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Patho > GI > Flashcards

GI Flashcards

1
Q

appendicitis s/s

A

vague, cramp-like, moves to RLQ

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2
Q

biliary colic s/s

A

severe, steady aching pain in RUQ or epigastrium lasting 1-4hrs, associated with meals, occurs at night

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3
Q

acute cholecystitis s/s

A

persistent pain with fever, pain referred to R scapula

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4
Q

Pancreatitis s/s

A

epigastric/periumbilical steady, boring pain radiating to back, relieved when sitting, recent alcohol engestion

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5
Q

bowel ischemia s/s

A

sudden, severe onset

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6
Q

if you have afib and bowel ischemia what are you at risk for

A

arterial embolism

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7
Q

bowel obstruction s/s

A

crampy, midabdominal pain, no BMs

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8
Q

Nephrolithiasis s/s

A

begins gradually and escalates to severe in 20-60mins with flank pain to groin

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9
Q

Jaundiced occurs with what?

A

Hepatitis, doesn’t occur in cholecytitis or biliary colic unless bile duct obstruction

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10
Q

Diminished peripheral pulses occur with what?

A

bowel ischemia or AAA

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11
Q

absent bowel sounds occur in which problems?

A

pancreatitis, bowel ischemia

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12
Q

bowel sounds are high pitched in which problem?

A

bowel obstruction

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13
Q

rebound tenderness occurs with?

A

peritoneal irritation—IMMEDIATE REFERRAL

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14
Q

point tenderness occurs with which problems?

A

appendicitis, diverticulitis, cholecystitis

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15
Q

McBurney’s point occurs with which problem?

A

appendicitis

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16
Q

Murphy’s sign occurs which which problem?

A

associated with cholecystitis

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17
Q

severe abdominal pain but a normal physical exam would indicate which problems?

A

ischemic bowel, pancreatitis, acute intermittent porphyria

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18
Q

on ultrasound fluid filled will look?

A

dark

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19
Q

on ultrasound solid masses will look?

A

white

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20
Q

which scan is good for pancreatitis and diverticulitis?

A

CT

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21
Q

an increased anion gap=acids are added. This is associated with which problems?

A

bowel infarcts, DKA, severe pancreatitis

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22
Q

a normal anion gap=loss of base but chloride is preserved. This is associated with which problems?

A

diarrhea, illial loop problems

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23
Q

what happens to K with bowel infarcts?

A

it increases

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24
Q

which test is mandatory to do if woman is not 2 years post metapause to r/o preg related conditions?

A

Serum HcG

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25
Q

what happens to serum amylase levels in pancreatitis?

A

markedly increases

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26
Q

what happens to serum amylase levels in biliary disease, bowel obstruction, DKA, bowel ischemia

A

moderately increases

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27
Q

which problem has an elevated alkaline phoshate?

A

cholecystitis

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28
Q

mild pyuria is found with which problems?

A

diverticulitis and appendicitis

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29
Q

hematuria is key in which problem?

A

nephrolithiasis

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30
Q

Watson-Schwartz test

A

used in acute porphyria to differentiate porphobilinogen from urobilinogen

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31
Q

porphobilinogen

A

intermediate product of heme synthesis

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32
Q

where is porhobilinogen found? and what happens to it?

A

in urine, normal when fresh but then turns wine or black when heated and diluted HCL

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33
Q

intermittent porphyria

A

rare metabolic disorder

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34
Q

porphyria

A

disorders of heme synthesis

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35
Q

which vascular problems should be considered in the elderly?

A

bowel ischemia or AAA

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36
Q

abdominal plains are good for which tests?

A

obstruction or perforation

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37
Q

DKA s/s

A

abdominal pain, vomiting, ketonuria, anion gap acidosis

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38
Q

Hematemesis

A

frank blood in vomit

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39
Q

Hematochezia

A

bright blood in stool, bleeding from lower bowel

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40
Q

Melena

A

black tarry stool, bleeding from upper bowel (ileocecal valve)

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41
Q

which lab values will melena produce?

