Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PANRE > GI and Nutrition 10% > Flashcards

GI and Nutrition 10% Flashcards

1
Q

Mechanical or functional abnormality of the Lower Esophageal Sphincter (LES)

A

Reflux esophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Medication induced esophagitis etiology

A

NSAIDS or bisphosphonates (drugs that prevent the loss of bone density, used to treat osteoporosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Asthma symptoms and GERD not responsive to antacids.

A

Eosinophilic esophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Eosinophilic esophagitis findings

A

Allergic, eosinophilic infiltration of the esophagus; barium swallow will show multiple corrugated rings.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Esophagitis with linear yellow-white plaques with odynophagia (pain on swallowing).

A

Fungal: Infectious Candida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fungal esophagitis treatment

A

Fluconazole 100 mg PO daily

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Esophagitis with shallow ulcers noted on EGD; treatment

A

HSV; acyclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Esophagitis with deep ulcers on EGD; treatment

A

CMV; ganciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Additional infectious esophagitis causes

A

EBV, Mycobacterium tuberculosis, and Mycobacterium avium intracellulare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Failure of LES relaxation and increased LES tone, decreased peristalsis, slowly progressive dysphagia to liquids and solids, episodic regurgitation

A

Achalasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Achalasia test/findings

A

Barium swallow: “parrot-beak” - dilated esophagus tapered to distal obstruction. Definitive diagnosis: esophageal manometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Corkscrew appearance on barium swallow

A

Diffuse esophageal spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dysphagia to liquids and solids caused by injury at brainstem or cranial nerves

A

Neurogenic dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Outpouching of posterior hypopharynx - regurgitation of undigested food and liquid into the pharynx several hours after eating, foul odor of breath. Diagnostic test.

A

Zenker diverticulum; barium swallow.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Decreased esophageal sphincter tone and peristalsis, dysphagia to both solids and liquids

A

Scleroderma esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dysphagia to solids but not liquids

A

Esophageal stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Esophageal mucosal tear caused by forceful vomiting - history of alcohol intake and an episode of vomiting with blood

A

Mallory Weiss tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Progressive dysphagia to solid foods along with weight loss, reflux and hematemesis

A

Esophageal neoplasms.

Squamous cell m/c worldwide and adenocarcinoma common in US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Complication of Barrett’s esophagus, affects distal (lower) 1/3rd of esophagus

A

Adenocarcinoma.
Screen barrett’s patients every 3-5 years with endoscopy
[A/B = Adeno/Barrett’s]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q 
Associated with smoking and alcohol use.
Affects proximal (upper) 2/3rds of esophagus
A

Squamous cell carcinoma

[S/S = Smoking/Squamous]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Solid food dysphagia in a patient with a history of GERD

A

Esophageal strictures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Thin membranes in the mid-upper esophagus. May be congenital or acquired.

A

Esophageal web.

Plummer-Vinson = esophageal webs + dysphagia + iron deficiency anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

A diaphragm-like mucosal ring that forms at the esophagogastric junction (the B ring). If the lumen of this ring becomes too small, symptoms occur

A

Schatzki ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Dilated veins in the distal esophagus or proximal stomach caused by elevated pressure in the portal venous system, typically from cirrhosis.

A

Esophageal varices

Budd-Chiari syndrome (from occlusion of hepatic veins)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Esophageal varices treatment

A

Endoscopic banding and IV octreotide (causes vasoconstriction in the blood vessels, and
reduces portal vessel pressures in bleeding varices). Prevent with nonselective beta blockers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Retrosternal pain/burning shortly after eating worse with carbonation, greasy foods, spicy foods and laying down

A

GastroEsophageal Reflux Disease (GERD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Gastroesophageal reflux disease (GERD) testing

A

Endoscopy with biopsy—the test of choice but not necessary for typical uncomplicated cases. Indicated if refractory to treatment or is accompanied by dysphagia, odynophagia, or GI bleeding.
Upper GI series (barium contrast study)—this is only helpful in identifying complications of GERD (strictures/ulcerations)
PH Probe is gold standard for diagnosis (but usually unnecessary)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Gastroesophageal reflux disease (GERD) treatment

