GI Flashcards
What is the most sensitive and what is the most specific test for pancreatic cancer?
sensitive is CT
specific is ECRP
What is the type of bilirubin increased in each disease and what is the underlying problem? Crigler? Gilbert? Dubin Johnson? Rotor?
unconjugated, UGT don’t work
un, UGT don’t work, but only when the body is stressed
direct or conjugated, cant transport out of liver
direct or conjugated, cant store in liver
When I want to make a diagnosis of viral infection like the flu, what test to do?
PCR
diagnostic test and treatment for volvulus?
sigmoidoscopy diagnosis it and treats it
what is a late sign of liver disease?
fetor hepaticus which is a sweet, fecal odor of breath
what med closes the PDA and which med keeps it open?
NSAIDS close it
prostaglandins open it
What is the finding on pulmonary function test for restrictive lung disease?
deceased DLCO
what is the difference between primary sclerosing cholangitis and primary biliary cirrhosis?
PSC is stricture and dilation of both intra and extra hepatic ducts
PBC is only intrahepatic ducts
What is the most common hereditary cause of colon cancer? How do we screen these folks? What is another cancer these people get?
hereditary non poly colorectal cancer or lynch syndrome
colonoscopy started at 20-25 or ten years earlier than family diagnosis
endometrial cancer
Best treatment for hemochromatosis?
phlebotomy
What is the most common type of benign liver tumor?
What will they look like on CT?
cavernous hemangioma
complete opacification on delayed image
How do we treat these hemangiomas?
is asymptomatic and less than 5cm, nothing. grater than 5cm, image it in 6-12 months.
symptomatic, surgery,
What is the most common cause of lower GI bleeding in people around 60? What is the classic presentation?
diverticulosis
painless rectal bleeding
Dysphagia caused by circumferential membrane in the distal esophagus?
schatzkis rings
what are the two MAJOR risk factors for peptic ulcer disease?
NSAIDS and H pylori
stress and alcohol are only minor
most common complication of diverticulitis is?
fistula
2 main causes of cirrhosis to see on exam?
4 major clinical signs?
What is the underling mechanism of the disease causing problems?
alcohol or chronic viral hepatis with C and B
jaundice, gynecomastis, spider angiomata, ascities
portal vein htn
What liver tumor is associated with contraceptive use?
hepatic adenoma
Under what three circumstances will you remove the adenoma?
symptomatic, over 5 cm, or stopped OCs and the tumor didn’t shrink or go away.
What will be the differentiating factor between dubin Johnson syndrome and rotor syndrome?
coproportphryn 1 is greater than 80% in urine for dubin and less than 20% in rotor
what is angiodysplasia?
Another name for it?
common association?
AV malformation in the GI tract and one of the most common vascular anomalies in the gut causing painless lover GI bleeds
AV malformations
von Willebrand
Explain how we determine what the cause of ascites is and the two results and options?
we use the serum to fluid albumin gradient
if it is greater than 1.1, we are confident it is because of portal hypertension. This increases the hydrostatic pressure causing fluid to leak out and leave protein in the vessel. this would be things like, portal vein thrombosis, cirrhosis, heptic carcinoma, CHF, budd chiari)
If the gradient is less than 1.1 we are not thinking portal htn. more like infection, rheumatoid conditons, cancers lsewhere.
What condition am I thinking with antimitochondrial antibodies?
What can we use to treat the itching from the increased bile acids?
primary biliary cirrhosis
chlestyramine or colestipol
first line treatment for c diff?
second line?
vancomycin
fidaxomicin or pulse tapered vancomycin
when diverticulosis is diagnosed incidentally and is asymptomatic, how do we manage?
high fiber diet
What do I always need to have in mind when someone has history of chronic pancreatitis and sudden ab pain?
acute mesenteric ischemia
5 lab values for wislons dz?
low albumin low ceruloplasmin low total serum increased free serum copper increased urine excretion of copper
2 lab values for primary biliary cholangitis?
antimitochondrial antibodies
high alkaline phosphatase
what is diagnostic test for zenkers and how to treat?
barium swallow
myotomy
What is the diagnostic test for acute diverticulitis?
CT with contrast
two types of hiatal hernias?
how to treat?
sliding and paraesophageal.
usually sliding is associated with gerd so treat the gerd.
symptomatic para need surgery
What is a complication of diverticulitis and how will it present?
fistula
air in the urine on imaging
what cancer is found at the confluence of the hepatic ducts?
cholangiocarcinoma, called a klatskin tumor
association and identifying symptom for primary sclerosing cholangitis?
UC
pruritis
Identifying symptom of primary biliary cirrhosis?
xanthomata with pruritis
charcots triad is for which disease?
cholangitis
what are the two initial and confirming tests for cholecystitis?
US
HIDA
triad of hereditary hemochromatosis?
skin hyperpigmentation, hepatic cirrhosis, and diabetes from iron depositing all over.
“Bronze Diabetic”
what is diagnostic of spontaneous bacterial peritonitis?
Two most common bugs causing it?
Paracentesis of the ascites showing polys leukocytes greater than 250
E coli
Klebsiella
diagnostic test of choice for diverticulitis?
CT
