GI Correlation Flashcards
what are acholic stools?
white clay colored stools, which result from the absence of secretion of bile into the GI tract
what is Cullen sign?
ecchymosis around the umbilicus secondary to hemorrhage
what is dyspepsia?
postprandial epigastric discomfort
what is dysphagia?
difficulty in swallowing
what is hematemesis?
vomiting blood
what is hematochezia?
passage of bright red blood or maroon stools
what is melena?
dark colored stool consistent with broken down hemosiderin in bowel; tarry
what is pneumobilia?
abnormal presence of gas in the biliary system/bile ducts
what is pneumomediastinum?
abnormal presence of air or gas in the mediastinum
what is a pneumoperitoneum?
abnormal presence of air or gas in the peritoneal cavity
what is odynophagia?
painful swallowing
if someone comes in with RUQ what should you think?
gallbladder issues
if someone comes in with epigastric pain what should you think?
pancreatitis or PUD/GERD
if someone comes in LUQ pain what should you think?
gastritis or PUD
if someone comes in with RLQ pain what should you think?
appendicitis
if someone comes in with LLQ pain what should you think?
diverticulitis
if someone comes in with peri-umbilical pain what should you think?
small or large bowel obstruction or appendicitis
what is visceral pain secondary to?
distention or stretching
what is parietal pain secondary to?
inflammation in the parietal peritoneum
how is oropharyngeal dysphagia characterized and what is the most likely category of causation?
trouble initiating swallowing and neurologically caused
what questions are important to ask if someone comes in with esophageal dysphagia?
solids liquids, or both; progressive or not; constant or intermittent
what are the categories of causation for esophageal dysphagia?
mechanical or motility
what is in a CBC?
blood cell count
what is a CBC with Diff?
a blood count with the percentage and absolute differential counts (Baso, Eos, Mono)
what does a basic metabolic panel show?
your electrolytes
what does a comprehensive metabolic panel show?
your electrolytes + liver function tests
what would you order if you were checking for pancreatitis?
lipase and amylase
what would you order to assess the liver?
AST/ ALT, GGT, fractionate bilirubin, and PT/INR
what does an acute abdominal series consist of?
a single view chest x-ray and a flat and upright x-ray of the abdomen
what is an acute abdominal series good for?
great to check quickly for free air (pneumoperitoneum) bowel obstruction and/or constipation
what is the barium swallow x-ray used for?
to differentiate between mechanical lesions and motility disorders
barium study is more sensitive for detecting subtle esophageal narrowing due to what?
rings, achalasia, and proximal esophageal lesions
what is the study of choice when a patient has persistent heartburn, dysphagia, odynophagia, or structural abnormalities detected on barium study?
EGD
what is the use of an EGD?
it is diagnostic and therapeutic
what is an ultrasound good for?
imaging fluid filled structures like the gallbladder, bladder, kidneys, aorta and vessels, and the heart
what is an US limited by?
air and fat
what is an ERCP used for?
if you have a patient with gallbladder disease who has elevated liver function tests–> they may have a stone in the common duct
what is the main difference between an ERCP and an MRCP?
an ERCP is both diagnostic and therapeutic while an MRCP is only diagnostic
what is a HIDA scan?
test specific for the gallbladder; measures the functional ability of the gallbladder
if you perform a HIDA scan on a patient and their gallbladder ejection fraction is less than 38%, what do they have?
biliary dyskinesia
what scan gives you the most information about abdominal pathology?
CT scan
how is diagnosis of GERD made?
based on clinical symptoms alone or an upper endoscopy
what are peptic ulcers?
defects in the gastric or duodenal mucosa that extend through the muscularis mucosa
what are two major risk factors for developing peptic ulcers?
H. pylori infection and NSAIDs
what is the most common cause of an UGI bleed?
peptic ulcers
how would you diagnose PUD?
EGD and check for H. pylori infection
what is the treatment for PUD?
proton pump inhibitor and eradicate H. pylori
H. pylori is associated with many types of GI pathology including:
PUD, chronic gastritis, gastric adenocarcinoma, gastric mucosa associated lymphoid tissue (MALT) lymphoma, and duodenal ulcers
what are two ways you can test for H. pylori?
urea breath test and fecal antigen test
how would you get a false negative fecal or urea breath test?
if the patient doesn’t stop their proton pump inhibitor medication 14 days prior to the test
what is melena secondary to 90% of the time?
UGIB
what is hematochezia due to?
lower GI bleed
how is an UGIB defined?
any GI bleed originating proximal to the ligament of Treitz
what organs are involved in an UGIB?
the esophagus, stomach, the duodenum
how is a LGIB defined?
any GI bleed originating distal to the ligament of Treitz
what organs are involved in an LGIB?
jejunum, ileum, colon, and rectum
what are esophageal and gastric varices?
dilated submucosal veins resulting from portal hypertension
what are esophageal and gastric varices most often a result of?
alcoholic liver disease
what is cholelithiasis?
gallstones
what is cholecystitis?
inflammation of the gallbladder usually secondary to stone/obstruction in the neck of the gallbladder or cystic duct- LFTs are normal
what is choledocholithiasis?
when there is a stone stuck in the common bile duct (neither the liver nor the gallbladder can drain bile, LFTs are elevated
what is ascending cholangitis?
the biliary tree gets inflamed and infected; air in the biliary tree
what is gallstone pancreatitis?
when a gallstone gets stuck in the pancreatic duct- elevated LFTs and pancreatic enzymes (lipase and amylase)
how is a dysfunctional gallbladder diagnosed?
with a HIDA scan
what are the risk factors for pancreatitis?
gallstones and alcohol abuse
where does the appendicitis pain become localized?
McBurney’s point
what is diverticulosis?
small pouches called diverticula in the colon
what is diverticulitis?
infection or inflammation of the diverticula
what would the barium swallow test look like on a patient with achalasia?
like a bird’s beak in the distal esophagus
what is Chagas disease?
esophageal dysfunction indistinguishable from primary idiopathic achalasia
when should Chagas disease be considered?
in patients from endemic regions like mexico, central and south america
what is chagas disease caused by?
a parasite= trypanosoma cruzi
