GI misc 2 Flashcards

1
Q

Involves protrusion of the stomach through the diaphragm via the esophageal hiatus.

It can cause symptoms of GERD

A

Hiatal hernia

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2
Q

Cause of travelers diarrhea

A

e-coli

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3
Q

cause of diarrhea after a picnic and egg salad

A

staph aureus

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4
Q

cause of diarrhea from shellfish

A

vibrio cholerea

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5
Q

cause of diarrhea from poultry or pork

A

salmonella

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6
Q

cause of diarrhea from poorly canned home foods

A

C. perfringens

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7
Q
A
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8
Q

cause of diarrhea breakout in daycare

A

Rotavirus

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9
Q

cause of diarrhea on a cruise ship

A

Norovirus

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10
Q

Diarrhea after drinking fresh mountain stream water?

Incubation time?

A

Giardia lamblia

incubation: 1-3 wks

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11
Q

Diarrhea caused by what?

foul-smelling bulky stool and may wax and wane over weeks before resolving

A
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12
Q

What composition is recommended by WHO for oral rehydration therapy?

Na, K, Cl, Citrate, glucose?

A

90mmol Na

20mmol K

80mmol Cl

10mmol citrate

111mmol glucose

Rehydralyte is closest to this recommendation!

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13
Q

What is the MCC bacterial gastroenteritis in children and adults

A

Campylobacter jejuni

(starts with fever and malaise, followed by N/V/D, fever and abdominal pain. D may contin blood)

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14
Q
A
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15
Q

3 classic sxs of enterohemorrhagic E. coli

A

no fever

bloody stool

+abdominal tenderness

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16
Q

What is hemolytic uremic syndrome and what is it a/w

A

Enterohemorrhagic E. coli a/w hemolytic uremic syndrome

  • Hemolytic anemia
  • Renal failure
  • Thrombocytopenia
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17
Q

MC type of rectal cancer

A

adenocarcinoma

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18
Q

MC site for blood borne mets of rectal cancer is where

A

liver

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19
Q

sxs of what

hematochezia, tenesmus, rectal mass, feeling of incomplete evacuation of stool

A

rectal cancer

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20
Q

6 risk factors of rectal cancer

A

receptive anal intercourse

  1. HPV
  2. Chronic fistulas
  3. Irradiated anal skin
  4. Leukoplakia
  5. lymphogranuloma venereum
  6. condyloma acuminatum
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21
Q

painless rectal bleeding and a change in bowel habits in a pt 50-80 y/o

A
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22
Q

When is colon cancer screening recommended

What are screening options

A

50-75y/o

  • Stool tests: guaic based fecal occult blood (gFOBT), Fecal immunochemic test (FIT)–> both once a year
  • FIT-DNA test- q1-3yrs
  • colonoscopy q10yrs
  • flex sig q5yrs or q10yrs w/ a FIT yearly
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23
Q

