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MJ- Family Med EOR > GI misc > Flashcards

GI misc Flashcards

1
Q

What is seen on labs for cholecystitis

A

leukocytosis

Incr. alk phos

Incr. GGT

Incr. conj. bilirubin

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2
Q

Pocelain gallbladder= ?

A

chronic cholecystitis

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3
Q

Gold standard for diagnosing choledocholithiasis

A

ERCP

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4
Q

What is the Boas sign?

A

Referred right subscapular pain seen in cholelithiasis

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5
Q

what condition is sentinel pile seen in

A

anal fissure

(sentinel pile= thickened mucosa/skin at the distal end of an anal fissure, often confused w/ a sm. hemorrhoid)

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6
Q

What is the MC site of an anal fissure

A

posteroir midline (comparatively low blood flow)

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7
Q

which type of hemorrhoid is painful?

Which bleeds?

A

painful- external, below dentate line

Bleed- internal

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8
Q

Which IBD is limited to the mucosa and submucosa

A

UC

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9
Q

Which IBD is transmural

A

chrons

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10
Q

IBD: MC site is rectum

A

UC

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11
Q

How do you dx Ulcerative colitis

A
  • by barium enema LEAD PIPE APPEARANCE
  • and colonoscopy with bx–> continuous inflammation starting from rectum and extending proximally w/ loss of haustral makings and lumen narrowing
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12
Q

2 compliactions of ulcerative colitis

A

toxic megacolon

colorectal cancer

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13
Q

What does antibody test show in ulcerative colitis

A

Antineutrophil cytoplasmic antibodies (pANCA)

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14
Q

Which IBD do you see apthous ulcers in

A

Chron’s disease

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15
Q

What 3 things might be seen in long standing chron’s disease

A

anemia

polyarthralgia

fatigue

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16
Q

Which IBD?

Distribution from mouth to anus

A
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17
Q

Obstruction, abscess, fistula and sinus tracts are common in which IBD?

A

Chrons

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18
Q

Low or high cancer risk in chrons

A

low

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19
Q

What does antibody test show in Chrons

A

+Anti-Saccharomyces cerevisiae antibodies (ASCA)

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20
Q

What criteria is used in dx of IBS

A

Rome III criteria

(The American college of gastroenterologists doesn’t recommend lab testing or diagnostic imaging in patients younger than 50 y/o w/ typical sxs of IBS w/o ALARM sxs)

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21
Q

Which infection has been associated with increased prevalence of IBS

A

Giardia Lamblia

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22
Q

What GI condition is associated with postprandial urgency

A

IBS

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23
Q

What are the ALARM features of IBS

A

Weight loss

Iron deficiency anemia

FHx of organic GI illness (IBD, celiac sprue, colorectal cancer)

