GI Flashcards

1
Q

acute gastritis from

A

imbalnace btwn mucosal defense and acidic enironment

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2
Q

when does pyloric stenosis present

A

2 weeks after birth

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3
Q

napkin ring lesion with decreased stool caliber LLQ pain and bloody stool

explain napkin ring lesion

A

left sided carcinoma

napkin ring: grows around entire lumen and sqeeuzes down on the lumen = thinner stool

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4
Q

progressvie dysphagia (solids to liquids) weight loss, pain, hematemesis

A

esophageal carcinoma

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5
Q

zenker diverticulum

location
true or false
presents with what

A

outpouching of pharyngeal ucosa through defect in musclar wall (false divert)

arises above upper esophageal sphincter at junction of esophagus and pharynx

dysphagia, obstruction, halitosis

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6
Q

UC or crohns: lymphoid aggregates with granulomas

A

crohns

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7
Q

location in duodenum of PUD

A

anterior

when posterior can rupture and lead to bleeding from gastroduodenal artery or acute pancreatitis

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8
Q

benign cystic tumor with abundant lymphocytes and germinal centers (LN like stroma)
ssecond most common tumor of salivary gland

  • which gland?
A

warthin tumor

mostly in parotid

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9
Q

UC or crohns: strictures and string sign on image

A

crohns

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10
Q

esophageal varices presents with ___ hematemesis

A

painless

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11
Q

achalasia increase risk of what

A

esophageal SCC

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12
Q

most common site of h pylori in chronic gastritis

A

antrum

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13
Q

UC or crohns: pseudopolpys, loss of haustra, lead pipe sign

A

UC

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14
Q

UC or crohns: crypt abscesses with neurophils

A

UC

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15
Q

rare presentation with gastric carcnioma

A

acanthsis nigricans or leser trelat sign which is seb keratosis all over skin

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16
Q

omphalocele

A

persistent herniation of bowel into umbilical cord
covered by peritoneum and amnion of umbilical cord

cele = covered

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17
Q

adenomatous polyps due to

risk

A

neoplastic proliferation of glands

benign, but premalignant, may progress to adenocarcinoma

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18
Q

bilateral inflamed parotid glands infection

what other findings

A

mumps

orchitis, pancreatitis, aseptic meningetis

-sterility and increased serum amylase

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19
Q

defeneses for acute gastritis are

A

mucin from foveolar cells
bicarb from surface eptihelium
normal blood supply (provides nutrients)

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20
Q

____ is serum tumor marker that is useful for assessing treatmetn response and detecting recurrence of colorectal cancer

A

CEA

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21
Q

chronic autoimmune gastritis
overall
type of HS

A

autoimune destruction of gastric parietal cells which are in stomach body and fundus

abs against parietal cells or IF
-type IV HS

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22
Q

colonic carcinoma is associated with an increased risk for ___ ____ endocarditis

A

strep bovis

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23
Q

serrated colonic polyps

A

hyperplastic polyps
most common
benign, no malignant potential

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24
Q

recurrent aphthous ulcers, genital ulcers, uveitis
due to immune complex vasculitis
can be seen after viral infection

A

bechet syndrome

HLA B27

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25
Q

UC or crohns: cobblestone mucsoa

A

crohns

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26
Q

relapsing abdominal pain, bloating, flatulence, and change in bowel habits that improves with defecation

A

IBS

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27
Q

FAP with fibromatosis and osteomas

A

gardner syndrome

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28
Q

UC or crohns: smoking protects against

A

UC

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29
Q

clinical features of hirschprung disease

A

failure to pass meconium
empty rectal vault on DRE
massive dilation bowel proximal to obstruction

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30
Q

rules of 2 meckeles

A

2% of pop
2 inches long within 2 feet of ileocecal valve
first 2 yeears of life

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31
Q

lymph node spread

upper 1/3
middle 1/3
lower 1/3

A

upper: cervical nodes
middle: mediastinal or tracheobronchial nodes
lower: celiac and gastric nodes

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32
Q

UC or crohns: LLQ pain with bloody diarrhea

A

UC

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33
Q

clinical features of achalasia

A

dysphagia for solids AND liquids
putrid breath
high LES pressure on esophageal manometry
bird beak sign

