GI Flashcards
Right-Sided Heart Failure is associated with what type of GI Symptom?
Firm, Smooth, Tender, Pulsatile Liver
What is the sign on an X-Ray of a Cholocystoenteric Fistula?
Pneumobilia
Is Achalasia an Obstructive or Motility Disorder?
Motility Disorder
A patient has Lynch Syndrome, what organ is at particularly high risk of developing a Carcinoma?
Stomach (Gastric)
GIST’s develop from what type of Cells?
Interstitial Cells of Cajal
What condition presents between 2-6 weeks of age?
Pyloric Stenosis
What Surgery is Indicated for Recurrent Esophageal Varices?
TIPS
What lymph nodes will most likely be the earliest metastatic site for Gallbladder Cancer?
Lund’s Node
What drug can cause Hypokalemia?
Senna
What artery supplies the Posterior part of the Stomach?
Splenic Artery
What is the adverse effect of Metoclopramide in younger patients?
Oculogyric Crisis (Upward deviation of the eyes)
What is Courvoisier’s sign?
A palpable gallbladder in the presence of painless jaundice is unlikely to be gallstones
What is green vomit indicative of in a baby?
Bowel Obstruction
What Gene Mutation is associated with Pancreatic Cancer?
KRAS
Extra-Intestinal Manifestations of IBDs?
Aphthous ulcers Pyoderma gangrenosum Iritis Erythema nodosum Sclerosing cholangitis Arthritis Clubbing
Where is the site of obstruction in a patient with an annular pancreas?
Second part of the Duodenum
What is the Surgery for Achalasia?
Heler’s Cardiomyotomy
What Cells are needed to make a diagnosis of Barrett’s?
Columnar Epithelium + Goblet Cells
What are the Autoimmune Antibodies in Pernicious Anemia?
Autoimmune Antibodies to Parietal Cells
What is a sign of Cecal Carcinoma?
Weight Loss, Microcytic Anemia, Pain/Mass in the RIF
What Fistulas Can form as a Complication of Diverticular Disease?
Colovesical Fistula Colovaginal Fistula Colouterine Fistula Coloenteric Fistula Colocutaneous Fistula
Which has a Shorter Half-Life, Albumin or Prothrombin?
Prothrombin
Lynch Syndrome is Associated with what type of Tumors?
Right-Sided Colonic Malignancy & Endometrial Malignancy
What is Murphy’s Sign?
It is inspiratory arrest upon the palpation of the Right Upper Quadrant (Suggestive of Cholecystitis)
Affect of Somatostatin on the GI Tract
Stimulates pancreatic acinar cells to release lipase
Name a Laxative which has Carcinogenic Potential
Co-Danthramer is genotoxic and should only be prescribed to palliative patients.
Describe Diphenoxylate MOA
Diphenoxylate acts on μ-opioid receptors in the GI tract to slow down peristalsis
What artery supplies the Bile Duct?
Hepatic Artery
What Components of Blood are affected post-splenectomy?
The granulocyte and platelet count are the first to be affected following splenectomy. Then reticulocytes increase. Although lymphocytosis and monocytosis are reported, these take several weeks to develop.
What is underactive in Gilbert’s Syndrome?
There is decreased activity in Glucuronyltransferase.
What Causes Exudative Ascites?
Infection, Malignancy, Inflammation
What Arthritic Conditions are associated with IBD?
Migratory Polyarthritis & Sacrolitis
What is the most common cause of Nodular Hepatomegaly?
Liver Metastases
Describe a Cholestatic Picture. (LFTs)
ALP & GGT raised more than ALT/AST
What is the “Bird Beak Sign” on a Barium Swallow?
The gross dilatation of the proximal esophagus and the stricturing of the distal esophagus.
Describe a Carcinoid Tumor
It is an uncommon serotonin-secreting neuroendocrine tumor, that is typically seen in the terminal ileum.
What are the Charactersitics of Gilbert Syndrome?
Unconjugated Hyperbilirubinemia
Normal Liver function
No Hemolysis
No Evidence of Liver Disease
What is a Complication of Appendicitis?
It can result in a thrombosis of the appendicular artery (AKA endarteritis obliterans)
Symptoms of Appendicitis in Children
Pain
Tachycardia
Low-Grade Fever
Raised Inflammatory Markers
What is a risk factor for HCC that is associated with grains and seeds?
Aflatoxin
Are Psuedopolyps seen in UC or Crohns?
UC
An APC mutation is seen in FAP, what is seen on a Colonoscopy?
Multiple Colonic Adenomas
What is the MOA of Metoclopramide?
