GI: match buzzword to disease Flashcards
night blindness
bitot’s spot
Vit A Def
ataxia, global confusion, opthalmoplegia
Wernicke encephalopathy triad with dry beri beri
irreversible memory loss, confabulation, psychosis
korsakoff dementia
beriberi
vit B1 thiamine deficiency
Oral = magenta colored tongue, glossitis, angular cheilitis, stomatitis, lesions of mouth, pharyngitis Ocular = photophobia, corneal lesions Genital = scrotal dermatitis
B2 riboflavin def
Dermatitits
Diarrhea
Dementia
(death)
Pellagra— bit B3 def aka niacin
PT undergoing isonizaid for TB
Vit B6 Pyridoxine def
long-standing vegan PT
vit b12 or cobalamin def
PT has pernicious anemia
vit b12 or cobalamin def
PT has CD–what vit def?
vit b12 or cobalamin def
PT on metformin and/or PPI-=what vit def?
vit b12 or cobalamin def
symmetric paresthesia
vit b12 or cobalamin def
Macrocytic anemia (iincreased MCV)
vit b12 or cobalamin def
hyperkeratosis
hemorrhaging
hematologic s/s
Vit C def
bowing of long bones in an adult
Osteomalacia
bowing of femur and tibia bones in child
rickets
urine has mutsy/mousy odor
PKU
pruritic, papulovesicular rash most common on extensor surfaces, neck, trunk & scalp.
+steatorrhea
+bloating
Celiac
Borborygmi
lactose intol
type 1 hypersenstivity rxn
peanut/tree nut allg
elevated transaminases w/o specific history
tylenol OD
deep and rapid breathing, tachycardia, tinnitus
Salicylates OD
labs show
patient with an anion gap metabolic acidosis
Salicylate OD
burning, gnawing epigastric pain +/- N/V
PUD
dyspepsia classically relieved with food
Duodenal PUD
dyspepsia classically worse with food
Gastric PUD
Nocturnal dyspepsia
Duodenal PUD
CXR: air under the diaphragm
perforated PUD
severe, recurrent, multiple or refractory ulcers & diarrhea
Zollinger-ellison
PT has MEN 1
Zollinger-ellison
24-hour urinary 5-hydroxyindoleacetic acid/5-HIAA excretion
Carcinoid Tumor
Leather bottle
linitis plastica–gastric cancer
projectile, non-bilious vomiting
pyloric stenosis
PE: olive shaped, non-tender, mobile hard mass in abdomen
pyloric stenosis
Upper GI series show: String sign
pyloric stenosis
fat, fair, female, forty, fertile
cholelethiasis + cholecystitis
biliary colic
cholelithiasis
episodic, abrupt RUQ or epigastric pain after eating
cholelithiasis
*biliary colic
Continuous RUQ or epigastric pain
acute chole
+murphy sign
acute chole
+Boas sign
Acute chole
pain moves to the right shoulder
acute chole (+Boas sign)
LABS: elevated AST and ALT and incr Alk Phosph
PT: jaundice and prolonged biliary colic
choledocholithiasis
RUQ+ jaundice + fever
Charcot triad
*cholangitis
RUQ+ jaundice + fever + hypotension/shock + AMS
Reynolds pentad
*cholangitis
LABS: positive antimitochondrial antibodies (AMA)s
Primary biliary cholangitis/cirrhosis
LABS: P-ANCA positive
Primary Sclerosing cholangitis
weakness killian triangle
zenkers div
halitosis
zenkers diver
manometry shows non-peristaltic esoph contractions
distal/diffuse esophageal spasm
liquid and solid dysphagia–worsens when liquid is hot/cold
distal/diffuse esophageal spasm
barium esophagram shows corkscrew apperance
diffuse esophageal spasm
manometry shows increased during peristalsis
hypercontractile nutcracker esophagus
barium esophagram shows birds beak
achalasia
Noncircumferential thin membrane in the upper/mid esophagus
esoph web
PT has iron def anemia and dysphagia
esoph web
TRIAD=pummer Vinson syndrome
Circumferential diaphragm of tissue that protrudes into the esophageal lumen
Shatzki ring
esoph ring
Longitudinal superficial/mucosal tears
mallory weiss syndrome
Severe Retrosternal chest pain worse with deep breathing & swallowing,
Boerhaave syndrome
+crepitus on chest palpation
Boerhaave syndrome
+crunching sound on asuculation
+hamman’s sign aka Boerhaave syndrome
+ Hamman’s sign
Boerhaave syndrome
CXR: left-sided hydropneumotharax and pneumomediastinum
Borehaave syndrome
odynophagia + dysphagia + retrosternal CP
esophagitis –infectious
Atopic patient, dyspahgia to solids, odynophagia, reflux
Eosinophilic esoph
endoscopy shows corrugated rings with white exudates in esophagus
eosiniophilic esoph
Esophageal squamous epithelium is replaced by metaplastic columnar cells
Barretts
initial dysphagia to solids— then progress to liquid
esoph CA
Kayser-Fleischer rings
wilson dz
Decreased serum ceruloplasmin
Wilson dz
CM: ascites, hepatomegaly, RUQ pain
Budd Chiari
mildly abnormal LFTs in absence of ETOH abuse
NAFLD
lab work: + ANA, smooth muscle antibodies, incr LFTs
Type 1 auto immune hepatitis
lab work: anti-liver/kidney microsomal antibdoies and increased IgG
type 2 auto immune hepatitis
child + ASA ingestions
reye syndrome
IV drug use
Hep C
allergic to bakers yeast
do not give Hep B vaccine
cullen sign
acute pancreatits
periumbilical ecchymosis
acute pancreatitis
flank ecchymosis
acute pancrea
grey turner sign
acte pancreatits
Acute onset of severe, persistent epigastric pain often radiating to the back
acute pancreatitis
serum lipase 3x elevated
acute pancreatitis
CXR: sentinel loop
acute pancreatitis
calcifications + steatorrhea + DM
chronic pancreatitis
painless jaundice
pruritis
pancreatic CA
trousseau’s sign
pancreatic CA
migratory thrombophlebitis
pancreatic CA
Courvoiser’s sign
pancreatic CA
palpable, NONtender, distended gallbladder
pancreatic CA
Tumor markers = CA19-9
pancreatic CA
painless hematochezia) MCC
diverticulosis
Low grade fever, LLQ pain N/V
diverticulitis
abdominal pain with altered defectaion/bowel habits
+pain often relived with defecation
IBS
Rome IV criteria
used to diagnose IBS
Transmural inflammation colon
CD
Upper GI series (w/ small bowel follow thru) -> string sign
CD
Edoscopy shows skip areas with cobblestoning
CD
anti-Saccharomyces cerevisiae antibodies; iron & B12 deficiency on Lab work
CD
Diarrhea (often bloody), crampy abdominal pain (esp. LLQ) and tenesmus
UC
positive P-ANCA
UC
and/or
PSC
barium enema shows stovepipe or lead pipe sign
UC
hypotension, tachypnea, lactic acidosis, fever, AMS.