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34
Q

rectal bleed, diverticulitis, with LLQ pain, fistula with air or stool in urine

A

colonic diverticula

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35
Q

malignant tumor composed of mucinous and squamous cells
most common malignant tumor of salivary gland
usually in parotid and involves facial nerve

A

mucoepidermoid carcinoma

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36
Q

hamartomatous polyps throughout GI tract and mucocutaneous hyperpigmentation on lips oral mucosa and genital skin

A

peutz jeghers q

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37
Q

whipple disease site

A

small bowel lamina propria
foamy macrophages that are PAS postive
macrpohages compress lacteals so chylomicrons cannot be transferred from enterocytes to lympathics = fat malabosrption and steatorrhea

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38
Q

older adult with IDA has

A

colorectal carcinoma until proven otherwise

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39
Q

main causes of gastric ulcer

A

h pylori and NSAIds

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40
Q

esophageal web increases risk for what

A

esophageal SCC

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41
Q

UC or crohns: full thickness inflammation with kinfe like FISSURES

A

crohns

42
Q

risk factors with h pylori chronic gastritis

A

gastric adenocarcinoma and MALT lymphoma

43
Q

greatest risk for progression of adenoma to carcinoma is what

A

size over 2 cm, sessile growth, and villous histology

44
Q

most common tumor of salivary gland

A

pleomorphic adenoma

45
Q

duodenal biopsy of celiac

most damage where

A

flat villi
hyperplasia of crypts
increased lymphocytes
most damage at duodenum (think kristis dude scott)

46
Q

UC or crohns: anywhere from mout to anus with skip lesions

A

crohns

47
Q

abetalipoproteinemia
inheritance
defect
CF

A

AR
no B-48 or B-100

CF: malabsorption
no vldl and ldl

48
Q

diagnostic endoscopic biopsy of duodenal ulcer

A

hypertrophy of brunner glands

49
Q

2 types of chronic gastritis

A

chronic autoimmune gastritis

chronic h pylori gastritis

50
Q

achalasia is due to

A

damaged ganglion cells in the myenteric plexus
located btwn inner circular layer and outer longitdunal layer of musc propria

can be sen in trypans cruzi

51
Q

meckel diverticulum is what from what

A

outpouch of all 3 layers (true divert)

failure of viteline duct to involute

52
Q

distant metastasis of gastric carcinoma mainly with

A

liver or krukenberg

53
Q

tumor that arises in parotid, presents as mobile, painless circumscribed mass at angle of jaw and has high rate of recurrence bc of irregular margins

A

pleomorphic adenoma

54
Q

UC or crohns: toxic megacolon and carcinoma

A

UC

55
Q

turcot syndrome

A

FAP with CNS tumors (medulloblastoma and glial tumors)

think turbin

56
Q

adenoma carcinoma seq

A

APC mutation = increase risk for polyp
K-ras = formation of polyp
p53 = increased COX = progression to carcinoma
aspirin impedes this

57
Q

APC chromosome

A

5

58
Q

creeping fat

A

crohns

59
Q

inheritance of peutz jeghers and risk for what

A

AD

colorectal, breast, and gynecologic cancer

60
Q

prognosis FAP

A

must remove colon and rectum or will get carcinoma by 40 yrs old

61
Q

DNA mismatch repair enzyes with HNPCC is increased risk for what cancers

A

lynch and COE

colorectal, ovarian, endometrial

62
Q

duodenal atresia associated with and CF

A

with DS
polyhydramnios
double bouble sign
bilious vomiting

63
Q

plummer vinson syndrome triad

A

jake plummer out for BAE

beefy red tongue (atrophic glossitis)
anemia
esophageal webs

64
Q

laboratory findings celiac

A

IgA antibodies against endomysium, tTG, or gliadin

IgG antibodies present and useful for diagnosis in individuals with IgA def (increased in pts with celiac)

65
Q

hirschsprung disease is associated with what

A

down syndrome

66
Q

late complications of celiac

A

small bowel carcinoma and

t cell lymphoma

67
Q

risk factors acute gastritis

A

curling ulcer–> hypovolemia = decreased blood supply
NSAIDs
heavy alcohol
chemo
cushing ulcer = increased vagus nerve stim = increased acid production

shock

68
Q

clinical features of GERD

A

heartburn
adult onset asthma and cough
damage to enamel of teeth
ulceration with stricture and barret esophagus later

