GI Flashcards
1
Q
Vit. B3 (Niacin) Deficiency
A
Pellagra, 3 D’s:
- Diarrhea
- Dementia
- Dermatitis
2
Q
What are 5 findings seen in Refeeding Syndrome?
A
- Hypophosphatemia
- Hypokalemia
- Thiamine deficiency
- CHF
- Peripheral edema
3
Q
Dx for Intussusception
A
US
4
Q
Dx GOLD for CholeCystitis
A
HIDA
5
Q
Biliary tract infection 2ry to obstruction (gallstones, malignancy) . Dx?
A
CholAngitis
6
Q
Patient Hx: atherosclerosis dz.
CC: Bloody diarrhea and LQ pain.
What is the Dx?
A
Ischemic Colitis
7
Q
Malabsorption with Lactose Intolerance occurs where:
A
Small intestine
8
Q
Dx GOLD for Mesenteric Ischemia
A
CT angiography
9
Q
Tx for Intussusception
A
Air/Contrast enema
10
Q
What is the initial Dx method for Colorectal CA and what does it show?
A
- X-ray
- Apple-core sign
11
Q
Uncooked meat can lead to:
A
E. coli food poisoning
12
Q
What is seen with Vit. B6 (Pyridoxine) Deficiency?
A
- Sideroblastic anemia
- Convulsions
- Peripheral neuropathy
13
Q
↑ CEA (CarcinoEmbryonic Antigen) level is seen in:
A
Colorectal** > Pancreatic CA
14
Q
MCC of Intussusception
A
Tumor or Meckel’s diverticulum
15
Q
Lab test needed to make a Dx of ACUTE Hepatitis B:
A
Core antibodies
16
Q
MCC Ischemic Colitis
A
LOW blood flow in mesenteric vessels
17
Q
Cause of Mesenteric Ischemia:
A
Thrombus or embolic occlusion
18
Q
Intussusception presents with:
A
Vomiting and bloody stools (currant jelly)
19
Q
What Hep B serologic marker is indicative of immunity d/t vaccination?
A
ONLY Anti-HB surface (+)
20
Q
Tumor marker for Pancreatic CA:
A
CA 19-9
21
Q
What medication decreases gastric acidity which leads to a decrease in calcium absorption?
A
PPIs: Omeprazole
22
Q
Test used to determine eradication of H. pylori:
A
Urea breath test
23
Q
PPIs increase risk for:
A
C. difficile and fractures
24
Q
Sausage-like mass RUQ representing the actual intussusceptum and an empty space in RLQ representing the movement of the cecum out of its normal position. What is the sign called?
A
Dance’s sign
25
Which Abx can turn the eyes yellow in G6PD Deficiency?
-Bactrim
26
What is Ogilvie Syndrome?
Massive dilation of colon WITHOUT mechanical obstruction
27
Tx for small bowel obstruction:
NGT, surgery
28
MC occluded intestinal artery in Mesenteric Ischemia:
Superior
29
```
Sxs:
-Painless jaundice
-Wt. loss
-Depression
What is the Dx?
```
Pancreatic CA
30
Tx for Ogilvie Syndrome
- Colonic decompression
| - Neostigmine
31
1st and 2nd MCC Pancreatitis:
1st: Gallstones
2nd: EtOH
32
Dx GOLD for CholAngitis
Endoscopic Retrograde Cholangio-Pancreatography (ERCP)
33
Pancreatitis Tx
IV Fluids
34
Gall bladder (cystic duct) obstruction by gallstone → inflammation/infection. Dx?
CholeCystitis
35
What makes up Charcot triad?
- Jaundice
- Fever
- RUQ pain
36
With Familial Adenomatous Polyposis:
- At what age do screenings start?
- What screening is done?
- How often?
- Age 12
- Sigmoidoscopy
- Every 1-2 yrs
37
Tx for Esophagitis D/T Candida
Fluconazole
38
MCC PUD
H. pylori
39
In what Dx would we find Charcot triad?
Acute CholAngitis
40
RUQ or Epigastric pain that may radiate to shoulder. Dx?
Choledocholithiasis
41
How do we confirm GERD Dx?
Endoscopy
42
MC type of Pancreatic CA:
Adenocarcinoma
43
In Tx Ogilvie Syndrome with Neostigmine, what are two serious complications?
