quickies Flashcards
obstruction of biliary tract leading to infx
cholangitis
stone in CBD
choledocholithiasis
dilated submucosal veins in pts with portal HTN
esophageal varices
how do you treat an anorectal abcess
surgical drainage
decreased intestinal peristalsis assoc with surgery or trauma
paralytic ileus
(type of bowel obstruction)
a tear in the anoderm (MC posterior) that causes hematachezia and feels like a tear w/ BMs?
anal fissure
when is f/u for h pylori tx
4 weeks after tx
a tumor that hypersecretes gastrin and causes recurrent duodenal ulcers
zollinger-ellison syndrome
on Ba swallow, esophageal body looks like a “bird’s beak”
achalasia
GB issues assoc. with fever and chills
cholecystitis
cholangitis
“coffee grounds” in poop or vom should make you think
ulcer
what causes 50% of all UGI bleeds?
ulcers
screening guidelines for colon cancer
occult blood test q1y
colonoscopy q10y
nobody does flex sig but that’s q5y
ages 50-75
procedure for achalasia that cuts the LES surrounding muscles
myotomy
dx and tx of choledocholithiasis and cholangitis
ERCP
when is ALT elevated
in chronic inflam/damage
specific to liver
on endoscopy you see vesicles
HSV esophagitis
what differentiates the pain of a PUD from GERD?
gnawing, hunger-like
nocturnal awakening
procedure that uses an endoscope and a balloon to widen the esophageal muscles
pneumatic dialtion
(for achalasia + webs + rings)
procedure where the gastric fundus is wrapped around the lower end of the esophagus
for GERD/hiatal hernia
nissen fundoplication
low ceruloplasmin
wilson’s disease
autosomal recessive
pt is male and 50y with systemic problems (heart and joint, DM) and gray skin
hemachromatosis
lab value indicative of:
POSThepatic obstruction
(e.g. cholestasis)
direct bilirubin
thin membranes of squamous mucosa in mid to upper esophagus that causes dysphagia to solid food
esophageal web
esoph web + Fe def + glossitis
Plummer-Vinson syndrome
ERCP can induce:
pancreatitis
what sx would make you suspect gastritis
it’s often asx
go by history
treating mallory-weiss syndrome
maybe self-limiting
endoscope to control bleeding
preferred way to screen/prevent colon cancer
colonoscopy q10y
what type of esophageal motility d/o is hypercontractility?
nutcracker
gold standard for treating anal fissures
(after sitz and softeners and HC)
internal anal sphincterectomy
doc for pud?
PPIs
dx of diverticular dz
CT
life-threatening GB disorder
cholangitis
MRCP shows beading of the bile ducts
primary biliary cirrhosis
also has a lung disorder
alpha1 antitrypsin deficiency
man comes in with severe rectal pain that is worse with straining and sitting and on DRE you feel a palpable fluctuant mass
anorectal abcess + fistula
dx of exclusion characterized by abd pain, bloating, changing bowel habits MC seen in females before age 45
IBS
female
fat
forty
fair
fertile
risks for GB disorders
e.g. cholelithiasis
a) bright red in color, painless hemorrhoids
b) bluish in color, painful hemorrhoids
a) internal
b) external
colon d/os that can be an emergency
bowel obstruction
ischemic bowel
toxic megacolon
AST greater than ALT
alcohol (2:1)
drug toxicity
(think S is larger = Substance problem)
occurs in infants and elderly, twisting of the intestines
volvulus
(type of bowel obstruction)
swollen, fragile vessels in the colon caused by aging and degeneration that is a common cause of maroonish blood in the stool in the elderly
angiodysplasia
MC cause of esoph varices?
liver cirrhosis
caused by leakage of cecum contents which leads to a blockage
treated with surgery
appendicitis
lab value
if elevated with alk phos is specific to liver obstruction
GGTP
s/s of esoph varices rupture?
hematemesis + pt looks like death
gall stones are composed of either:
cholesterol (75%)
Ca salts
apple core lesion on contrast XR
colon cancer
what is the MC esopheageal d/o
GERD
4 drug tx for h pylori?