Metoclopramide acts directly on the smooth muscle of the LOS to cause it to contract.
What is the pathophysiology of Acute Pancreatitis?
It includes autodigestion of pancreatic tissue by the pancreatic enzymes, leading to necrosis
What is the cause of Pernicious Anemia?
Pernicious anaemia is due to autoimmune destruction of gastroparietal cells.
What is a contraindication for Laprascopic Surgery?
Raised Intracranial Pressure
What Blood tests are required for a carcinoid tumor?
Chromogranin A
Neuron-specific enolase (NSE)
Substance P
Gastrin
A colonic Polyp is associated with what growth/change process?
Dysplasia
Where do the peptic ulcers caused by Zollinger-Ellison Syndrome typically appear?
First/Second Part of the Duodenum
What is the physiological cause of pale stools or dark urine?
Decreased levels of conjugated bilirubin reaching the intestinal tract leads to a decreased production of stercobilin.
What is the most common site of ischemic colitis?
The Splenic Flexure
What type of epithelial cells exist in the gallbladder?
Simple Columnar Epithelium
The loss of which enzyme leads to steatorrhea?
Lipase
What tumor marker is associated with Colon Cancer?
CEA
What is the most commonly damaged nerve during vein harvest for CABG?
Saphenous nerve
What is the common presenting picture with Giardia lamblia?
Giardia causes fat malabsorption, therefore greasy stool can occur. It is resistant to chlorination, hence risk of transfer in swimming pools.
Where are bile salts absorbed?
Terminal Ileum
Name and list a reason for administering drugs for a patient with Crohn’s.
Corticosteroids - 2nd line to induce remission
5-ASA - 1st Line for inducing remission
Anti-TNF - Used in refractory and Fistulating Crohn’s
Name the borders of the Femoral Canal
Inguinal Ligament - Anterior
Pectineus - Posterior
Femoral Vein - Lateral
Lacunar Ligament - Medial
What is a structural abnormality that can lead to chronic pancreatitis?
Pancreas divisum
What is the most likely underlying condition in a patient with celiac disease that initially improves then the symptoms re-appear?
T-Cell Lymphoma
What drug increases the rate of gastric emptying in a vagotomized stomach?
Erythromycin
What type of tissue may be seen in Meckel’s Diverticulum?
Ectopic Tissue
What is the most common site of Bowel intussusception?
Ileocolic
What are the symptoms/signs of Scurvy?
Gingivitis
Perifollicular Hemorrhages
What drug should be avoided in bowel obstruction?
Metoclopramide
Raised Serum Urea levels are seen as a complication in what condition?
Upper GI Bleed
What is the MOA of metoclopramide?
It inhibits dopamine (D2) receptors and Serotonin (5-HT3) receptors, in the Chemoreceptor Trigger Zone (CTZ).
What is the first-line investigation in a suspected perforated Peptic Ulcer?
Erect Chest X-Ray
What deficiencies can lead to Budd-Chiari Syndrome?
Protein C/S
What are the 3 borders of the Hepatobiliary Triangle?
Common Hepatic Duct
The Cystic Duct
Inferior surface of the Liver
What does H.pylori increase/decrease in the stomach?
Increases Acid Production
What mutation is a risk factor for desmoid tumors?
APC Mutation
What is the hormone that inhibits Gastrin?
Somatostatin
What are the investigations for Achalasia?
Endoscopy
Barium Swallow
Esophageal Manometry
What Hormones do carcinoid tumors produce?
Serotonin, Bradykinin, Histamine, Prostaglandins
What is an isolated rise in ALP commonly associated with?
Primary Sclerosing Cholangitis
What embryological layer do Mallory Bodies originate from?
Endodermal
What are the symptoms of Small Intestinal Bacterial Overgrowth?
Symptomatic Anemia
Chronic Diarrhea
Low Vitamin B12
High Folate
What are the 4 features seen in the tetralogy of Fallot?
Pulmonary Stenosis
Right Ventricular Hypertrophy
VSD
Overriding Aorta
What cardiac abnormality is associated with Late-stage cirrhosis and alcohol abuse?
Dilated Cardiomyopathy
What drug is used in the prophylactic treatment of esophageal varices?
Non-Cardioselective Beta Blockers (Propranolol)
“Chain of Lakes” is seen in what condition?
Chronic Pancreatitis
GET SMASHED is a mnemonic for causes of pancreatitis. What does it stand for?
Gallstones Ethanol (alcohol) Trauma Steroids Mumps, malignancy Autoimmunity Scorpion stings Hyperlipidemia, hypercalcemia ERCP Drugs