carcinoma of the colon most commonly originates from what

A

adenomatous polyp

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24
Q

What is the role of CEA in colon cancer

A

Not diagnostic for colorectal cancer

elevated preop CEA levels correlate wtih postop recurrance rate

Help detect recurrance after surgical resection

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25
Apple core lesion on barium enema
adenocarcinoma of the colon
26
What is the MC GI cancer and 2nd MC cancer in US
colorectal cancer
27
What is the second MCC of cancer deaths
colorectal cancer
28
risk factors for colorectal cancer
low fiber, high fat diets FHx Lynch syndrome h/o IBD
29
Grey Turners sign and cullens sign
acute panreatitis
30
2 etiologies of acute pancreatitis
cholelithiasis alcohol abuse
31
What is Ranson's criteria for poor prognosis of acute pancreatitis (\>3= severe prognosis)
At admit: * Age \>55 * Leukocyte \>16k * Glucose \>200 * LDH \>350 * AST \>250 At 48 hrs: * Arterial PO2 \<60 * HCO3 \<20 * Ca \<8 * BUN: inc by 1.8+ * Hct: decr by \>10% * Fluid sequestration \>6L
32
Tx for acute pancreatitis
IVF analgesics bowel rest
33
What is the classic triad of chronic pancreatitis
pancreatic calcification steatorrhea DM
34
Tx for chronic pancreatitis
no alcohol low fat diet
35
Tumor marker for pancreatic cancer
CA 19-9
36
What criteria is used to predict mortality in acute pancreatitis
Ransons
37
Painless jaundice and a palpable non-tender GB (Courvoisier's sign)
pancreatic cancer
38
Pancreatic cancer is MC located at which part of pancreas
head
39
What is the most sensitive test for chronic pancreatitis
ERCP
40
MC etiology of appendicitis
Fecalith
41
Sxs of small bowel obstruction
**_colicky abd pain_** N **_bilious vomiting_** obstipation abdominal distention
42
6 MCC small bowel obstruction
adhesions hernias cancer IBD volvulus intussusception
43
Are polyps in the distal or proximal colon more likely benign
distal colon are commonly benign
44
Colonic polyps: \_\_\_\_ adenomas have a 30-70% risk of malignant transformation
villous
45
Once a colonic polyp is identified, how often should you follow-up with colonoscopy
q3-5yrs
46
* What is characterized by the development of hundreds to thousands of adenomatous polyps * Colorectal polyps develop by age 15 and cancer at 40 * Fam should undergo yearly sigmoidoscopy at 12 y/o * 1st deg rel should undergo genetic screening after 10
Familial adenomatous polyposis
47
48
Which of the following is NOT a cause of paralytic ileus a. GI surgery b. hypokalemia c. intra-abdominal sepsis d. hyperkalemia
d. hyperkalemia
49
large or small bowel obstruction? distention is early and pronounced. Pain is mild and vomiting and dehydration are late
Large bowel obstruction
50
What is the MCC small bowel obstuction
postoperative adhesions
51
What is the MCC of small bowel obstruction in children
intussusception
52
MC location of large bowel obstruction
sigmoid colon due to neoplasms, fecal impaction and diverticulitis
53
currant jelly stool
intussuception
54
physical exam: abdominal distention and tenderness **_sausage shaped abd mass in RUQ_**
Intusussception
55
What can be used for both dx and treatment for intussusception in children
barium or air enema (barium enema should not be used in adults)
56
Target sign on abdominal ultrasound
intussusception
57
in adults, intussusception is almost always caused by what
neoplasm
58
Causes of lower GI bleed (6)
1. **_Hemorrhoids_** (painless bleeding with wiping) 2. **_Anal fissures_** (severe rectal pain w/ defecation 3. **_Proctitis_** (rectal bleeding and abdominal pain 4. **_Polyps_** (painless rectal bleeding, no red flag signs 5. **_Colorectal cancer_** (painless rectal bleeding and chnage in bowel habits in 50-80y/o 6. rectal ulcers
59
5 causes of upper GI bleed
1. Peptic ulcer 2. Esophageal ulcer 3. Mallory-Weiss tear 4. Variceal hemorrhage or portal hypertensive gastropathy (jaundice, abd. distention) 5. Malignancy
60
61
What diagnostic studies do you use to evaluate hematochezia vs melena
hematochezia= colonoscopy melena= EGD
62
What are the 4 cardinal signs of strangulated bowel?
1. Fever 2. Tachycardia 3. Leukocytosis 4. Localized abdominal tenderness
63
what lab abnormalities (renal and electrolytes, etc) are ssen in bowel obstruction
ongoing emesis and third spacing lead to dehydration, prerenal azotemia hypochloremic hypokalemic metabolic acidosis
64
Causes of SBO "GIVES BAD CRAMPS"
* Gallston Ileus * Intussusception * Volvulus * External Compression * SMA syndroms * Bowel wall hematoma * Abscess * Diverticulosis * Chrons * Radiation enteritis * Annular pancreas * Meckel's diverticulum * Peritoneal adhesions * Stricture
65
When does Gilbert syndrome cause jaundice
during stress like severe infection, otherwise asxs
66
Causes of biliary tract obstruction
gallstones pancreatic carcinoma liver fluke cholangiocarcinoma
67
Signs of biliary tract obstruction
* JAUNDICE * incr alk phos * decr urine urobilinogen * dark urine * pale stool * pruritis
68
What is charcot's triad
COLANGITIS fever jaundice RUQ
69
What is Reynold's pentad?
CHOLANGITIS Charcot's tirad (fever, jaundice, RUQ pain) + mental confusion + hypotension
70
71
What is the gold standard for imaging the biliary system
ERCP
72
Cholangitis is commonly caused by what bacteria
E. coli
73
pruritis w/ progressive jaundise= ? cholangiography will show fibrosis of the bile ducts w/ dilation b/w strictures
Primary sclerosing cholangitis (common in pt w/ h/o ulcerative colitis)
74
What 4 conditions are cholangitis associated with
IBD Cholangiocarcinoma pancreatic cancer Colorectal cancer
75
which 2 GI pathogens can cause appendicitis-like presentation
Entamoeba histolytica Yersiniosis enterocolitica
76
Which bacteria can cause ileocecitis | (can get from pork)
Yersinia enterocolitica
77
Which 3 HIV meds commonly cause pancreatitis
Tenofovir didanosine stavudine
78
What is the MCC of bacterial foodborne dz in US? #2?
#1- salmonella (milk products, poultry, eggs) #2- Campylobacter (undercooked pork)
79
Salmonellosis is affected with what type of arthritis
reactive arthritis