Integrative GI Flashcards by Nathan Hansen

old alcoholic man, worsening midepigastric pain radiating to the back

N/V, steatorrhea
no rebound, similar sx in past

dx is ___
finding on imaging

chronic panc

pancreatic calcifications

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woman w severe epigastric pain radiating to back

no alcohol/drugs

inc lipase/amylase

test to determine etiology

or ____

RUQ ultrasound

TG measurement

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old man, recurrent severe RUQ pain, N/V, jaundice

Fever, elevated alk phos, WBC

mechanism of findings ___
dx is ___

obstructed CBD

acute cholangitis

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woman w RUQ pain, esp when eating greeasy food

labs normal

dx is ____
secretion of __ is causing sx

biliary colic

CCK

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elderly man, LLQ pain and fever, no temp

dx is _____
mechanism __ of protrusions in ___

diverticulitis

inflammation, colonic wall

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elderly man, epigastric pain radiating to the back, wl, jaundice

inc amylase/lipase, ALP

mass in pancreas
screen w elevated ___

CA 19-9

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young woman, vomiting bright red blood

history of freq vomiting, has since become more forceful

dx is ____

mallory weis syndrome

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MA woman, epigastric pain
hx of previous gastric/duodenal ulcers

H pylori is negative
more ulcers found

dx is ___
excessive secretion of __

ZE syndrome

gastrin

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severe pain OoP to exam, older person w CAD

dx is ___

mesenteric ischemia

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young woman, sudden lower ab pain

could be ___

w dyspareuia, chronic discharge dx is ___

ectopic pregnancy

PID

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paroxsymal, severe pain, cannot sit still, hematuria

dx is __

nephrolithiasis

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old person, debilitated, ab distension, massive colon on xray

dx is ____

sigmoid volvulus

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1-2 yr old pt, intermittent jelly-like stools

dx is ___

intussusception

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old man, flatulence/ab cramping

watery stools after trip to another country

resolved w loperamide/bismuth

dx is ___
caused by ___

travelers diarrhea

ETEC

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young woman, multiyear history of constipation/bloating/loose stools w mucus

no inflammatory findings

dx is ____

irritable bowel syndrome

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young man, vomiting after eating tuna salad

stomach cramping/loose watery stool

cause of sx ____

staph aureus

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shellfish exposure, travel w low K

microorganism is ___

classically described as __

Vibrio species

rice water stools

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HIV, chronic watery diarrhea

C
G
I
C
C

crypto
giardia
isospora
cyclospora
CMV

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chronic steatorrhea
duodenal biopsy w villous atrphy

dx is ____

look for ab to ___

celiac disease

TTG

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outdoor exposure w high eosinophils and diarrhea

dx is ___

stronglyoides

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watery diarrhea, facial flushing

dx is ____
look for high ____

carcinoid syndrome

5 HIAA

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young male, yellow eyes post illness

labs normal

dx is ____
deficient in ____

gilbert syndrome

glucuronyltransferase

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young boy, jaundice, dark urine, gray stools

hepatomegaly, inc direct bilirubin

mechanism is ___

obstructed biliary system

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mild jaundice, inc LDH, reticulocytes, peripheral smear shows schistocytes

dx is ____

hemolytic anemia

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MA woman, pruritis, very high alk phos dx is ___ antibodies present __

PBC antimitochondrial

liver dz, altered mental status, young person dx is ___ low ___

wilsons disease | ceruloplasmin

diabetes, CHF, liver dz, skin/teste findings dx is ____ mutation in _)___

hemochromatosis | HFE gene

MA woman, jaundice, high transaminases dx is _____ antibodies present

autoimmune hepatitis ASMA, ALKMA

man w jaundice, dark urine history of UC elevated alk phos, bilirubin CT shows dilated peripheral ___ mild dilatin of __ normal ____ dx is _____

intrahepatic duct hepatic duct bile duct PSC

transmural inflammation, skip lesions, fistulas, noncaseating granulomas dx is ____

chrons disease

bloody diarrhea, toxic megacolon dx is ____

extraintestinal manifestations common in S/U/A risk of ___

sclerozing cholangitis, uveitis, arthritis colon cacer

tender nodules on shins is ____ necrotic skin ulcers w purple/red borders is __

erythema nodosum pyoderma gangrenosum

woman w difficulty swallowing food/liquid hx of GERD ct shows bird beak dx is ___ dec ability of ___ to ____

achalasia | LES, relax

hx of GERD, upper endoscopy shows intestinal metaplasia dx is ____ risk of ____

Barrets Esophagus | adenocarcinoma

hernia protrudes through external inguinal ring, does not enter inguinal canal medial to inferior epigastric artery type of hernia

direct inguinal hernia

young boy, severe RLQ pain, anorexia/fever rebound/guarding resists active extension of hip dx is ___ inflammation over ___

AA psoas major muscle

old man, vomiting bright red blood exam shoes jaundice, spider angiomas, ascites, splenomegaly dx is ___ anastamoses for bleedign

cirrhosis left gastric vein and azygous vein

old woman, vomiting bright red blood taking lots of NSAIDs, EGD shows bleeding ulcer on posterior duodenum vessel source is ____

gastroduodenal artery

100+ polyps at young age, assc w osteomas, dental findings, lipomas/skin findings, retinal pigment hypertrophy dx is _____

Gardner syndrome

PJS assc w O/B/U/P tumors

ovary, breast, uterus, pancreas

small/large intestine and stomach w hamartomas, congenital abnormalities dx is ____

juvenile polyposis

acetominophen OD tx w __ restores ___ as precursor, binds ____

N acetylcysteine glutathione, NAPQI

OCP, develops ascitees concerned for ___ which is obstructed ____ may lead to ____

Budd chiari syndrome, hepatic vein hepatic adenoma

SE of MTX

hepatic fibrosis

Metoclopromide for N/gastroparesis/neuro sx SE include ___ ie smacking lips, protruded tongue, tics/troticollis

tardive dyskinesia

autoimmune hepatitis can be caused by __ and ____

nitrofurantoin/minocycline

infant, fails to pass meconium enema shows narrow rectosigmoid jxn, dilated above dx is ____ failed ____

hirschprung dz | NCC migration

Down syndrome, ab distension/vomiting xray shows ___ dx is ____

double bubble | duodenal atresia

young boy, painless lower GI bleeding w out diarrhea dx is ___

meckels diverticulum

infant, jaundice/hepatomegaly, E coli sepsis low glucose, reducing substances in urine dx is ___

galactosemia

young infant, postprandial vomiting, alkalosis/ low Cl dx is ____

pyloric stenosis

hernia in inguinal canal, lateral to the inferior epigastric artery dx is ___ presistent ___

indirect inguinal hernia | processus vaginalis

diarrhea, dementia, rash dx is ___ deficient in ___

pellagra | Niacin/B3

night blindness deficient in ___ excess retinol is ___

Vitamin A teratogenic

PN may be caused by __, __, ___ deficiencies

VB1 (thiamine_ VB6 (pyridoxine) VB12

macrocytic anemia caused by __ deficiency, normally in __ __ deficiency w neuro sx found in __ can be low by __ dz

folate, vegetables VB12, animal products terminal ileum

swollen gums, poor wound healing, bruising deficient in ___ dx is ___

VC | scurvy

neonatal hemorrhage, deficient in ____

rickets in breast fed infant deficient in ____

Vitamin D