A

H2 receptor blockers, proton pump inhibitors, diet modification (avoid fatty foods, coffee, alcohol, orange juice, chocolate; avoid large meals before bedtime); sleep with trunk of body elevated; stop smoking
Nissen fundoplication: antireflux surgery for severe or resistant cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Gastroesophageal reflux disease (GERD) complications:

A

Strictures or Barrett’s esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Dyspepsia and abdominal pain

A

Gastritis (inflammation along the stomach lining)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Gastritis testing

A

Gold standard diagnosis is endoscopy with 4 biopsies along stomach lining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Gastritis due to autoimmune or hypersensitivity reaction

A

Pernicious anemia: + schilling test + ↓ intrinsic factor and parietal cell antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Most common cause of gastritis; tests; treatment

A

Infection - H. pylori
Studies: Urea breath test or fecal antigen
Treatment: PPI (Ie. Omeprazole) + clarithromycin + amoxicillin +/- metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Gastritis, other causes

A

NSAIDS: cause gastric injury by diminishing local prostaglandin production in the stomach and duodenum
Alcohol: a leading cause of gastritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Weight loss, early satiety, abdominal pain/fullness and dyspepsia

A

Gastric neoplasms.

Adenocarcinoma is most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Metastatic signs of gastric neoplasms

A

Virchow’s node (Supraclavicular)

Sister Mary Joseph’s node (Umbilical)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Peptic ulcer disease causes

A

H. pylori (most common), NSAID use, Zollinger-Ellison syndrome (refractory PUD) - gastrin secreting tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Peptic ulcer disease: location - symptoms

A

Duodenal ulcer - pain improves with food

Gastric ulcer - pain worsens with food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Peptic ulcer disease testing

A

Endoscopy with biopsy is gold standard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Peptic ulcer disease treatment

A

H. pylori infection: Triple therapy PPI (ie. Omeprazole) + clarithromycin + amoxicillin +/- metronidazole.
NSAIDs use: discontinue
Zollinger-Ellison syndrome (gastrin-secreting tumor or hyperplasia of the islet cells in the pancreas causes overproduction of gastric acid, resulting in recurrent peptic ulcers: PPI and resect tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Projectile vomiting occurring shortly after feeding in an infant < 3 mo old with a palpable “olive-like” mass at the lateral edge of the right upper quadrant

A

Pyloric stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Pyloric stenosis testing

A

On ultrasound you will see a “double-track”

Barium studies will reveal a “string sign” or “shoulder sign”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

The 5 F’s: Female, Fat, Forty, Fertile, and Fair

A

Acute and chronic cholecystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Acute and chronic cholecystitis sign/symptoms

A

(+) Murphy’s sign (RUQ pain with GB palpation on inspiration)
RUQ pain after high fat meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Acute and chronic cholecystitis testing

A

Ultrasound is the preferred initial imaging.
HIDA (Hepatobiliary IminoDiacetic Acid) is the gold standard.
Porcelain gallbladder = chronic cholecystitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Acute and chronic cholecystitis treatment

A

Laparoscopic cholecystectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Complication of gallstones with symptoms secondary to an infected obstruction of the common bile duct; #1 cause

A

Cholangitis

E.coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Charcot’s triad of cholangitis

A

RUQ tenderness, jaundice, fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Reynold’s pentad of cholangitis

A

Charcot’s triad + altered mental status and hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Cholangitis diagnosis and treatment

A

ERCP (Endoscopic Retrograde Cholangio-Pancreatography)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Cholelithiasis

A

Precursor to cholecystitis

Cholesterol stones account for > 85% of gallstones in the Western world

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Cholelithiasis diagnosis

A

Abdominal ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Hepatitis A presentation

