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Step 1 Clues > PP GI > Flashcards

PP GI Flashcards

1
Q

What disease has a corkscrew x-ray?

A

Esophageal spasm

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2
Q

What disease has an apple core x- ray?

A

Cancer

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3
Q

What disease has a stacked coin x- ray?

A

Intussusception

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4
Q

What disease has a thumbprint x-ray?

A

Toxic megacolon

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5
Q

What disease has an abrupt cutoff x- ray?

A

Volvulus

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6
Q

What disease has a barium clumping x- ray?

A

Celiac sprue

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7
Q

What disease has a bird’s beak x-ray?

A

Achalasia

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8
Q

What disease has a string sign x-ray?

A

Pyloric stenosis

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9
Q

What diseases have solid dysphagia?

A

Schatzki’s rings, stricture, cancer

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10
Q

What diseases have solid and liquid dysphagia?

A

Esophageal spasm, scleroderma, achalasia

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11
Q

What is Barrett’s Esophagus?

A

Metaplasia, ↑AdenoCA risk

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12
Q

What are Esophageal Varices?

A

Vomit blood everywhere, portal HTN

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13
Q

What is Mallory-Weiss?

A

Tear LES (bld) mucosa with chronic vomiters

predispose: alcohol, Bolimia nervosa

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14
Q

What is Boerhaave’s?

A

Tear all layers of esophagus, left- sided pneumo/pain/effusion

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15
Q

What is Achalasia?

A

Lost LES Auerbach’s, bird’s beak, Chaga’s, choke on solids

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16
Q

What is Hirschprung’s?

A

Lost rectum Auerbach’s, no meconium passage

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17
Q

What is a Zenker’s diverticulum?

A

Cough undigested food from above UES, halitosis

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18
Q

What is a Traction diverticulum?

A

Eat big bolus => gets stuck above LES

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19
Q

What is Plummer-Vinson syndrome?

A

Esophageal webs, spoon nails, Fe- deficiency anemia

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20
Q

What are Schatzki rings?

A

Esophageal webs in lower esophagus

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21
Q

What is a TE fistula?

A

Choke w/ each feeding; cough w/ each feeding

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22
Q

What is an Esophageal atresia w/ TE fistula?

A

Vomit w/ 1st feeding, huge gastric bubble

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23
Q

What is Duodenal atresia?

A

Bilious vomiting w/1 feed, double bubble,
Down’s

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24
Q

What is Pyloric stenosis?

A

Projectile vomiting (3-4 wk old), RUQ olive mass

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25
Q

How does Choanale atresia present?

Conginital narrowing back of the nasal cavity

A

Turns blue with feeding

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26
Q

How is the Tetrology of Fallot presentation different?

A

Turns blue with crying

raise pulmonary vascular resistance: decre RV preload—R to L shunt

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27
Q

What makes Scleroderma unique?

A

↓LES pressure

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28
Q

What makes Esophageal spasms unique?

A

↑Peristalsis

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29
Q

What makes Achalasia unique?

A

↓Peristalsis and ↑LES pressure

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30
Q

What disease has a RUQ olive mass?

A

Pyloric stenosis

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31
Q

What disease has a RLQ sausage mass?

A

Intussusception

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32
Q

What is a Bezoar?

A

Mass of hair or vegetables =>
antrum obstruction

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33
Q

What is Gastritis type A?

A

Upper GI bleed, anti-parietal cell Ab
B12 def

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34
Q

What is Gastritis type B?

A

Upper GI bleed, spicy foods, H. pylori

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35
Q

Gastric ulcer

lesser curvature may cause bleeding from the

A

left gastric artery.

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36
Q

Duodenal ulcer

posterior wall may cause bleeding from the

A

gastroduodenal artery

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37
Q

What is a Duodenal ulcer?

complication

A

Too much acid: pain after meal/ at night, type O blood, H. pylori, pain relieved by eating

GI Bleed and perforation

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38
Q

What is a Gastric ulcer?

A

Broken mucus layer: pain during
meal, NSAIDs, type A blood

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39
Q

What is a Sliding hiatal hernia?

A

Fundus slides from esophageal hiatus to thorax => sucks acid into thorax

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40
Q

What is a Rolling hiatal hernia?

A

Fundus sticks through hole in diaphragm, strangulates bowel “rolls

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41
Q

What is Menetrier’s disease?

