GI Flashcards by Mohamed Tabib

Right-Sided Heart Failure is associated with what type of GI Symptom?

Firm, Smooth, Tender, Pulsatile Liver

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What is the sign on an X-Ray of a Cholocystoenteric Fistula?

Pneumobilia

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Is Achalasia an Obstructive or Motility Disorder?

Motility Disorder

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A patient has Lynch Syndrome, what organ is at particularly high risk of developing a Carcinoma?

Stomach (Gastric)

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GIST’s develop from what type of Cells?

Interstitial Cells of Cajal

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What condition presents between 2-6 weeks of age?

Pyloric Stenosis

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What Surgery is Indicated for Recurrent Esophageal Varices?

TIPS

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What lymph nodes will most likely be the earliest metastatic site for Gallbladder Cancer?

Lund’s Node

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What drug can cause Hypokalemia?

Senna

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What artery supplies the Posterior part of the Stomach?

Splenic Artery

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What is the adverse effect of Metoclopramide in younger patients?

Oculogyric Crisis (Upward deviation of the eyes)

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What is Courvoisier’s sign?

A palpable gallbladder in the presence of painless jaundice is unlikely to be gallstones

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What is green vomit indicative of in a baby?

Bowel Obstruction

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What Gene Mutation is associated with Pancreatic Cancer?

KRAS

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Extra-Intestinal Manifestations of IBDs?

Aphthous ulcers
Pyoderma gangrenosum
Iritis
Erythema nodosum
Sclerosing cholangitis
Arthritis
Clubbing

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Where is the site of obstruction in a patient with an annular pancreas?

Second part of the Duodenum

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What is the Surgery for Achalasia?

Heler’s Cardiomyotomy

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What Cells are needed to make a diagnosis of Barrett’s?

Columnar Epithelium + Goblet Cells

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What are the Autoimmune Antibodies in Pernicious Anemia?

Autoimmune Antibodies to Parietal Cells

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What is a sign of Cecal Carcinoma?

Weight Loss, Microcytic Anemia, Pain/Mass in the RIF

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What Fistulas Can form as a Complication of Diverticular Disease?

Colovesical Fistula
Colovaginal Fistula 
Colouterine Fistula 
Coloenteric Fistula 
Colocutaneous Fistula

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Which has a Shorter Half-Life, Albumin or Prothrombin?

Prothrombin

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Lynch Syndrome is Associated with what type of Tumors?

Right-Sided Colonic Malignancy & Endometrial Malignancy

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What is Murphy’s Sign?

It is inspiratory arrest upon the palpation of the Right Upper Quadrant (Suggestive of Cholecystitis)

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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?

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 ```