Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CPD 2 > GI Part 2 > Flashcards

GI Part 2 Flashcards

1
Q

What is the most common benign esophageal tumor?

A

leiomyoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where is primary esophageal CA usually found? Inside or outside of the lumen?

A

inside the lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Who is most at risk for SCC in the esophagus?

A

African Americans by 4-5x
Men
more common in asia and south africa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some risk factors of SCC? Pick 5

A 
alcohol
tobacco
achalasia
HPV
lye ingestion
sclerotherapy
Plummer-Vinson syndrom
irradiation
esophageal webs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which esophageal CA is most common?

A

SCC (75%)

adenocarcinoma (50% in whites)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Risk factors of adenocarcinoma?

A

smoking
NOT ALCOHOL
Barrett’s esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where is secondary esophageal CA usually found? Inside or outside of the lumen?

A

outside the lumen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the most common CAs to metastasize to the esophagus?

A

melanoma and breast CA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

SSX: esophageal CA (early and later)
hint: there’s a ton of possibilities

A 
Early: asx
Later: progressive dysphagia
wt. loss
hoarseness
Horner's
nerve compression
dyspnea
maybe odynophagia, vomiting, hematemesis, melena, iron deficiency anemia, aspriation, cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Work up: esophageal CA

A

endoscopy with biopsy
CT
endoscopic US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does esophageal CA like to metastasize?

A

lung and liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the prognosis of esophageal CA?

A

overall poor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes esophageal varices?

A

elevated pressure in the portal venous system, typically from cirrhosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

SSX: esophageal varices

A

sudden, painless, upper GI bleeding. often massive

maybe signs of shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What labs and imaging would you want for esophageal varices?

A

Labs: evaluation for coagulophathy, CBC, PT PTT LFT
Imaging: endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the prognosis for esophageal varices?

A

80% resolve spontaneously
mortality is high
recurrence is common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What portion of the population is infected with H. pylori?

A

50% by age 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Who is more at risk for H. pylori infx?

A

blacks, hispanics, asians

nurses and gastroenterologists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How much more likely is a person with H. pylori infx to develop stomach CA?

A

3-6x

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

SSX: H. pylori

A

often Asx
gastritis
PUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the most sensitive, non-invasive test for H. pylori?

A

serologic test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Besides serologic testing, what other work-up could you do for H. pylori?

A

Non-invasive: Urea breath test/stool antigen test (confirm tx effectiveness)

Invasive: Endoscopy (not recommended for this dx alone)
with mucosal biopsy for RUT/histologic staining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

4 Etiologies: Gastritis

A

Infection (H. pylori)
Drugs
Stress
AI phenomena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

SSX: gastritis

A

Asx or
dyspepsia
GI bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Work-up: gastritis

A

endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the most common type of gastritis?

A

erosive gastritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are specific causes of erosive gastritis? name 3

A 
NSAIDS
alcohol
stress
radiation
viral infx
vascular infx
direct trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is often the first sign of erosive gastritis?

A

hematemsis
melena
blood in nasogastric aspirate
(bleeding can be mild-massive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Dx: erosive gastritis

A

endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Prevalence of PUD?

A

any age

most often middle-aged though

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is a major history question when considering PUD?

A

Any family hx of PUD? (50-60% of duodenal ulcers have positive family hx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the risk factors for PUD?

A

H. pylori infection (both gastric and duodenal ulcers)
NSAIDS
smoking
Family hx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Genearl SSX: PUD

A

burning or gnawing pain

often chronic and recurrent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Pt. says epigastric pain occurs mid-morning and is relieved by food, but recurs 2-3 hrs. after a meal. You are thinking ulcer. Where do you think the ulcer is located?

A

Duodenum

35
Q

Pt. says epigastric pain often awakes them at night. You are thinking ulcer.Where do you think the ulcer is located?

A

Duodenum

36
Q

Pt. say epigastric pain is totally inconsistent and they see no pattern. You are thinking ulcer. Where do you think the ulcer is located?

A

Stomach (gastric)

37
Q

Work-up: PUD

A

Lab: sometimes serum gastrin levels
Imaging: endoscopy

38
Q

What is the most common complication of PUD and what sxs would make you think this is happening?

A 
Hemorrhage 
hematenesis of fresh blood or coffee ground material
hematochezia (fresh blood out anus)
melena (tarry upper GI blood out anus)
weakness
orthostasis
syncope 
thirst
39
Q

Your pt with known PUD comes in with pain that is persistent, intense and referring to the back? What complication are you considering? How would you confirm this dx?

A

Penetration (confined perforation)

CT/MRI

40
Q

Your pt with known PUD comes in with sudden, intense continuous epigastric pain that spreads rapidly throughout the abdomen and is most prominent in RLQ. Pain is said to radiate to one or both shoulders. Pt. can only lay still. What PE findings would you expect and what would you do to confirm dx?

A

diminished or absent bowel sounds
painful abdomen papation, rigidity, rebound tenderness

CT or x-ray shows free air under the diaphragm or in peritoneal cavity

41
Q

Your pt with known PUD calls the clinic reporting recurrent, large-volume vomiting occurring more frequently at the end of the day and often as late as 6-hr. after a meal. Loss of appetite with persistent bloating or fullness after eating. What complication are you considering?

