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CK_GI > UWORLD > Flashcards

UWORLD Flashcards

1
Q

patient with septic shock has huuuuuuuge increase AST/ALT, little increase in total bile/alk phos

A

shock liver (ischemic hepatic injury)

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2
Q

3 criteria for acute liver failure

A
  • hepatic encephalopathy
  • PT/INR > 1.5
  • elevated transaminases
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3
Q

What conditions make a diverticulitis “complicated”?

A

abscess, fistula, perforation, obstruction

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4
Q

How to treat diverticulitis abscesses?

A

<3cm - IV abs, observation

>3cm/worsening symptoms - surgery

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5
Q

young woman on OCPs, develops dull RUQ pain, cholesttatic symptoms, solitary hyper echoic/solid lesion in liver

A

hepatic adenoma

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6
Q

how to work up bilious emesis in neonate

A
  • immediate x-ray

- CONTRAST studies to determine level of obstruction

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7
Q

Neonate (hours old) has bright green vomiting, has not had a bowel movement yet, CFTR F 508 mutation

A

meconium ileus

likely 2/2 CF

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8
Q

child with impaired adaptation to darkness, photophobia, dry sealy skin, xerosis cornea, hyperkeratosis shoulders/butocks, extensors, silver grey plaques on bulbar conjunctiva (Biltot spots)

A

vitA deficiency

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9
Q

4 week intermittent bloody diarrhea, develops more severe symptoms with fever, hypotension, and diffuse abdominal tenderness, decreased bowel sounds

A 
toxic megacolon (likely from undx IBD)
CONFIRM WITH ABDOMINAL X-RAY to see dilated bowel loops
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10
Q

positive urobilinogen in urine vs positive bilirubin in urine

A

urobilnogen - high unconj bilirubin

bilirubin - high conj bilirubin

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11
Q

how do dx pancreatic cancer (most sensitive test)

A

IMAGING
u/s or abdominal CT of U/s inconclusive

CA-19-9 tumor marker good for evaluating treatment response BUT NOT FOR SCREENING

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12
Q

which cause of anion gap metabolic acidosis can cause rectangular envelope shaped stones and renal acute renal failure

A

ethylene glycol

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13
Q

which cause of anion gap met acidosis can cause blindness

A

methanol

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14
Q

elderly patient with cardiac risk factors develops acute abdominal pain that worsens, becomes diffuse, associated with metabolic acidosis, elevated amylase and phosphate

A

acute mesenteric ischemia

acidosis is from increased lactate from ischemia

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15
Q

IBD with noncaseating granulomas on biopsy

A

chron’s

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16
Q

IBD associated with toxic megacolon

A

UC

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17
Q

IBD associated with pseudopolyps

A

UC

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18
Q

frequent water diarrhea (10-20 BMs per day), hypokaelima, metabolic alkalosis, dark brown discoloration of colon with pale patches of lymph follicles

A

laxative abuse

(melanosis coli is black discoloration)

could be VIPoma but this isn’t a/w melanosis

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19
Q

chronic relic pain, voiding symptoms, pain with ejaculation, negative urine culture, positive for leukocytes

A

chronic prostatitis (noninfectious chronic prostate inflammation)

20
Q

rx long QT syndrome

A

beta blocker with pacemaker to prevent exertion heart rate and prevent torsades

21
Q

person with churn’s s/p ideal resection presents with patchy alopecia, pustular crusting skin rash, impaired taste

A

zinc deficiency

22
Q

person with churn’s s/p ileal resection presents with thyroid dysfunction, heart failure symptoms

A

selenium deficiency

23
Q

person with chron’s s/p ileal resection presents with fragile hair, skin depigmentation, neurologic dysfunction…

A

copper deficiency

24
Q

GI side effect of isoniazid

A

DRUG INDUCED HEPATITIS

25
Q

crampy, post prandial pain, food aversion, weight loss…progressive over a year, malnutrition

A

chronic mesenteric ischemia

26
Q

new onset hearing loss or chronic ear drainage despite abx therapy…otoscope exam shows perisperhal granulation and skin debris

A

cholesteatoma

can lead to hearing loss

27
Q

AIDS patient, bloody diarrhea, weight loss

A

CMV

any AIDS pt with active CMV infection needs ocular exam to rule out CMV retinitis

28
Q

AIDS patient, profuse watery diarrhea

A

crypto

29
Q

AIDS patient, watery diarrhea, high grade fever

A

MAC

30
Q

acute MR during MI does what to left heart vs chronic MR

A

acute - increases left ventricular end diastolic pressure, leading to acute pulmonary edema
chronic - increases left atrial size/compliance

31
Q

How to work up patient with recurrent ulcers, even some in jejunum and thickened gastric folds

A

suspect gastrinoma

first do fasting serum gastrin after they’ve been off PPI for at least one week…

if greater than 1000…highly suspicious
if less than 1000…do SECRETIN STIM TEST (will stimulate gastrin secretion in gastrinoma cells…if normal, secretin will inhibit gastric G cells from producing gastrin)

32
Q

African American patient, heroin user, HIV positive presents with nephrotic snydrome

A

FSGS

33
Q

Nephrotic syndrome after recent URI

A

IgA nephropathy

34
Q

nephrotic syndrome in patient with Hodgkin lymphoma

A

minimal change

35
Q

how to work up patient who coughs, chokes, has nasal regurgitation when swallowing liquids or solids…hx of stroke, dementia, older patient

A

patient likely has oropharyngeal dysphagia

DO VIDEOFLUROSCOPIC MODIFIED BARIUM SWALLOW

36
Q

how to diagnose and treat leprosy

A

dx- full thickness biopsy edge of lesion

rx- dapsone plus rifampin

37
Q

younger patient, fever, night sweats, weight loss, diarrhea, lymphadenopathy, arthralgias, first test to get?

A

HIV test

do that considering others like IBD, Whipple, celiac, etc

fever, night sweats, weight loss concerning for something scarier than GI stuff

38
Q

When to start doxy prophylaxis for tick bite?

A

after tick has been attached for >36 hours

39
Q

best abx prophylaxis for bite wound

A

polymicrobial?

amoxicillin-clavulanate

40
Q

neonate, first week of life, hugely elevated unconj bilirubin, dehydration (red urate crystals in diaper), stool doesn’t transition from meconium to yellow/green

A

breastfeeding failure jaundice (poor lactation, poor stooling, less bilirubin elimination, bilirubin re-enters circulation)

vs. breast milk jaundice (adequate breast feedings, peaks at 2 weeks, higher levels of b-glucouronidase which deconjugates bill)

41
Q

elderly patient, otitis externa, fever, high ESR, purulent discharge, dx and rx

A

malignant (necrotizing) otitis externa
rx with IV cipro

usually from pseudomonas

42
Q

best imaging test for diverticulitis

A

contrast abdominal CT

NOT A BARIUM STUDY OR COLONOSCOPY IF RISK OF PERFORATION

43
Q

bilateral interstitial infiltrates, immunosuppressed, elevated LDH, dr cough, fever ,respiratory failure, no GI symptoms…dx and dx test

A

PCP

bronchoalveolar lavage

44
Q

fever, RUQ pain, hepatomegaly, diarrhea, single sub capsular cyst in right lobe, hiking trip in developing country of liver…dx and rx

A

entamoeba histolytica
metronidazole

“amebic dysentery”

45
Q

reduction of both passive and active range of motion, stiffness>pain, no history of injury, patient>40

A

adhesive capsulitis

46
Q

histology of Reye syndrome

A

microvascular steatosis (fatty infiltration)

47
Q

bone risk of patient on long term steroids

A

avascular necrosis

CK_GI (3 decks)

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