PP Clues - GI Flashcards
1
Q
Corkscrew XR
A
Esophageal spasm
2
Q
Apple core XR
A
Cancer
3
Q
Stacked coin XR
A
Intussusception
4
Q
Abrupt cutoff in XR
A
Volvulus
5
Q
Bird’s beak XR
A
Achalasia
6
Q
String sign on XR
A
Pyloric Stenosis
7
Q
Causes of Solid Dysphagia
A
Schatzki’s Rings
Strictures
Cancer
8
Q
Schatzki’s Rings
A
LEW
9
Q
Causes of Liquid Dysphagia
A
Scleroderma
Achalasia
Esophageal spasm
10
Q
Barrett’s Esophagus
A
Metaplasia
Increased risk of adenocarcinoma
11
Q
Esophageal Varicies
A
d/t Portal HTN
Vomit blood when they rupture
12
Q
Mallory-Weiss
A
Chronic vomiters
Tear at LES mucosa
13
Q
Boorhave’s Esophagus
A
Transmural rupture of the esophagus
14
Q
Achalasia
A
Increased LES pressure
Decreased peristalsis
Loss of LES Auerbach’s plexus
Bird’s beak on XR
15
Q
Hirschsprung’s
A
Congenital lack of Auerbach’s in the rectum
Newborn won’t pass meconium
16
Q
Zenker’s Diverticulum
A
Above UES
Cough undigested food
Halitosis
17
Q
Traction Diverticulum
A
Below UES
18
Q
Plummer-Vinson Syndrome
A
UEW
Spoon nails
d/t Iron deficiency anemia
19
Q
TE Fistula (H-type)
A
Choke with each feeding
20
Q
Esophageal Atresia with TE Fistula (C-type)
A
Vomit with 1st feeding
Huge gastric bubble
21
Q
Duodenal Atresia
A
Bilious vomiting with 1st feeding
Double bubble
Down’s Syndrome
22
Q
Pyloric Stenosis
A
Projectile (non-bilious) vomiting
RUQ olive sign
23
Q
Choanal Atresia
A
Turns blue with feeding
24
Q
Sclerodema
A
Decreased LES pressure
25
Esophageal Spasms
Increased peristalsis
26
RUQ Olive mass
Pyloric Stenosis
27
RLQ Sausage mass
Intussusception
28
Bezoar
Mass of undigestable material
| Antrum obstruction
29
Type A Gastritis
AI
Anti-parietal cell Ab
Atrophic/Achlorhydria
Adenocarcinoma risk
30
Type B Gastritis
H. pylori
| Spicy food
31
Duodenal Ulcer
Loss of barrier
Pain after meal and during night
Relieved by eating (weight gain)
Associated with H. pylori and Type O blood
32
Gastric Ulcer
Loss of barrier
Pain during meals
Associated with NSAIDs and Type A blood
33
Sliding Hiatal Hernia
Fundus slides through esophageal hiatus into thorax
34
Rolling Hiatal Hernia
Bowel protrudes through defect in diaphragm
| Strangulates bowel
35
Menetrier's Disease
Lose protein through thick rugal folds (generalized edema)
36
Constipation
37
Diarrhea
> 200g per day
38
Osmotic diarrhea
Watery
39
Cause of secretory diarrhea
Laxative use
40
Inflammatory
Blood and pus
41
Celiac Sprue
Jejunum
Wheat allergy
Villous atrophy
Anti-gluten/gliaden Ab
42
Tropical Sprue
Distal ileum
43
Mesenteric Ischemia
Pain out of proportion to exam
44
Bugs that cause bloody diarrhea
```
CASES
Campylobacter
Ameoba (E. histolytica)
Shigella
E. coli
Salmonella
```
45
Cholangitis
Inflammation of Bile Duct
46
Charcot's Triad
Jaundice
Fever
RUQ Pain
47
Reynold's Pentad
```
Jaundice
Fever
RUQ Pain
(+) Hypotension
(+) Change in mental status
```
48
Ascending Cholangitis
Common bile duct infection d/t stone
49
Primary Sclerosing Cholangitis
p-ANCA
Bile duct inflammation
Beading
Associated with UC
50
Primary Biliary Cirrhosis
Anti-mitochondrial Ab
Bile ductules destroyed
Xanthelasma
51
Cholestasis
Obstruction of bile duct
Pruritis
Increased alkaline phosphatase
Jaundice
52
Cholecystitis
Inflammation of gall bladder
| Murphy sign
53
Cholelithiasis
Formation of gallstones
| RUQ pain
54
Choledocholithiasis
Gallstone obstructs bile duct
55
MC Gallstone
Cholesterol
56
Conjugated Bilirubin
Water soluble
| Direct
57
Unconjugated Bilirubin
Fat soluble
| Indirect
58
Signs of Alcoholic Cirrhosis
Spider angioma
Palmar erythema
Gynecomastia
59
Hepatorenal Syndrome
Build up of liver toxins causing renal failure
60
Xanthoma
Cholesterol build up in tendons
61
High Cholesterol causes
Atherosclerosis
62
Xanthelasma
Triglyceride buildup under eye
63
High Triglycerides cause
Pancreatitis
64
Type 1 Hyperlipidemia
```
Bad LPL (liver)
High Chylomicrons
```
65
Type 2A Hyperlipidemia
MC
Bad Clathrin Pit/B100 receptors
High LDL
66
Type 2B Hyperlipidemia
Fewer LDL/VLDL receptors
| High LDL and VLDL
67
Type 3 Hyperlipidemia
Bad ApoE