A

Acute - fatigue malaise, nausea, vomiting, anorexia, fever and right upper quadrant pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Hepatitis A transmission

A

Fecal-oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Hepatitis A testing

A

Serum IgM anti-HAV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Hepatitis A vaccine

A

Killed (inactivated) - given in two doses; recommended for travelers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Hepatitis B presentation

A

Acute and chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Hepatitis B transmission

A

Sexual or sanguineous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Hepatitis B serology

A 
HBeAg – highly infectious
HBsAg – ongoing infection
Anti-HBc – had/have infection
IgM – acute
IgG – not acute
Anti-HBs – immune
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Hepatitis B increases risk of _______________

A

Hepatocellular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Hepatitis B vaccine

A

Given to all infants (birth, 1-2 mo, 6-18 mo)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Hepatitis C presentation

A

Chronic [C = chronic] ; asymptomatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Hepatitis C transmission

A

IV drug use is most common. Also sexual or sanguineous.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Hepatitis C screening

A

Testing for anti-HCV antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Hepatitis C diagnosis

A

HCV RNA quantitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Hepatitis C increases risk of _________

A

Cirrhosis and hepatocellular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Hepatitis C treatment

A

Antiretrovirals target complex of enzymes needed for HCV RNA synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Hepatitis D only occurs when coinfected with ______ and increases risk of _______

A

Hepatitis B; hepatocellular carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Hepatitis E demographic

A

Pregnant woman, 3rd world countries.

Hepatitis E + mother = high infant mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

A late stage of hepatic fibrosis that has resulted in widespread distortion of normal hepatic architecture

A

Cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Most common cause of cirrhosis

A

Chronic hepatitis (21%); Alcohol abuse is second (21%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Cirrhosis labs

A

AST > ALT, ↑ risk for hepatocellular carcinoma: monitor AFP, ↑ ALP and GGT, low albumin, prolonged PT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Budd-Chiari syndrome

A

Hepatic vein thrombosis; triad of abdominal pain, ascites and hepatomegaly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Cirrhosis signs/symptoms

A

Ascites, pulmonary edema/effusion, esophageal varices, Terry’s nails (white nail beds)
Skin changes: spider angiomata, palmar erythema, jaundice, scleral icterus, ecchymoses, caput medusae, hyperpigmentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Hepatic encephalopathy

A

Asterixis (flapping tremor), dysarthria, delirium, and coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Liver neoplasms presentation

A

Abdominal pain, weight loss and right upper quadrant mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Liver neoplasms etiology

A

Cirrhosis, Hepatitis B, Hepatitis C, Hepatitis D, Aflatoxin from aspergillus

78
Q

Liver neoplasms testing

A

Tumor Marker: ↑ alpha-fetoprotein and abnormal liver imaging

79
Q

Acute pancreatitis presentation

A

Epigastric abdominal pain with radiation to the back, pain relieved by leaning forward, elevated lipase

80
Q

Acute pancreatitis etiology

A

Cholelithiasis or alcohol abuse

81
Q

Acute pancreatitis diagnosis

A

Clinical: + elevated lipase and amylase.

CT required to differentiate from necrotic pancreatitis

82
Q

Acute pancreatitis signs

A

Grey Turner’s sign (flank bruising), Cullen’s sign (bruising near umbilicus)

83
Q

Acute pancreatitis treatment

A

IV fluids (best), analgesics, bowel rest

84
Q

Pancreatic pseudocyst

A

Acute pancreatitis complication; a circumscribed collection of fluid rich in pancreatic enzymes, blood, and necrotic tissue

85
Q

Acute pancreatitis Ranson’s criteria

A 
The Ranson criteria form a clinical prediction rule for predicting the severity of acute pancreatitis.  Three or more means more severe course:
Age > 55
Leukocyte: >16,000
Glucose: >200
LDH: >350
AST: >250
Calcium: <8.0
86
Q

Chronic pancreatitis findings

A

Classic triad of pancreatic calcification (plain abdominal x-ray), steatorrhea (high fecal fat), and diabetes mellitus