A

increased BUN d/t absorption of nitrogenous and products from digestion of blood

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42
Q

positive occult testing is d/t which problems?

A

gastritis, peptic ulcer or lesions of the small intestine

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43
Q

which cranial nerves help with swallowing?

A

V, IX, X, XII

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44
Q

dysphagia

A

difficulty in swallowing

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45
Q

Odynophagia

A

painful swallowing

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46
Q

Achalasia

A

lower esophageal sphincter fails to relax and food stays in the lower esophagus

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47
Q

esophageal diverticulum

A

outpouching of esophageal wall leading to retention of food

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48
Q

s/s esophageal diverticulum

A

gurgling, belching, coughing, foul-smelling breath

49
Q

Mallory-Weiss Syndrome and whats it associated with?

A

tears in esophagus, associated with severe alcoholism, vomiting

50
Q

what can Mallory-Weiss Syndrome lead to?

A

inflammatory ulcers or mediastinitis

51
Q

mediastinitis

A

infection of the mediastinum

52
Q

which test should be done to evaluate Gastroesophageal reflux?

A

EGD; esophagogastroduodenoscopy

53
Q

What does Aspirin or NSAIDS prevent the stomach from making?

A

prostaglandin E

54
Q

what does prostaglandin E do?

A

helps protect lining of the stomach so hydrochloric acid cant attack it, NSAIDS stop this from happening

55
Q

H.Pylori

A

disrupts the mucosal barrier that protects the stomach from harmful effects of its digestive enzymes

56
Q

acute gastritis

A

transient inflammation of the gastric mucosa, associated with endotoxins, alcohol and asa

57
Q

chronic gastritis

A

characterized by the absence of grossly visible erosions and the presence of chronic inflammatory changes

58
Q

what does chronic gastritis lead to?

A

atrophy of the glandular epithelium of the stomach

59
Q

C. urea breath test, stool antigen, endoscopic biopsy and titer blood tests are used to test for which infection?

A

H. pylori infection

60
Q

Duodenal ulcers have low or high gastric acid?

A

high gastric acid

61
Q

gastric ulcers have low or high gastric acid?

A

normal or reduced gastric acid

62
Q

why is there a reduced amount of gastric acid with gastric ulcers?

A

because the cells atrophy (decrease in size)

63
Q

risk factors for ulcers

A

male, first degree relatives with duodenal ulcers, stress, smoking, ASA, NSAID use

64
Q

s/s of duodenal ulcers

A

food and antacids provide relief, awaken in middle of night but NOT before bkfst, melena

65
Q

when does pain occur with duodenal ulcers?

A

2-3 hours after meal

66
Q

why does food provide relief of duodenal ulcers?

A

because it coats the stomach

67
Q

does food help with gastric ulcer pain?

A

no, it aggravates it

68
Q

gold standard for peptic ulcer disease

A

culture

69
Q

what else causes PUD

A

pancreatitis, GERD, MI, cholecystitis, non-ulcer dyspepsia

70
Q

location of gastric ulcers

A

stomach

71
Q

location of duodenal ulcers

A

duodenum

72
Q

when does pain occur with gastric ulcers?

A

1-2 hours after eating

73
Q

Zollinger-Ellison Syndrome

A

gastrin-secreting tumor (gastrinoma)

74
Q

treatment for Zollinger-Ellison Syndrome?

A

surgical removal of gastrinoma

75
Q

s/s Zollinger-Ellison Syndrome?

A

diarrhea, impaired fat digestion, elevated serum gastrin, decreased intestinal pH

76
Q

Gastric Cancer s/s

A

weight loss, palpable mass, ascites

77
Q

what results from a deficiency of intrinsic factor which is necessary for intestinal absorption of vit B12?

A

pernicious anemia

78
Q

important vit B12 deficiency symptom?

A

paresthesias of the hands and feet

79
Q

dumping syndrome

A

rapid emptying of the gastric contents into the small intestine

80
Q

when does dumping syndrome occur?

A

about 30 mins after eating

81
Q

s/s of dumping syndrome

A

abdominal cramping, diarrhea, tachycardia, perspiration, weakness and dizziness, Borborygmi

82
Q

Borborygmi

A

gurgling, splashing sound normally heard over the large intestine

83
Q

Gastroenteritis

A

inflammation of the stomach and intestinal tract, usually s/t infectious agent from eating, traveling

84
Q

whats the most common cause of gastroenteritis

A

ingestion of contaminated food or drink (x48 hrs)

85
Q

Gastroenteritis s/s

A

abdominal pain fever, dehydration, orthostatic hypotension, dry mucosal membranes, decreased skin turgor

86
Q

Gold standard test for Gastroenteritis

A

culture

87
Q

Crohn disease

A

granulomatous inflammation, affects any area of the bowel, leads to thickening and scarring

88
Q

ulcerative colitis

A

uniform, affects the colon, limited to mucosa

89
Q

alarm symptoms of IBS that need to be investigated

A

weight loss, anemia, fever, persistent diarrhea causing dehydration, severe constipation, family hx colon ca, onset of symtomps >50

90
Q

if <50 with alarm symptoms of IBS what test do you do?

A

labs and flexible sigmoidoscopy

91
Q

if >50 with alarm symptoms of IBS what test do you do?

A

colonoscopy and obtain biopsy

92
Q

transmural of bowel

A

affects entire bowel

93
Q

tenesmus

A

painful urgency to move bowels

94
Q

Crohns disease s/s

A

palpable mass, rectal fistulas, perirectal abscess, cramp-like pain, weight loss, fever

95
Q

what can acute ileitis mimic?

A

appendicitis

96
Q

Irritable Bowel Disease includes which problems?

A

Crohns disease and ulcerative colitis

97
Q

Lower GI bleed problems

A

Diverticulosis, colon ca or polyps, A-V malformation, Hemorrhoids

98
Q

with IBD will serum albumin be low or high?

A

low

99
Q

crohns disease appearance

A

cobblestone

100
Q

ulcerative colitis appearance

A

psuedopolyps

101
Q

ulcerative colitis main s/s

A

bloody diarrhea

102
Q

who gets Chronic Mesenteric Ischemia?

A

patients with vascular disease

103
Q

mesenteric ischemia

A

ischemia in either the superior or inferior mesenteric arteries to the large or small intestine

104
Q

who gets acute mesenteric ischemia?

A

patients who are at risk for systemic embolization (recent MI, afib)

105
Q

what tests do you need to do for an acute or chronic mesenteric ischemia? and what is gold standard?

A

doppler ultrasound, CT but ANGIOGRAPHY is gold standard!

106
Q

Ischemic colitis s/s

A

rectal bleeding, mild to moderate left-sided aabdominl pain

107
Q

Ischemic colitis is secondary to what?

A

inadequate blood supply to watershed areas of the colon

108
Q

preferred test for ischemic colitis

A

colonoscopy

109
Q

Diverticulosis and where is it found

A

outpouching of the intestinal mucosa, most common in sigmoid colon

110
Q

Diverticulitis and s/s

A

inflammation of one or more of diverticuli, LLQ pain, diarrhea, fever

111
Q

external hemorrhoids location

A

lie below anal sphincter and can be see on inspection

112
Q

internal hemorrhoids location

A

lie above anal sphincter, cant be seen on inspection

113
Q

which scan is most effective for appendicitis if patient is NOT pregnant

A

CT

114
Q

Peritonitis and s/s

A

inflammation of the peritoneum, fever, chills, right guarding of abdomen, pallor, abdominal distention

115
Q

perforated peptic ulcer, ruptured appendix, PID, gangrenous bowel, abdominal trauma are all causes of which problem?peritonitis

A

peritonitis

116
Q

Celiac Disease

A

immune-mediated disorder triggered by ingestion of gluten

117
Q

what happens to the immune response with patients who have celiac disease?

A

inappropriate T-cell response in genetically predisposed pts, may impair absorption

118
Q

how does the metabolic disorder, intermittent porphyria occur?

A

excessive use of sulfonamides and barbiturates, they become sensitive to light

Patho (20 decks)

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