- Bradycardia
| - Asystole
44
2 skin PE findings of Pancreatitis:
- Grey Turner sign: ecchymosis of left flank
| - Cullen sign: umbilical ecchymosis
45
MCC of CholAngitis
Choledocholithiasis leading to bacterial infection, E. coli
46
What sign shows a palpable non-tender gallbladder. Dx?
- Courvoisier Sign
| - Pancreatic CA
47
Pancreaticoduodenectomy is AKA:
Whipple procedure
48
What antibody is found in Crohn's?
ASCA (Anti-Saccharomyces cerevisiae antibodies)
| -think "Crohn's da asco!"
49
MC metabolic abnormality in bulimia nervosa 2ry to vomiting:
Hypokalemia
50
What labs are seen in PKU?
↓ phenylalanine hydroxylase (PAH) leads to →
- ↓ tyrosine
- ↑ phenylalanine
51
Dermatological condition associated with Celiac Disease:
Dermatitis Herpetiformis (eczematous-like rash)
52
MC infectious etiology of diarrhea in AIDS:
Cryptosporidium
53
What condition should be suspected in a dehydrated neonate with hyperkalemic, hyponatremic metabolic alkalosis?
Adrenal crisis
54
Pyloric Stenosis: non-bilious or bilious vomiting?
Non-bilious
55
MC type of Esophageal CA in U.S. is and d/t:
- Adenocarcinoma
| - Complication of GERD/Barrett's
56
Best to confirm Achalasia:
Esophageal Manometry
57
Tx GOLD for CHRONIC Anal Fissures:
Lateral internal sphincterotomy
58
Pt. presents with severe, watery diarrhea with white mucus. Dx?
Cholera
59
Tx for Hepatic Encephalopathy
Lactulose
60
MC liver disease in U.S.
Nonalcoholic fatty liver
61
Common complication of acute hepatitis and when does it occur:
- Aplastic anemia
| - 6–12 weeks after hepatitis
62
What makes up Reynold's Pentad?
Charcot Triad plus:
- HypoTN
- AMS
63
MC site of FB obstruction
Cricopharyngeus muscle, C6 level
64
Sxs: Musty, urine/body odor. Dx?
PKU
65
Tx for Hypokalemia
Potassium + Mg
66
Dx for Celiac Dz.
Small bowel Bx
67
MCC of SCC of Esophageal CA
Smoking and EtOH
68
Sxs: irritability that comes and goes, lethargy, abdo distention. Dx?
Intussusception
69
MCC of Appendicitis
Fecalith
70
Tx for PKU
- Tyrosine
| - AVOID Phenylalanine
71
What 2 labs are seen in Celiac Dz?
- IgA anti-Endomysial (EMA)
| - Anti-tissue Transglutaminase (anti-tTG) antibodies
72
Hirschsprung’s Dz. complication
Toxic megacolon
73
Tx for Spontaneous Bacterial Peritonitis
IV 3rd-gen. Cephalosporin (ASAP)
74
Does Appendicitis present with Leukocytosis and fever?
Yes!
75
Eating improperly refrigerated rice, meats, veggies or dried fruits may lead to:
Bacillus cereus
76
Topical mgmt midline anal fissures:
Nitroglycerin
77
MC surgical ER in pregnant women
Acute appendicitis
78
Dx for Pyloric Stenosis
US
79
MCC worldwide for Esophageal CA and where is it located?
- SCC
| - Upper/Middle
80
52 yo male with abdominal pain and elevated liver enzymes, >10,000. What is the likely diagnosis?
Viral Hepatitis
81
What labs are seen in Spontaneous Bacterial Peritonitis?
Neutrophils >250
82
Nocturnal pruritus ani. Dx?
Pinworms
83
What is a finding of Yersinia?
Fecal WBCs and RBCs
84
What is true in elderly with abdominal pain?
Likely requiring emergent surgery
85
PKU diet
- HIGH veggies, low meats
| - Avoid Aspartame
86
What are the sacs called in the small bowel?
Valvulae conniventes (plicae circulares)
87
Which ID is associated with neuro Sxs or febrile seizures?
Shigella
88
What autoantibody is seen in UC?
p-ANCA
89
Dx for Hepatocellular CA (HCC)
US and ↑ alpha-fetoprotein
90
PE: gynecomastia, asterixis. Esophageal varices. Labs: ↑ ammonia. Dx?
Cirrhosis
91
What is seen with Vit. A Deficiency?