87
Q

Chronic pancreatitis etiology; treatment

A

Alcohol abuse; no alcohol, low-fat diet

88
Q

Pancreatic neoplasm presentation

A

Painless jaundice is pathognomonic

89
Q

Pancreatic neoplasm, most common

A

Ductal adenocarcinoma located at pancreatic head

90
Q

Courvoisier’s sign

A

Jaundice and palpable non-tender gallbladder with pancreatic neoplasms

91
Q

Trousseau sign

A

Migratory phlebitis; sign of malignancy with pancreatic neoplasms

92
Q

Virchow’s node (or signal node)

A

A lymph node in the left supraclavicular fossa (the area above the left clavicle) that is associated with pancreatic cancer

93
Q

Pancreatic neoplasm diagnosis

A

Abdominal CT scan - 75% show tumor at the head of the pancreas, 25% at the tail

94
Q

Pancreatic neoplasms treatment

A

Whipple procedure: remove antrum of stomach, part of duodenum, head of pancreas, gall bladder

95
Q

Appendicitis presentation

A

Umbilical pain → then pain over McBurney’s point (RLQ).

Nausea and vomiting, fever, chills, anorexia.

96
Q

Appendicitis most common etiology

A

Acute inflammation of the appendix secondary to fecalith

97
Q

McBurney’s sign

A

Pain with palpation of RLQ - appendicitis

98
Q

Rovsing’s sign

A

RLQ pain with palpation of the LLQ - appendicitis

99
Q

Obturator Sign

A

RLQ pain upon flexion and internal rotation of right lower extremity - appendicitis

100
Q

Iliopsoas sign

A

RLQ pain with right hip extension - appendicitis

101
Q

Appendicitis treatment

A

Appendectomy

102
Q

Small bowel inflammation from allergy to gluten

A

Celiac disease

103
Q

Celiac disease symptoms

A

Usually occur following ingestion of gluten-containing food (diarrhea, steatorrhea, flatulence, and weight loss). Also, has extraintestinal manifestations.

104
Q

Celiac disease diagnosis; treatment

A

IgA anti-endomysial and anti-tissue transglutaminase antibodies.
Small bowel biopsy is gold standard for diagnosis.
Lifelong gluten free diet.

105
Q

Constipation defined

A

Any two of the following features: straining, lumpy hard stools, a sensation of incomplete evacuation, use of digital maneuvers, a sensation of anorectal obstruction or blockage with 25 percent of bowel movements, and decrease in stool frequency (less than three bowel movements per week).

106
Q

Constipation treatment

A

Increase fiber (20-25 grams per day), exercise and water in diet. Bulk-forming laxatives first line and osmotic laxatives can be used in patients not responding satisfactorily to bulking agents.

107
Q

Patients who are older than 50 with new onset constipation should be evaluated for ______

A

Colon cancer

108
Q

Out-pocketing of colon wall - most common location is the sigmoid colon

A

Diverticular disease

109
Q

Diverticulosis presentation

A

Painless rectal bleeding

110
Q

Diverticulitis presentation

A

Constipation, LLQ pain, fever, ↑ WBC, and generally don’t bleed

111
Q

Diverticular disease diagnosis

A

CT: Fat stranding and bowel wall thickening

112
Q

Diverticular disease treatment

A

Metronidazole and Ciprofloxacin + bowel rest

113
Q

Inflammatory bowel disease types

A

Ulcerative colitis, Crohn’s disease

114
Q

Ulcerative colitis natural history; findings

A

Isolated to the colon starts at rectum and moves proximally; continuous lesions; mucosal surface only

115
Q

Ulcerative colitis testing

A

Barium enema: Lead pipe appearance (loss of haustral markings)

116
Q

Ulcerative colitis treatment

A

Medications: Prednisone and mesalamine

Colectomy is curative

117
Q

Crohn’s disease natural history; findings

A

From mouth to anus, transmural, skip lesions, and cobblestoning, fistulas common

118
Q

Crohn’s disease treatment

A

Flares: Prednisone +/- Mesalamine +/- Metronidazole or Ciprofloxacin.
Maintenance: Mesalamine
Surgery is not curative

