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- Med School Review 🔥 > GI > Flashcards

GI Flashcards

1
Q

TPN + RUQ pain

A

Cholesterol gallstones 2/2 GB stasis

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2
Q

Pneumaturia

A

Colovesical fistula

(Diverticulitis, Crohn, or CRC)

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3
Q

Epigastric burning + postprandial bloating

A

PUD

(2/2 H. pylori, NSAIDs, GERD)

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4
Q

Duodenal ulcer in young pt

A

H. pylori

(Triple PAC or BisMuTh PPI Quadruple Therapy)

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5
Q

Abd pain that improves w/ eating and worse w/ empty stomach; wakes pt up at night

A

Duodenal ulcer

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6
Q

Transudative pleural effusion thru small diaphragmatic defects in setting of ascites

A

Hepatic hydrothorax

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7
Q

Cause of ascites

A

Splanchnic vasodilation from cirrhosis-induced portal HTN

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8
Q

Platypnea + orthodeoxia

A

Hepatopulmonary syndrome

(increased dyspnea and oxygen desaturation respectively while upright)

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9
Q

Intrapulmonary vascular dilations in setting of chronic liver disease

A

hepatopulmonary syndrome

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10
Q

Ascites Tx

A

Fluid & salt restriction, diuretics

(Spironolactone + Furosemide)

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11
Q

Diagnostic test for Zenker’s diverticulum

A

Contrast esophagram

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12
Q

Wilson’s disease

(Copper) age of onset

A

5-35yo

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13
Q

More specific LFT for liver injury

A

ALT

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14
Q

Esophageal variceal PPX (non-bleeding)

A
  • Nonselective BBs (propranolol, nadolol), or
  • Endoscopic variceal ligation (contraindication to BBs)
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15
Q

“Alligator skin” on colonoscopy

A

Laxative abuse

(melanosis coli)

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16
Q

Dark brown colonic mucosal pigmentation on colonoscopy

A

Laxative abuse

(factitious diarrhea)

[Melanosis coli]

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17
Q

Hospital worker

A

Factitious

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18
Q

Symptom relief after BM

A

IBS

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19
Q

Intense pain to lightly brushing periumbilical skin

A

VZV reactivation

(shingles; pain may precede dermatomal rash by several days)

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20
Q

Biggest reversible risk factor for pancreatic cancer

A

Smoking

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21
Q

Biggest reversible risk factor for MALT lymphoma

A

H. pylori

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22
Q

Tx for acetaminophen-induced ALF

A

Liver transplant

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23
Q

Most common cause of death in ALF (acute liver failure)

A

Cerebral edema

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24
Q

Secretin stimulation test

A

2nd line test for non-diagnostic elevations in fasting serum gastrin

(secretin specific to gastrinoma cell stimulation

[inhibits normal gastric G cells]); 3rd line = Calcium infusion study

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25
Q

Achlorydria

A

Failure of gastric acid secretion, leading to elevated gastrin levels that mimic ZES or PUD

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26
Q

High fasting serum gastrin level

A

Zollinger-Ellison Syndrome

(ZES; gastrinoma)

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27
Q

D-Xylose

A

Monosaccharide that does not require enzymes to be absorbed by the SI

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28
Q

D-xylose passes unabsorbed

A

Celiac disease

(malabsorption due to villous atrophy of the small intestine)

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29
Q

LGIB in young pt w/ no risk factors. Next step?

A

Anoscopy

(in-office) (likely hemorrhoids or rectal fissure)

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30
Q

N-acetyl-p-benzoquinone mine (NAPQI)

A

Hepatotoxic component of acetaminophen normally detoxified through glucuronidation

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31
Q

5-HIAA

A

Carcinoid Syndrome Dx

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32
Q

Carcinoid Dx

A

Elevated 24hr urinary 5-HIAA

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33
Q

Episodic flushing

A

Carcinoid syndrome

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34
Q

Most common cause of liver mass

A

liver met

(from CRC or pancreatic cancer)

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35
Q

+FOBT + Liver mass

A

CRC + Liver met

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36
Q

New-onset anemia in elderly pts

A

GI bleed until proven otherwise!

