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Step 1 > GI > Flashcards

GI Flashcards

1
Q

Cleft lip/palate

A

Failure of facial prominences to fuse

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2
Q

Painful ulcer with gray base surrounded by erythema in mouth

A

Aphthous ulcer

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3
Q

Multiple bouts of oral ulcers, genital ulcers and difficulty seeing

A

Behcet syndrome

- Immune complex vasculitis

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4
Q

White, rough patch on side of tongue

A

Oral hairy leukoplakia

- EBV

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5
Q

anti-endomysial

A

Celiac sprue

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6
Q

anti-transglutaminase

A

Celiac sprue

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7
Q

Intrapeithelial CD8, crypt hyperplasia, villous atrophy/flattening

A

Celiac sprue

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8
Q

Liver tumor with central scar

A

Focal nodular hyperplasia

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9
Q

Abdominal pain, jaundice, pruritis, weight loss

A

Cholangiocarcinoma

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10
Q

Cholangiocarcinoma risk factors

A

PSC, Clonorchis, cirrhosis, choledochal cysts

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11
Q

anti-mitochondrial

A

PBC

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12
Q

anti-topoisomerase

A

systemic sclerosis

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13
Q

Xanthoma/hypercholesterlemia, pruritis, icterus, jaundice, HSM, elevated IgM, alk phos, GGT, 40 y/o woman

A

PBC

- Auto-immune granulomatous

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14
Q

Mumps complications

A

Sterility if post-puberty
Asceptic meningitis
Pancreas

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15
Q

Salivary gland inflammations

A

Stone from SA

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16
Q

Tumor of cartilage and epithelium in partoid. Mobile, painless

A

Pleomorphic adenoma

-HIGH rate of recurrence

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17
Q

1 salivary tumor

A

Pleomorphic adenoma

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18
Q

Hx of salivary tumor with sudden onset facial paralysis

A

Pleomorphic adenoma –> carcinoma

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19
Q

Cystic salivary tumor with lymphoid tissue

A

Warthin

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20
Q

1 malignant salivary tumor

A

Mucoepidermoid

- Parotid & CN VII

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21
Q

Plummer-Vinson Syndrome

A

Iron deficiency anemia
Esophageal web
Atrophic glossitis/beef red tongue

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22
Q

Painful hematemesis with crackling noise in skin

A

Mallory-Weiss

- alcohol or bulemia

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23
Q

Boerhave syndrome

A

Esophageal rupture from mallory-weis –> subcutaneous emphysema (crakckling)

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24
Q

1 cause of death in cirrhosis

A

Rupture of esophageal varices

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25
Q

Painless hematemesis, portal HTN

A

Rupture of esophageal varices

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26
Q

Progressive dysphagia, bad breath, high LES pressure

A

Achalasia

  • loss of myenteric plexus = can’t relax
  • T. cruzi
  • –> SCC
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27
Q

Adult onset asthma

A

GERD

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28
Q

Risk factors for GERD

A 
Alcohol
Obesity
Fat rich diet
Caffeine
Hiatal hernia
Tobacco
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29
Q

Type of epithelium in Barrett’s

A

Metaplasia from stratified squamous –> Non-ciliated columnar w/ goblet cells

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30
Q

Risk factors for SCC of esophagus

A 
Upper 2/3
#1 worldwide
Alcohol
HOT TEA - Iran, China
Achalasia
Webs
Lye/injury
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31
Q

Projectile non-bilious vomiting, visible peristalsis, small palpable mass in abdomen

A

Pyloric stenosis

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32
Q

CuRling ulcer

A

BuRn –> hypovolemia –> inc acid

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33
Q

Cushing ulcer

A

Inc ICP –>inc vagus –> inc acid

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34
Q

Atrophy of gastric mucosa, achlorhydria, megaloblastic anemia

A

Auto-immune gastritis

  • Fundus & Body
  • Abs –> parietal cells or intrinsic factor
  • INC ADENOCARCINOMA
  • Damage by T-cells (Type IV HS)
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35
Q