119
Q

Intussusception presentation

A

Sudden onset of significant, colicky abdominal pain that recurs every 15 to 20 min, often with vomiting. Affects children after viral infections or adults with cancer

120
Q

Intussusception findings

A

Currant jelly stools; sausage-like mass in the abdomen

121
Q

Intussusception diagnosis; treatment

A

Abdominal x-ray will reveal a “Crescent sign” or a “Bull’s eye/target sign/coiled spring lesion” representing layers of the intestine within the abdomen.
Barium enema is both diagnostic and therapeutic in children.

122
Q

Irritable bowel syndrome defined

A

According to the Rome IV criteria, IBS is defined as recurrent abdominal pain, on average, at least one day per week in the last three months, associated with two or more of the following criteria:
Related to defecation
Associated with a change in stool frequency
Associated with a change in stool form (appearance)

123
Q

Ischemic bowel disease presentation

A

Sudden onset abdominal pain occurring 10-30 minutes after eating in a patient (usually elderly) with a risk of emboli formation (on the exam it is usually atrial fibrillation or CHF). It is associated with bleeding per rectum with or without diarrhea.

124
Q

Ischemic bowel disease most common artery affected

A

Superior mesenteric artery

125
Q

Ischemic bowel disease symptoms, acute; chronic

A

Acute: Abdominal pain out of proportion to findings
Chronic: pain 10-30 mins after eating, relieved by lying or squatting

126
Q

Ischemic bowel disease diagnosis; treatment

A

Mesenteric angiography is the gold standard for diagnosis.

Revascularization is the gold standard treatment

127
Q

Lactose intolerance symptoms

A

Abdominal bloating and cramps, flatulence, diarrhea, nausea, borborygmi (rumbling stomach), or vomiting after consuming significant amounts of lactose

128
Q

Lactose intolerance diagnosis; treatment

A

Lactose hydrogen breath test - definitive diagnosis.

Treatment focuses on avoidance of dairy products, use of lactose-free products, or the use of lactase supplements.

129
Q

Colon cancer presentation

A

Painless rectal bleeding and a change in bowel habits in a patient 50-80 years of age

130
Q

Colon cancer screening

A

Colonoscopy begins at 50 then every 10 years until 85.
Fecal occult blood testing - annually after age 50.
Flexible sigmoidoscopy - every 5 years with FOB testing.
Sometimes CT colonography

131
Q

Colon cancer testing

A

Barium enema - apple core lesion; adenoma most common type.

Tumor Marker: CEA

132
Q

Colon cancer characteristics

A

More likely to be malignant: sessile, > 1 cm, villous.

Less likely to be malignant: Pedunculated, < 1 cm, tubular.

133
Q

Colon cancer treatment

A

Resection and adjuvant chemotherapy

134
Q

Small bowel obstruction presentation

A

Look for vomiting of partially digested food, severe abdominal distension and high pitched hyperactive bowel sounds progressing to silent bowel sounds.

135
Q

Small bowel obstruction testing

A

KUB (kidney, ureter, bladder) shows dilated loops of bowel with air fluid levels with little or no gas in the colon

136
Q

Small bowel obstruction etiology

A

Adhesion, hernia, fecal impact, volvulus, neoplasm

137
Q

Small bowel obstruction treatment

A

Bowel rest, NG tube placement, surgery as directed by underlying cause

138
Q

Colon polyps incidence

A

Colonic polyps are common; the incidence ranges from 7% to 50% (depending on the diagnostic method used)

139
Q

Colon polyps and risk of malignant transformation

A

The main concern is malignant transformation, which occurs at different rates depending on the size and type of polyp
Distal colon are commonly benign if seen in the proximal colon they are more likely to be cancerous
The larger the colonic polyp, the greater the risk of malignant transformation
Villous adenomas have a 30-70% risk of malignant transformation
The greater the number of concomitant colonic polyps, the greater the risk of malignant transformation

