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tsomkapQ > GI COPY > Flashcards

GI COPY Flashcards

1
Q

What GI disease has a Corkscrew on X-Ray?

A

Esophageal spasm and Volvus

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2
Q

What GI disease has an Apple Core on X-Ray?

A

Colorectal Cancer

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3
Q

What GI disease has a stacked coin on X-Ray?

A

Intussusception

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4
Q

What GI disease has a Thumb Print on X-Ray?

A

Toxic Megacolon

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5
Q

What GI disease has an Abrupt Cut off on X-Ray?

A

Volvulus

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6
Q

What GI disease has Barium Clumping on X-Ray?

A

Celiac Sprue

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7
Q

What GI disease has a Bird’s Beak on X-Ray?

A

Achalasia (Think Chagas disease)

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8
Q

What GI disease has a String Sign on X-Ray?

A

Pyrloric Stenosis and Crohn’s Disease

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9
Q

What GI diseases are the causes of solid and liquid dysphagia?

A

Schatzki’s Rings, Stricture, Cancer

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10
Q

What GI diseases are the causes of liquid Dysphagia?

A

Scleroderma and Achalasia

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11
Q

What is Barrett’s Esophagus?

A

Metaplasia of the lower esophagus increased risk of Adenocarcinoma

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12
Q

What are Esophageal Varices?

A

Due to Portal HTN, vomit large amounts of blood when they rupture

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13
Q

What is Mallory-Weiss?

A

Tearing of the lower esophageal sphincter (LES), associated with chronic vomiting, cough up a little blood and possible visible varices

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14
Q

What is Boerhaave Syndrome?

A

Transmural tearing of the Esophagus. Left Sided most common, pneumonia/Pain/Effusion

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15
Q

What is Achalasia?

A

Increased LES Pressure (no Auerbach’s Plexus), Bird’s Beak on X-Ray and also seen in Chagas Disease

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16
Q

What is Hirschprungs Disease?

A

Failure of innervation to the rectum (No Auerbach’s Plexus), lack of meconium passage in the newborn, Neural crest cell migration problem

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17
Q

What is Zenker’s Diverticulum?

A

Cough up undigested food from above the UES, Halitosis, motor dysfunction problem

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18
Q

What is a Traction Diverticulum?

A

Out pouch between the UES and LES

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19
Q

What is Plummer-Vinson Syndrome?

A

esophageal webbing at the UES, spoon nails from iron deficiency anemia

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20
Q

What is Schatzki’s Ring?

A

Esophageal webs in the lower Esophagus

Dysphagia (mucosal tissue)

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21
Q

What is a Tracheoesophageal (TE) Fistula (H-Type)?

A

Chokes with each feeding and is Congenital

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22
Q

What is an Esophageal Atresia with a TE Fistula (C-Type)?

A

Baby vomits with first feeding, large gastric bubble and distended abdomen (failure of apoptosis)

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23
Q

What is duodenal Atresia?

A

Bilious vomiting with first feeding, double bubble sign on x-ray, associated with Downs Syndrome

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24
Q

What is Pyloric Stenosis?

A

Non-bilious projectile vomiting (3-4 week old) and RUQ Olive Mass on Palpation

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25
Q

How does Choanal Atresia Present?

A

Baby turns blue with feeding, pinks up when breast of bottle is removed (blocked nasal passages)

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26
Q

How does Tetrology of Fallot (TOF) present differently from Choanal Atresia?

A

TOF Babies… Turns blue with crying and has No feeding issues

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27
Q

What makes Scleroderma Unique?

A

Can have a decreased LES pressure or and increased LES pressure

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28
Q

What makes Esophageal Spasms Unique?

A

Increased Peristalsis

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29
Q

What makes Achalasia unique?

A

Decreased Peristalsis and increased LES pressure

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30
Q

What GI disease has a RUQ Olive Mass?

A

Pyloric Stenosis

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31
Q

What GI diseases has a RLQ Sausage mass?

A

Intussusception

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32
Q

What is a Bezoar?

A

Mass of non-digestible product (i.e. Hair) causing an occlusion at the pylorus

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33
Q

What is Type A gastritis?