A

Protein-losing, thick stomach rugal folds

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42
Q

What defines Constipation?

A

< 3 BM per week

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43
Q

What defines Diarrhea?

A

> 200g per day

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44
Q

What is Osmotic diarrhea?

A

Watery

stops with intravenous nutrition

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45
Q

What is Secretory diarrhea?

A

active secretion of water

Hi cAMP

46
Q

endocrine

secretory diarrhea

A

Hyperthyroidism
Addison disease
Diabetes mellitus

47
Q

bacteria

secretory diarrhea

A

Cholera (“rice water” diarrhea)
Enterotoxigenic E. coli (traveler’s diarrhea)
C. perfringens
C. difficile (associated with antibiotic and PPI use)
Protozoa: e.g., giardiasis, cryptosporidiosis
Viruses: e.g., norovirus, rotavirus, adenovirus

48
Q

neuroendocrine

secretory diarrhea

A

Carcinoid syndrome
Gastrinoma

49
Q

What is Inflammatory diarrhea?

A

Blood, pus, leukocyte

damage to instinal mucosa, electrolyte disruption

50
Q

infectious cause

inflamatory diarrhea

A

Shigellosis (bacillary dysentery)
Nontyphoidal: salmonellosis
Enteroinvasive Escherichia coli,
E. coli (O157:H7)
Campylobacteriosis
Yersiniosis
Amebiasis (amebic dysentery caused by Entamoeba histolytica)
Clostridioides difficile (rarely bloody)

51
Q

Ulcerative colitis, Crohn disease
Colorectal cancer

associated with what diarrhea

A

inflamatory diarrhea

blood and pus

52
Q

What is Celiac sprue?

A

Jejunum, wheat allergy, villous atrophy, anti-gliadal Ab

change diet

53
Q

What is Tropical sprue?

A

Ileum celiac sprue

54
Q

1° Biliary Cirrhosis

findings

A

anti-mitochondrial Ab,
bile ductules destroyed,
xanthelasma

55
Q

1° Sclerosing Cholangitis?

findings

A

p-ANCA Ab,
bile duct inflammation,
beading,
onion skinning,
Associated w/ UC

56
Q

What is Mesenteric ischemia?

A

Pain out of proportion to exam

57
Q

What bugs cause bloody diarrhea?

A

“CASES”
Campylobacter
Amoeba (E. histolytica)
Shigella
E. coli
Salmonella

58
Q

What is the difference b/w 1° Biliary Cirrhosis and 1° Sclerosing Cholangitis?

A

1° Biliary Cirrhosis: anti-mitochondrial Ab, bile ductules destroyed, xanthelasma
1° Sclerosing Cholangitis: p-ANCA Ab, bile duct inflammation, beading, onion skinning, associated w/ UC

59
Q

What is Ascending Cholangitis?

A

Common duct stone gets infected

60
Q

What are the signs of alcoholic cirrhosis?

A

Spider angioma, palmar erythema, Dupuytren’s contractions,

61
Q

What is Hepatorenal Syndrome?

A

Pts w/ liver disease build up liver toxins that cause renal failure

62
Q

What is Cholangitis?

A

Inflammation of bile duct => Charcot’s triad, Reynold’s pentad

63
Q

What is Cholecystitis?

A

Inflammation of gallbladder => Murphy’s sign

64
Q

What is Cholelithiasis?

A

Formation of gallstones => RUQ colic

65
Q

What is Choledocholithiasis?

A

Gallstone obstructs bile duct

66
Q

What is Cholestasis?

A

Obstruction of bile duct => pruritis, ↑alkaline phosphatase, jaundice

67
Q

What is Conjugated bilirubin?

A

Water soluble “direct”

68
Q

What is Unconjugated bilirubin?

A

Fat soluble “indirect”

69
Q

What is the most common
type of gallstone?

A

Cholesterol (can’t see on x-ray)

70
Q

What type of gallstones can be seen on x- ray?

A

Ca-bilirubinate

71
Q

What is a Xanthoma?

A

Cholesterol buildup (elbow or Achilles)

72
Q

What is a Xanthelesma?

A

Triglyceride buildup (under eye)

73
Q

What does high cholesterol cause?

A

Atherosclerosis

74
Q

What does high triglycerides cause?

A

Pancreatitis

75
Q

What is Type 1 Hyperlipidemia?

A

Bad Liver LL (CM)

Lipoprotein lipase, hi chilomicron

76
Q

What is Type 2a Hyperlipidemia?

A

Bad LDL or B-100 receptors: trapped
in ER (LDL only)

77
Q

What is Type 2b Hyperlipidemia?

A

Less LDL/VLDL receptors (LDL/VLDL)

78
Q

What is Type 3 Hyperlipidemia?

A

Bad Apo E (IDL/VLDL)

79
Q

What is Type 4 Hyperlipidemia?

A

Bad Adipose LL (VLDL only)

80
Q

What is Type 5 Hyperlipidemia?

A

Bad C2 (VLDL/CM) b/c C2 stimulates LL

81
Q

What is Crigler-Najjar?

A

Unconjugated bilirubin, usually in infants

82
Q

What is Gilbert’s syndrome?

A

Glucoronyl transferase is saturated
=> stress
unconjugated bilirubin

83
Q

What is Rotor’s?

A

Bad bilirubin storage => conjugated bilirubin

84
Q

What is Dubin-Johnson?

A

Bad bilirubin excretion => black liver

85
Q

What is Cullen’s sign?

A

Bleed around umbilicus =>
hemorrhagic pancreatitis

86
Q

What is Turner’s sign?

A

Bleed into flank => hemorrhagic pancreatitis

87
Q

What tests are used for following pancreatitis?

A

Amylase – sensitive, breaks down
carbs

88
Q

What does Ranson’s criteria tell you?

A

Poor prognosis for pancreatitis pts

89
Q

What is Ranson’s criteria at presentation?

A

“WAGLA”
WBC: >16K/μL (infection)
Age: >55 (usually multiple illnesses)
Glucose: >200 mg/dL (islet cells are fried)
LDH: >350 IU/L (cell death)
AST: >250 IU/L (cell death)

90
Q

What is Ranson’s criteria at 48hr?

A

“BuCH was a SOB”
BUN: ↑ >5mg/dL (↓renal blood flow)
Ca: <8 mg/dL (saponification)
Hct: drops >10% (bleed into pancreas)
Sequester >6 L fluid => 3rd spacing
pO2: <60mm Hg (fluid/protein leak → ARDS)
Base deficit >4mEq/L (diarrhea => pancreatic enzymes are dead)

91
Q

What is Carcinoid syndrome?

A

Diarrhea, flushing, wheezing

92
Q

What produces Currant Jelly sputum?

A

Klebsiella

93
Q

What produces Currant Jelly stool?

A

Intussuception

94
Q

What is Gardener’s syndrome?

A

Familial polyposis w/ bone tumors

95
Q

What is Turcot’s syndrome?

A

Familial polyposis w/ brain tumors

96
Q

What is Familial polyposis?

A

100% risk of colon cancer, APC defect => annual colonoscopy at 5y/o

97
Q

What is Peutz-Jegher syndrome?

A

Hyperpigmented mucosa => dark gums/vagina w/hyperplastic polyps

98
Q

What is Crohn’s disease?

A

IBD w/ cobblestones, melena, creeping fat, fistulas

99
Q

What is Ulcerative colitis?

A

IBD w/ pseudopolyps, hematochezia, lead pipe colon, toxic megacolon

100
Q

What is Intussuception?

A

Currant jelly stool, stacked coin appearance on enema, sx come and go

101
Q

How does Diverticulosis present?

A

Bleeds

102
Q

How does Diverticulitis present?

A

Hurts

103
Q

How does Spastic Colon present?

A

Intermittent severe cramps

104
Q

How does IBS present?

A

Alternating diarrhea/constipation

105
Q

How do External Hemorrhoids present?

A

Pain

106
Q

How do Internal Hemorrhoids present?

A

No pain

107
Q

What is Pseudomembranous Colitis?

A

Overgrowth of C. difficile due to normal flora being killed off, usually by Clindamycin use

108
Q

What is Whipple’s disease?

A

T. whippleii destroy GI tract, then spread causing malabsorption,

109
Q

What color is an upper GI bleed?

A

Black

110
Q

What color is a lower GI bleed?

A

Red

111
Q

What adds color to stool?

A

Bilirubin

112
Q

What is the default color of stool?

A

Clay-colored

Step 1 Clues (27 decks)

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