A

Gastric outlet obstruction

42
Q

What increases the risk of PUD recurrence?

A

failure to eradicate H. pylori
continued NSAID use
smoking
gastrinoma (if refractory to tx)

43
Q

What are the 6 possible PUD complications?

A 
hemorrhage
penetration
free perforation
gastric outlet obstruction
recurrence
gastric CA
44
Q

What is the most common gastric CA?

A

gastric adenocarcinoma

45
Q

What are the two most common causes of acute pancreatitis?

A

biliary tract disease

chronic alcoholism

46
Q

SSX: acute pancreatitis?

A

steady, boring upper gi pain radiating to the back lasting hours to days
N/V
Pancreatic position
low fever

47
Q

PE: acute pancreatitis

A

tenderness to palpation
hypoactive/absent bowel sounds
maybe pleural effusion

48
Q

work up: acute pancreatitis

A 
labs:
elevated serum amylase and lipase
maybe elevated WBC
imaging:
abd. xray: pancreatic calcifications
chest xray: atelectasis or pleural effusion
CT after dx
49
Q

Top two causes of chronic pancreatitis

A

chronic alcoholisms

idiopathic

50
Q

SSX: chronic pancreatitis

A

post-prandial pain
episodic abd. pain lasting hours to days
pancreatic position

51
Q

Dx: chronic pancreatitis

A

clinical suspicion based on Hx of abd. pain and chronic alcoholism

52
Q

Work-up: chronic pancreatitis

A

Labs: amylase and lipase are normal (unlike in acute)
imaging: plain film, CT to rule out CA

53
Q

What is the most common pancreatic CA?

A

primary ductal adenocarcinoma

54
Q

What part of the pancreas is more likely to have CA?

A

head

dx earlier because obstruction produces jaundice

55
Q

What makes pancreatic CA in body or tail have a poorer prognosis?

A

usually dx at more advanced stages

56
Q

SSX: pancreatic CA

A 
90% have advanced tumors at dx
sever abd pain radiating to the back
weight loss
Head: jaundice and pruritis
Body/tail: splenomegaly, gastric/esophageal varices, GI hemorrhage
57
Q

What disease so pancreatic CA and chronic pancreatitis often cause?

A

diabetes

58
Q

work-up: pancreatic CA

A

Labs: routine labs-elevated alk. phos and bilirubin
CA 19-9 antigen (non-specific, used for monitoring)
Imaging: ct or mrcp

59
Q

What particular Hx questions are important when approaching pt. with liver disease?

A

exposures (toxins, alcohol, drugs, herbs, occupational)

60
Q

Good ROS questions for liver disease?

A

general: fatigue, anorexia, fever
skin: jaundice?
GI: RUQ pain? N/V? Loose fatty stools?

61
Q

What are the most common liver markers?

A

AST

ALT

62
Q

What is the most sensitive technique for imaging the biliary system?

A

US

63
Q

SSX: Hepatitis (prodromal/pre-icteric phase)

A 
anorexia
malaise
n/v
fever
RUQ pain
64
Q

SSX: Hepatitis (icteric phase)

A

dark urine
jaundice
systemic sxs
enlarged tender liver

65
Q

What is the most common cause of acute viral hepatitis?

A

HAV

66
Q

Does HAV cause chronic hepatitis?

A

nope

67
Q

What is the 2nd most common cause of acute viral hepatitis?

A

HBV

68
Q

Which hep strains can become chronic hepatitis, cirrhosis and hepatocellular carcinoma?

A

HBV

HCV

69
Q

Which hep strain has the highest rate of chronicity?

A

HCV

70
Q

What are the Labs results seen with hepatitis?

A

elevated AST and ALT

antibodies to HAV, HBV or HCV

71
Q

What happens to the liver in fulminant hepatitis?

A

it gets smaller

72
Q

What are the risk factors for non-alcoholic fatty liver?

A

obesity
dylipidemia
glucose intolerance

73
Q

SSX: non-alcoholic fatty liver

A

usually Asx

fatigue, malaise, RUQ discomfort

74
Q

What is the main PE finding with non-alcoholic fatty liver?

A

hepatomegaly

75
Q

Work-up: non-alcoholic fatty liver

A

Labs: elevated ast, alt
procedure: liver biopsy

76
Q

How do you dx non-alcoholic fatty liver?

A

presence of risk factors

r/o hep infx and excessive alcohol intake

77
Q

risk factors: alcoholic liver disease

A

drinking lots of alcohol
male
genetic/metabolic traits
poor nutritional status

78
Q

what disorders can results from alcoholic liver disease?

A

alcoholic fatty liver
alcoholic hepatitis
cirrhosis

79
Q

PE finding for alcoholic fatty liver?

A

non-tender enlarged liver

80
Q

SSx: alcoholic hepatitis

A 
undernourished
fatigue 
fever
jaundice
RUQ pain
81
Q

PE findings alcoholic hepatitis

A

hepatomegaly

hepatic bruits

82
Q

SSX: cirrhosis

A

same as alcoholic hepatitis

83
Q

PE findings cirrhosis

A

small liver

maybe nail clubbing

CPD 2 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions