GI Flashcards
gm neg bacteria that leads to diarrhea and is also linked to guillain barre (GBS)
campylobacter jejuni
white nails with “ground glass” appearance
distal band of reddish brown
seen in liver dz (ie cirrhosis)
Terry’s nails
true or false…
sulfasalazine is first drug of choice for inflammatory bowel disease
true
prolonged PPI use can decrease what levels?
B12
what can you give a person whos come into close contact w someone with Hep A and has not been previously vaccinated
immunoglobulin
what hemorrhoid stages for band ligation vs hemorrhoidectomy
band ligation= stge I, II or III
hemorrhoidectomy for stage III or IV hemorrhoid with chronic bleeding or a stage II hemorrhoid that is acutely thrombosed.
It is recommended that patients with a single first-degree relative with colon cancer diagnosed at or after age 60 should begin screening at age….
40
*with colonscopy
chief cells produce…
pepsinogen
pepsinogen –> pepsin in acidic environment
HCL is secreted by….
parietal cells
gastrin
histamine
Ach
all stimulate…
parietal cells (which produce HCl)
somatostatin (delta cells) inhibits…
gastrin
large intestine does mostly what absorption?
water
most of the small intestine absorption is done by the…
duodenum
secretin and CCK are in the…
duodenum
3 MC causes of infectious esophagitis
candida
CMV
HSV
linaer, yellow white plaques on EGD
candida
tx= fluconazole PO
large superficial, shallow ulcers on EGD
CMV
tx= gancilovir
small, deep ulcers on EGD
HSV
*tx= acylovir
first line dx= endoscopy
if endoscopy normal, esophageal manometry
gold standard- 24h ambulatory pH
GERD
loss of Auerbachs plexus
achalasia
failure of LES relaxation, lack of peristalsis
*dysphagia to both solids and liquids
gold standard- esophageal manometry
**“birds beak of LES”
achalasia
pharyngoesophageal pouch
dysphagia, regurg of undigested food
dx- barium swallow
(fake diverticulum bc only mucosa involvement)
Zenker’s diverticulum
*if lg enough, remove diverticulum
small, can observe
full thickness rupture of distal esophagus
*RF= repeated vomiting (ie bulimia, etoh)
crepitus, pneumomediastinum
dx= chest CT
boerhaave’s syndrome
**must repair surgically
longitudinal mucosal lacerations of gastroesophageal junction or gastric cardia
Mallory weiss tear
*us self limiting
MC type of hiatal hernia
GE junction and stomach slide into mediastinum
Type 1 (sliding)
MC esophageal neoplasm
RF= tobacco, etoh
upper 1/3 of esophagus
squamous cell
RF= Barrett’s esophagus
lower 1/3 of esophagus
Adenocarcinoma
MC cause of gastritis
H. pylori
h.pylori 3 drug treatment
CAP
Clarithromycin
Amoxicillin
PPI
(can do flagyl instead of amox if PCN allergy)
which is MC, duodenal or gastric ulcers
duodenal
which ulcer gets better w food?
duodenal
(gastric gets worse w food)
gastrinomas (gastric secreting neuroendocrine tumors)
*multiple peptic ulcers
*“kissing” ulcers
Zollinger Ellison syndrome
MC in duodenal wall (also seen in pancreas)
MC type of gastric cancer
Adenocarcinoma
*biggest RF= h.pylori
linitis plastica on upper endoscopy
gastric ca
*MC=adenocarcinoma
usually presents 3-12 weeks of life
*string sign
pyloric stenosis
hepatic vein obstruction
*can be primary (due to hepatic vein thrombosis, MC)
or can be secondary to hepatic vein occlusion due to tumor obstruction
Budd-Chiari syndrome
decreased liver drainage, portal HTN, cirrhosis
triad:
- ascites
- hepatomegaly
- RUQ pain
*can also get jaundice
Budd-Chiari Syndrome
management of Budd-Chiari syndrom
- TIPS
- angioplasty w stent
- anticoag meds
- ascites management
increased indirect bili
prehepatic
hemolytic
increased direct bili
post-hepatic
bile duct blockage
pancreatic ca
increased both direct and indirect bili
intra-hepatic
lactulose
neomycin
protein restriction
*can be used in management of encephalopthy due to…
acute hepatic failure
AST > 2x ALT seen in…
alcoholic hepatitis
only hepatitis associated with spiking fevers?
Hep A
(feco-oral transmission)
tx of hep A
self limiting, supportive
*can give HAV immune globulin for close contacts that are not immunized
labs show only positive anti-HBs (surface antibody)
immunization against Hep B
any anti-HBc (core antibody) suggests…
Hep B infection
IgM= acute IgG= chronic
jaundice seen when bili gets above..
2.5
free copper accumulation in liver, brain, kidney, cornea
kayser-fleischer rings
Wilsons disease
glucose > 200
Age > 55
LDH > 350
AST > 250
WBC> 16,000
Ransons criteria for pancreatitis
higher the score, higher the mortality
MC type and location of pancreatic cancer
Adenocarcinoma
head of pancreas
CEA, CA-19-9 are tumor markers associated with
pancreatic cancer
- vomiting
- abdominal pain
- passage of blood per rectum, currant jelly stools
intussusception
barium contrast enema is diagnostic and therapeutic for
intussusception
Endomysial IgA Ab
transglutaminase Ab
Small bowel biopsy
Celiac dz
diverticulitis tx
cipro and flagyl
colon > 6 cm
toxic megacolon
which is transmural, chrons or UC?
chrons
MC location of Chrons
terminal ileum
+ ASCA
chrons
+P-ANCA
Ulcerative colitis
true or false
progression of IBD treatment:
- aminosalicylates (sulfasalazine, mesalamine)
- steroids
- immune modifying agents
true
polyp with the highest risk of becoming cancerous
villous adenoma
inguinal canal tract
MC in young kids and young adults
R side more common
**lateral to epigastric vessels
indirect hernia
weakness in Hesselbach’s triangle
does not reach scrotum
direct hernia
inferior epigastric vessels (artery)
rectus muscle/sheath
inguinal ligament
Hesselbach’s triange
*direct hernias go thru this
two hernias MC in women
femoral
obturator
at what age do you repair an umbilical hernia in a kid?
5 yo
this deficiency leads to pellagra:
- diarrhea
- dementia
- dermatitis
Niacin (B3)
