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wolfpacc clues > GI > Flashcards

GI Flashcards

1
Q

What GI disease has a Corkscrew on X-Ray?

A

Esophageal spasm and Volvus

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2
Q

What GI disease has an Apple Core on X-Ray?

A

Colorectal Cancer

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3
Q

What GI disease has a stacked coin on X-Ray?

A

Intussusception

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4
Q

What GI disease has a Thumb Print on X-Ray?

A

Toxic Megacolon

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5
Q

What GI disease has an Abrupt Cut off on X-Ray?

A

Volvulus

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6
Q

What GI disease has Barium Clumping on X-Ray?

A

Celiac Sprue

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7
Q

What GI disease has a Bird’s Beak on X-Ray?

A

Achalasia (Think Chagas disease)

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8
Q

What GI disease has a String Sign on X-Ray?

A

Pyrloric Stenosis and Crohn’s Disease

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9
Q

What GI diseases are the causes of solid and liquid dysphagia?

A

Schatzki’s Rings, Stricture, Cancer

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10
Q

What GI diseases are the causes of liquid Dysphagia?

A

Scleroderma and Achalasia

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11
Q

What is Barrett’s Esophagus?

A

Metaplasia of the lower esophagus increased risk of Adenocarcinoma

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12
Q

What are Esophageal Varices?

A

Due to Portal HTN, vomit large amounts of blood when they rupture

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13
Q

What is Mallory-Weiss?

A

Tearing of the lower esophageal sphincter (LES), associated with chronic vomiting, cough up a little blood and possible visible varices

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14
Q

What is Boerhaave Syndrome?

A

Transmural tearing of the Esophagus. Left Sided most common, pneumonia/Pain/Effusion

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15
Q

What is Achalasia?

A

Increased LES Pressure (no Auerbach’s Plexus), Bird’s Beak on X-Ray and also seen in Chagas Disease

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16
Q

What is Hirschprungs Disease?

A

Failure of innervation to the rectum (No Auerbach’s Plexus), lack of meconium passage in the newborn, Neural crest cell migration problem

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17
Q

What is Zenker’s Diverticulum?

A

Cough up undigested food from above the UES, Halitosis, motor dysfunction problem

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18
Q

What is a Traction Diverticulum?

A

Out pouch between the UES and LES

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19
Q

What is Plummer-Vinson Syndrome?

A

esophageal webbing at the UES, spoon nails from iron deficiency anemia

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20
Q

What is Schatzki’s Ring?

A

Esophageal webs in the lower Esophagus

Dysphagia (mucosal tissue)

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21
Q

What is a Tracheoesophageal (TE) Fistula (H-Type)?

A

Chokes with each feeding and is Congenital

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22
Q

What is an Esophageal Atresia with a TE Fistula (C-Type)?

A

Baby vomits with first feeding, large gastric bubble and distended abdomen (failure of apoptosis)

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23
Q

What is duodenal Atresia?

A

Bilious vomiting with first feeding, double bubble sign on x-ray, associated with Downs Syndrome

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24
Q

What is Pyloric Stenosis?

A

Non-bilious projectile vomiting (3-4 week old) and RUQ Olive Mass on Palpation

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25
Q

How does Choanal Atresia Present?

A

Baby turns blue with feeding, pinks up when breast of bottle is removed (blocked nasal passages)

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26
Q

How does Tetrology of Fallot (TOF) present differently from Choanal Atresia?

A

TOF Babies… Turns blue with crying and has No feeding issues

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27
Q

What makes Scleroderma Unique?

A

Can have a decreased LES pressure or and increased LES pressure

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28
Q

What makes Esophageal Spasms Unique?

A

Increased Peristalsis

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29
Q

What makes Achalasia unique?

A

Decreased Peristalsis and increased LES pressure

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30
Q

What GI disease has a RUQ Olive Mass?

A

Pyloric Stenosis

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31
Q

What GI diseases has a RLQ Sausage mass?

A

Intussusception

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32
Q

What is a Bezoar?

