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IM > GI, Harrison > Flashcards

GI, Harrison Flashcards

1
Q

Lymphadenopathy to peritoneal cul de sac palpable on rectal or vaginal examination in patients with gastric CA

A

Blumer’s shelf

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2
Q

Type of gastric CA: Leather bottle appearance

A

Diffuse adenoCA

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3
Q

Aortic wall diameter indicative of AAA

A

> 3 cm or > 50% greater than uninvolved proximal vessel

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4
Q

Pseudoaneurysm involves what layers of the blood vessel

A

Intima and media disrupted; dilatation lined by adventitia only and sometimes by perivascular clot

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5
Q

Aneurysm that affects the entire circumference resulting in a diffusely dilated lesion

A

Fusiform

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6
Q

Aneurysm that affect only a portion of the circumference resulting in out pouching of vessel wall

A

Saccular

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7
Q

MCC pathologic condition associated with degenerative aortic aneurysms

A

Atherosclerosis

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8
Q

Mycotic aneurysms are caused by

A

Salmonella, staph, strep, fungi

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9
Q

Vasculitis that causes thoracic and abdominal aneurysms

A

Behcet’s disease

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10
Q

T/F AAA is usually asymptomatic

A

T

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11
Q

T/F AAA rupture usually occurs without warning

A

T

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12
Q

Modality useful for screening and for serial documentation of aneurysmal size of AAA

A

Abdominal ultrasonography

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13
Q

Modality of choice for rapid bedside diagnosis in patients presenting with suspected or actual rupture of AAA

A

Abdominal ultrasonography

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14
Q

Accurate, non-invasive test to determine the location and size of AAA

A

CT with contrast, MRI

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15
Q

Indications for surgery of AAA

A

1) Symptomatic 2) >5.5 cm even if asymptomatic

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16
Q

EGD visualises up to what part of the GIT

A

Second part of duodenum

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17
Q

Gold standard for diagnosis of colonic mucosal disease

A

Colonoscopy

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18
Q

Flexible sigmoidoscopy visualises up to what part of the GIT

A

60 cm from anal verge

19
Q

Structure identified in ERCP which is cannulated and radio contrast material injected under fluoroscopic guidance

A

Ampula of Vater

20
Q

MCC of ascites

A

Liver cirrhosis

21
Q

Ascites occurs within ___ years in majority of patients with cirrhosis

A

10

22
Q

Distinguishes ascites secondary to portal hypertension from other causes

A

Serum-ascites albumin gradient (SAAG); >1.1 g/dL is from liver cirrhosis, cardiac ascites, portal vein thrombosis, veno-occlusive disease, Budd-Chiari syndrome, fatty liver of pregnancy; less than 1.1 g/dL is from other causes

23
Q

Presence of this substance in ascitic fluid indicates pancreatic ascites/pancreatitis

A

Amylase

24
Q

Cloudy ascites

A

Infection

25
Q

Milky ascites

A

Chylous

26
Q

Bloody ascites

A

Traumatic paracentesis or malignancy

27
Q

Predominantly lymphocytic ascites

A

Tuberculous

28
Q

Low-sodium diet consists of ___ mg/d

A

1,500-2000

29
Q

Diuretic/antimineralocorticoid of choice for ascites

A

Spironolactone

30
Q

Diuretic that causes gynecomastia

A

Spironolactone

31
Q

Therapeutic paracentesis is indicated for

A

1) Large-volume ascites 2) Unresponsive to diuretic therapy 3) Refractory ascites

32
Q

Indicated after large-volume paracentesis to prevent complications of hypotension and renal impairment, if less than 5L

A

Volume expansion with synthetic plasma substitute or NSS

33
Q

Indicated after large-volume paracentesis to prevent complications of hypotension and renal impairment, if greater than or equal to 5L

A

Albumin at 8g/L ascites removed

34
Q

T/F Paracentesis for ascites is considered safe even in coagulopathy

A

T

35
Q

TIPS is inserted between ___ to relieve portal hypertension

A

Hepatic and portal veins

36
Q

TIPS is indicated for

A

Refractory ascites when paracentesis is contraindicated or ineffective, or becomes intolerable

37
Q

Shunt obstruction in TIPS occurs in majority of patients after ___

A

1 year

38
Q

TIPS is contraindicated in

A

1) >70y/o 2) Preexisting hepatic enceph 3) Preexisting cardiac dysfunction 4) Child-Pugh score >12

39
Q

Represents a significant worsening of prognosis in patients with cirrhosis

A

Ascites

40
Q

Reflects irreversible chronic injury of the hepatic parechyma

A

Cirrhosis

41
Q

End-stage liver disease due to excessive and chronic ingestion of alcohol

A

Laennec’s cirrhosis

42
Q

Cirrhosis in which the aetiology is unknown

A

Cryptogenic

43
Q

Alcoholic cirrhosis is significantly accelerated if concomitant ___ is present

A

Hepatitis C infection

44
Q

Central event leading to hepatic fibrosis

A

Activation of hepatic stellate cell

IM (8 decks)

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