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Clin Med= GI > Overview of GI > Flashcards

Overview of GI Flashcards

1
Q

GI tract Consists of? (4)

A

Esophagus, Stomach, Small Intestine, Large Intestine

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2
Q

Mucosal Layers of the GI tract

A

Provide barrier to luminal contents

Site of transfer of luminal contents

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3
Q

Biliary conduits (Pancreatic and Biliary Tract)

A

Deliver bile and enzymes to promote breakdown of luminal contents

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4
Q

Making a Ddx in the GI tract

A

Take away that when creating a Ddx you need to consider all of these**
Esophagus, Stomach, Small Intestine, Large Intestine

Mucosal Layers

Biliary conduits (Pancreatic and Biliary Tract)

Lymphatic System

Vascular Supply

Nerve Innervation

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5
Q

Function of the mouth

A

Processing of Food (food mixed with salivary amylase)

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6
Q

Function of the esophagus

A

Propulsion of food bolus to stomach - partially controlled by lower esophageal sphincter (LES); (Transit time: seconds)

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7
Q

Function of the stomach

A

Further processing of food (via mixing with pepsin and acid); Secretion of intrinsic factor for B12 absorption (Transit time: minutes to few hours)

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8
Q

Function of the small intestine

A 
Nutrient absorption (via specialized enzymes and transporters); waste elimination to colon (Transit time: few hours)
Proximal Small Intestine: Rapid absorption of nutrient breakdown products & minerals
Distal Intestine (i.e., ileum): absorption of B12 & bile acids
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9
Q

Function of the colon

A

Preparation of waste material for evacuation: stool dehydration; fermentation of undigested carbs/fatty acids (Transit time: >24 hours for most individuals)
Proximal Colon: Mix and Absorb material
Distal Colon: Expel stool

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10
Q

Disorders of the Pancreas

A 
Impaired Digestion/Absorption 
Altered Secretion 
Hypersectretion
Altered Gut Transit-- Obstruction - neoplastic obstruction, acid-induced stricture - ***Most common cause of colonic obstruction = colon cancer)
Immune Dysregulation 
Compromised vascular supply
Neoplasm
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11
Q

Disorders of the Esophagus (6)

A 
Esophagitis
Gastroesophageal reflux disease (GERD)
Motility disorders
Mallory-Weiss tear
Esophageal Neoplasms
Esophageal Strictures
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12
Q

Disorders of the stomach (6)

A 
Gastroesophageal reflux disease (GERD)
Gastritis
Gastric Neoplasms
Peptic ulcer disease
Pyloric stenosis
Gastroparesis
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13
Q

Disorders of the gallbladder and biliary tract

A 
Cholelithiasis
Acute and chronic cholecystitis
Choledocholithiasis
Biliary Cirrhosis
Cholangitis
Acute Bacterial
Primary Sclerosing
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14
Q

Hepatic Disorders

A 
Jaundice
Hyperbilirubinemia
Acute and chronic hepatitis
Alcoholic Liver Disease
Hepatic Cirrhosis
Steatohepatitis
Ascites
Portal Hypertension
Hemachromatosis
Hepatic Neoplasms
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15
Q

Disorders of the pancreas

A

Acute pancreatitis
Chronic pancreatitis
Pancreatic neoplasms

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16
Q

Disorders of the small intestines and the colon

A 
Appendicitis
Celiac disease 
Constipation
Diarrhea
Diverticular disease
Inflammatory bowel disease
Intussusception
Irritable bowel syndrome (IBS) 
Ischemic bowel disease
Lactose intolerance 
Intestinal Neoplasms
Obstruction
Intestinal Polyps 
Toxic megacolon
Conditions related to Post-Bariatric Surgery
Malabsorption Syndromes
Angiodysplasia
17
Q