Complications of H. pylori gastritis

A

Intestinal type adenocarcinoma

B- cell MALT

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36
Q

Epigastric pain improves w/ meals

A

Duodenal ulcer

  • posterior –> gastroduodenal a. rupture or pancreatitis
  • hypertrophy of Brunner glands
  • NEVER malignant
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37
Q

Epigastric pain worsens w/ meals

A

Gastric ulcer

- LESSER curvature

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38
Q

Intestinal type gastric carcinoma

A 
Ulcer
H.pylori
Nitrosamines
Sister-Mary Joseph nodule
Lesser curvature
Type A blood
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39
Q

Signet ring cells (nucleus on edge d/t mucous), early satiety, thickening of stomach wall

A

Diffuse type gastric carcinoma

- No H. pylori or nitrosamines

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40
Q

Cancer assoc w/ B/L ovarian tumors

A

Diffuse gastric type

41
Q

Acute onset of diffuse seborrheic keratoses

A

Lesar-Trelat sign = gastric carcinoma

42
Q

Assoc with duodenal atresia

A

Down syndrome

Double bubble sign

43
Q

Most common congenital GI anomaly

A

Meckels

44
Q

Volvulus in elderly

A

Sigmoid

45
Q

Volvulus in younger ppl

A

Cecum

46
Q

Kid w/ currant jelly stools

A

Intussusception

Kids = lymphoid hyperplasia from rotavirus
Adults = tumor
47
Q

Causes of SI ischemia

A

Transmural

  • SMA thrombosis, embolism - A-fib, poluarteritis
  • SMV - polycythemia vera, Lupus

Mucosal = hypotension

48
Q

HLA DQ6, 8

A

Celiac sprue

49
Q

Chronic diarrhea w/ small vesicles on skin

A

Celiac sprue

  • dermatitis herpetiformis
  • IgA in dermal papillae
  • IgA deficiency
  • DUODENUM
50
Q

Refractory celiac disease can lead to?

A

CA

T-cell Lymphoma

51
Q

Site of celiac disease

A

DUODENUM

52
Q

Site of tropical sprue

A

Jejunum & ileum –> vit B12 & folate deficiency

Responds to antibiotics

53
Q

Steatorrhea w/ PAS + MO in lamina propria of SI

A

MO loaded with T. whippelii

Can also cause arthritis, involve valves, LN, CNS

54
Q

B-48

A

Chylomicrons

55
Q

B-100

A

LDL, VLDL

56
Q

Tumor + for chromogranin

A

Carcinoid

57
Q

Only small bowel cancer

A

Carcinoid

58
Q

5-HIAA in urine

A

Carcinoid

59
Q

What must you have to order to have carcinoid syndrome (bronchospasm, diarrhea, flushing, R sided valve disease)?

A

Mets –> liver

No L-sided heart disease b/c LUNG HAS MAO

60
Q

Most common cause of acute abdomen

A

Appendicitis
Kids = lymphoid hyperplasia
Adults = fecalith

61
Q

30 y/o women w/ recurrent bouts of diarrhea and abdominal pain

A

IBD

62
Q

Hallmarks of UC

A

CRYPT ABSCESSES w/ neutrophils

PSC, p-ANCA

63
Q

Hallmarks of CD

A

Transmural
NON-bloody diarrhea
GRANULOMAS

Cobblestone, creeping fat, strictures
calcium stones, fistulas
Ankylosing spondylitis, erythema nodosum, uveitis

64
Q

Dx of hirschsprungs

A

Rectal suction bx

65
Q

Hematochezia, LLQ pain, constipation, older ppl

A

Diverticula

66
Q

Hematochezia, RLQ pain, constipation, older ppl

A

Angiodysplasia

- cecum

67
Q

Pneumaturia, UTIs with fecaluria

A

Fistula from sigmoid diverticula

68
Q

Post-prandial pain, weight loss, pain and bloody diarrhea

A

Ischemic colitis

- atherosclerosis of SMA @ SPLENIC FLEXURE

69
Q

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

A

IBD

70
Q

Most common polyp

A

serrated, benign, L colon

71
Q

Adenoma-Carcinoma sequence

A

APC –> KRAS –> p53

72
Q

Adenomatous polyps

A

benign –> malignant

ASPIRIN IMPEDES PROGRESSION

73
Q

High risk polyps for progression

A

> 2cm
Sessile/Flat
Villous = villain

74
Q

Gardner syndrome

A

Fibromatosis & Osteomas (skull)