A

Upper GI bleed, autoimmune (anti-parietal cell antibodies), Atrophic / Achlorhydria and increased risk for adenocarcinoma (body & fundus region of the stomach)

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34
Q

What is Type B gastritis?

A

Upper GI bleed, associated with eating spicy foods, loss of barrier protection and H. Pylori infections (antrum of stomach)

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35
Q

What is a Duodenal Ulcer?

A

Pain 20-30 minutes after eating, relieved with food, caused by H. Pylori infection 80-90% of the time and weight gain

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36
Q

What is a Gastric Ulcer?

A

Loss of protective barrier, pain during the meal, associated with NSAIDs, H. Pylori infection and weight loss

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37
Q

What is a Sliding Hiatal Hernia?

A

Fundus of the stomach herniates through the Esophageal Hiatus into the Thorax

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38
Q

What is a Rolling Hiatal Hernia?

A

Bowel Protruded through a defect in the Diaphragm. This can strangulate the bowel and can cause Atelectasis

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39
Q

What is Menetrier’s Disease?

A

Loss of protein through the rugal folds. Causes generalized edema. CMV association in children and H. Pylorus in Adults

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40
Q

What defines constipation?

A

Less than 3 bowel movements per week

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41
Q

What defines Diarrhea?

A

> 200 grams of stool per day

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42
Q

What is Osmotic Diarrhea?

A

High osmolality in the bowel pulling water into the lumen

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43
Q

What is Secretory Diarrhea?

A

Water pushed from cells into the gastric lumen (increased cAMP)

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44
Q

What is Inflammatory Diarrhea?

A

Diarrhea with blood and pus

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45
Q

What is Celiac Sprue?

A

Found in the Jejunum
Wheat Allergy
Villous atroph
Anti-gluter-gliadin antibodies

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46
Q

What is Tropical Sprue?

A

Found in the distal ilium
Caused by bacterial or viral, amoeba or parasitic infection
Villous atrophy

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47
Q

What is Mesenteric Ischemia?

A

Abdominal pain of of proportion to physical exam

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48
Q

What bugs cause Bloody Diarrhea?

A

“CASES”: Campylobacter, AMoeba (Entamoeba Histolytica), Shigella, E. coli and Salmonella

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49
Q

What is Primary Biliary Cirrhosis?

A

Anti-Mitochondrial antibody Bile ducts are destroyed

Xanthelasmas present and pruritis

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50
Q

What is Primary Sclerosing Cholangitis?

A

Anti-smooth muscle antibody (20-50%), bile ducts are scarred from inflammation, there is beading and onion skinning, it’s associated with UC and P-ANCA (80%)

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51
Q

What is Ascending Cholangitis?

A

Common bile duct infection due to stones

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52
Q

What are the physical signs of Alcoholic Cirrhosis?

A

Spider Angioma, Palmar Erythema, Gynecomasatia and Dupuytren’s Contracture

53
Q

What is Hepatorenal Syndrome?

A

Build up of liver toxins that cause renal failure

54
Q

What is Cholangitis?

A

Inflamed bile duct

55
Q

What is Cholecystitis?

A

Inflammation of the gallbladder

56
Q

What is Cholelithiasis?

A

Formation of gallstones

57
Q

What is Choledocholithiasis?

A

Gallstone obstructs the bile duct

58
Q

What is Cholestasis?

A

Obstructed bile duct

High Alk Phos (if in the common bile duct)

59
Q

What is Conjugated Bilirubin?

A

Water soluble and direct Bilirubin

60
Q

What is Unconjugated Bilirubin?

A

Fat soluble and indirect Bilirubin

61
Q

What is the most common type of Gallstone?

A

Cholesterol stone (not see on X-ray)

62
Q

What type of Gallstone can be seen on X-Ray?

A

Calcium Bilrubinate stone

63
Q

What is a Xanthoma

A

Cholesterol build up (common at the elbow or Achilles tendon)

64
Q

What is a Xanthelasma?

A

Triglyceride build up and is seen under the eyes (Xanthoma subtype)

65
Q

What can high Cholesterol Cause?

A

Atherosclerosis

66
Q

What can high Triglycerides Cause?