A

Mass of non-digestible product (i.e. Hair) causing an occlusion at the pylorus

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33
Q

What is Type A gastritis?

A

Upper GI bleed, autoimmune (anti-parietal cell antibodies), Atrophic / Achlorhydria and increased risk for adenocarcinoma (body & fundus region of the stomach)

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34
Q

What is Type B gastritis?

A

Upper GI bleed, associated with eating spicy foods, loss of barrier protection and H. Pylori infections (antrum of stomach)

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35
Q

What is a Duodenal Ulcer?

A

Pain 20-30 minutes after eating, relieved with food, caused by H. Pylori infection 80-90% of the time and weight gain

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36
Q

What is a Gastric Ulcer?

A

Loss of protective barrier, pain during the meal, associated with NSAIDs, H. Pylori infection and weight loss

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37
Q

What is a Sliding Hiatal Hernia?

A

Fundus of the stomach herniates through the Esophageal Hiatus into the Thorax

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38
Q

What is a Rolling Hiatal Hernia?

A

Bowel Protruded through a defect in the Diaphragm. This can strangulate the bowel and can cause Atelectasis

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39
Q

What is Menetrier’s Disease?

A

Loss of protein through the rugal folds. Causes generalized edema. CMV association in children and H. Pylorus in Adults

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40
Q

What defines constipation?

A

Less than 3 bowel movements per week

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41
Q

What defines Diarrhea?

A

> 200 grams of stool per day

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42
Q

What is Osmotic Diarrhea?

A

High osmolality in the bowel pulling water into the lumen

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43
Q

What is Secretory Diarrhea?

A

Water pushed from cells into the gastric lumen (increased cAMP)

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44
Q

What is Inflammatory Diarrhea?

A

Diarrhea with blood and pus

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45
Q

What is Celiac Sprue?

A

Found in the Jejunum
Wheat Allergy
Villous atroph
Anti-gluter-gliadin antibodies

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46
Q

What is Tropical Sprue?

A

Found in the distal ilium
Caused by bacterial or viral, amoeba or parasitic infection
Villous atrophy

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47
Q

What is Mesenteric Ischemia?

A

Abdominal pain of of proportion to physical exam

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48
Q

What bugs cause Bloody Diarrhea?

A

“CASES”: Campylobacter, AMoeba (Entamoeba Histolytica), Shigella, E. coli and Salmonella

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49
Q

What is Primary Biliary Cirrhosis?

A

Anti-Mitochondrial antibody Bile ducts are destroyed

Xanthelasmas present and pruritis

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50
Q

What is Primary Sclerosing Cholangitis?

A

Anti-smooth muscle antibody (20-50%), bile ducts are scarred from inflammation, there is beading and onion skinning, it’s associated with UC and P-ANCA (80%)

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51
Q

What is Ascending Cholangitis?

A

Common bile duct infection due to stones

52
Q

What are the physical signs of Alcoholic Cirrhosis?

A

Spider Angioma, Palmar Erythema, Gynecomasatia and Dupuytren’s Contracture

53
Q

What is Hepatorenal Syndrome?

A

Build up of liver toxins that cause renal failure

54
Q

What is Cholangitis?

A

Inflamed bile duct

55
Q

What is Cholecystitis?

A

Inflammation of the gallbladder

56
Q

What is Cholelithiasis?

A

Formation of gallstones

57
Q

What is Choledocholithiasis?

A

Gallstone obstructs the bile duct

58
Q

What is Cholestasis?

A

Obstructed bile duct

High Alk Phos (if in the common bile duct)

59
Q

What is Conjugated Bilirubin?

A

Water soluble and direct Bilirubin

60
Q

What is Unconjugated Bilirubin?

A

Fat soluble and indirect Bilirubin

61
Q

What is the most common type of Gallstone?

A

Cholesterol stone (not see on X-ray)

62
Q

What type of Gallstone can be seen on X-Ray?

A

Calcium Bilrubinate stone

63
Q

What is a Xanthoma

A

Cholesterol build up (common at the elbow or Achilles tendon)

64
Q

What is a Xanthelasma?