signs of intestinal infarction—- acute mes. ischemia
Labs: leukocytosis, lactic acidosis**
acute mesenteric ischemia
atherosclerotic dz
chronic mesenteric ischemia
Most common at “watershed” areas
ischemic colitis
(“thumbprinting on CT of abdomen
Ischemic colitis
+absent bowel sounds
AXR with dilated loops of bowel with no transition zone
Paralytic ileus
Profound bloody diarrhea, abdominal pain & distention, N/V, tenesmus.
+ s/s of systemic–fever, AMS, tachy, hypotension, etc
Toxic megacolon
Abdominal CT: ; “bird-beak
Volvulus
Abdominal X-ray: “bent inner tube” or “coffee bean” sign
Volvulus
obstipation
late findnig for SBO
Bowel sounds = high-pitched tinkles on auscultation & visible peristalsis
early SBO findings
AXR: step ladder appearance
SBO
mucocutaneous hyperpigmentation
Peutz-Jehgers Syndrome (Colorectal CA)
anemia, weakness, RLQ mass
right sided tumor of colorectcal CA
pencile stools
MC left
colorectal CA
Barium enema: apple core lesion
Colorectcal CA
painless bright red blood per rectum–esp on toilet paper
internal hemorrhoid
AXR = double bubble sign
duodenal atrisa
“currant jelly”
intussusception
Sausage shaped mass in the RUQ
intussusception
Abd XR = lack of gas in the bowels
intussusception
cruise ship, hosptials, restaurants
Norovirus
young child in winter months presents with vomiting (novemenr-march)
Norovirus
nonimmunized kid with diarrhea…. fall and winter months…vomiting first s/s..then fever… watery diarrhea
rotavirus
decreased disaccaridase activity
rotavirus
ate mayo, dairy, eggs, salads— very quickly dev vomiting and nausea— then diarrhea
staph A
re-heated fried rice
Bacillus Cereus
one week into traveling…
enterotoxic E Coli
History of travel in endemic area
vibrio cholera
liquid, gray, turbid stool
w/o fecal odor
Rice water stool
vibrio cholera
voluminous watery diarrhea– about 15L/day
vibrio cholera
do not give anti motility drugs to what pt
infectious invasie tissue damaging pathogens
do not give anti motility drugs to what pt
invasive
safety pin apperance on culture
yersinia
recently ate pork…
Yersinia
recently ate tofu
yersinia
raw undercooked poultry
campy
domestic pets
campy j.
kids + puppy=?
campy j.
Guillan-Barre syndrome assoc with which microbe
Campy enteritis
“S, comma or seagull shape organism”
campy
cattle or other ruminants
Enterohemmorrhagic E coli 0157:H7
infantile diarrhea
Enteropathogenic E coli
grossly bloody diarrhea
hemorrhaigc colitis secondary to Enterohemorrhaigic E coli
avoid abx and avoid anti motility in which infectous diarrhes
enterohemmorrhagic E coli
hx of travel to where sanitation is poor
salmonella typhi
Pea soup green diarrhea
salmonella typhi
rose spots
salmonella typhi
undercooked beef,
Enterohemmorrhagic E coli 0157:H7
unpast. milk
Enterohemmorrhagic E coli 0157:H7
unpast apple cider
Enterohemmorrhagic E coli 0157:H7
day care centers
Enterohemmorrhagic E coli 0157:H7
undercooked shellfish
virbiro
MC causes of foodborne dz in US
nontyphoidal salmonella
contact with reptiles
nontyphoidal salmonella
explosive watery diarrhea that progresses to mucoid and bloody diarrhea
shigella
backpackers diarrhea
Giardia Lamblia
ingestion of water from a stream/well
Giardia Lamblia
frothy greasy foul smelling diarrhea, steatorrhea NO blood or pus
Giardia Lamblia
which bacetria can lead to liver complications
amebiasis—- amebic liver abscess
RUQ pain + right sided pleural effusion + hepatic tendernss
liver amebic abscess