rectal bleeding

norcturnal sxs

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24
Q
A
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25
MCC Large bowel obstructions in adults? MCC of all bowel obstructions
**_colon cancer_**= MCC in elderly people **_Adhesions_**= MCC of all bowel obstructions
26
4 causes of large bowel obstruction
volvulus adhesions hernias colon cancer
27
dx of what? **Abdominal x-ray (KUB)** demonstrating **distended proximal colon** with **_haustra_**, **air-fluid levels**, no gas in rectum
Large bowel obstruction
28
What is reflux esophagitis
mechanical or functional abnormality of the **_LES_****\***
29
which 2 groups of meds commonly cause medication induced esophagitis
NSAIDs or bisphosphonates
30
what is seen with barium swallow in eosinophilic esophagitis
ribbed esophagus and **_multiple corrugated rings_**
31
Which esophagitis: Shallow punched out lesions on EGD
* HSV
32
Which esophagitis: Large solitary ulcers or erosions on EGD
CMV
33
What is the GOLD standard for diagnosing GERD?
PH monitoring with intra-esophageal electrode
34
What condition? Outpouching of the hypopharynx which causes **_foul smelling breath_** and **_regurgitation of solid foods_**
35
Once pt is diagnosed with Barrett's esophagus, how should you screen and what are you screening for?
upper endoscopy q3-5yrs for dysplasia or adenocarcinoma
36
What 6 drugs lower LES pressure ("CAPTAN")
CCBs anticholinergics progesterone Tricyclic antidepressants antihistamines Nitrates
37
Patients with unremarkable endoscopy findings who have typical sxs despite tx w/ PPI should undergo what
24-h pH testing
38
Sxs of what? Belching, bloating, distention and heartburn, abdominal pain
gastritis
39
3 causes of gastritis
1. H. pylori (MC) 2. Inflammation of the stomach lining (NSAIDs and alcohol) 3. Autoimmune or hypersensitivity rxn (pernicious anemia)
40
location of H. pylori gastritis
antrum and body
41
location of autoimmune or hypersensitivity rxn (pernicious anemia)
body of the fundus
42
Autoimmune or hypersensitivity rxn as cause of gastiritis- dx of pernicious anemia
+schilling test + decr. intrinsic factor and parietal cell antibodies
43
44
45
Which type of ulcer: Pain IMPROVES with food Pain WORSENS with food
Improves- dueodenal ulcer Worsens- Gastric ulcer
46
Which type of ulcer: Pain WORSENS with food
Gastric ulcer
47
Gold standard for dx of Peptic ulcer disease
endoscopy with biopsy
48
What best describes H. pylori? (description of bacteria)
gram-negative **_spiral_**-shaped bacillus
49
GOLD standard for diagnosing Gastritis
Endoscopy w/ 4 biopsies along stomach lining
50
What is the result of an unregulated release of gastrin resulting in gastric acid hypersecretion
Zollinger-Ellison syndrome (gastrinoma
51
how do you dx Zollinger-Ellison syndrome (gastrinoma)
gastrin levels (\>150 is suggestive, \>200 is diagnostic
52
What should you look for if there is a patient with suspected PUD but has persistent or increased sxs after PPI
H. pylori
53
What 4 meds may result in false-neg urea breath test in a patient w/ H. pylori?
PPI H2 blockers Bismuth Antibiotics
54
What are 3 pulmonary sxs of GERD
hoarsness cough wheeze
55
What type of hernia can worsen GERD sxs
Hiatal hernia
56
What is the 2 MCC of cirrhosis in US
#1- Hep C #2- alcohol
57
What are 7 classic skin changes seen in cirrhosis
* **spider angiomata** * **palmar erythema** * jaundice * scleral icterus * ecchymoses * **caput medusae** * hyperpigmentation
58
What 8 physical exam findings might be seen in ESLD
* Hepatomegaly (small, fibrotic liver in ESLD) * Terry's nails (white nail beds) * Splenomegaly * central obesity * abdominal fluid wave, shifting dullness (ascites) * gynecomastia * Esophageal varices * Pulm edema/effusion * skin changes
59
**_Asterixis_** (flapping tremor), dysarthria, delirium and coma are signs of what
Hepatic encephalopathy
60
What should be used to screen for **hepatocellular carcinoma** in pt w/ progressive cirrhosis
**_alpha fetoprotein_** (if elevated then MRI) Abd US q6-12 mo
61
what should you think if a pt with cirrhosis has **fever and abdominal pain**
Spontaneous bacterial peritonitis
62
What triad? 1. abdominal pain 2. ascites 3. hepatomegaly
**_Budd Chiari_** (hepatic vein thrombosis)
63
Elevated alk phos, GGT and total/direct bilirubin indicates what
cholestasis
64
Cirrhosis labs
* AST\>ALT * Elevated alk phos, GGT and total/direct bili (cholestasis) * anemia * Decr. platelet * Low albumin * low cholesterol * Prolonged PT, PTT and INR

MJ- Family Med EOR (17 decks)

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