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D&T test 7- GI > GI cases > Flashcards

GI cases Flashcards

1
Q

Peutz-Jeghers is what? and is associated with what two conditions?

A
  • it is hammartomatous polyps throughout GI track

- associated w: GI carcinoma, hyperpigmented lesions around mouth, hands, genitals

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2
Q

Kaposi’s sarcoma lesions usually present where

A

hard palate

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3
Q

oral hairy leukoplakia is associated with what

A

ebv

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4
Q

What disease does coxsackie virus cause in mouth and how does it present

A

(Hand-foot-mouth disease) painful vesicles or small white papules occur on an erythematous base typically at the junction of
the soft and hard palate

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5
Q

Dermatitis herpetiformis is assc with what disease? presents how? What pathogenesis

A

Celiac dz: vesicles on extensor surfaces of knees and elbows.
type III HSR with IgA-anti-IgA complex deposition at tip of dermal papillae

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6
Q

CP: erythema multiform vs. SJS/TEN

A

erythema: targetoid lesions

SJS/TEN: blistering throughout

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7
Q

erythema multiform vs. SJS/TEN: etiology

A

erythema: HSV, mycoplasma

SJS/TEN: drug rxn: NSAIDs, ABX, anti-epileptic

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8
Q

Bullous Pemphigoid vs Pemphigus Vulgaris: antibodies vs what? bullae presentation, sign?

A

Vulgaris: antibodies vs Desmosomes (clincially more severe), Nikolsky sign, flaccid bullae

Bullous: tense bullae, Anti-Hemidesmosome Abs, no sign

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9
Q

What are the major risk factors for SqCC of the mouth? (4)

A

Alcohol, tobacco, HPV, chronic inflammation

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10
Q

is SqCC of mouth painful or painless? MC population?

A

painless

MC >40

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11
Q

What direction/general location of the lesions has a better prognosis in oral SqCC

A

more anterior = better px (catch it sooner if it’s on the lips)

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12
Q 
Salivary gland tumors: MC:
age
sex
race
which gland
A

parotid
females
30-60
AA

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13
Q

TEF: how does it present and why (3)

A
  1. polyhydramnios- baby can’t swallow and absorb amniotic fluid
  2. air in abdomen= distention
  3. pneumonitis (aspiration)
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14
Q

What doe sthe VATER syndrome stand for

A

V= vertebral
A = anal atresia
TE fistula
R - renal disease/radial agenesis

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15
Q

What does VACTERL stand for

A 
V = vertebral anomalies
A  = anal atresia
C= cardiac anomalies
TE fistula
R = renal disease/radial agenesis
L = limb abnormalities
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16
Q

What does CHARGE stand for?

A 
C= coloboma
H = heart defects
A = atresia of nasal choanae
R = retardation of development
G = GU abnormalities
E = ear abnl/deafness
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17
Q

What does CREST stand for?

A 
Calcinosis
Raynauds
Esophageal dysmotility
Sclerodactyly
Telangectasias
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18
Q

CP and test (and how performed) for Myasthenia Gravis

A

weaker as the day goes on

tensilon test - administer edrophonium (AChesterase inh) - if gets stronger = MG

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19
Q

Pathogenesis of achalasia (primary and secondary)

A

Primary: myenteric plexus degeneration in LES –> decreased NO and VIP –> inability to relax LES

Secondary: Chagas (t. cruzi) damages plexus…

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20
Q

What 3 drug be used to treat Achlalasia and how does they work

A
  1. Botulism - ACH inhibitor –> decreased m. tone
  2. Nitrates: NO produciton
  3. CCB = sm relaxation
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21
Q

Candidiasis, HSV, CMV esophagitis:

drug tx

A

Candida: Fluconazole
HSV: Acyclovir
CMV: Gangcyclovir

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22
Q

2 possible outcomes of Barrets esophagus

A
  1. regression with mild dysplsia

2. continued exposure = increased dysplasia, CA, ulceration, stricture

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23
Q

How does a Cushing ulcer cause Gastritis?

A

increased ICP due to trauma, etc –> increased ACh release –> increased acid production

24
Q

Which PUD shows pain that gets better with meals and what is the reasojn

A

Duodenal ulcer: pancreas secretes bicarb into duodenum with meals

25
Q

What drug is a treatment for esophageal varices and how does it work

A

octreotide- decreases splanchnic BF to entire gastric tree

26
Q

difference in gross apearnace and location of Esophageal Adenocarcinoma and esophageal SqCC?

