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PP GI Flashcards

0
Q

What disease has an apple core x-Ray?

A

Cancer

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1
Q

What disease has a corkscrew x-Ray?

A

Esophageal spasm

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2
Q

What disease has a stacked coin x-Ray?

A

Intussusception

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3
Q

What disease has a thumbprint x-Ray?

A

Toxic megacolon

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4
Q

What disease has an abrupt cutoff x-Ray?

A

Volvulus

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5
Q

What disease has a barium clumping x-Ray?

A

Celiac sprue

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6
Q

What disease has a birds beak x-Ray?

A

Achalasia

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7
Q

What disease has a string sing on contrast x-Ray?

A

Cron’s

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8
Q

What disease have solid dysphagia?

A

Schatzki rings
Strictures
Cancer

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9
Q

What disease have solid and liquid dysphagia?

A

Esophaeal spasm
Scleroderma
Achalasia

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10
Q

What is Barrett’s esophagus?

A

Metaplasia ( squamous to columnar epithelia)
Increase Adeno CA
Goblet cells seen in the distal esophagus

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11
Q

What are Esophageal Varices?

A

Vomit blood everywhere

Portal HTN

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12
Q

What is Mallory-Weiss?

A

Tear LES mucosa
Chronic vomiters
Hematemesis with retching

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13
Q

What is Boerhaave’s?

A

Tear all layers of esophagus

Left side pneumo/ pain/ effusion

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14
Q

What is Achalasia?

A

Los LES Auerbach’s
Birds beak
Chaga’s
Choke on solids

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15
Q

What is Hirschsprung’s?

A

Lost rectum Auerbach’s

No meconium passage

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16
Q

What is Zenker’s diverticulum?

A

False diveticulum
Esophaeal diverticula located immediately above the UES
Cough undigested food from above UES
Halitosis

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17
Q

What is Traction diverticulum?

A

Esophaeal diverticula located near the midpoint of the esophagus
Eat big bolus => get stuck above LES

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18
Q

What is Plummer-Vinson syndrome?

A 
Esophageal webs
Spoon nails
Fe-deficiency anemia
Glossitis 
Dysphagia
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19
Q

What are Schatzki rings?

A

Esophageal webs in lower esophagus

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20
Q

What is a TE fistula?

A

Choke w/ each feeding

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21
Q

What is Duodenal atresia?

A

Bilious vomiting w/ 1st feed
Double bubble
Downs

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22
Q

What is an Esophageal atresia w/ TE fistula?

A

Vomiting w/1st feeding

Huge gastric bubble

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23
Q

What is Pyloric stenosis?

A 
Projectile vomiting (3-4 wk old)
RUQ olive mass
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24
Q

How does Choanal atresia present?

A

Turns blue with feeding

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25
Q

How is the Tetrology of Fallot presentation different?

A

Turns blue with crying

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26
Q

What makes Scleroderma unique?

A

Decrease LES pressure

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27
Q

What makes Esophageal spasms unique?

A

Increase peristalsis

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28
Q

What make Achalasia unique?

A

Decrease peristalsis

Increase LES pressure

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29
Q

What disease has a RUQ olive mass?

A

Pyloric stenosis

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30
Q

What disease has a RLQ sausage mass?

A

Intussusception

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31
Q

What is a Bezoar?

A

Mass of hair or vegetables => Antrum obstruction

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32
Q

What is Gastritis Type A?

A

Upper GI bleed

Anti-parietal cell Ab

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33
Q

What is Gastritis Type B?

A

Upper GI bleed
Spicy food
H. pylori

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34
Q

What is a Duodenal ulcer?

A

Too much acid: pain after meal/ at night
Type O blood
H pylori
Pain relieved by eating

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35
Q

What is a Gastric ulcer?

A

Broken mucus layer: pain during meal
NSAIDS
Type A blood

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36
Q

What is a Sliding hiatal hernia?

