calcifications) seen on US?

A

Gallbladder cancer

64
Q

What patients are at risk for acalculous cholecystitis?

A
  • Critically ill patients

- TPN

Step 2/Level 2 (18 decks)

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