(colonoscopy & endoscopy)

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37
Q

All cirrhotics w/ ascites are ____ until proven otherwise!

A

SBP

(diagnostic paracentesis)

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38
Q

Palpable NONTENDER gallbladder

A

Pancreatic cancer

(Courvoisier sign; think painless jaundice = pancreatic cancer)

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39
Q

____ in cirrhosis leads to spider angiomas and palmar erythema

A

Hyperestrinism

(2/2 impaired hepatic metabolism of circulating estrogens (CYP450), which lead to vascular wall dilation)

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40
Q

Anti-SM vs. Anti-Smith

A
  • Anti-Smooth Muscle = AIH (Autoimmune Hepatitis; ANA+)
  • Anti-Smith = SLE (+Anti-dsDNA, Anti-phospholipid)
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41
Q

Epigastric pain improved when leaning forward

A

Chronic pancreatitis

(vs. pericarditis = chest pain)

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42
Q

Pancreatic calcifications on CT

A

Chronic pancreatitis

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43
Q

RUQ pain + fever post-operative or

in hospitalized pt

A

Acalculous cholecystitis

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44
Q

D-penicillamine

A

Copper chelator

(Wilson disease tx)

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45
Q

MALT Lymphoma

A

90% have hx of H. pylori

(smoking is NOT related to MALT, it is associated to gastric adenocarcinoma)

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46
Q

Abd pain after cholecystectomy

A

Postcholecystectomy Syndrome

(PCS)

  • Dx: Abd US —> ERCP
47
Q

Elevated LFTs + ANA+

A

Glucocorticoids

48
Q

Marker to screen for HCC in HCV or cirrhosis pts

49
Q

ACS drug that elevates LFTs

50
Q

Ursodeoxycholic Acid (UDCA)

A

Aka ursodiol: dissolves bile acids;

Treats: PBC, PSC, & cholecystitis in pt ineligible for surgery;

Hydrophilic bile acid used in treatment of PBC to delay histologic progression, improve sx, and possibly survival

51
Q

Pruritus & fatigue in middle-aged woman

52
Q

Bowel wall thickening, pneumatosis intestinalis & thrombus on abd CT

A

Mesenteric ischemia

53
Q

CBD dilation on Abd US or CT

A

Acute Cholangitis (AC)

54
Q

If not treated promptly (ERCP within 48 hours), acute cholangitis can lead to ____

A

Septic shock

55
Q

Intravenous Drug Use

A

HIV, HCV, Hepatitis, Endocarditis, Empyema

56
Q

The major cause of morbidity & mortality in alcoholic liver disease

A

Esophageal varices

57
Q

Tx of suspected variceal hemorrhage

(in cirrhosis pt)

A

AEIOVarices

  • Abx
  • Endoscopy (urgent)
  • IVF volume resuscitation
  • IV Octreotide
58
Q

Screen pt with ZES for ___

A

MEN1

(PTH, ionized calcium, prolactin)

59
Q

Sheep, dogs, or Southwest

A

Echinococcus tapeworm

(hydatid liver cysts)

60
Q

Long-term OCPs

A

Hepatic adenoma

61
Q

Elevated alk phos + GGT

A

Biliary compression or obstruction

62
Q

Most common source of liver metastasis

A

Colon cancer

63
Q

Elevated AFP, normal B-hCG

64
Q

Worsens GERD

A

Lying down, chocolate, peppermint

65
Q

Diarrhea that occurs even during fasting or sleep

A

secretory diarrhea

66
Q

Drug-induced pancreatitis

A

Diuretics, Valproic acid, MNZ

67
Q

5-ASA

A

Mesalamine (IBD)

68
Q

Empiric Tx for traveler’s diarrhea

A

Ciprofloxacin

(E. Coli)

69
Q

Tx for giardiasis

70
Q

Cancer caused by H. pylori

A

MALT lymphoma or gastric adenocarcinoma

71
Q

AST:ALT 2:1

A

Alcoholic hepatitis

72
Q

Most common site of metastasis in colon cancer

73
Q

Smoker

A

think CANCER (or COPD)

