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Gi Review for Awesome People > Lecture 1 > Flashcards

Lecture 1 Flashcards

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1
Q

where does gallbaldder pain refer?

A

right shoulder or subscapular region

liver are and back

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2
Q

where does pancreas pain refer?

A

Left mid back

and epigastrium

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3
Q

vomit bile w/I 15 minutes of eating; believed by be cause by reflux of bile into stomach

A

Bilious vomiting

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4
Q

Foreceful emesis w/o prior nausea or retching. Found often in increased ICP, but can be seen in other conditions

A

Projectile vomiting

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5
Q

Vomiting of food eaten more than 6 hours previously

A

Gastric retention

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6
Q

Most common; explosive bouts of n/v in conjunction w/ watery diarrhea, cramping, abdominal pain, myalgias, HA and fever. Rapid recovery usually within 7-10 days

A

Viral gastroenteritis

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7
Q

Greater than 1 Liter per day of diarrhea
decreased absorption of Na/Cl
includes fatty acid induced diarrhea

A

Secretory diarrhea

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8
Q

Diarrhea stops when patients fasts. Elevated osmotic gap on stool analysis. Can be due to laxatives with magnesium

A

Osmotic diarrhea

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9
Q

2 causes of inflammatory diarrhea?

A

Ulcerative colitis

Parasites

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10
Q

Motility disorders that can cause diarrhea?

A 
IBS
Hyperthyroid
Carcinoid
Scleroderma
Diabetes
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11
Q

Abdominal distention, diarrhea, postprandial abdominal distention. Hypomotility leads to bacterial overgrowth. WIll have watery diarrhea or steatorrhea.

A

Scleroderma

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12
Q

Abdominal pain; hematemesis or “coffee ground” emesis; passing melena tarry stool (stool may be frankly bloody or maroon with massive or brisk upper GI bleeding)

A

Upper GI bleeding

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13
Q

Left lower quadrant pain

tenderness, fever, and leukocytosis. Tender mass is noted frequently

A

Diverticulitis

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14
Q

Due to neurologic or neuromuscular dz. Have problems starting swallowing. Possibility of aspiration/ regurgitation. Common in elderly, cortical brainstem lesion. More problem with liquids than solids

A

Transfer dysphagia

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15
Q

Most common cause of motor dysphagia. Slowly progressive motility disorder. Lack of relaxation of LES. hallmark- loss of cels in myenteric ganglia. Episodes of aperistalsis. Sensitivity to gastrin and cholinergic agents. Liquids and solid both difficult. Pain and regurg common.

A

achalasia

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16
Q

tx of achalsaia

A

open LES with balloon dilation
Botox injections
surgical myotomy

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17
Q 
Type of scleroderma 
calcinosis 
Reynards phenomenon 
esophageal dysmotility 
sclerodacytyl 
telangiectasia
A

CREST syndrome

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18
Q 
non-progressive dysphagia
liquids and solids affected
substernal chest pain
can appear like angina 
Will have periods normal peristalsis
A

Diffuse esophageal spasm

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19
Q

high amplitude contractions in distal esophagus
Principal symptom is chest pain
Non-progressive
Liquids and solids

A

Nut cracker esophagus

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20
Q

Tx of diffuse esophageal spasm

A

nitrate/ calcium channel blockers

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21
Q

Dx of diffuse esophageal spasm and nutcrack esophagus

A

esophageal manometry

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22
Q

Tx of nutcracker esophagus

A

calcium channel blockers

nitrates

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23
Q

Anxiety disorder. Say they have problem swallowing but they don’t

A

globus hystericus

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24
Q 
Acid stimulation of chemoreceptors
prolonged severe contractile waves
distention of stretch receptors 
common with GERD
Similar to IBS; seen in patients w/ nutcracker esophagus
A

Esophageal chest pain

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25
Q

most common histology of esophageal cancer

A

squamous cell carcinoma

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26
Q

Only have difficulty with solid food. rapid onset

A

Mechanical obstruction

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27
Q

test of choice for transfer dysphagia

A

barium swallow

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28
Q

rings of fibrous tissue that occur in the lower esophagus and cause intermittent dysphagia to solids. Trouble with large piece of bread or meat

A

Esophageal rings (Schatski’s Ring)

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29
Q

Tx for Schatski’s Ring

A

balloon or bougie dilation

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30
Q

rings that occur in the proximal esophagus

A

esophageal webs

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31
Q

causes occasional heartburn
LES is often weak and hiatal hernia can contribute
Bitter regurg or water brash
can have cough, asthma, horseness
retrosternal burning sensation radiating upward
large meals in supine position

A

GERD

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32
Q

dx of GERD

A

ambulatory pH study
Endoscope
can be done in clinic just based on S/S

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33
Q

tx of GERD

A

elevated head in bed, weight loss, avoid fatty foods
Histamine 2 receptor antagonist
PPI
promotility therapy

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34
Q

Metaplasia in the esophagus can lead adenocarcinoma. Due to years of acid exposure. Seen in people with hx of GERD

A

Barrett’s esophagus

35
Q

tx of Barrett’s

A

Endoscope every few years with biopsy
PPI
Resection if needed

36
Q

what type diarrhea does zollinger diarrhea cause?