- Night vision loss
- Dry skin
- Bitot spots on conjunctiva
92
Difference between Cholangitis and Acute Cholecystitis
Cholangitis: ↑ serum bilirubin level (jaundice)
93
Diverticulitis vs. Diverticulosis diet
Diverticulitis: low fiber (to allow healing)
Diverticulosis: HIGH fiber
94
Tx for Rectal Prolapse
Manual reduction (with no vascular compromise)
95
Initial and GOLD Dx for Pancreatic CA
Initial: CT
GOLD: fine needle bx
96
What are the sacs called in the large bowel?
Haustra
97
Tx for Giardiasis
Metronidazole
98
What is the upper limit of normal diameter for the different segments of bowel?
- 3-6-9 rule
- Small bowel (3 cm)
- Colon (6 cm)
- Cecum (9 cm)
99
Best initial Tx for Esophageal Stricture
Dilation and PPIs to prevent
100
MCC upper GI bleed
PUD
101
CT: bowel wall edema and free peritoneal fluid. Dx?
Ischemic Colitis
102
How much Vitamin D should infants, kids, and adolescents get in a day?
400 IU/day
103
Bone deformities, ↓ calcium, ↓ phosphate, ↑ alkaline phosphatase. Dx?
Rickets (low Vit. D)
104
1st line Rx for constipation
Bulk-forming: Methylcellulose, Psyllium
105
Tx for Ulcerative Colitis
- Sulfasalazine
| - Surgery cures
106
Pt. Hx of eating fresh produce. PE: Fever, abdominal pain and bloody diarrhea. Dx?
Salmonellosis
107
"Pseudo-appendicitis". N/V/D/F, RLQ pain.
Yersinia Enterocolitica
108
Dx for Toxic Megacolon
X-ray → colon dilated > 6cm
109
Inguinal hernia that presents with mass in abdominal wall
Direct
110
Tx for Portal HTN of Cirrhosis
Spironolactone
111
1st steps in mgmt for Toxic Megacolon
IVF, bowel rest, and NG tube
112
Alcoholic. Oculomotor dysfunction (MC nystagmus), cerebellar dysfunction (ataxia), AMS. Dx?
Wernicke encephalopathy
113
Dx tool used for Cirrhosis and Pancreatitis
US
114
PE: Murphy's sign, Boas sign. Dx?
CholeCystitis
115
Tx for C. difficile
PO Vanco*, PO Metro
116
A patient presents with sclerosing cholangitis. What is the next step in management?
ERCP
117
MCC intestinal obstruction <2yo
Intussusception
118
MCC large bowel obstruction?
Neoplasm
119
Sign indicative of a retrocecal location of appendix
Psoas
120
Labs for Pyloric Stenosis
Hypochloremic, hypoK metabolic alkalosis
121
MCC gastric cancer
H. pylori
122
Mesenteric Ischemia arrhythmia RF
A. Fib
123
What imaging test is CI in Diverticulitis?
Colonoscopy
124
Dx for Lactose Intolerance
Hydrogen breath test
125
Dx for Alcoholic Hepatitis
AST > ALT (2:1)
126
Dx for Acute Hepatitis A
(+) Anti-HAV IgM
127
MC viral cause of Intussuception
Adenovirus
128
Loose teeth, gum bleed, and poor wound healing would be a deficiency in what vitamin?
C (Ascorbic Acid; Scurvy)
129
What electrolyte abnormality commonly causes an ileus?
HypoK
130
Pt. Hx of allergies. PE: stacked circular rings in esophagus. Dx?
Eosinophilic Esophagitis
131
What vitamin deficiency presents with anemia, peripheral neuropathy, ataxia?
E
132
Initial imaging TOC for bowel obstruction:
Abdominal x-ray
133
MC patho of Spontaneous Bacterial Peritonitis
E. coli
134
Tx for Traveler's Diarrhea
Rehydration + Cipro (or Azithro)
135
What lab values are associated with poor prognosis for pancreatitis?
- Age > 55
- WBC > 16,000
- Blood Glu > 200 mg/dL
- Serum lactate dehydrogenase > 350 units/L
- Aspartate aminotransferase > 250 units/L
136
What imaging tool confirms Small Bowel Obstruction?
Abdominal CT
137
What mgmt should be avoided in Hemolytic Uremic Syndrome?
Antibiotics
138
What is the imaging of choice for Diverticulitis?
CT
139
What is the MCC of foodborne disease in the U.S.?
Salmonellosis
140
MCC of Pancreatic cancer
Smoking
141
Diarrhea and recent travel on a cruise ship. Dx?
