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Internal Medicine > GI System > Flashcards

GI System Flashcards

1
Q

Jejunal ulcers

A

R/o Zollinger-Ellison syndrome by checking gastrin level

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2
Q

Main cause of duodenal ulcers

A

H pylori

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3
Q

Main cause of gastric ulcers

A

NSAIDs, ASA

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4
Q

Triple therapy

A

PPI, clarithromycin, amoxicillin

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5
Q

Pernicious anemia

A

Lack of intrinsic factor necessary for absorption of Vitamin B12 2/2 autoantibodies to parietal cells in the FUNDUS of stomach, associated with Type A gastritis

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6
Q

Curling ulcers

A

Stress ulcers associated with burn injuries

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7
Q

Cushing ulcers

A

Stress ulcers associated with traumatic brain injury

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8
Q

How to NOT test if H pylori infection cleared?

A

H pylori antibodies

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9
Q

How to test if H pylori infection cleared?

A

Urea breath test or repeat stool antigen

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10
Q

Krukenberg tumor

A

gastric adenocarcinoma that metastasizes to ovary

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11
Q

Virchow node

A

Enlarged left supra-clavicular lymph node in setting of gastric cancer

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12
Q

Dumping syndrome

A

Delivery of hyper-osmotic chyme to small intestine causing massive fluid shifts into the bowel, seen particularly in procedures that bypass the pylorus; p/w:
-Bloating
-Cramping
-Diarrhea
-Vasomotor sxs (weakness, flushing, palpitation, diaphoresis)
all after ingestion of meal

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13
Q

Achlorhydia

A

Absence of HCl secretion most commonly caused by pernicious anemia , where anti-parietal cell antibodies destroy acid-secreting parietal cells

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14
Q

Radiologic imaging studies used to detect slow or intermittent GI bleeds.

A

Isotope- labeled (Technetium 99m) RBC scan using nuclear medicine

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15
Q

Radiologic imaging studies used to detect rapid bleeds and embolization of bleeding vessels.

A

Mesenteric CT angiography

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16
Q

Antibiotic treatment for diverticulitis

A

Fluoroquinolone + metronidazole

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17
Q

Osmotic diarrhea

A

Non-absorbable solutes (e.g. lactose or other sugar intolerance) remain in bowel and retain water

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18
Q

Secretory diarrhea

A

Associated with excess bowel secretion of fluid 2/2:

  • Bacterial toxins (E Coli, cholera)
  • VIPoma
  • Bile acids (after ileal resection)
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19
Q

Infectious diarrhea

A

Associated w/:

  • Invasive bacteria (Shigella, Salmonella, Yersinia, Campylobacter, ETEC, stream-drinkers Giardia)
  • p/w: fever, WBCs
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20
Q

First line treatment of C difficile.

A

PO metronidazole

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21
Q

Young woman with completely benign exam, GI complaints, h/o anxiety, psychosocial stressors

A

Irritable bowel syndrome

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22
Q

HUS

A

Hemolytic uremic syndrome 2/2 E. coli or Shigella diarrhea in children p/w:

  • Thrombocytopenia
  • Hemolytic anemia (schistocytes, helmet cells, fragmented RBCs on blood smear)
  • Acute renal failure
23
Q

Fistulas, abscesses, Transmural inflammation, non-caseating granulomas, cobble-stoning, string sign on barium XR

A

Crohn’s disease

24
Q

Crypt-abscess, bleeding ulcers, Pseudo-polyps, lead-pipe colon on barium XR

A

Ulcerative colitis

25
Q

Surgical tx for UC

A

Protocolectomy with ileoanal anastomosis

26
Q

Toxic megacolon

A

UC

27
Q

Ulcerative colitis is associated to what autoimmune biliary disease

A

Primary sclerosing cholangitis

28
Q

Pyoderma gangrenosum

A

UC

29
Q

In an active Hepatitis B infection, what antibody is the first to appear?

A

IgM Hepatitis core antibody (HBcAb)

30
Q

Management of acute exposure to Hepatitis B?

A

Hep B immunoglobulin, Hep B vaccine

31
Q

What does a positive Hep C antibody mean?

A

It means pt had infection in the past but it does NOT mean it is cleared. Many patients become chronic carriers t/f test for Hep C virus RNA.

32
Q

Hep E and pregnant women?

A

Hep E in pregnant women is fatal.

33
Q

Anti-smooth muscle antibody

A

Autoimmune hepatitis seen in young women, tx with steroids

34
Q

Hematochromatosis

A

Excessive iron reabsorption by intestine and deposited in:
-Liver (cirrhosis, hepatocellular carcinoma)
-Pancreas (diabetes)
-Heart (dilated cardiomyopathy)
-Skin (bronze pigmentation)
-Joints (arthritis)
Tx: Phlebotomy

35
Q

Hepatolenticular degeneration

A

Wilson diseases: characterized by liver disease with CNS/psychiatric manifestations (caused by copper deposits in the basal ganglia)

36
Q

Treatment of Hyperammonemia 2/2 liver failure?

A

Decreased protein intake

Lactulose (prevents absorption)

37
Q

Signs ans symptoms of Biliary tract obstruction

A
  • Elevated conjugated bilirubin
  • Elevated Alk Phos
  • Pruritis
  • Clay-colored stools
  • Dark urine (strongly positive for conjugated bilirubin since unconjugated is not excreted in the urine, it’s tightly bound to albumin)
38
Q

Imaging modality used to visualize a gallstone?

A

Ultrasound

39
Q

Courvoisier sign

A

Jaundice with a palpably enlarged gallbladder, seen in Pancreatic cancer

40
Q

Positive anti-mitochondrial antibodies in a woman c/o jaundice, pruritis, xanthelesma

A

Primary biliary cholangitis

41
Q

Primary sclerosing cholangitis

A

Young adult with inflammatory bowel disease (UC) with fever, chills, pruritis, RUQ pain

42
Q

“Onion skin” bile duct

A

Primary sclerosing cholangitis

43
Q

Charcot triad (for cholangitis)

A
  • Fever
  • RUQ pain
  • Jaundice
44
Q

Treatment for achalasia

A

Dx: Esophageal manomatery
Tx: CCB, balloon dilatation, botulism toxin injection

45
Q

CREST syndrome

A 
Calcinosis
Raynaud phenomenon
Esophageal dysmotility
Sclerodactylyl
Telangiectasia

Anticentremere

46
Q

Grey Turner sign

A

Blue-black flanks 2/2 hemorrhagic pancreatic exudate

47
Q

Cullen sign

A

Blue-black umbilicus 2/2 hemorrhagic pancreatic exudate

48
Q

Common cause of Chronic pancreatitis

A

Alcoholism

49
Q

Smoking vs. Alcohol is a greater risk factor for pancreatic cancer?

A

Smoking

50
Q

Crigler-Najjar syndrome

A

severe unconjugated hyperbilirubin from birth

51
Q

Gilbert syndrome

A

mild unconjugated hyperbilirubin 2/2 stress

52
Q

Treatment of pathologic jaundice with unconjugated bilirubin > 15

A

Phototherapy to convert unconjugated bilirubin to water-soluble form that can be excreted

53
Q

Treatment of pathologic jaundice with unconjugated bilirubin is >20

A

Exchange transfusion

Internal Medicine (12 decks)

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