140
Q

Most common cause of painless rectal bleeding in the pediatric population

A

Colon polyps

141
Q

Colon polyps follow-up

A

Once identified follow-up colonoscopy in 3-5 years

142
Q

Familial adenomatous polyposis (FAP)

A

Characterized by the development of hundreds to thousands of colonic adenomatous polyps.
Colorectal polyps develop by mean age of 15 years and cancer at 40 years

143
Q

Familial adenomatous polyposis (FAP) screening

A

First-degree relatives of patients with FAP should undergo genetic screening after age 10 years
The family should undergo yearly sigmoidoscopy beginning at 12 years of age

144
Q

Complication of ulcerative colitis (most common), Crohn’s, Hirschsprung’s, pseudomembranous colitis, enteritis.

A

Toxic megacolon

145
Q

Toxic megacolon findings

A

KUB shows dilated colon > 6 cm and colonic distention, fever, markedly distended abdomen, peritonitis, and shock.

146
Q

Anal fissure presentation

A

Tearing rectal pain and bleeding which occurs with or shortly after defecation, bright red blood on toilet paper. Pain lasts for several hours and subsides until the next bowel movement

147
Q

Rectal abscess and fistula etiology

A

Anorectal abscess is a result of infection, whereas fistula is a chronic complication of an abscess.

148
Q

Rectal abscess findings

A

Painful swelling at the anus as well as painful defecation. Examination reveals localized tenderness, erythema, swelling, and fluctuance; fever is uncommon.
Deeper abscesses may produce buttock or coccyx pain and rectal fullness; fever is more likely.

149
Q

Rectal fistula defined; symptoms

A

Anorectal fistula is an open tract between two epithelium-lined areas and is associated with deeper anorectal abscesses.
Fistulae will produce anal discharge and pain when the tract becomes occluded.

150
Q

Fecal impaction presentation

A

Belly cramping and bloating, small amount of stool leakage and rectal discomfort in an elderly bed-bound patient.

151
Q

Hemorrhoids, external, findings/treatment

A

Lower 1/3 of anus (below dentate line).

Significant pain, and pruritus but no bleeding; treat with excision for thrombosed external hemorrhoids.

152
Q

Hemorrhoids, internal, findings/treatment

A

Upper 1/3 of anus.

No Pain, bright red blood per rectum, pruritus and rectal discomfort; treat with fiber, sitz baths, reduction if needed

153
Q

Anorectal cancer presentation

A

Rectal bleeding + tenesmus (a feeling of incomplete emptying after a bowel movement)

154
Q

Most common anorectal cancer

A

Adenocarcinoma

155
Q

Anorectal cancer diagnosis; treatment

A

Typically colonoscopy is done: whenever rectal bleeding occurs, even in patients with obvious hemorrhoids or known diverticular disease, coexisting cancer must be ruled out.
Treated with wide local surgical excision, radiation with chemotherapy for large tumors with mets.

156
Q

Indirect inguinal hernia

A

Most common. Passage of intestine through the internal inguinal ring down the inguinal canal, may pass into the scrotum. Often congenital and will present before age one.

157
Q

Direct Inguinal Hernia

A

Passage of intestine through the external inguinal ring at Hesselbach triangle, rarely enters the scrotum.

158
Q

Hiatal (diaphragmatic)

A

Involves protrusion of the stomach through the diaphragm via the esophageal hiatus. It can cause symptoms of GERD; acid reduction may suffice, although surgical repair can be used for more serious cases.

159
Q

Ventral hernia

A

Often from previous abdominal surgery, obesity. Abdominal mass noted at site of previous incision.

160
Q

Umbilical hernia

A

Very common, generally is congenital and appears at birth. Many umbilical hernias resolve on their own and rarely require intervention. Refer to surgery if an umbilical hernia persists >2 years of life.

