GI

Question 1

Backflow of gastric contents into esophagus through LES

Inflammation caused by reflux of highly acidic material (esophagitis)

Answer 1

GERD

Question 2

Any condition or agent that alters closure strength of LES or increases abdominal pressure, fatty foods, caffeine, large amounts of alcohol, cigarette smoking, pregnancy, anatomic features (ex: hiatal hernia)

Answer 2

GERD

Question 3

Clinical manifestations

Heartburn, regurgitation, chest pain, dysphagia

Answer 3

GERD

Question 4

Increasing LES pressure
Enhancing esophageal clearance
Improving gastric emptying
Treatment for _________

Answer 4

GERD

Question 5

Suppressing gastric acidity
Avoiding tobacco and aggravating food and drink
Treatment for _______

Answer 5

GERD

Question 6

Over-the-counter antacids and histamine (H2)-blocking medications used for treatment of ______

Answer 6

occasional GERD

Question 7

Proton pump inhibitors (PPIs) are the mainstays for ______

Answer 7

chronic GERD

Question 8

Upper GI endoscopy for ongoing symptoms
Endoscopic dilatation for strictures
Treatment for _____

Answer 8

GERD

Question 9

Surgical intervention (thoracoscopic Nissan fundoplication) for ________

Answer 9

intractable GERD

Question 10

Columnar tissue replaces normal squamous epithelium of the distal esophagus.
Carries a significant risk for esophageal cancer

Answer 10

Barrett esophagus/type of GERD

Question 11

Progression can lead to ulceration, fibrotic scarring.

Esophageal strictures

Answer 11

GERD

Question 12

Pulmonary symptoms—cough, asthma, and laryngitis—from reflux in breathing passages

Answer 12

GERD

Question 13

Complication of portal hypertension resulting from alcoholic or viral hepatitis

Answer 13

Esophageal Varices

Question 14

In developing countries, Schistosoma species of liver flukes major cause
Affects more than half of cirrhotic patients
High mortality rate

Answer 14

Esophageal Varices

Question 15

Inflammation of the stomach lining

Answer 15

Gastritis

Question 16

Precipitated by ingestion of irritating substances
Example: alcohol and aspirin, NSAIDs, viral, bacteria, autoimmune
______ Gastritis

Answer 16

Acute

Question 17

Clinical manifestations

May be asymptomatic; anorexia, n/v, postprandial discomfort, hematemesis

Answer 17

Gastritis

Question 18

Treatment

Remove offending agent

Answer 18

Gastritis

Question 19

Helicobacter pylori is nearly always a factor
Transmission: person to person, fecal-oral route, reservoir in water sources
in _______

Answer 19

chronic gastritis

Question 20

Complications
Peptic ulcer disease
Atrophic gastritis
Gastric adenocarcinoma
Mucosa-associated lymphoid tissue lymphoma
Decreased acid and intrinsic factor

Answer 20

chronic gastritis

Question 21

Inflammation of stomach and small intestine (usually self-limiting)

Answer 21

Gastroenteritis

Question 22

_______ gastroenteritis: usually result of another GI disorder

Answer 22

chronic

Question 23

______ gastroenteritis: direct infection by pathogenic bacteria or bacterial toxin
May be caused by imbalance in normal bacterial flora by introduction of unusual bacteria (travel)

Answer 23

acute

Question 24

Disorders of upper GI tract caused by action of acid and pepsin
Injury to the mucosa of the esophagus, stomach, or duodenum
Range from a slight mucosal injury to severe ulceration

Answer 24

Peptic Ulcer Disease

Question 25

Increase in factors that tend to injure the mucosa relative to factors that tend to protect it

Answer 25

Peptic Ulcer Disease (PUD)

Question 26

NSAIDs, stress (glucocorticoids), smoking, genetics | causes of ______

Answer 26

PUD

Question 27

No connection between ______ and PUD

Answer 27

diet

Question 28

Key role in promoting both gastric and duodenal ulcer formation

Answer 28

H Pylori

Question 29

Thrives in acidic conditions Slow rate of ulcer healing High rate of recurrence

Answer 29

H Pylori

Question 30

H Pylori a cause of ______

Answer 30

PUD

Question 31

Clearance of H. pylori promotes ulcer healing IN ____

Answer 31

PUD

Question 32

Caused by breakdown of protective mucous layer that normally prevents diffusion of acids into gastric epithelia because of chronic irritations Aspirin, NSAIDs, alcohol, and bile acids

Answer 32

Gastric PUD

Question 33

Inappropriate excess secretion of acid

Answer 33

Duodenal PUD

Question 34

Increased basal activity of vagus nerve Stimulates pyloric antrum cells to release gastrin to act on gastric parietal cells to release HCl Results in high level of HCl

Answer 34

Duodenal PUD

Question 35

Epigastric burning pain that is usually relieved by the intake of food (especially dairy products) or antacids

Answer 35

PUD

Question 36

Life-threatening complications, such as GI bleeding, may occur with no warning.

Answer 36

PUD

Question 37

Pain of _______ulcers typically occurs on an empty stomach but may present soon after a meal. Pain of _______ulcer classically occurs 2 to 3 hours after a meal and is relieved by further food ingestion.