A

Triglyceride build up and is seen under the eyes (Xanthoma subtype)

65
Q

What can high Cholesterol Cause?

A

Atherosclerosis

66
Q

What can high Triglycerides Cause?

A

Pancreatitis

67
Q

What is Type 1 Hyperlipidemia?

A

Defective Liver Lipoprotein Lipase (chylomicrons are elevated)

68
Q

What is Type 2A Hyperlipidemia?

A

Defective LDL-Clathrin Pit or B-100 (LDL are elevated)

69
Q

What is Type 2B Hyperlipidemia?

A

Deficiency of adipose receptors and LDL receptors (Increased LDL and VLDL levels)

70
Q

What is Type 3 Hyperlipidemia?

A

Defective ApoE (Elevated ILD)

71
Q

What is Type 4 Hyperlipidemia?

A

Defective Adipose Lipoprotein Lipase, elevated VLDL

72
Q

What is Type 5 Hypderlipidemia?

A

Defective enzyme and receptor (C-II)
Elevated VLDL and Chylomicrons
Associated with DM

73
Q

What do Chylomicrons do?

A

They take Triglycerides (TG) from GI to liver and endothelium

74
Q

What does VLDL do?

A

It takes TG’s from liver to adipose

75
Q

What does IDL do?

A

It takes TG’s from adipose to tissue

76
Q

What does LDL do?

A

It carries Cholesterol (only one to do this)

77
Q

Where is VLDL made?

A

Liver

78
Q

What are the breakdown products of VLDL?

A

IDL and LDL

79
Q

What is the treatment for hypercholesterolemia?

A

Statins

80
Q

What is the only statin to undergo renal excretion?

A

Pravastatin

81
Q

What blood level should be monitored in patients taking statins?

A

Liver enzymes every 3 months and Serum Cr

82
Q

What is the MOA of Statins?

A

Inhibit HMG CoA reductase

83
Q

What is Crigler-Najjar Type I?

A

Unconjugated bilirubin buildup
Newborn or infants
No UDP-GT
Phenobarbital yields no change

84
Q

What is Gilbert’s Syndrome?

A

Stress induced elevated
Unconjugated Bilirubin
Increased load saturates Glucuronyl Transferase

85
Q

What is Rotor’s?

A

Defective Bilirubin storage and Elevated Conjugated Bilirubin

86
Q

What is Dubin-Johnson?

A

Defective Bilirubin storage
BLACK LIVER
Increased conjugated bilirubin

87
Q

What is Cullen’s SIgn?

A

Bruising around the umbilicus

Caused by hemorrhagic pancreatitis (late sign)

88
Q

What is Grey-Turner’s Sign?

A

Bleed into Flanks and caused by Hemorrhagic Pancreatitis (early signs)

89
Q

What tests are used for following Pancreatitis?

A

Amylase (sensitive) breaks down Carbohydrates and Lipase (specific) breaks down Triglycerides

90
Q

What will Ranson’s criteria tell you and what will you see at 48 hours?

A

Prognosis of Pancreatitis patients
BUN >5 mg/dL (decreased RBF)
Calcium <8mg/dL (saponification)
HCT drops >10% (bleeding into pancreas)
sequester > 6 liters of fluid (3rd spacing)
Oxygen pO2 <60 mmHg (fluid/protein leak, leads to ARDS)
base deficit >4 mEq/L (diarrhea due to no pancreatic enzymes)

91
Q

What is Carcinoid Syndrome (Triad)?

A

Diarrhea, flushing and wheezing

92
Q

What is Peutz Jegher Syndrome?

A

Hyper-pigmented lower lip, patients will have dark gyms and vagina, and small bowel polyps

93
Q

What produces Currant Jelly Sputum

A

Klebsiella

94
Q

What produces Currant Jelly stool?

A

Intussusception

95
Q

What is Turcot’s Syndrome?

A

Familial Polyposis with Brain Tumors

96
Q

What is Gardener’s Syndrome

A

Familial Polyposis with Bone Tumors

97
Q

What is Familial Polyposis?

