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DT4- Exam 2 > McGuffin- Adult GI Disease- Leah > Flashcards

McGuffin- Adult GI Disease- Leah Flashcards

1
Q

RUQ pain lasting more than 6 hours; worse w/fatty meal
Pt stops mid-exhalation upon RUQ palpation
Pericholecystic fluid on U/S:

What is the diagnosis if:

  • stones are present on US
  • stones are NOT present on US
A

Stones: cholecystitis
No stones: acalculous cholecystitis
(Seen in trauma/burn patients)

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2
Q
  • Difficulty swallowing/regurgitation of food before swallowing
  • birds beak appearance on barium swallow

What’s the diagnosis?
What might relieve the symptoms and what bug might be assc?

A

Achalasia
Might be relieved by nitroglycerin
(Confused with cardiac pathology)
Occasionally assc with Chagas Disease

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3
Q
  • Anemia
  • Blood in stool
  • Collections of dilated vessels on colonoscopy

Diagnosis?
Age group?

A

Angiosysplasia; patients over 60

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4
Q
  • Fever
  • RLQ pain
  • Worsening right sided pain with left sided palpation
  • Rebound tenderness
  • Psoas sign +

Diagnosis?

A

Appendicitis

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5
Q
  • Hypoactive bowel sounds + some high pitched tinkling noises
  • Prior history of GI surgery
  • Obstipation

What’s the diagnosis?
What would you see on KUB?

A

Bowel Obstruction

See dilated bowel loops and air fluid levels on KUB

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6
Q
  • Flushing
  • Diarrhea
  • Wheezing
  • Rt sided heart lesion

What’s the diagnosis?
What metabolite will be elevated?

A

Carcinoid tumor

High 5HIAA

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7
Q

Severe Pain radiating to back or infrarenal pain
Hx of atherosclerosis

Diagnosis?
Possible outcome?

A

AAA –> death likely if ruptured

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8
Q
  • Diarrhea, bloating, cramping,
  • Failure to thrive
  • papules, plaques, vesicles on skin

Whats the diagnosis?
What would you see on small bowel biopsy?

A

Celiacs- glialdin (gluten) antibodies

Destroyed villi on biopsy

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9
Q
  • RUQ pain for a few hours after fatty meal
  • N/V

Whats the diagnosis?
What do you see on US?
How is this different than cholecystitis?

A

Cholelithiais

  • stones present on US
  • Stones seen in both cholelithiasis and cholecystitis, but in cholecystitis, there is inflammation and “pericholecystic” fluid on US. Pain will last more than 6+ hours.
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10
Q

Painless rectal bleeding
history of low fiber diet
Old lady

Most likely diagnosis?
Colonoscopy findings?

A

-Diverticulosis, outpouchings of sigmoid colon

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11
Q
  • LLQ pain
  • fever
  • Leukocytosis

Whats the dx? What might the pt have history of?

A
  • DiverticulITIS

- History of diverticulOSIS

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12
Q

Type of esophageal cancer in the upper esophagus?

Lower?

A
  • Upper: squamous cell

- Lower: adenocarcinoma

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13
Q

Risk factors (3) for esophageal cancer

A
  • tobacco
  • alcohol
  • Barrett’s
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14
Q
  • Choking & coughing when eating
  • Halitosis
  • Regurgitating food eaten a while back

Whats the diagnosis?

A

Esophageal diverticulum

traps food, hence bad breath and late regurgitation

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15
Q

Whats a Zenker’s diverticulum?

A

-False diverticulum between inferior pharyngeal constrictor and cricopharyngeus muslce

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16
Q
  • Severe retrosternal chest pain
  • Crepitus on palpation of chest
  • hematemesis

Whats the diagnosis?
What will the patient have a history of?

A

-Esophageal rupture/ BoerHaave syndrome
(Mallory Weiss tear gone bad)
-Hx of alcoholism and retching

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17
Q
  • chest pain esp when drinking cold liquid
  • corkscrew esophagus on barium swallow
  • relieved by nitroglycerin

Whats the diagnosis?

A

-Esophageal spasm

18
Q
  • Painless hematemesis
  • Hypotension
  • Anemia
  • History of alcoholism

Whats the diagnosis?