74
Q

PBC

A

Women; +AMA

75
Q

PSC

A

Men; UC; +pANCA

76
Q

Cholestatic pattern

A

Predominantly elevated alk phos + mildly increased AST/ALTs

77
Q

Autoimmune rxn to gliadin peptide

A

Celiac disease

78
Q

Fatigue + Foul-smelling greasy diarrhea

A

Celiac disease

79
Q

Nonabsorbable disaccharides

A

Lactulose, lactilol —> Tx for hepatic encephalopathy

80
Q

Hepatic encephalopathy Tx:

A
  • Lactulose
  • Rifaximine
  • Limit protein intake
81
Q

Melena

A

UGI Bleed

(PUD from H. pylori vs. NSAIDs; Varices [cirrhosis])

82
Q

Elevated alk phos + jaundice

A

Biliary obstruction:

Pancreatic/biliary cancer vs. CBD stricture (painLESS) vs. gallstones (painFUL)

83
Q

Conjugated Hyperbili + PainLESS

A

Cancer or CBD strictures

84
Q

Conjugated Hyperbili + PainFUL

A

Gallstones

85
Q

Jaundice + Urine negative for bilirubin

A

Unconjugated hyperbilirubinemia

86
Q

Cholestasis

A

Conjugated bilirubinemia

87
Q

Urine+ for bilirubin

(“dark urine”)

A

Conjugated hyperbilirubinemia

because unconjugated bilirubin is bound to albumin in blood and not water-soluble

88
Q

Impaired glucose control in diabetics is seen w/ ____ deficiency

89
Q

Alopecia + hypogonadism is seen in ___ deficiency

90
Q

Thyroid dysfunction + Cardiomyopathy is seen in ___ deficiency

91
Q

Dermatitis, Diarrhea, Dementia

A

Pellagra (Niacin [B3] Deficiency)

  • can be caused by INH
92
Q

Impaired taste is seen in ____ deficiency

93
Q

Anti-mitochondrial antibody+

A

PBC

(Primary biliary cholangitis)

94
Q

Charcot triad

A

Fever, jaundice, RUQ pain

(Ascending cholangitis)

95
Q

Bronze diabetes

A

Hemochromatosis

(pigmentation + DM)

96
Q

Clay-colored stools

A

lack of bilirubin

97
Q

Clay-colored stools + wt loss

A

CBD cancer

(biliary cancer)

98
Q

Tx of CBD cancer

A

ERCP

(endoscopic US first)

99
Q

Migratory thrombophlebitis

A

Pancreatic Cancer

100
Q

Courvoisier’s Sign

A

Palpable distended GB

(Biliary malignancy)

101
Q

Virchow’s Node

A

L supraclavicular adenopathy

(GI cancer)

102
Q

DES Tx

A

CCBs

(or NTG)

103
Q

Halitosis

A

Zenker diverticulum

(proximal esophageal pouch)

104
Q

Periumbilical pain out of proportion to physical exam findings

A

Bowel ischemia from vascular obstruction

105
Q

Post-prandial R shoulder/subscapular pain

A

Cholecystitis or biliary colic 2/2 gallstones

(referred pain)

106
Q

Dysphagia post-alkali ingestion

A

Schatzki Ring

(lower esophageal ring)

107
Q

Dysphagia + regurgitation

108
Q

Sideropenic dysphagia

A

Plummer-Vinson syndrome

(premalignant to SCC; triad: Iron-deficiency anemia, dysphagia, esophageal webs)

109
Q

Corkscrew esophagus on barium swallow

A

DES

(Diffuse Esophageal Spasm)

110
Q

Asymmetric esophageal narrowing on barium swallow

A

Adenocarcinoma (in setting of chronic GERD)

111
Q

Dysphagia to solids but not liquids

A

Esophageal stricture

(Peptic stricture) or early esophageal cancer

112
Q

Dysphagia of solids first, then liquids

A

Esophageal cancer

Or:

  • If intermittent: lower esophageal ring
  • If progressive but no wt loss: Peptic stricture
113
Q

Air under diaphragm or retroperitoneum on abd XR

A

Perforation

114
Q

LLQ pain in elderly

A

Diverticulitis

(Abd CT)

- Med School Review 🔥 (23 decks)

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