PPI 2x daily
tetracycline
metronidazole
bismuth
5 things causing gastritis
stress
NSAIDs
alcohol
h pylori
z-e syndrome
autoimmune d/o of the small intestine
when in babies causes irritability, anxiety, anorexia and distension
celiac disease
1st line tx for GERD
2nd line tx for GERD
h2r blockers
PPIs
what’s goodsall’s rule
with fistula in ano
if it’s anterior, it’s straight
if it’s posterior, it’s curved
lab value indicative of:
PREhepatic obstruction
(e.g. RBC hemolysis)
indirect bilirubin
gold standard dx test for ischemic bowel
mesenteric angiogram
autosomal recessive related to Cu overload
wilson’s disease
caused by congenital causes or chronic GERD scarring
esophageal ring
a patient with IBD has abd pain and no bowel sounds are heard on PE
toxic megacolon
no s/s
ALT greater than AST
lots of liver texture on US
non-alcoholic fatty liver disease
which type of ulcer is 5x more common
duodenal
MC cause of rectal bleeding
anal fissure
s/s: early bowel sounds heard early, decreased bowel sounds heard late, cramping, no stool or liquidy stool, dull to percussion
bowel obstruction
after some event, the distal esophagus gets an intraluminal mucosal tear caused by increased intraabdominal pressure
mallory-weiss syndrome
occurs when the cystic duct becomes blocked
cholecystitis
alcoholic with jaundice, HSM, ascites
alcoholic hepatitis
what is a polyp that is benign but premalignant and can be sessile or pedunculated?
adenoma
CHARCOT’S TRIAD
abd pain
jaundice
fever
(seen in cholangitis)
is chrons or UC more common?
UC
man with ulcerative colitis is likely to develop this liver disease
primary biliary cirrhosis
dx/tx of esophageal varices rupture?
emergent endoscopy
variceal ligation
3 common steps for diagnosing things in the colon
- colonoscopy
- CT
- angio
s/s: odynophagia, dysphagia, chest pain
cause: 50% of the time caused by GERD
esophagitis
fluctuant mass with erythematous base and purulent d/c at the gluteal cleft
pilonidal cyst
what hepatocytes look like if they are damaged
fibrotic + oval cells
painless hematemesis after trauma, straining, seizures
mallory-weiss syndrome
how do you dx an esophageal spasm
barium swallow
anal crypts that have been obstructed by glands and may become infected
anorectal abcess +/- fistula
difficulty passing stool in more than 25% of poop events for more than 3 months
constipation
smoking causes _____ esoph cancer and alcohol causes _____ esoph cancer
smoke: adenocarcinoma
etoh: SCC
what type of esopheageal motility d/o is no LES relaxation/aperistalsis?
achalasia
hereditary cause of indirect bilirubin
causes icteric sclera, jaundice, and acute illness at birth
Gilbert’s disease
what’s the MC anorectal problem at age 50+
hemorrhoids
what are the 2 h pylori dx tests
fecal antigen test
c-urea breath test
pt with lupus has high liver enzymes and a + ANA
how do you dx
prob autoimmune hepatitis
bx
3 drug tx for h pylori?
PPI 2x daily
amox
clarithromycin
when the LES and part of stomach move up into the chest
hiatal hernia
obesity puts you at an increased risk for what esoph cancer
AC
“telescoping” of the intestine (folds in on itself)
intussusception
(type of bowel obstruction)
Barrett’s esophagus puts you at an increased risk for what type of cancer
adenocarcinoma
ALT greater than AST
viral
fatty liver
(think L is larger = Long-term)
dx cholelithiasis and cholecystitis
US
preferred way to screen/detect polyps
immunochemical based fecal occult blood test
lab test pathognomonic for hemochromatosis
HFE gene analysis
causes 50% of lower GI bleeds/BRBPR
diverticulosis
how do you manage a barrett’s esophagus
endoscopy with bx q 2y
what is another name for an esophageal ring
Schatzki’s ring
chron’s vs UC:
a) causes loose, bloody stool
b) causes massive amounts of lg diarrhea +/- mucus and blood
a) UC
b) chron’s
tx for tylenol OD
N-acetylcysteine
2 reasons a PUD happens
- impaired mucosal defense factors (e.g. nsaids)
- overwhelmed defense factors (e.g. infx)
what lab value do you order that is unique to IBD?
ASCA
caused by high cholesterol, nucleation of cholesterol, or gall bladder hypomotility
cholelithiasis
esophageal cancer is most often this type
adenocarcinoma
chron’s vs UC:
a) causes full GI lesions
b) causes colonic lesions
a) chron’s
b) UC
when is AST elevated
in acute inflammation/damage
not specific to liver
skin manifestation of some people with celiac disease*
dermatitis herpetiformis
pt with a fatty diet who looks thin and reports colic pain and has elevated alk phos.. suspect?
colon cancer
Kayser-Fleischer rings around iris are pathognomonic for
wilson’s disease
ring of tissue at junction of esoph + stomach that causes dysphagia to large bolus
esophageal ring
dxing mallory-weiss syndrome
endoscopy