A

Funds slides from esophageal hiatus to thorax => stuck acid into thorax

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37
Q

What is a Rolling hiatal hernia?

A

Fundus sticks through hole in diaphragm

Strangulates bowel “rolls through a hoe”

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38
Q

What is Ménétrie’s disease?

A

Protein losing

Thick stomach rugal folds

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39
Q

What defines Costipation?

A

< 3 BM per week

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40
Q

What defines Diarrhea ?

A

> 200g per day

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41
Q

What is Osmotic diarrhea?

A

Watery

42
Q

What is Secretory diarrhea?

A

Laxative use

43
Q

What is inflammatory diarrhea ?

A

Blood, pus

44
Q

What is Celiac sprue?

A

Wheat allergy
Villous atrophy
Anti-gliadal Ab
Associated with DQ2 and DQ8 and dermatitis herpetiforme

45
Q

What is Tropical sprue?

A

Ileum celiac sprue

46
Q

What is ischemic colitis?

A

Pain out of proportion to exam due to reduction of intestinal blood flow

47
Q

What bugs cause bloody diarrhea?

A

“CASES”

  • Campylobacter
  • Ameoba ( E. histolytica)
  • Shigella
  • E. coli
  • Salmonella
48
Q

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

A 
1st Biliary Cirrhosis 
- female ( 49)
- Anti-mitochondrial Ab
- Bile ductules destroyed
- Xanthelasma 
1st Sclerosing Cholangitis
- men (around 40)
- p-ANCA AB
- Bile duct inflammation
- Beading
- Onion skinning
- Associated w/ UC and cholangiocarcinoma
49
Q

What is Ascending Cholangitis?

A

Common duct stone gets infected

50
Q

What are the sings of alcoholic cirrhosis?

A

Spider angioma
Palmar erythema
Dupuytrens contractions
Gynecomastia

51
Q

What is Hepatorenal syndrome?

A

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

52
Q

What is cholangitis?

A

Inflammation of bile duct => charcots triad, Reynolds pentad

53
Q

What is cholecystitis?

A

Inflammation of the gall bladder => Murphy’s sing

54
Q

What is cholelithiasis?

A

Formation of gallstones => RUQ colic

55
Q

What is Choledocholithiasis?

A

Gallstone obstruct bile duct

56
Q

What is Cholestasis?

A

Obstruction of bile duct => pruritus, increase alkaline phosphatase, jaundice

57
Q

What is Conjugated bilirubin?

A

Water soluble “direct”

58
Q

What is Unconjugated bilirubin?

A

Fat soluble “indirect”

59
Q

What is the most common type of gallstone?

A

Cholesterol “can’t see on x-ray”

60
Q

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

A

Ca-bilirubinate

61
Q

What is xanthomas?

A

Cholesterol buildup ( elbow or Achilles )

62
Q

What is a Xanthelasma?

A

Triglyceride buildup (under eye)

63
Q

What does high cholesterol cause?

A

Atherosclesosis

64
Q

What do high triglycerides cause?

A

Pancreatitis

65
Q

What is Crigler-Najjar?

A

Absent UDP-glucuronyl transferase
Unconjugated bilirubin
Usually in infants

66
Q

What is Gilbert’s syndrome?

A

Mildly decrease UDP-glucuronyl transferase or decrease bilirubin uptake
Asymptomatic

67
Q

What is Rotors?

A

Bad bilirubin excretion => like Dubin-Johnson but without the black liver

68
Q

What is Dubin-Johnson?

A

Bad bilirubin excretion => black liver

Conjugated hiperbilirubinemia

69
Q

What is Cullen’s Sign?

A

Bleed around umbilicus => hemorrhagic pancreatitis

70
Q

What is Turners sign?

A

Bleed into flank => hemorrhagic pancreatitis

71
Q

What tests are used for fallowing pancreatitis?

A

Amylase- sensitive, break down carbs

Lipase- specific, breaks down TGs

72
Q

What does Ranson’s criteria tell you?

A

Poor prognosis for pancreatitis pts

73
Q

What is Carcinoid syndrome?

A 
Due to production of 5-HT 
Bronchospasm
Flushing 
Diarrhea
Right side heart disease/ murmur
74
Q

What produces Current Jelly sputum?

A

Klebsiella

75
Q

What produces Currant Jelly stool?

A

Intussusception

76
Q

What is Gardeners syndrome?

A

Familial polyposis w/ bone tumors

77
Q

What is Turcot’s syndrome?

A

Familial polyposis w/ brain tumor

78
Q

What is Familial polyposis?

A

100% risk of colon cancer

APC defect => annual colonoscopy at 5y/o

79
Q

What is Peutz Jegher syndrome?

A

Hyperpigmentated mucosa => dark gums / vagina

80
Q

What is Crohn’s disease?

A

IBD w/ cobblestone
Melena
Creeping fat
Fistulas

81
Q

What is Ulcerative colitis?

A

IBD w/ pseudopolyps
Hematochezia
Lead pipe colon
Toxic megacolon

82
Q

What is Intussusception?

A

Currant jelly stool
Stacked coin enema
Six come and go

83
Q

How does diverticulosis present?

A

Often asymptomatic

84
Q

How does diverticulitis present?

A

LLQ pain

85
Q

How does Spastic Colon present?

A

Intermittent severe cramps

86
Q

How does IBS present?

A

Alternating diarrhea / constipation

87
Q

Hoe do External Hemorrhoids present?

A

Pain

88
Q

How do Internal hemorrhoids present?

A

No pain

89
Q

What is Pseudomembranous Colitis?

A

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

90
Q

What is Whipple’s disease?

A

T. Whippleii destroy GI tract, then spread causing malabsorption
Arthralgia

91
Q

What color is an upper GI bleed?

A

Black

92
Q

What color is a lower GI bleed?

A

Red

93
Q

What adds color to stool?

A

Bilirubin

94
Q

What is the default color of stool?

A

Clay-colored

95
Q

What is the default color of urine?

A

Tea-colored

96
Q

What is an Epiphrenic diverticulum?

A

Esophaeal diverticula located immediately above the LES

97
Q

Which are the Retroperitoneal structures?

A 
SAD PUCKER
Suprarenal ( adrenal)
Aorta and IVC
Duodenum ( 2-4th part)
Pancreas ( not the tail)
Ureters
Colon ( descending and ascending)
Kidney 
Esophagus 
Rectum
98
Q

Bile?

A

Rate limiting enzyme: cholesterol 7 alpha hydroxylase
Functions:
- digestion and absorption of lipids and fat-soluble vit
- cholesterol excretion
- antimicrobial activity

99
Q

What is Whipple’s disease?

A

Infection with Tropheryma whippleii
PAS-positive foamy
Can cause: cardiac symptoms, athralgias and neurologyc symptoms
Older men

100
Q

What is Abetalipoproteinemia?

A

Decrease synthesis of apolipoprotein B that result in inability to generate Chylomichron
Fat accumulation in enterocytes
Present in early childhood with malabsorption and Neurologic manifestations

101
Q

What is Meckel’ diverticulum?

A 
True diverticulum
Present with the Rule of five 2's:
- 2 inches long
- 2 feet from the ileocecal valave
- 2% of population
- first 2 years of life
- 2 type of epithelia ( gastric/pancreatic)
102
Q

What is Wilson’s disease?

A

Inadequate hepatic copper excretion and failure of copper to enter circulation as Ceruloplasmin
Characteristics:
- decrease Ceruloplasmin
- corneal deposits ( Kayser-Fleischer ring)
- hemolytic anemia
- basal ganglia degeneration ( parkinsonian symptoms)
- dementia, dyskinesia, dysarthria
Tx: penicillamine

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