A

adeno: flat lesion in lower 1/3
SqCC: exophytic lesion in upper2/3

27
Q

what 3 sx are seen with gastric CA

A

weight loss, vomiting, epigastric pain

28
Q

What are the 2 LNs assoc with gastric cancer (and where are they?)

A

Virchow’s Node - supraclavicular

Sister Mary joseph Nodule - periumbilical

29
Q

What are the 4 types of gastric CA and which are associated with H. pylori

A

GIST - GI stromal tumor
Intestinal - associated with H.pylori
Diffuse type
MALToma/primay gastric malignant lymphoma

30
Q

What mutations cause GIST (2) and is it benign or malignant

A

KIT or PDGF- benign

31
Q

What causes intestinal-type adenoCA of stomach (4)

A

H.pylori metaplasia, smoked foods, smoking, achlorhydia

32
Q

Diffuse type adenoCA of stomach:

micro appearance, gross appearance

A

micro: signet ring cells diffuse throughout
gross: linitis plastica = thick stomach wall

33
Q

Which 2 bacteria cause diarrhea with inflammation? What is found in stool?

A

Shigella, Campylobacter

WBCs in stool

34
Q

Which 2 bacteria cause diarrhea with NO inflammationo?

A

ETEC, vibrio cholerae

35
Q

How do you dx Celiac dz? (3) and what is one sx?

A

small bowel bx shows blunted villi

Anti-endomysial, or anti-transglutaminase Abs

sx = steatorrhea

36
Q

What is one etiology of lactose intolerance

A

vrial illness –> blunting and atrophy of the intestinal villi –> diarrhea, steatorrhea

37
Q

tx for tropical and celiac sprue

A 
celiac = gluten free diet
tropical = abx
38
Q

Whipple disease: etiology, finding, associated complications (3)

A

T. whipplei infx
PAS+ foamy macrophages
complications: cardiac, arthralgia, neurologic

39
Q

3 things that C.diff presents with

A

watery stool
leukocytosis
fever

40
Q

What are the 2 exotoxins in C. diff and what do they cause

A

Exotoxin A: watery diarrhea, cell death, infl

Exotoxin B: actin depolymerization –> pseudomembranes

41
Q

What 2 drugs tx C.diff

A

oral vancomycin, metronidazole

42
Q

4 CP of appendicits

A

fever, nausea, diarrhea, peritonitis

43
Q

What is elevated in appendicitis (2)

A

WBC, CRP

44
Q

Rovsing’s sign

A

RLQ with palpationof LLQ

45
Q

McBurney sign

A

sever RLQ pain with rebound tenderness

46
Q

What is the etiology and course of appendicitis

A

fecalith or lymphoid hyperplasia in appendix –> inflammation –> edema –> venous congestion –> rupture –> pain improvement –> peritonitis

47
Q

What else can present with LLQ pain besides Appendicitis?

A

Intussuception

48
Q

Intussuception: CP (2), dx, tx

A

CP: intermittent pain (colicky), “currant jelly stool

dx: US of abdomen

tx : air enema

49
Q

Tx steps for lower GI bleed

A
  1. stabilize (fluids, pRBC)
  2. hold offending meds (NSAIDs)
  3. PPI + octreotide
  4. SCope
  5. tagged RBC scan
50
Q

Meckel’s diverticulum: pathogenesis, CP

A

vitelline duct persists –> can contain ectopic gastric (can release acid –> painless bleed) or pancreatic tissue

51
Q

What are meckels rules of 2’s

A 
~2% of pop = MC congenital malf
2 feet of ileocecal valve
2 inches long
2x as common in males
symptomatic by age 2
52
Q

How does diverticulitis present (4)

A

Fever, LLQ pain, leukocytosis, diarrhea

53
Q

tx for diverticulitis

A

Abx (metronidazole) or surgery

54
Q

4 things that cause ileus

A

Surgeries, opiates, hypokalemia, sepsis

55
Q

preferred screening guideline for Colorectal cancer?

A 
COLONSCOPY
At 50 (or 10 years younger than youngest relative with colorectal cancer) – whichever is youngest
56
Q

What is dx? Dysphagia, GERD , hx of autoimmune problems

what labs?

A

scleroderma

anti-centromere Abs

D&T test 7- GI (14 decks)

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