161
Q

Strangulated hernia

A

Hernia becomes strangulated when the blood supply of its contents is seriously impaired.

162
Q

Obstructed hernia

A

An irreducible hernia containing intestine that is obstructed from without or within, but there is no interference to the blood supply to the bowel.

163
Q

Incarcerated hernia

A

Hernia so occluded that it cannot be returned by manipulation, it may or may not become strangulated.

164
Q

Traveler’s diarrhea

A

E-coli.

165
Q

Diarrhea after a picnic and egg salad

A

Staphylococcus aureus.

166
Q

Diarrhea from shellfish

A

Vibrio cholerae.

167
Q

Diarrhea from poultry or pork

A

Salmonella.

168
Q

Diarrhea in a patient post antibiotics

A

C. Difficile.

169
Q

Diarrhea in poorly canned home foods

A

C. perfringens.

170
Q

Diarrhea breakout in daycare center

A

Rotavirus.

171
Q

Diarrhea on a cruise ship

A

Norovirus.

172
Q

Diarrhea after drinking (not so) fresh mountain stream water

A

Giardia lamblia; Campylobacter

173
Q

Giardia lamblia presentation

A

Incubates for 1-3 weeks, causes foul smelling bulky stool and may wax and wane over weeks before resolving.

174
Q

Campylobacter presentation

A

Incubation 2-5 days; rapid onset fever, cramping abdominal pain, bloody diarrhea

175
Q

Kwashiorkor

A

Inadequate intake of protein and may lead to edema.

176
Q

Marasmus

A

Inadequate intake of ALL energy forms (including protein).

177
Q

Vitamin A deficiency

A

Elderly, alcoholics, liver disease - night blindness, dry skin.

178
Q

Vitamin D deficiency

A

Elderly, low sunlight - rickets, osteomalacia.

179
Q

Vitamin E deficiency

A

Neuropathy, ataxia

180
Q

Vitamin K deficiency

A

Bleeding (makes clotting factors causes an increase in PT/INR).

181
Q

Vitamin C deficiency

A

Alcoholics, elderly men - scurvy (poor wound healing, petechiae, bleeding gums).

182
Q

Thiamine (B1) deficiency

A

Alcoholics, poverty.
Beriberi (tingling, poor coordination, edema, cardiac dysfunction).
Wernicke’s encephalopathy (ataxia, confusion).
Korsakoff syndrome (confabulation, retrograde and anterograde amnesia).

183
Q

Niacin (B3) deficiency

A

Poverty, alcoholics.

Pellagra (diarrhea, dermatitis, dementia).

184
Q

Pantothenic Acid (B5) deficiency

A

Alcoholics - Numbness, tingling, headache, fatigue, insomnia.

185
Q

Pyridoxine (B6) deficiency

A

Adolescents, alcoholics - Dermatitis, atrophic glossitis, sideroblastic anemia.

186
Q

Folate deficiency

A

Pregnancy, alcoholics - Neural tube defects, megaloblastic anemia, glossitis, confusion.

187
Q

Cobalamin (B12) deficiency

A

Elderly, vegans, atrophic gastritis - Megaloblastic anemia, subacute combined degeneration of spinal cord, seizures, dementia.

188
Q

Phenylketonuria (PKU)

A

An autosomal recessive disorder and inborn error of metabolism involving absent or virtually absent phenylalanine hydroxylase (PAH) enzyme activity.
Phenylalanine and its metabolites accumulate in the central nervous system, causing mental retardation and movement disorders.

189
Q

Phenylketonuria (PKU) presentation

A

Infants are normal at birth - after a few months, mental retardation is evident.
Presents as blond, blue-eyed, with fair skin, mental retardation, eczema, and a musty, mousy body odor of phenylacetic acid.

190
Q

Phenylketonuria (PKU) screening

A

Neonates are screened for PKU 24 to 48 h after birth.

Treatment: Low phenylalanine diet and tyrosine supplementation by age 3.

PANRE (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions