GI Flashcards
What 2 meds commonly cause esophagitis
NSAIDs
Bisphophonates
Pt w/ asthma and GERD not responsive to antacids
A barium swallow will show a ribbed esophagus and multiple corrugated rings
eosinophilic esophagitis
shallow punched out lesions on EGD
tx?
HSV esophagitis
tx w/ acyclovir
large solitary ulcers or erosions on EGD
tx?
CMV esophagitis
tx w/ ganciclovir
tx for corrosive esophagitis
steroids
tx for esophageal spasm (corkscrew esophagus on barium)
Nitro
CCB
Virchow’s node (lyphadenopathy at the left supraclavicular region
gastric cancer
Signs of what
Virchow’s node (left Supraclavicular)
Sister Mary Joseph’s node (Umbilical)
gastric cancer
Endoscopic finding: Linitis plastica
Finding of wht?
gastric cancer
What things in your diet increase risk of gastric cancer
Where is it MC
smoked meats, high nitrates, low fruits and vegetables, alcohol, tobacco
Very common in Japan
What are the sxs of gastric cancer
“WEAPON”
Weight loss
Emesis
Anorexia
Pain/epigastric discomfort
Obstruction
Nausea
what is diagnostic for Zollinger Ellison syndrome
gastrin levels (> 150 pg/mL is suggestive - > 200 pg/mL is diagnostic)
50% of patients with PUD + diarrhea have what
zollinger ellison syndroms
what bacteria most commonly causes cholangitis
E. coli
what is Charcot’s triad
Reynaulds pentad?
CHARCOTS= F + Jaundice + RUQ pain
Reynaulds= above + hypotension + AMS
what antibiotic is a major cause of biliary sludge
ceftriaxone
what is the most concerning hepatitis for babies
Hep E + mother –> high infant mortality
Travel from asia is indicative of what hepatitis
hep A
what is elevated in HCC
Alpha fetoprotein
(if elevated then get MRI)
fever + abdominal pain in patient with cirrhosis= ?
spontaneous bacterial peritonitis
Budd Chiari (hepatic vein thrombosis) is triad of what?
abdominal pain
ascites
hepatomegaly
MCC acute pancreatitis
(“GET SMASHED”)
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune disease
Scorpion sting
Hypercalcemia
Hyperlipidemia
ERCP
Drugs
what test is most sensitive for chronic pancreatitis
ERCP
tumor marker for pancreatic cancer
CA 19-9
what is Courvoisier’s sign.
Nontender, palpable gallbladder
may indicate pancreatic neoplasm.
MC pancreatic cancer
ductal adenocarcinoma- usu. @ head of the pancreas
what node is seen in pancreatic cancer
Virchow’s node (left supraclavicular)
what 2 blood tests can be useful in testing for celiac dz
IgA endomysial antibody
IgA tTG antibody
the malabsorption syndrome in celiac disease is due to what
sensitivity to Gliadin (a fraction of GLUTEN)
what is seen on histology on a biopsy from someone with celiacs dz
villous atrophy
hypertrophy of intestinal crypts
incr. lymphocytes in lamina propria
What 2 bacteria are MCly implicated in diverticulosis
E. coli
Bacteroides fragilis
currant jelly stool
intussusception
abd. x-ray showing: “Crescent sign” or a “Bull’s eye/target sign/coiled spring lesion”
ultasound showing: “target sign”
intussusception
What holistic remedy can help in IBS (hint: oil)
peppermint oil
What are the ALARM symptoms for GI
Weight loss
Iron deficiency anemia
FHx of certain organic GI illnesses (eg, inflammatory bowel disease, celiac sprue, colorectal cancer)
rectal bleeding
nocturnal symptoms
what will be seen on abdominal x-ray in ischemic bowel
“thumb-printing” of small bowel or right colon due to submucosal bleeding
what is gold standard for dx of ischemic bowel
Mesenteric angiography
tx for ischemic bowel
revascularization
What is the hydrogen breath test vs the urea breath test for?
hydrogen breath test= lactose intolerance
Urea breath test= H. pylori
Colonic Polyps:
_______ adenomas have a 30-70% risk of malignant transformation
villous adenomas
- 1st degree relatives of patients with Familial adenomatous polyposis (FAP) should undergo genetic screening after what age
10 y/o
The family of patients with Familial adenomatous polyposis (FAP) should undergo yearly sigmoidoscopy beginning at what age
12y/o
if an adenometous colonic polyp is removed during colonoscopy, when should colonoscopy be repeated
3-5yrs
colonic polyps: what 3 things increases risk of malignant transformation
- villous adenoma
- Large polyp (the larger, the higher the risk)
- The higher the number of polyps
which 2 meds may help prevent formation of new polyps in patients with polyps or colon cancer
Aspirin
COX-2 inhibitors
Toxic megacolon is commonly a complication of what disease
ulcerative colitis
(less commonly Chrons)
tx for toxic megacolon
decompression of the colon
+/- colectomy
what is the most common site of an anal fissure
Posterior midline (comparatively low blood flow)
What is a sentinel pile
Thickened mucosa/skin at the distal end of an anal fissure that is often confused with a small hemorrhoid
tx for anal fissures
Fluid, fiber, sitz baths
Nitro ointment, topical CCB, or botox
if resistent: Lateral anal sphincterotomy
tx for rectal abscess
surgical drainage + warm-water cleansing, analgesics, stool softeners and a high-fiber diet
What disease process should you be worried about in an elderly person with recurrent fecal impaction?
colon cancer
At what age should you refer to surgery if an umbilical hernia persists that was present at birth
>2y/o
Location of direct inguinal hernia
Passage of intestine through the external inguinal ring at Hesselbach triangle
RARELY enters the scrotum
child w/ a musty, mousy odor
PKU
How is PKU inherited
autosomal recessive disorder
(absent phenylalanine hydroxylase (PAH) enzyme activity)
Affects CNS—> mental retardation
tx for PKU?
lifelong dietary phenylalanine restriction (low protein)
Foods high in phenylalanine:
- milk
- cheese
- nuts
- fish
- chicken
- meats
- eggs
- legumes
- aspartame (in diet soda)
What can act as a poison for patients with PKU
the sweetener aspartame
blond, blue-eyed, with fair skin, mental retardation, eczema, and a musty, mousy body odor
PKU
How often should the phenylalanine levels of infants undergoing treatment for phenylketonuria be monitored?
weekly