A

Pancreatitis

67
Q

What is Type 1 Hyperlipidemia?

A

Defective Liver Lipoprotein Lipase (chylomicrons are elevated)

68
Q

What is Type 2A Hyperlipidemia?

A

Defective LDL-Clathrin Pit or B-100 (LDL are elevated)

69
Q

What is Type 2B Hyperlipidemia?

A

Deficiency of adipose receptors and LDL receptors (Increased LDL and VLDL levels)

70
Q

What is Type 3 Hyperlipidemia?

A

Defective ApoE (Elevated ILD)

71
Q

What is Type 4 Hyperlipidemia?

A

Defective Adipose Lipoprotein Lipase, elevated VLDL

72
Q

What is Type 5 Hypderlipidemia?

A

Defective enzyme and receptor (C-II)
Elevated VLDL and Chylomicrons
Associated with DM

73
Q

What do Chylomicrons do?

A

They take Triglycerides (TG) from GI to liver and endothelium

74
Q

What does VLDL do?

A

It takes TG’s from liver to adipose

75
Q

What does IDL do?

A

It takes TG’s from adipose to tissue

76
Q

What does LDL do?

A

It carries Cholesterol (only one to do this)

77
Q

Where is VLDL made?

A

Liver

78
Q

What are the breakdown products of VLDL?

A

IDL and LDL

79
Q

What is the treatment for hypercholesterolemia?

A

Statins

80
Q

What is the only statin to undergo renal excretion?

A

Pravastatin

81
Q

What blood level should be monitored in patients taking statins?

A

Liver enzymes every 3 months and Serum Cr

82
Q

What is the MOA of Statins?

A

Inhibit HMG CoA reductase

83
Q

What is Crigler-Najjar Type I?

A

Unconjugated bilirubin buildup
Newborn or infants
No UDP-GT
Phenobarbital yields no change

84
Q

What is Gilbert’s Syndrome?

A

Stress induced elevated
Unconjugated Bilirubin
Increased load saturates Glucuronyl Transferase

85
Q

What is Rotor’s?

A

Defective Bilirubin storage and Elevated Conjugated Bilirubin

86
Q

What is Dubin-Johnson?

A

Defective Bilirubin storage
BLACK LIVER
Increased conjugated bilirubin

87
Q

What is Cullen’s SIgn?

A

Bruising around the umbilicus

Caused by hemorrhagic pancreatitis (late sign)

88
Q

What is Grey-Turner’s Sign?

A

Bleed into Flanks and caused by Hemorrhagic Pancreatitis (early signs)

89
Q

What tests are used for following Pancreatitis?

A

Amylase (sensitive) breaks down Carbohydrates and Lipase (specific) breaks down Triglycerides

90
Q

What will Ranson’s criteria tell you and what will you see at 48 hours?

A

Prognosis of Pancreatitis patients
BUN >5 mg/dL (decreased RBF)
Calcium <8mg/dL (saponification)
HCT drops >10% (bleeding into pancreas)
sequester > 6 liters of fluid (3rd spacing)
Oxygen pO2 <60 mmHg (fluid/protein leak, leads to ARDS)
base deficit >4 mEq/L (diarrhea due to no pancreatic enzymes)

91
Q

What is Carcinoid Syndrome (Triad)?

A

Diarrhea, flushing and wheezing

92
Q

What is Peutz Jegher Syndrome?

A

Hyper-pigmented lower lip, patients will have dark gyms and vagina, and small bowel polyps

93
Q

What produces Currant Jelly Sputum

A

Klebsiella

94
Q

What produces Currant Jelly stool?

A

Intussusception

95
Q

What is Turcot’s Syndrome?

A

Familial Polyposis with Brain Tumors

96
Q

What is Gardener’s Syndrome

A

Familial Polyposis with Bone Tumors

97
Q

What is Familial Polyposis?

A

100% ridk of Colon Cancer, APC gene defect and annual Colonoscopy start at 5 years of age

98
Q

What is Ulcerative Colitis?

A

Starts at the rectum and ascends,
1%/year risk for CA
IBD with Pseudopolyps, hematochezia, Lead pipe colon and Toxic Megacolon

99
Q

What is Crohn’s Disease?