A

100% ridk of Colon Cancer, APC gene defect and annual Colonoscopy start at 5 years of age

98
Q

What is Ulcerative Colitis?

A

Starts at the rectum and ascends,
1%/year risk for CA
IBD with Pseudopolyps, hematochezia, Lead pipe colon and Toxic Megacolon

99
Q

What is Crohn’s Disease?

A

Transmural, Cobblestones, Melena, Creepig Fat, Fistula, Skip lesions

100
Q

What is Intussusception?

A

Currant Jelly Stool, Stacked Coin Enema, sausage shaped mass and knees to chest for comfort

101
Q

How does Diverticulosis Present?

A

Gross blood

102
Q

How does Diverticulitis present?

A

Pain in LLQ, no visible blood and may cause peritonitis

103
Q

How does Spastic Colon present?

A

Intermittent severe cramps

104
Q

How does Irritable Bowel Syndrome (IBS) present?

A

Alternating diarrhea/ constipation
History of stress
No abnormalities on colonoscopy

105
Q

What is Pseudomembranous Colitis?

A

Overgrowth of C. Diff

Due to normal flora being killed off from long term antibiotic use

106
Q

What is Whipple’s Disease?

A 
Tropheryma Whipplei (T. Whipplei) destroy the GI tract
Causing Malabsorption/Arthralgia, PAS (+)
107
Q

What color is stool with an Upper GI Bleed?

A

Black (Dark Red) (Melena)

108
Q

What color is stool with a Lower GI Bleed?

A

Bright Red Blood (Hematochezia)

109
Q

What adds color to Stool?

A

Stercobilinogen being oxidized to stercobilin

110
Q

What gives urine its yellow color?

A

Urobilinogen being oxidized to urobilin

111
Q

What is the common side effect of the ERCP procedure?

A

Pacreatitis from blocking the pancreatic duct during the procedure

112
Q

What is Charcot’s Triad?

A

Jaundice, Fever (usually with rigors) and RUQ pain

113
Q

What is Reynold’s Pentad?

A

Jaundice, Fever (usually with Rigors), RUQ Pain, Hypotension and change in mental status

114
Q

What separates unconjugated bilirubin from albumin?

A

Sulfur (no Sulfur Rx in pregnancy)

115
Q

What does Sudan Black Stain test for?

A

Steatorrhea (fat malabsorption), patient seen with chronic pale, greasy, malodorous diarrhea and no evidence of infection

116
Q

What are the risk factors for Primary Liver Cancer?

A

Hepatitis B & C, Aflatoxin, Alcohol, Smoking and Hemochromatosis

117
Q

What are the risk factors for Esophageal / Gastric CA?

A

Smoking, alcohol and nitrates

118
Q

What are the bacteria associated with Colon CA?

A

Clostridium Melanogosepticus and Streptococcus Bovis

119
Q

What Hepatitis B labs indicate an acute recent infection?

A

HBcAg+, HBsAg+, (HBcAb+/-)

120
Q

What hepatitis B labs indicate recent immunization within >2/52wks?

A

HBsAg+

121
Q

What hepatitis B labs indicate immunization >2/52 weeks?

A

HBsAb+

122
Q

What hepatitis B labs indicate previous infection and now immunity?

A

HBcAb+, HBsAb+, HBsAg-

123
Q

What hepatitis B labs indicate infectious state?

A

HBeAg+

124
Q

What hepatitis B labs indicate non-infectious state?

A

HBeAg-

125
Q

What hepatitis B labs indicate a chronic carrier state?

A

HBsAg+, (>6 months), HBsAb (+/-)

126
Q

What hepatitis B labs indicate that the patient is in the window period?

A

HBeAb+, HBcAb+, HBsAg-

127
Q

What are the bugs that cause gastroenteritis within 8 hours of eating the preformed toxin?

A 
Staph Aureus (potato salad)
Clostridium Perfringens (holiday turkey/ham)
Bacillus Cereus (fried rice syndrome)

wolfpacc clues (16 decks)

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