Norovirus
142
Tx for Wernicke Syndrome
Thiamine Repletion
143
What test is done in a patient that has an elevated Alkaline Phosphatase?
ERCP
144
In a pt. with a hyperplastic polyp <10mm, when would the next colonoscopy be?
10 years (regular)
145
With no RFs, in addition to yearly hemoccult screening of the stool, how often should flexible sigmoidoscopy be performed?
Every 5 years
146
The parents of a 16-year-old boy presents to the clinic with their son asking that you examine him. Over the past 10 mo, he has developed behavioral problems and emotional lability. PE: well-developed male, cooperative with exam but easily distracted. It is noteworthy for dysarthria, a resting tremor and the presence of gray-green pigmentation surrounding each pupil. What is the most likely diagnosis?
Wilson Disease (xs copper in body)
147
Patient with Hx of Crohn’s disease and is allergic to NSAIDs. What is the best to prescribe?
Steroids and TNF blockers (-mab)
148
Tx for Chronic Pancreatitis
Steroids > Colchicine
149
A 3-week-old presents with mom who states baby has continuous bilious vomiting. What is the likely Dx?
Volvulus (twisting)
150
Next step for GALLSTONES (Cholecystitis) with inconclusive ultrasound
HIDA scan
151
What is the next step if ultrasound came back negative for gallstones?
ERCP
152
Celiac Dz vs. Lactose Intolerance
CD: failure to thrive
153
MC type of inguinal hernia
Indirect
154
Pt. presents with his 3rd anorectal abscess. What do you suspect?
Crohn's
155
Tx for Ascities
- Spironolactone
| - Na+ restriction
156
Tx for Diverticulitis
Cipro (or Bactrim) + Metro
157
Pseudomembranous Colitis AKA:
C. diff
158
What is ileus and what can cause this?
- ↓ peristalsis WITHOUT structural obstruction
| - Post surgery, opiates, hypoK
159
Initial Dx for Hirschsprung disease
Anorectal manometry
160
Tx for Abdominal Hernia
Kids:
- Observe: close by 2 yo
- Surgery: if >5 yo
161
Pt. presents after ingesting an unknown medication. She has anorexia, N/V, RUQ pain and jaundice. Labs show abnormal coag studies. She has hepatic necrosis. Dx?
Acetaminophen Toxicity
162
Acetaminophen Toxicity Workup
- APAP levels, then Nomogram
- LFTs
- PT, PTT, INR
- UA, ECG
163
Tx for Esophagitis D/T CMV (CD4 <200)
Ganciclovir
164
What is a hallmark sign of Zollinger-Ellison Syndrome (ZES)?
Acid diarrhea
165
Pt. presents with a horizontal anal fissure. What do you suspect?
HIV or Crohn's
166
Dx for Ischemic Colitis
Colonoscopy
167
MC type of Colorectal CA
Adenocarcinoma
168
What is the best Tx for Esophageal Varices?
Band ligation
| -Then sclerotherapy > Octreotide > BB > PPI
169
What is the best way to Dx H. pylori?
Endoscopy with bx or Fecal antigen
170
What is a common sign of gastric ulcers vs. duodenal?
GU: get wt. loss
171
What meds are CI in a patient with GERD?
CCB and Nitroglycerin
172
Tx for Wilson Disease
D-Penicillamine
173
Pt. presents with IBS. She complains of abdominal cramps. How would you like to treat this patient?
-Antispasmodics: Atropine
OR
-Anticholinergics: Dicyclomine
174
Pt. reports that a family member in the house was recently diagnosed with Hep. A. What is your management?
Give immunoglobin (within 2 wks)
175
What will be elevated in hepatitis?
- Indirect bilirubin
| - Conversion can't happen D/T liver damage in hepatitis → jaundice
176
Which test would show as positive for a chronic hepatitis B patient?
Surface antigen
177
GOLD Dx for Hirschsprung Disease
Rectal Bx
178
57 yo presents with cogwheel rigidity and elevated liver enzymes. What is the likely Dx?
Wilson's Disease
179
49 yo female presents with abdominal pain, ascites, hepatomegaly and elevated liver enzymes. What would an US help diagnose?
Budd Chiari DVT (Hepatic Vein Obstruction)
180
What GI Dx's use US?
- Cirrhosis
- Pancreatitis
- Intussusception
- Hepatocellular CA
- Pyloric Stenosis
181
What GI Dx's use CT?
- Diverticulitis
- Small Bowel Obstruction
- Initial for: Pancreatic CA