Disorders of the rectum

A 
Anal fissure
Abscess/fistula
Fecal impaction
Hemorrhoids
Rectal neoplasms

Others
Hernias
Vitamin and nutritional deficiencies

18
Q

Epidemiology of GI disorders

A

in U.S 60-70 million patients affected by GI conditions /diseases
(Around 20% of the Population!)
141.8 Billion in 2004
abdominal pain is #23 out of #35 of the top primary Dx

19
Q

GI disease prevention

A 
Screening for GI Disorders
Dietary Lifestyle
Activity Lifestyle
Tobacco Use
Alcohol Use
Family History
ROS
Screening for alcohol use and abuse
Screening for hepatitis risk factors
Screening for colon cancer
20
Q

Colorectal Cancer Epidemiology

A 
3rd most common cancer in adults (both males and females)
Nearly 10% of all cancer deaths
>90% patients > age 50
Neoplastic changes to adenomatous polyps
Nearly 15% have positive family history
21
Q

Current USPSTF Guidelines for Routine Screening of Colorectal Cancer: For patients at average risk!

A

No one screening option clearly superior
All begin at age 50
Colonoscopy every 10 years
High Sensitivity Fecal Occult Blood Test (FOBT)
Annually with six samples (sensitivity 24% - compared to 5% for single sample)*
Positive tests -> colonoscopy
Flex Sigmoidoscopy q 5 years with FOBT q 3 yrs

22
Q

Guidelines for patients at high risk (USPSTF Guidelines)

A

First degree relative <60 years of age, 2+ first degree relatives with colorectal cancer OR adenomatous polyps
Screening Colonoscopy at age 40 OR 10 years before youngest case in immediate family (whichever is earlier)

23
Q

Colonoscopy Surveillance

A

F/U colonoscopy within 3-6 years
Single small adenoma (1 cm)
Multiple adenomas
Adenoma with high-grade dysplasia or villous change

F/U colonoscopy within 1 year
History of resection of colorectal cancer

24
Q

Some GI Symptoms

A 
Nausea & Vomiting
Heartburn/Reflux
Dysphagia
Odynophagia
Sensation of food trapping
Hematemesis
Abdominal pain
Abdominal distension
Diarrhea/Constipation
Pruritis
Jaundice
Changes in bowel habits
Hemorrhoids
Hematochezia
Melena
Changes in stool caliber
Changes in belching or  flatulence
25
Q

MC GI symptoms (6)

A 
Abdominal pain
Heartburn
Nausea & Vomiting
Altered Bowel Habits
GI Bleeding
Jaundice
26
Q

Ddx for RUQ pain

A 
Nephrolithiasis*
Appendicitis*
Cholecystitis*
Choledocalithiasis
Cholangitis
Gastritis
Hepatic Abscesses
Hepatic Tumors
27
Q

Ddx for RLQ pain

A 
Appendicitis*
Bowel Incarceration
Cecal Diverticulitis
Cholecystitis*
Meckel Diverticulitis
Nephrolithiasis*
28
Q

Ddx for LUQ pain

A 
Diverticulitis*
Nephrolithiasis*
Peptic Ulcer Disease (PUD)
Perforated Ulcer
Splenic Disease
Pyelonephritis*
29
Q

Ddx LLQ pain

A 
Diverticulitis*
Ectopic Pregnancy
Incarceration
Inflammatory Bowel Disease   (IBD)*
Nephrolithiasis*
Pelvic Inflammatory Disease (PID)
Perforated colon
Pyelonephritis*
30
Q

Ddx for midepigastric pain

A 
PUD
Perforated Ulcer
Pancreatitis
Abdominal Aortic Aneurysm
Esophageal Varices
Hiatal Hernia
Esophageal Rupture (Boerhaave Syndrome)
Mallory-Weiss Tear
31
Q

Work up of GI Disorders

A

Labs
Luminal content evaluation (e.g., stool biopsies, ova & parasite (O&P) testing)
Endoscopic Procedures with and without Histopathology
Imaging tests

Clin Med= GI (2 decks)

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