| High IDL and VLDL
68
Type 4 Hyperlipidemia
```
Bad LPL (adipose)
High VLDL
```
69
Type 5 Hyperlipidemia
Bad C2
High VLDL and Chylomicrons
Associated with DM
70
Chylomicrons
Takes triglycerides from GI to liver and endothelium
71
VLDL
Takes triglycerides from liver to adipose
72
IDL
Takes triglycerides from adipose to tissue
73
LDL
Only one to carry cholesterol
74
Breakdown product of VLDL
IDL and LDL
75
Crigler-Najjar Type I
Unconjugated bilirubin buildup in infants
76
Gilbert's Syndrome
Stress leads to uncreased unconjugated bilirubin
Increased load saturates glucuronyl transferase
Deficiency in UDP-glucuronyl transferase
77
Rotor's
Bad bilirubin storage leads to increased conjugated bilirubin
78
Dubin Johnson
Bad bilirubin excretion leads to increased conjugated bilirubin
Black liver
79
Cullen's Sign
Hemorrhagic pancreatitis
| Bleeding around umbilicus
80
Turner's Sign
Hemorrhagic pancreatitis
| Bleeding into flank
81
Tests for Pancreatitis
Amylase (sensitive) - breaks down carbs
| Lipase (specific) - breaks down triglycerides
82
Ranson's Criteria
Prognosis of pancreatitis
83
Carcinoid Syndrome
Flushing
Wheezing
Diarrhea
84
How to DX Carcinoid Syndrome
5HIAA in the urine
85
MC primary location for Carcinoid Tumor
Appendix
86
MC metastatic origin for Carcinoid Tumor
Small bowel
87
MC metastatic sites for Carcinoid Tumor
Lung and Heart
88
MC location for benign Carcinoid Tumor
Appendix
89
Currant Jelly Sputum
Klebsiella
90
Currant Jelly Stool
Intussusception
91
Familial Polyposis
100% risk of colon cancer
APC defect
Begin colonoscopies at age 5
92
Gardener's Syndrome
Familial polyposis with bone tumors
93
Turbot's Syndrome
Familial polyposis with brain tumors
94
Peutz-Jegher Syndrome
Hyperpigmented mucosa
95
Chron's Disease
```
IBD with:
Cobblestones
Melena
Creeping fat
Fistulas
```
96
Ulcerative Colitis
```
IBD with:
Pseudopolyps
Hematochezia
Lead pipe colon
Toxic megacolon
```
97
Intussusception
Current jelly stool
| Stacked coin on XR
98
Diverticulosis presentation
Bleeds (painless)
99
Diverticulitis presentation
LLQ pain
100
Spastic Colon presentation
Intermittent severe cramps
101
IBS presentation
Alternating diarrhea/constipation with HX of stress
102
External Hemorrhoids presentation
Pain on defecation
103
Internal Hemorrhoids presentation
No pain
104
Pesudomembranous Colitis
Overgrowth of C. difficile d/t normal flora being killed off d/t over use of antibiotics
105
Whipple's Disease
T. whippelii destroys GI tract then spreads causing malabsorption and arthralgias
PAS (+)
106
Color of Upper GI Bleed
Brown
107
Color of Lower GI Bleed
Red
108
Adds color to stool
Stercobilinogen oxidized to stercobilin
109
Add color to urine
Urobilinogen oxidized to urobilin
110
Default color of stool
Clay colored
111
Default color of urine
Tea colored
112
Risk Factors for Primary Liver Cancer
```
Hep B and C
Aflatoxin
Vinyl Chloride
Alcohol
CCl4
Anyline dyes
Smoking
Hemochomatosis
Benzene
Schistosomiasis
```
113
Risk Factors for Esophageal and Gastric Carcinoma
Smoking
Alcohol
Nitrates
Japanese
114
Cause of Gastroenteritis within 8 hours of eating
Pre-formed toxin:
S. aureus (potato salad)
C. perfringens (turkey/ham)
B. cerus (fried rice)
115
Bacteria associated with Colon Cancer
S. bovis
| C. malangosepticus
116
Hepatitis B labs during Window period
HBeAb (+)
| HBcAb (+)
117
Hepatitis B labs during acute recent infection
HBcAg (+)
HBsAg (+)
HBcAB (+)
118
Hepatitis B labs within 2 weeks of immunization
HBsAg (+)
119
Hepatitis B labs after more than 2 weeks of immunization
HBsAb (+)
120
Hepatitis B labs of somebody with a previous infection who is now immune
HBcAb (+)
| HBsAb (+)
121
Hepatitis B labs of somebody who is currently infectious
HBeAg (+)
122
Hepatitis B labs of a chronic carrier
HBsAg (+) for > 6 months
123
Only Statin that is renaly excreted
Preavastatin
124
Statins that need liver enzymes checked every 3 months
Atorvastatin
Lovastatin
Simvastatin
125
MoA of Statins
Inhibit HMG CoA reductase
| Most active around 8PM (take at this time for maximum efficacy)
