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UWorld Step 2 > IM GI - Rd 2 > Flashcards

IM GI - Rd 2 Flashcards

1
Q

How does SBO present w/bowel sounds?

What else?

A

High-pitched initially

N/V, ABD pain, dilated loops of small bowel

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2
Q

What can make a pt more susceptible to C diff infection?

A

PPI

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4
Q

PBC presents how?

A

Pruritus, fatigue, jaundice, ABD pain

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5
Q

SAAG > 1.1 indicates what?
D/t what?

< 1.1 indicates what etiologies?

A

Portal HTN
Cirrhosis, budd-chiari, cardiac ascites

TB, nephrotic syndrome, cancer

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5
Q

Wilson disease main CF?

A

Hepatic - acute LF, chronic hepatitis, cirrhosis
Neuro - Parkinsonism, gait disturbance, dysarthria
Psych - depression, personality change, psychosis

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6
Q

TPN causes what?

Predisposes to what?

A

GB stasis

Gallstones and bile sludge —> cholecystitis

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7
Q

US of the RUQ shows a well-demarcated, hyperechoic lesion indicates what?

Treat how?

A

Hepatic adenoma

Surgical excision > needle biopsy

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9
Q

How does insulin effect lipolysis?

How does T2DM effect lipolysis?

A

Decrease lipolysis in adipose

Increased lipolysis and FFA release —> causes NAFLD

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10
Q

Pt has duodenal ulcer, what is the best treatment?

What has no effect in the treatment?

A

PPI + ABx

Quitting smoking or drinking

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11
Q

Endoscopy that shows multiple stomach ulcers and thickened gastric folds indicates what?

A

Gastrinoma

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13
Q

What does the D-xylose test show in pts with Celiac disease?

A

Impaired absorption - urinary and venous levels are low

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14
Q

What Vitamin Deficiency presents w/impaired taste, alopecia, pustular skin rash, impaired wound healing, hypogonadism?

Commonly in what disease?

A

Zinc def

Crohn’s

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15
Q

What TB drug can cause panlobular mononuclear infiltration and hepatic cell necrosis?

A

INH

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16
Q

Pt presents w/toxic megacolon symptoms, what is the best 1st test to do?

A

KUB

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17
Q

Multiple duodenal ulcers and even a jejunal ulcer indicates what?

How are pancreatic enzymes effected?

A

ZE - Gastrinoma

Inactivated

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18
Q

What is the 1st step in a pt w/suspected variceal hemorrhage?

Next?

Hg should be kept above what in variceal hemorrhage?

A

2 large bore IVs

IVF, IV octreotide, Ceftriaxone

> 9

18
Q

What is an effort rupture of the esophagus?

A

Boerhaave’s syndrome, complication of endoscopy or penetrating trauma

IT IS A RUPTURE —> AKA TEAR of the esophagus

20
Q

What is a possible complication of disease progression in PBC?

Why is it not ascending cholangitis?

A

Osteomalacia/porosis, HCC, malabsorption

Occurs only with extrahepatic biliary obstruction

20
Q

Pleural effusion (usually left) w/or w/out pneumothorax in a pt that has been vomiting can indicate what?

What other abnormal chest finding?

A

Esophageal rupture (Boerhaave syndrome)

Widened mediastinum

21
Q

What are the 3 motility GI disorders?

How to diagnose?

A

SAD - scleroderma, achalasia, DES

BME - barium swallow, manometry, EGD

22
Q

What meds commonly cause pill-induced esophagitis?

Presents how?

See what on gastrogram?

A

Tetracyclines, NSAIDs, bisphosphonates, KCl

SUDDEN onset, severe odynophagia

MC mid-esophagus w/circumferential ulcer

23
Q

What does hyperestrinism in liver cirrhosis cause?

A 
Spider Angioma
Palmar erythema
Dec body hair
Gynecomastia
Testicular atrophy
23
Q

Alcoholic pt comes in w/evidence of cirrhotic liver, what test should be done?
Why?

A

Upper EGD

Exclude varices and determine risk of hemorrhage

24
Q

Zenker diverticulitum occurs d/t what?

A

Motor dysfunction - posterior herniation bw fibers of cricopharnygeal muscle

25
Q

Episodic painless GI bleeding in old person indicates what?

Characterized by what?

A

Angiodysplasia

Dilated submucosal veins and AVMs

26
Q

V high levels ALP along with elevated conjugated bilirubin levels indicate what?

1st step in w/u?

A

Cholestasis d/t intra or extrahepatic biliary obstruction

RUQ US

27
Q

Pt w/pmhx of chronic pancreatitis now presents w/vague ABD pain and weight loss, what is most likely Dx?

1st step in management?

A

Pancreatic cancer

CT ABD w/Contrast

27
Q

What is a mucosal tear at the GE junction?

A

Mallory-Weiss tear

28
Q

What is elevated in the urine in pts w/Carcinoid syndrome?

A

5-HIAA, breakdown product of serotonin

29
Q

What are the MOST appropriate diagnostic tests for acute HepB infection?

A

HBsAg and anti-HBc (IgM)

29
Q

Pt w/obvious pancreatitis but also has ALT > 150 needs to have what done in the workup?

Why?

A

RUQ US

Gallstone pancreatitis

30
Q

Pts w/upper GI bleeding often have what?

Why?

A

Increased BUN/Cr ratio

Inc urea production from Hg breakdown and increased urea production (d/t hypovolemia)

32
Q

Pt that has intermittent RUQ pain and nausea after having a cholecystectomy has what?

Treat how?

A

Postcholecystectomy syndrome

ERCP

33
Q

Dude Is Just Feeling Ill Bro

Means what?

A

Absorption
duodenum - iron
Jejunum - folate
Ileum - b12

35
Q

What is hepatic hydrothorax?

Presents how?

A

Transudative pleural effusion d/t small defects in the diaphragm

Ascites, peripheral edema

UWorld Step 2 (17 decks)

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