69
Q

UC or crohns: malabdorption with nutritianl def

calcium oxalate nephrolithiasis, fistual formation

A

crohns

70
Q

which carcinoma may have hoarse voice too

A

SCC of esophagus

recurrent laryngeal nerve

71
Q

squamous cell carcinoma in oral cavity

  • risk factor
  • most common location
  • precursor lesion
A

alcohol and tobacco
floor of mouth
oral leukoplakia and erythroplakia are precursor lesions

72
Q

sessile growth

A

no stalk connecting to lining

73
Q

benign tumor with stromal (cartilage) and epithelial tissue

A

pleomorphic adenoma

74
Q

UC or crohns: rectum and extend proximal to cecum with involvment continuous

A

UC

75
Q

outpouching of mucosa and submucosa through muscularis propria in colon

A

colonic diverticula

false

76
Q

age of colorectal screening

A

50

77
Q

clinical features chronic gastritis

A

atrophy of mucosa and intestinal metaplasia
achlorhydria with increased gastrin level and antral G cell hyperplasia

megaloblastic anemia bc no IF

increased risk gastric adenocarciom (intestinal type)

78
Q

FAP inheritance

A

Auto dom

APC gene mutation chrom 5

79
Q

gastric ulcer can be caused by gastric carcinoma (intestinal subtype)

benign vs malignant look like

A

beining peptic ulcers that are punched out with radiating folds of mucosa

malignant ulcers are large and irregular with heaped up margins

80
Q

autosomal dominant disorder resulting in thin walled BVs especially in the mouth and GI tract

A

hereditary hemorrhagic telangiectasia

81
Q

epigastric pain ulcer that gets better with meals

A

duodenal ulcer

82
Q

no involution of vitteline duct

A

menconium in umbillicus

83
Q

SCC of esophagus arises where

and risk factors

A

middle third or upper third

alcohol and tobacco
very hot tea
achalasia (food stuck, rots)
esophageal web 
esophageal injury from lye ingrestion in hair straightner
84
Q

sialadenitis cause and bacteria

A
obstructing stone (sialolithiais)
staph aureus
85
Q

in children most common cause of intussusception is

where
adults cause?

A

lymphoid hyperplasia due to rotavirus
in terminal ileum
into cecum

tumor in adults

86
Q

similar to celiac but after infectious diarrhea

damage is where

A

tropical spure

jejunum and ileum

87
Q

large irregular ulcer with heaped up margins at lesser curvature of the antrum

A

intestinal type gastric adenocarcinoma

88
Q

carcinoid heart disease

A

characterized by right sided valvular fibrosis = tricuspid regurge and pulmonary valve stenosis
no left involvement bc monoamine oxidase in lung

89
Q

UC or crohns: rlq pain with no blood in diarrhea

A

crohns

90
Q

UC or crohns: terminal ileum most common

A

crohns

91
Q

what would be sign of pleomorphic adenoma becoming carcinoma

A

signs of facial nerve damage

rare

92
Q

treatment for pyloric stenosis

A

myotomy

93
Q

location of ischemic colitis and main cause

A

splenic flexture

atheroscleoris of SMA most common cause

postprandial pain and weight loss

94
Q

raised lesion with iron deficiency anemia (bleeding) and vague pain

A

right sided carcinoma

95
Q

UC or crohns: mucosal and submucosal ulcers

A

UC

96
Q

tracheoesophageal fistual presents with

A

vomiting, polyhydramnios, and abdominal distension and aspiration

97
Q

risk factors of GERD

A

lose LES tone

alcohol, tobacco, obestity, fat rich diet, caffeine, hiatal hernia

98
Q

microsatellite instability colorectal carcinoma

A

microsatellites are repat seq of noncoding DNA
instability indicates defective DNA copy mech (DNA mismatch repeair enzymes)
HNPCC due to inherited mutations in DNA mismatch repeair enzymes

colorectal carcioma arises de novo (no adenomatous polyp) at early age and is right sided

99
Q

duodenal ulcer main cuase

A

h pylori

rarely ZE syndrome

100
Q

risk factors intestinal type gastric adenocarcinoma

A

h pylori
autoimmune gastritis
nitrosamines
blood type A