Answer 37

GASTRIC; DUODENAL

Question 38

Upper GI barium contrast radiography or by endoscopy | diagnosis for _______

Answer 38

PUD

Question 39

_____ ulcers should be visualized with endoscopy and biopsied to rule out malignancy.

Answer 39

gastric

Question 40

Testing for H. pylori diagnoses _____ Recommended for ____ Controversial for _____

Answer 40

PUD; gastric; duodenal

Question 41

Encourage healing of the injured mucosa by reducing gastric acidity. Prevent recurrence H. pylori antibiotics Treatment for ______

Answer 41

PUD

Question 42

H2 antagonists Proton pump inhibitors Sucralfate (forms protective coating over injured mucosa) Treatment for _______

Answer 42

PUD

Question 43

Smoking cessation Avoidance of ASA and NSAIDs Treatment for _______

Answer 43

PUD

Question 44

Stress reduction Avoid irritating foods that exacerbate symptoms. Caffeinated beverages and alcohol for ex. Treatment for ________

Answer 44

PUD

Question 45

Complications: perforation, bleeding

Answer 45

PUD

Question 46

Chronic inflammatory disease of the mucosa of the rectum and colon Large ulcers form in mucosal layer of colon and rectum.

Answer 46

Ulcerative Colitis

Question 47

Begins as inflammation at base of crypts of Lieberkühn; damage results; abscess formation in crypts; abscesses begin to coalesce, large ulcerations develop in epithelium

Answer 47

Ulcerative Colitis

Question 48

Associated with increased cancer risk after 7 to 10 years of disease Have exacerbations and remissions

Answer 48

Ulcerative Colitis

Question 49

Hallmark clinical manifestations are bloody diarrhea and lower abdominal pain.

Answer 49

Ulcerative Colitis

Question 50

Mainstay treatment for acute ulcerative colitis is _____

Answer 50

corticosteroids

Question 51

Broad spectrum antibiotic Salicylate analogs Treatment for ______

Answer 51

Ulcerative Colitis

Question 52

Immunomodulating agents Azathioprine Mercaptopurine Treatment for ______

Answer 52

Ulcerative Colitis

Question 53

Intravenous followed by oral cyclosporine for refractory Infliximab (Remicade) for refractory for treatment of ______

Answer 53

Ulcerative Colitis

Question 54

Also called regional enteritis or granulomatous colitis

Answer 54

Crohn Disease

Question 55

Affects proximal portion of the colon or terminal ileum | Chronic inflammation of all layers of intestinal wall resulting from blockage and inflammation of lymphatic vessels

Answer 55

Crohn Disease

Question 56

Suggestive findings are ulcerations, strictures, fibrosis, and fistulas

Answer 56

Crohn Disease

Question 57

Clinical manifestations Intermittent bouts of fever, diarrhea, if bloody, not as severe as ulcerative colitis; constant, chronic RLQ pain, may have RLQ mass, tenderness

Answer 57

Crohn Disease

Question 58

Alleviating and reducing inflammation Smoking cessation Drugs similar to ulcerative colitis Treatment for _______

Answer 58

Crohn Disease

Question 59

No cure for ______

Answer 59

Crohn Disease

Question 60

Prednisone and sulfasalazine Antibiotics: metronidazole Treatment for _______

Answer 60

Crohn Disease

Question 61

Azathioprine, 6-mercaptopurine, methotrexate, and biological therapies (refractory) Antitumor necrosis factor agents infliximab, adalimumab, and certolizumab (refractory) Treatment for _______

Answer 61

Crohn Disease

Question 62

Acute inflammation and necrosis of large intestine

Answer 62

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

Question 63

Caused by Clostridium difficile (exposure to antibiotics) | Mediated by bacterial toxins

Answer 63

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

Question 64

Clinical manifestations | Diarrhea (often bloody), abdominal pain, fever, leukocytosis, sepsis, colonic perforation (rare)

Answer 64

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

Question 65

Stop current antibiotic (if possible). Treat ischemia. Treat contributing conditions. Treatment for ________

Answer 65

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

Question 66

Oral antibiotics: metronidazole or vancomycin | Treatment for______

Answer 66

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

Question 67

Recurrence common Rare: fecal transplant (transfer of fecal material from another healthy person to the source patient via enema or gastric tube) or colectomy

Answer 67

Antibiotic-Associated Colitis (Pseudomembranous Enterocolitis)

Question 68

Which information is correct regarding pseudomembranous colitis? Pseudomembranous colitis: develops because of overgrowth of Clostridium difficile. does not recur following treatment. is a major cause of diarrhea in premature infants. may also be called regional enteritis.

Answer 68

develops because of overgrowth of Clostridium difficile.

Question 69

Inflammation of the vermiform appendix | Obstruction by fecalith

Answer 69

Appendicitis

Question 70

Clinical manifestations Periumbilical pain, RLQ pain (“McBurney’s point”) (classic, but may be anywhere), nausea, vomiting, fever, diarrhea, RLQ tenderness, systemic signs of inflammation

Answer 70

Appendicitis

Question 71

Immediate surgical removal | Antibiotics with fluid/electrolyte replacement

Answer 71

Appendicitis

Question 72

Untreated _______may result in rupture of the appendix and subsequent peritonitis.

Answer 72

Appendicitis

Question 73

Localized abscesses may be managed with tube drainage and antibiotics.

Answer 73

Appendicitis

Question 74

Presence of diverticula (herniations) in the colon: diverticulosis

Answer 74

Diverticular Disease

Question 75

Results from low intake of dietary fiber | Results in high intraluminal pressure

Answer 75

Diverticular Disease

Question 76

Antibiotics, surgery for abscess | Treatment for _______

Answer 76

Diverticular Disease

Question 77

______—asymptomatic | _______ (inflamed diverticuli)—fever, acute lower abdominal pain, leukocytosis

Answer 77

Diverticulosis; Diverticulitis