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GI Exam 1 > Intro > Flashcards

Intro Flashcards

1
Q

best test for gallbladder problems?

A

US first then HIDA scan

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2
Q

should you order an AXR?

A

if you think you will need a CT then go straight to that

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3
Q

Initial study of choice for suspected cholelithiasis and cholecystitis

A

US

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4
Q

when to use the capsule endoscopy

A 
Obscure GI bleeding
Chronic diarrhea
Malabsorption
Crohn’s disease 
Esophageal disease
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5
Q

what is endoscopic ultrasound used for

A
  • pancreatitis
  • cardidopulmonary dysfunction
  • tumor seeding w/biopsy (cancer staging)
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6
Q

best test to detect pancreatic cancer

A

endoscopic ultrasound

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7
Q

best therapeutic intervention for examination of the upper GI tract, the papilla of Vater, and the pancreatic duct

A

Endoscopic Retrograde Cholangiopancreatography (ERCP)

allows for biopsy, removal of stones

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8
Q

most important indication for ECRP

A
  • obstructive jaundice

- also preferred method of examination for a patient with possible choledocholithiasis

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9
Q

what is Magnetic Resonance Cholangiopancreatography (MRCP) used for?

A

non-invasive evaluation of the pancreatic and biliary systems. Can only take pictures, no therapeutic intervention

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10
Q

what type of cells make up the esophagus

A

squamous epithelium except for distal 1-2 cm where it turns to columnar (z-line)

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11
Q

sense of impaired transport of bolus through esophagus

A

dysphagia

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12
Q

pain with swallowing

A

odynophagia

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13
Q

difficulty initiating swallows is termed

A

oropharyngeal dysphagia

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14
Q

food “sticking” after swallowing is termed

A

esophageal dysphagia

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15
Q

difficulty swallowing solids only is caused from mechanical obstruction. Intermittent is caused from ( ) and progressive is caused from ( )

A
  • esophageal ring

- stricture/malignancy

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16
Q

difficulty swallowing solids and liquids is caused from a motility disorder. Intermittent is caused from ( ) and progressive from ( )

A
  • esophageal spasm

- achalasia/scleroderma

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17
Q

first test typically ordered for dysphagia

A

barium esophagram (swallow)

18
Q

secondary tests ordered for dysphagia

A
  • endoscopy w/biopsy

- endoscopic US

19
Q

diagnostic tests you can order for esophageal disorders

A
  • esophageal manometry
  • acid reflux (pH) studies
  • CT/MRI
20
Q

best test that demonstrates reflux

A

24 hour pH monitor

21
Q

best test that dmeonstrates the effects of reflux

A

endoscopy

22
Q

Barrett’s metaplasia

A

squamous changes to columnar from stomach acid

23
Q

hiatal hernia

A

stomach pushes up through the diaphragm leading to increased transient LES relaxation

24
Q

main tx of GERD

A
  • PPIs

- H2 antagonists

25
Q

surgical tx of GERD

A

nissen fundoplication, helps restore normal anatomy

26
Q

dysphagia to solid and liquids, think….

A

achalasia,

-insufficient LES relaxation and loss of esphageal peristalsis

27
Q

best way to dx achalsia

A
  • barium esophagram w/fluoroscopy

- bird beak shown

28
Q

achalsia tx

A
  • pneumatic dilation
  • surgical heller myotomy
  • botox if high risk for sx
  • nitrates or CCBs
29
Q

dx of diffuse esophageal spasms

A
  • x/ray/esophagram

- “corkscrew”

30
Q

tx of diffuse esophageal spams

A
  • muscle relaxants

- CCBs

31
Q

what happens to the esopgus in pts with scleroderma

A
  • loss of peristalsis in distal 2/3

- loss of LES function

32
Q

how to test for scleroderma

A

Esophageal manometry and intraesophageal pH readings are the most sensitive means of detection

33
Q

scleroderma tx

A
  • PPIs

- H2 blockers

34
Q

best way to dx esophageal stricture

A

esophagram

endoscopy to evaluate mucosa

35
Q

how to tx esophageal stricture

A

-maloney dilators

36
Q

esophageal rings vs webs

A

rings-commonly in distal esophagus (schatzki)

webs-proximal esophagus, associated w/Fe deficiency

37
Q

dx esophagela rings and webs

A

esophagram

38
Q

gurgling sensation in the neck can indicate

A

zenkers diveticulum

39
Q

dx and tx of zenkers

A
  • barium swallow

- sx for symptomatic pts regardless of size

40
Q

MC benign tumor of the esophagus

A

leiomyoma

41
Q

Often associated with vertebral anomalies (ex: spina bifida)

60% present in the first year of life with either respiratory or esophageal symptoms

A

esophageal cysts

42
Q

MC esophageal cancer

A

squamous cell carcinoma

MC complaint is dysphagia

GI Exam 1 (4 decks)

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