Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

T2 GI > MOD (esoph, acute abd, listeria/actin) > Flashcards

MOD (esoph, acute abd, listeria/actin) Flashcards

1
Q

What might gradual vs sudden onset of abdominal pain (with unknown etio) indicate?

  • Steady vs crampy?
  • right shoulder/scapula vs flank/groin?
A
  • gradual may be organ distension or peritoneal irrigation, sudden may be perforation/ hemorrahage/ infarct
  • steady may be inflammation like appendicitis, crampy may be obstructive process
  • right shoulder/scapula may be right side stuff like gb, liver spleen etc, falnk or groin may be kidney/ureter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is mittelschmerz?

A

one sided abd pain due to ovulation (not med emergency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What might distended abd indicate? rigidity

A

-distended abdomen may mean obstruction or ascities, rigid may be peritonitis (decr movement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What 3 bowel sounds do you listen for and what migh tthey indicate?

A

absent- paralytic ileus
increased sounds (borborygmi)- mech obstruction
bruit-vascular disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Obturator/psoas sign?

A

can use to detect appendix inflam(?), rotate right leg or stretch psoas to see if appendix is impinged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

~7 ACUTE abodomen issues that need immediate surgery?

A 
Ischemic bowel disease
acute Appendicitis
acute Pancreatitis 
chronic Pancreatitis 
bowel Obstruction
bowel Perforation
Mesenteric Lymphadenitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

4 mechs of ischemic bowel disease?

A

(mucosa impacted first)
1 acute emboli
2 chronic atherosclerosis
3 non-occlusive mestnteric ischemia (severe hypotension)
4 venous thrombosis (outflow issue causing congestion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Histo in emboli vs athero plaque?

A

emboli cause patchy necrosis due to occlusion, athero plaque is more central and diffuse

foregut-celiac, sma-midgut

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Emboli and ather clinical pres

A

older female w colon pain, sudden cramping, left lwoer abd pain, desire to defecate, bloody stool/diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What predisposes to venous thrombosis?

A

hypercoag state, estrogen/steorids/afib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

differential Ddx for RLQ pain?

A

diverticulitis, ectopic preg, ovulation/ovarian cyst, colitis, chrons (terminal ileum first)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q 
Acute PANCREATITIS clinical pres?
What things are elevated in order? What is decr?
What might be the cause?
Clinical course?
Histo?
A
  • abd pain constant/intense upper/epigastric refers to back or shoulder,
  • Elev triglyerides, hypocalcemia
  • Can be caused by alc (M) or gallstones (F)
  • interstit inflam/edema, proteolysis, fat necr/hemorr
  • amy elev first, then lipase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Chronic pancreatitis? Cause

A

irrev dmg to exocrine pnacr parenchyma and FIBROSIS, usually from alc, inccr cancer risk, severe chronic abd pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Bowel obstruction? causes?

-what does tympanic abd mean?

A

Can be from herniation, adhesion (post surgical), volvulus, intussusception, tumor
-tympanic abd means lots of air in it, eg from volvuluus (sigmoid or cecal in elderly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Bowel perforation? 3-4 causes? CT? Hinchley classes?

A

Peritonitis that req immed surgery

  • can be from peptic ulcer/pylori, appendiciits causing abcess, diverticulutis (operate on hinchley II/IV, I/II ABX <5cm abcess), or iatrogenic (eg colonoscopy)
  • CT: faciform ligament w air in peritoneum (black space on xs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Mesenteric lymphadenitis?
pop?
what is it similar to?
org?

A
  • self limit inflam that mimics appendicitis/intuss
  • may be due to Yersenia
  • mroe common in kids
  • resolves
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can GERD proceed to?

A

ulcer bleeding, stricture, barrets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

causes for reflux

A

inflam of esoph mucosa (ph<4)
incompetent lower esoph sphincter, transient LES relaxation, delayed esoph clearance, gastric stasis where P in stomach greater than sphincter barrier (loss of receptive relaxation), disruption to esoph via meds, chem, etc, hiatal hernia, short LES
-esophagitis can also be from candida and herpes etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hiatal hernia

A

gastric reflux w chest pain, herniation of stomach thru diaph, tx with anti reflux or surg

20
Q

short LES with distention causes?

A

risk factors: motility disorders, decr saliv, epith dmg due to alc, hot liquid (incr perm of gap jxn) (shorter spinchter means can cause esoph)

21
Q

GERD tx and pathology?

A

monitor, but usu use PPI
-chronic inflam > epith hyperplasia > introduces inflam cells causing ulceration/erosion of mucosa, elong of dermal papillae (histo)

22
Q 
Stricture in esoph? 
Sx?
Tx?
Cause?
Path?
A

“lump in throat” often in oropharynx

  • sx: dysphagia
  • tx: dilation of stricture via stent
  • path: complication of reflux! (fibrosis and narrowing) use PPI etc
23
Q 
Barrett's esophagus?
pop?
what histo changes happen?
color of mucosa?
what can it progress to? (what type)
A

oftentimes middle aged men, conseq of GERD

  • metaplasia of squamous epith into intestinal cells (non cil columnar with goblet cells), ulceration and replacement of cells
  • salmon color mucosa
  • can go from metaplasia to dysplasia to adenocarcinoma (intervene @ low grade dysplasia, metaplasia usu doesnt progress to this)
24
Q

Squamous cell carcinoma risk factors? pop?