75
Q

Turcot syndrome

A

FAP + medulloblastoma or glial tumors

76
Q

Kid with polyp protruding from anus

A

Juvenile, hamartomatous polyp, solitary

Polyposis = multiple –> carcinoma

77
Q

Multiple GI hamartomas, hyperpigmentation on lips, oral mucosa, genitals

A

Peutz-Jeghers sydrome

INC RISK for colorectal, breast, GYN cancer

78
Q

Napkin ring lesion, dec stool caliber, LLQ pain

A

Colorectal carcinoma

- adenomacarcinoma sequence

79
Q

Raised lesion, iron deficiency anemia, vague pain

A

Colorectal carcinoma

- Microsatellite instability = DNA mismatch –> instability in repeating non-coding DNA

80
Q

Kid in car accident w/ pain radiating into back, N/V, elevated lipase

A

Acute pancreatitis

81
Q

Inc urine, amylase:cr, inc amylase and lipase, DEC Ca

A

Acute pancreatitis

82
Q

Chain of lakes, pain radiating into the back, steatorrhea, fat sol vitamin deficiencies, excess neutral fats in stool

A

Chronic pancreatitis

  • etOH or CF
  • Amylase and lipas NOT helpful
  • Inc risk for DM-II, carcinoma
83
Q

Thin elderly male presents with new onset diabetes, pain worse lying down, better bending forward, pale stools, palpable GB, CA 19-9, migratory thrombophlebitis

A

Pancreatic carcinoma

- smoking and chronic pancreatitis

84
Q

Risk factors for cholesterol gallstones

A 
Radiolucent
Women, 40, OCPs - high estrogen
Cholestyramine binds bile acids
Clofibrate inc HMG-CoA reductase
Native American
CD
Cirrhosis
85
Q

Pigmented gallstones

A

Radioopaque

Extravascular hemolysis - infection from ascaris, clonorchis

86
Q

Rokitansky-Aschoff sinus

A

Herniation of GB mucosa –> mucular wall

87
Q

Porcelain GB

A

chronic cholecystitis
- dystrophic calcification

–> carcinoma in elderly woman

88
Q

Bands of fibrosis and regenerative nodules , ascites, anemia, hemorrhoids

A

Cirrhosis

- TGF-beta from STELLATE CELLS

89
Q

Asterixis, gynecomastia, spider angiomas, palmar erythema, jaundice

A

Cirrhosis

- both PT and PTT inc but follow PT

90
Q

Mallory bodies

A

Swelling of hepatocytes

DEGENERATED INTERMEDIATE FILAMENTS

91
Q

Inc ferritin, dec TIBC, inc serum iron, inc % sat

A

Hemochromatosis

  • HFE gene
  • testicular atrophy
  • Prussian blue stain (vs. lipofuscin)
92
Q

ATP7B gene

A

Wilson disease

93
Q

Behavioral changes, chorea, dementia, discolored iris

A

Wilson disease

  • -> HCC
  • Tx = D-penicillamine
94
Q

Periductal onion skinning, string of pearls, p-ANCA, UC

A

PSC

95
Q

Only flu-like illness you use aspirin

A

Kawasaki

96
Q

Intraperitoneal bleeding during pregnancy

A

Rupture of hepatic adenoma

- OCPs

97
Q

Risks for HCC

A

HBV, HCV
storing grains - Aflatoxin from Aspergillus
Cirrhosis

High AFP

98
Q

Nodular free edge of liver

A

Mets to liver

- LUNG, BREAST, colon, pancreas

99
Q

3 most common causes of small bowel obstruction

A

ABCs - adhesions, bulges/hernia, cancer

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