A

Transmural, Cobblestones, Melena, Creepig Fat, Fistula, Skip lesions

100
Q

What is Intussusception?

A

Currant Jelly Stool, Stacked Coin Enema, sausage shaped mass and knees to chest for comfort

101
Q

How does Diverticulosis Present?

A

Gross blood

102
Q

How does Diverticulitis present?

A

Pain in LLQ, no visible blood and may cause peritonitis

103
Q

How does Spastic Colon present?

A

Intermittent severe cramps

104
Q

How does Irritable Bowel Syndrome (IBS) present?

A

Alternating diarrhea/ constipation
History of stress
No abnormalities on colonoscopy

105
Q

What is Pseudomembranous Colitis?

A

Overgrowth of C. Diff

Due to normal flora being killed off from long term antibiotic use

106
Q

What is Whipple’s Disease?

A 
Tropheryma Whipplei (T. Whipplei) destroy the GI tract
Causing Malabsorption/Arthralgia, PAS (+)
107
Q

What color is stool with an Upper GI Bleed?

A

Black (Dark Red) (Melena)

108
Q

What color is stool with a Lower GI Bleed?

A

Bright Red Blood (Hematochezia)

109
Q

What adds color to Stool?

A

Stercobilinogen being oxidized to stercobilin

110
Q

What gives urine its yellow color?

A

Urobilinogen being oxidized to urobilin

111
Q

What is the common side effect of the ERCP procedure?

A

Pacreatitis from blocking the pancreatic duct during the procedure

112
Q

What is Charcot’s Triad?

A

Jaundice, Fever (usually with rigors) and RUQ pain

113
Q

What is Reynold’s Pentad?

A

Jaundice, Fever (usually with Rigors), RUQ Pain, Hypotension and change in mental status

114
Q

What separates unconjugated bilirubin from albumin?

A

Sulfur (no Sulfur Rx in pregnancy)

115
Q

What does Sudan Black Stain test for?

A

Steatorrhea (fat malabsorption), patient seen with chronic pale, greasy, malodorous diarrhea and no evidence of infection

116
Q

What are the risk factors for Primary Liver Cancer?

A

Hepatitis B & C, Aflatoxin, Alcohol, Smoking and Hemochromatosis

117
Q

What are the risk factors for Esophageal / Gastric CA?

A

Smoking, alcohol and nitrates

118
Q

What are the bacteria associated with Colon CA?

A

Clostridium Melanogosepticus and Streptococcus Bovis

119
Q

What Hepatitis B labs indicate an acute recent infection?

A

HBcAg+, HBsAg+, (HBcAb+/-)

120
Q

What hepatitis B labs indicate recent immunization within >2/52wks?

A

HBsAg+

121
Q

What hepatitis B labs indicate immunization >2/52 weeks?

A

HBsAb+

122
Q

What hepatitis B labs indicate previous infection and now immunity?

A

HBcAb+, HBsAb+, HBsAg-

123
Q

What hepatitis B labs indicate infectious state?

A

HBeAg+

124
Q

What hepatitis B labs indicate non-infectious state?

A

HBeAg-

125
Q

What hepatitis B labs indicate a chronic carrier state?

A

HBsAg+, (>6 months), HBsAb (+/-)

126
Q

What hepatitis B labs indicate that the patient is in the window period?

A

HBeAb+, HBcAb+, HBsAg-

127
Q

What are the bugs that cause gastroenteritis within 8 hours of eating the preformed toxin?

A 
Staph Aureus (potato salad)
Clostridium Perfringens (holiday turkey/ham)
Bacillus Cereus (fried rice syndrome)
128
Q

Patients who test positive for TTG and anti-endymysial antibodies may develop a skin condition. What is the treatment?

A

celiac disease (gluten intolerance with resulting gastrointestinal symptoms) may develop a skin condition called dermatitis herpetiformis. This condition is characterized by pruritic, papulovesicular lesions located symmetrically on the extensor surfaces of the elbows, knees, sacrum, buttocks, face, neck, trunk, and occasionally the mouth.

Treatment consists of initiation of a gluten-free diet and administration of dapsone.

tsomkapQ (117 decks)

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