A

Secretory diarrhea

37
Q

3 things to stop before H. pylori testing

A

Pepto-Bismol,
H2 Blockers (Zantac, Pepcid etc)
Proton Pump Inhibitors (Nexium, Prilosec)

38
Q

Patient presents with PUD, negative for H. Pylori and NSAIDs and has recurrent ulcers what should you suspect?

A

Zollinger- Ellison Syndrome

39
Q

Diarrhea
R lower quadrant pain
diarrhea is non-bloody
weight loss/ vomiting/ fever

A

Crohn’s Dz

40
Q

where does crohn’s dz occur

A

any portion of GI
transmural cobblestoning
skipped lesion

41
Q

what deficiency may you have with crohn’s

A

Vit B 12

Iron deficiency

42
Q

rectum is always involved
pain, bloody diarrhea, urgency, bleeding, mucus passage
tenesmus, urgency

A

Ulcerative colitis

43
Q

complications of UC?

A

toxic megacolon
perf
anemia- Fe deficiency
adenocarcinoma of colon

44
Q

extra-intestinal manifestations of IBD

A

arthritis
liver complications
MSK complications

45
Q

ways to diagnose IBD

A

Labs test for inflammation/ anemia
colonoscopy
radiography

46
Q

what are the red flag symptoms that will rule out IBS.

A 
weight loss 
anemia
nocturnal symptoms
steatorrhea
onset of symptoms after age 50 
Fever
family hx of colon cancer
sudden changes in symptoms
47
Q

Drugs to manage IBS

A 
Anticholingerics
acid suppression
motility agents
antidepressants
don't put on narcotics
48
Q

Common in child care centers; person to person (fecal-oral) transmission. Watery noninflammatory diarrhea. Rarely causes bacteremia; lasts 3-6 days.

A

Acute Shigellosis

49
Q

From contaminated meat, dairy or poultry products, can be from spices. 2-3 days.
Fever, nausea, vomiting, diarrhea

A

Acute salmonellosis

50
Q

main cause of traveler’s diarrhea. Outbreaks from foodborn transmission.

A

E. Coli

51
Q

winter outbreaks; vomiting and diarrhea in families, nursings homes, schools.

A

Norovirus

52
Q

Outbreaks among children; unusual and mild in adults

worldwide distribution

A

Rotavirus

53
Q

waterborne transmission; protozoan. Day care centers. IgA deficiency.

A

Giardia lamblia

54
Q

Common in immunocomprimised; HIV and AIDS patients. waterborn transmission, travel

A

cryptosporidium

55
Q

causes of immunosupression disorders of the intestines

A

Cryptosporidium, Isospora, Cyclospora

56
Q

parasitic and protozoan causes of intestinal infections

A

Giardia, Amoeba

57
Q

what does the overgrowth of C. diff lead to?

A

pseudomembranous colitis

58
Q

what are invasive pathogens that cause inflammatory damage?

A

Salmonella, Norwalk Virus., Entamoeba

59
Q

Cytotoxin elaborating-destroy mucosal epithelial cells

A

C. Diff

60
Q

Neurotoxin elaborating-one cause of food poisoning & vomiting

A

Staph A

61
Q

what is bleeding like with diverticulur dz?

A

profuse and painless bleeding

62
Q

Hepatitis caused by feca-oral contamination. Common in child care, NICU or sexual transmission . There is no carrier state.

A

HAV

63
Q

Hepatitis caused by percutaneous, perinatal and sexual contact. can have vertical transmission

A

HBV

64
Q

hepatitis that is less than 6 months.

A

acute hepatitis

65
Q

incubation time of HAV

A

2-6 weeks

66
Q

incubation time of HBV

A

1-6 months

67
Q

HCV incubation time

A

5-10 weeks

68
Q

Hepatitis that most commonly turns into chronic hepatitis?

A

Hep C

69
Q

what make HBV different from the rest

A

it is DNA, rest are RNA

70
Q

Similar to HEA

incubation of 2-9 weeks. Can have massive hepatitis necrosis.

A

Hep E

71
Q

2 hepatitis that have massive hepatic necrosis

A

Hep D

Hep E

72
Q

When do IgM levels go back to zero in Hep A?

A

4 months after expsoure

73
Q

HbsAG will be positive when?

A

Hep B (acute or chronic)

74
Q

When will IgM antiHBc be positive?

A

only with acute HBV

75
Q

What types of hepatitis can be chronic

A

B C D

76
Q

Most common cause of chronic hepatitis

A

NASH

Nonalcoholic Steatohepatitis

77
Q

what most commonly causes the drug type of hepatitis.

A

Acetaminophen

78
Q

what is the pathological picture of hepatitis

A

monocyte infiltration, cell necrosis, hyperplasia & cholestasis

79
Q

how do you treat Hep B?

A

interferon

Lamuvidine

80
Q

How do you treat Hep C?

A

Interferon

Ribavirin

81
Q

when will you have mallory bodies in hepatitis? Fever, jaundice, and hepatomegaly and common. spider angiomas

A

Alcoholic hepatitis

82
Q

ABCDEFs of fulminant hepatic failure

A

Acetaminophen Hep A autoimmune hepatitis
hep B
Hep C, cryptogenic
Hep D, drugs
Esoteric causes- Wilson’s, Budd-Chiari syndrome
Fatty infiltration- Reye’s, acute fatty liver of pregnancy

83
Q

how long do you have give N-acetylcystine before a liver starts shutting down?

A

17 hours

Gi Review for Awesome People (4 decks)

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