A 
esophageal varices 
(dilated submucosal veins in the lower 1/3 of the esophagus)
19
Q
  • GERD
  • Dysphagia of SOLIDS only
  • Otherwise normal

Diagnosis?

A

-Esophageal web

fibrovascular CT lesions

20
Q

-Chest pain & odynophagia
Suggestive of?
Possible causes?

A

-esophagitis
infectious: CMV/Candida/HSV/ VZV
chemical exposure
GERD

21
Q

What do the lesions of the following look like?
Candida esophagitis
CMV esophagitis
HSV esophagitis

A
  • Candida: nodular filling defect on barium swallow, pseudomembranes
  • CMV: linear ulcers
  • HSV: punched out ulcers

(+ intranuclear inclusions in both CMV HSV: he writes only CMV, Gusack writes both? Gusack more likely to ask.)

22
Q
  • Abdominal pain
  • Acanthosis nigricans
  • Left supraclavicular and umbilical lymphadentopathy:

Diagnosis?

A

Gastric cancer

Hx smoked foods, gastritis, anchlorhydria, H. pylori

23
Q

Intractible vomiting
Early satiety
Weight Loss

Suggestive of?

A

Gastric outlet obstruction, possibly secondary to cancer

Adult version pyloric stenosis

24
Q

-Burning abdominal pain, worse with food

Suggestive of?

A

-Gastritis

many possible etiologies: erosive, autoimmune, H. Pylori

25
Q
  • Burning chest pain
  • Night time cough
  • acid taste in mouth

Suggestive of?

A

-GERD (loss of LES tone)

26
Q

Liver disease in which AST is higher than ALT?

Disease in which they are both EXTREMELY high?

A

-AST is HIGHER than ALT in ALCOHOL INTOX.
(Usually, ALT is higher- think alphabetical order, L before S)

-will both be extremely high in shock liver

27
Q
  • String lesion on CT of bowel
  • Skip lesions sparing rectum on colonoscopy
  • Transmural inflammation

Diagnosis?

A

Chrons

28
Q
  • Bloody diarrhea
  • Continuous lesions of rectum, colon +/- ileum
  • Mucosal and submucosal inflammation
  • Lead pipe appearance of bowel on CT

Diagnosis?

A

Ulcerative colitis

29
Q
  • Anxious woman
  • frequent stool changes
  • abdominal pain

Diagnosis?

A

-IBS

30
Q

Causes of Mallory Weiss Tear?

A

-alcoholism, bulimia

31
Q

SEVERE abdominal pain
History of atherosclerosis/ a-fib
Elevated lactate/ metabolic acidosis

Diagnosis?

A

Mesenteric Ischemia

32
Q

African American Male
Pain radiating to back
jaundice
weight loss

Diagnosis?

A

Pancreatic Cancer

33
Q

LUQ pain
History of gall stones/alcoholism
Elevated lipase and amylase

diagnosis?

A

Acute Pancreatitis

34
Q
  • Loss of fat in stool
  • Weight loss
  • Hyperglycemia/ polyuria

Diagnosis?

A

-Chronic Pancreatitis

35
Q
  • Burning epigastric pain
  • N/V
  • Melena/ hematochezia

diagnosis if worse with food?
better with food?

A

Gastric ulcer- worse with food

Duodenal ulcer- better with food

36
Q
  • History of GERD
  • Sudden onset SEVERE epigastric pain
  • Guarding, rebound tenderness

diagnosis?

A

Perforated ulcer

37
Q
  • tongue pain and burning
  • dysphagia
  • dry skin esp at lips and mouth angles

diagnosis?

A

Plummer Vinson Syndrome

iron deficiency

38
Q

Watery diarrhea and plaques on colon following abx use?

A

Pseudomembranous colitis

39
Q

Abdominal pain, fever, chills, ascites
Neutros on pericentesis
Mental status changes, guarding & rebound

Diagnosis?

A

Bacterial peritonitis

40
Q

Weird movements
Golden brown ring around cornea
Low ceruloplasmin
Dementia

Diagnosis?

A

Wilsons Disease

DT4- Exam 2 (12 decks)

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