Gi Flashcards
Esophageal webs are associated with what two things
Iron def anemia and glossitis (Plummer Vinson syndrome)
Three causes of infectious esophagitis
Candida, hav, cmv
Candidal esophagitis is an __-defining illness
AIDS
Distal esophageal spasm is often precipitated by ingestion of ___ and relieved by ___
Hot or cold liquids
Nitroglycerin
On barium swallow in distal esophageal spasm, you will see
Corkscrew shaped esophagus
Tx of distal esophageal spasm
Ccbs, tcas or nitrates for symptomatic relief
Etiology of achalasia
Degeneration of inhibitory neurons in the myenteric (Auerbach) plexus
On manometry, which is th second and definitive test for achalasia, you see (in achalasia)
Increased resting les pressure, incomplete les relaxation on swallowing and decreased peristalsis in esophagus
Short term tx of achalasia
Nitrates, ccbs, botulinum injection
Long term tx of achalasia
Balloon dilation or surgical (heller) myotomy
Esophageal cancer: ___ of the esophagus occurs in upper and middle thirds whereas ___ occurs in lower third
Scc
Adeno
Scc of esophagus is associated with what behaviors
Tobacco and alcohol
Etiology of type a chronic gastritis. Where does it occur
Due to autoantibodies to parietal cells
Occurs in fundus
Type a gastritis causes ___ anemia due to lack of ___
Pernicious
Lack of intrinsic factor necessary for absorption of vit B12
Type b chronic gastritis occurs in the
Antrum of stomach
Type b chronic gastritis is caused by what two things
NSAIDs and h pylori
What ulcers are associated with burn injuries
Curling ulcers
What ulcers are associated with tbi
Cushing
Best test for h pylori
Urea breath test or stool antigen test
Gastric adenocarcinoma that metastasizes to the ovary is called
A krukenberg tumor
Gastric cancer may present with ___ node
Virchow (enlarged left supraclavicular node)
If you suspect peptic ulcer perf what should you do
Upright kub
What drug can help pts with pud who require nsaid therapy for other reasons
Misoprostol
Three common causes of pediatric diarrhea
Rotavirus, Norwalk virus, enterovirus
Four bugs that cause bloody diarrhea
Salmonella
Shigella
E. coli
Campylobacter
Tx of carcinoid syndrome
Octreotide and surg resection
Cutaneous flushing, diarrhea and abdo cramps, cardiac valvular lesions and wheezing, think
Carcinoid syndrome
4 ds of pellagra
Diarrhea
Dementia
Dermatitis
Death
Why do pts with carcinoid syndrome develop niacin deficiency
Because tryptophan is metabolized ibto serotonin
Pellagra is due to a deficiency of
Vitamin b3 (niacin)
Labs in sbo often reveal
Dehydration, metabolic alkalosis, leukocytosis
Strep bovis positive culture. What next?
Colonoscopy-association between s bovis and crc
Rank in order based on danger to develop into crc: pedunculated, villous and tubular/sessile polyps
Villous>tubular/sessile>pedunculated
Presentation of ischemic colitis
Abdo pain and then bloody diarrhea after meals or exertion
Ct scan with contrast of ischemic colitis
Thickened bowel Wall, atherosclerosis
Colonoscopy of ischemic colitis
Pale mucosa with petechial bleeding
One unit of prbcs should increase hemoglobin by ___g/dL and hematocrit by ___ units
1; 3-4
Direct hernias lie ___ and indirect hernias lie ___ to Inferior Epigastric vessels
MDs Don’t LIE
MeDial=direct
Indirect=Lateral
Cholangitis is infection of the
Common bile duct
Triad of ruq pain, fever and jaundice, think
Charcot triad of cholangitis
Cholelithiasis vs choledocholithiasis
Cholelithiasis=stones in gallbladder
Choledocholithiasis=stone in cbd
Cholecystits is caused by
Prolonged blockage of cystic duct by a stone leading to distention, inflammation and infection
Pts with uc should have colonoscopies how often
Every 1-2 years beginning 8-10 years after diagnosis
Lab findings in acute cholangitis
Leukocytosis
High bili
High alk phos
Hbsab for hep b indicate
Immunity to hep b
Hbcab for hep b
IgM is positive in window period, igG is indicator of prior or current infection
Can you get free intraperitoneal fluid with hepatic laceration
Yes
Watery tea colored odorless diarrhea, muscle weakness/cramps, hypochlorhydria
Vipoma, tumor of pancreatic islet cells
Muscle weakness due to hypokalemia
Biopsy in celiacs dx shows
Villous atrophy
Do you get iron def anemia in celiac dz
Yes
Biopsy on microscopic (collabgenous) colitis
Mucosal subepithelial collagen deposition
What kind of diarrhea do you get in microscopic colitis
Watery