A

NOT related to barretts!

risk factors, occurs more ww, AA, alc/smoking, env

25
Q

Mallory Weiss syndrome? what could it progress to? tx?

A

tearing of mucosa/sub and maybe mm of esoph, due to vomiting usu from alc or bulemia
-can progress to boorhave’s–rupture of esoph leading to air in mediastinum and subcut emphysema (surg emergency), tx by stopping bleeding

26
Q

Achalasia sx? tx?

A

denervation of inhib nerves of LES so cant relax, dilated and spastic esoph, cant swallow, weight lsos, aspiration, tx with surg

27
Q

esophageal varices?
cause?
can progress to?
tx>

A

dilated submucosal blood vessels secondary to HTN

  • can rupture leading to bleeding
  • tx with meds, shunts to lower portal pressure, endoscop injxn etc
28
Q

Esoph web? (syndr assoc?) ring? tx?

A

Esoph web-thin mucusal fold in upper esoph which may cause dysphagia
-assoc with vinson plummer syndrome (iron def anemia, esoph web and BEEFY RED TONGUE) (what else causes this?)
-ring-distal esoph
tx is dilation

29
Q

Esoph diverticulum? type? tx? sx? path? site?

A

weakening of muscle in esoph, can cause dysphagia, aspiration and bad/rotting breath, tx is surg

  • can be zenker’s diverticulum–prolapse of esoph thru killians triangle
  • sx: bad breath, mass in neck, aspiration, gurgling/regurg
30
Q

Esoph atresia? can progress to (compl)? tx?

A

congenital narrowing, may proceeded to aspiration pneumoitis, tx with surg
-high lifetime risk for dysmotility, aspiration and squamous cell carc

31
Q 
Listeria monocytogenes
Pop?
o2 req
gram
hemolysis
motility
sources
A

“santas list”

  • neonates, preg women, elderly, immunosupr
  • can cause life threatening bacteremia and CNS infxn
  • small fac anaerobic gram + rod, beta hemolytic, exhibits tumbling motility
  • can be mistakenly reported as diphteroids
  • soil, decaying veg, raw meats/deli/veg/milk and soft cheeses
32
Q

Listeria transm? what increases risk? mech?

A

not human-human except mat-fetal, transm via contam foods

  • H2 blockers and antiacids incr risk (ulcers) bc alklainize
  • org gets into blood and is endocytosed by epith cells in gastric mucosa
33
Q

How does Listeria spread/ VFs?

A

invades cells by producing surface prot internalin which interacts with e caderin receptors on epith cells causing endocytosis.
produces listeriolysin O VF which allows escape of orgs, migrate to cell memb to form filopods
has surface prot actin A that allows cell to cell dissem (w.o being exposed dir to immuno defense_
iron is VF bc enhances growth, so in pts with iron overload like hemochrom or transfusion

34
Q

How are ppl resistant to LM?

A

cell mediated immunity (if impaired more likely to get listeria), eg imunosuppr, transplant, preg, aids etc, low cd4

35
Q

brain abcess with immunosuppr may indicate?

A

listeria

36
Q

2 forms of neonatal listeria?

A

early sepsis and premature (infxn amniotic fluid, conjunctiva etc, intrauterine), late onset meningitis after birth from vag orgs during deliv

37
Q

3 forms of CNS listeriosis?

A

meningitis, cerebritis, and abscess

meningitis is most common, CSF will have gram NEG stains! normal glucose levels, seizures etc

38
Q

Gi form of listeria is?

A

self limiting!

39
Q

Major listeria infections? (~5)

A

pregnancy (fever followed by stillbirth), neonatal early (amni) and late (mening), CNS in immunodef or elderly, GI self limiting, endocarditis

40
Q

In which clinical settings should we suspect listeriosis>

A

neonatal sepsis or menin
mening or CNS abcess in immunsup or elderly
diphteroids on gram stain
food borne GI with neg cultures(???)

41
Q

complications (~3) of invasive listeriosis?

A

DIC, ARDS, rhabdomyolysis with ARF

42
Q 
Actinomyces israelli?
source/host?
granules
gram/O2 reqs?
shape?
A

“israelii soldier”
humans an animal host, source is plants and soil
-sulfur granules (yellow popcorn granules in suppurative inflam)
-gram positive branching filamentous rods, NO acid fast, anaerobes

43
Q

main sx of actinomyces?
incr risk in?
histo?

A

cervicofacial, and later abd (from appendicitis) or pelv(IUD)/thor (aspiration secondary) issue, IC pts NOT at incr risk! (GI issues incr risk)

  • lumpy jaw is most common, following dental procedure, abcess draining sinus, prululent exudate with sulfur granules, can dissem
  • histo: hard to culture, supp inflam, sufur, periph edges with club shaped projxn, basophilic granular structures centrally amorphas, gram + branching filamentous rods
44
Q

Nocardia?
stain/O2
sx
what is it similar to/how do you distinguish?

A

“No card game for old men”

-similar clinical to actinomycosis, but aerobic, partially acid fast, and gram pos branching filaments

45
Q

ddx for actino?

A

include nocardia and bortrymycosis (not branching filaments)

46
Q

Tx for actinomycoses?

A

Penecillin

T2 GI (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions