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Medicine > Uworld GI > Flashcards

Uworld GI Flashcards

0
Q

liver cyst with egg-shell calcifications? Cause?

A

Hydatid cyst. Ecchinococcus. From dogs.

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1
Q

Class of drugs for nausea?

A

5HT antagonists

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2
Q

Treatment of a patient with Hepatic encephalopathy?

A
  1. Treat precipitant
  2. Lactulose (decreases ammonia levels)
  3. Antibiotics (neomycin and rufaximin) to decrease ammonia-producing bacteria in colon
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3
Q

Aspiration of amoebic liver abscess would show? Dx by? Treatment?

A

Sterile abscess – diagnose by stool examination for trophozoites. Metronidazole

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4
Q

All patients with cirrhosis should be screened for? Prophylaxis?

A

Esophageal varices by endoscopy. Beta blockers

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5
Q

When to drain pancreatic pseudocyst?

A

Size >5 cm, lasts longer than six weeks, secondarily infected

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6
Q

Single most important test to assess liver function?

A

PT (acute rise can suggest Fulminant liver failure)

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7
Q

Extrahepatic findings with drug-induced liver injury? Exception?

A

Rash, arthralgias, fever, leukocytosis, eosinophilia

Exception: isoniazid (hepatitis without extrahepatic manifestations)

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8
Q

Types of drug-induced liver disease?

A
  1. Cholestasis (chlorpromazine, nitrofurantoin, erythromycin, anabolic steroids)
  2. Fatty liver (tetracycline, valproate, antiretrovirals)
  3. Hepatitis (halothane, phenytoin, Isoniazid, Alpha-methyldopa)
  4. Fulminant liver failure (acetaminophen, Carbon tetrachloride)
  5. Granuloma (allopurinol, phenylbutazone)
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9
Q

Effects of oral contraceptives on liver?

A

Abnormal liver function tests without evidence of necrosis or fatty change

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10
Q

Fulminant liver failure definition? Caused by?

A

Hepatic encephalopathy (confusion) that develops within 8 weeks of acute liver failure

Acetaminophen, alcohol, amphetamines, hepatitis B/D

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12
Q

Symptoms of Wilson’s disease?

A

Liver: hepatomegaly, elevated liver enzymes

Neuro: resting tremor, muscular rigidity, drooling?

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13
Q

Criteria for Toxic megacolon?

A

Radiologic findings

with 3 of: fever, HR>120, leukocytosis>10,500, anemia

with 1 of: altered MS, hypoNa, hypotension, electrolyte disturbances

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14
Q

Melanosis coli?

A

Dark discoloration of the colon with patches of lymph follicles. Due to diuretic abuse

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15
Q

Tests for dysphagia (in order?)

A
  1. Barium Esophagram
  2. Endoscopy
  3. Motility Studies
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16
Q

Drugs that cause Pancreatitis if pt has: volume overload? IBD? Immunosupressants? Seziures? Infection?

A 
furosemide, thiazides
Sulfasalazine, 5-ASA
azothioprine, L-asparaginase
Valproic acid
Metronidazole, tetracycline
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17
Q

Deficiency of Zinc causes?

A

alopecia, abnormal taste, blisters

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18
Q

Constant burning pain with intense pain with light touch to the abdomen with other signs?

A

HZV

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19
Q

Drugs that cause esophagitis?

A

KCl, Fe, Quinine
tetracyclines
NSAIDs
Bisphosphonates

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20
Q

Types of polyps and risk of cancer?

A
  1. hyperplastic - no risk
  2. hamartomatous - small risk
  3. adenoma - largest risk (esp is villous)
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21
Q

Scleroderma - effect of ESO?

A

incompetency of LES over time

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22
Q

How to diagnose chronic pancreatitis?

A

CT scan shows calcifications of the pancreas

lipase and amylase NOT diagnostic

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23
Q

Pt with UC: regular surveillance only really beneficial if looking for? Other complications?

A

ColonCA

(doesn’t help for other complications: toxic megacolon, sclerosing colangitis, uveitis, erythema nodosum, spondyloarthropathy)

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24
Q

Best test for C diff?

A

Stool cytotoxin assays, NOT stool cultures

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25
Q

Ischemic colitis - symptoms? affects what areas of the colon?

A

acute abdominal pain followed by diarrhea

Watershed areas: splenic flexure and recto-sigmoid junction

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26
Q

Zollinger-Ellison syndrome causes fat malabsorption because?

A

increased acid neutralizes lipase

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27
Q

pt with chronic abdominal pain, weight loss, and food avoidance with no specific findings on PE - think? Test by?

A

Mesenteric ischemia. Dopplers

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28
Q

Test for lactose intolerance?

A
  1. positive H-breath test
  2. increased stool osmotic gap
  3. Reducing substances in stool
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29
Q

Hepatorenal syndrome? tx?

A

portal HTN leads to formation of NO, which dilates vessels, leading to decreased BP and renal hypoperfusion

Midodrine and octreotide

30
Q

Medical treatment used to dissolve gallstones in individuals who are Symptomatic but poor surgical candidates?

A

Ursodeoxycholic acid

31
Q

Tx options for gallstones?

A

If asymptomatic, do nothing

If low risk or have acute cholecystitis or porcelain gallbladder do laparoscopic cholecystectomy

If high-risk, use ursodeoxycholic acid (to dissolve) or shock-wave lithotripsy

32
Q

Hepatic hydrothorax?

A

Pleural effusions due to cirrhosis or liver disease (not due to underlying cardiac or pulmonary problem)

33
Q

Treatments for hepatic hydrothorax?

A
  1. Liver transplant
  2. Thoracentesis followed by salt restriction and diuretics
  3. Transjugular intrahepatic portosystemic shunt (TIPS)
34
Q

Emphysematous cholecystitis? Caused by?

A

Form of acute cholecystitis due to infection by gas forming bacteria (SPECKS - Clostridium, E. coli, staph, Streptococcus, Pseudomonas, Klebsiella)

35
Q

Treatment for emphysematous cholecystitis?

A

Fluid resuscitation, cholecystectomy, parenteral antibiotic therapy

36
Q

Mechanism of non-alcoholic fatty liver disease?

A

Insulin resistance leads to increased fatty acid oxidation, which leads to increased oxidative stress, resulting in proinflammatory cytokines causing inflammation, fibrosis, cirrhosis

37
Q

Disease that can cause an aversion to smoking?

A

Hepatitis A

38
Q

Pathogenic factors involved in the development of hepatic encephalopathy?

A
  1. Ammonia accumulation
  2. Production of false neurotransmitters
  3. Increased GABA sensitivity
  4. Zinc deficiency
39
Q

Treatment of acute cholangitis?

A
  1. Broad-spectrum antibiotics and supportive care

2 If no response, ERCP

40
Q

Acute pancreatitis: when to do abdominal CT scan?

A

In patients with clinical findings suggestive of pancreatitis but fail to improve with conservative treatment

41
Q

Patient with newly diagnosed hepatitis C. Should receive?

A

Vaccinations against hepatitis A and B if not already immune

Treat with interferon-alfa and ribavirin unless pregnant

42
Q

Shock liver?

A

Ischemic hepatopathy from shock leads to a massive increase in transaminases, and smaller increases and bilirubin and alkaline phosphatase.

43
Q

Evaluations of patients with acute versus chronic hepatitis?

A

Liver function tests and viral serology versus liver biopsy

44
Q

Causes of acalculous cholecystitis?

A

Gallbladder inflammation in the absence of gallstones

  1. Burns
  2. Trauma
  3. prolonged TPN
  4. prolonged fasting
  5. mechanical ventilation
45
Q

Paroxysmal nocturnal hemoglobinuria cause? Leads to?

A

Abnormal GP1(prohibits binding of CD 55 and CD 59 which inhibit RBC destruction).

Leads to intravascular hemolytic anemia and hepatic vein thrombosis.

46
Q

Bilirubinuria suggests and increase in?

A

Conjugated hyperbilirubinemia

47
Q

Tranfusion threshold?

A

7 in normal pt

10 in pt with cardiac dz

48
Q

Angiodysplasia is commonly seen in patients with?

A

Aortic stenosis or end stage renal disease

49
Q

Vessels in Mallory Weiss tears versus variceal tears?

A

Submucosal arteries versus submucosal veins

50
Q

Biopsy findings in:

  1. Ischemic colitis
  2. IBD
A
  1. Epithelial necrosis

2. Neutrophilic cryptitis

51
Q

Steps to treat ascites?

A
  1. Sonja at water restriction
  2. Spironolactone
  3. Loop diuretic
  4. Paracentesis
52
Q

Patient with enlarged, non-tender gallbladder with evidence of biliary obstruction?

A

Pancreatic cancer

53
Q

Treatment for patients with small non-bleeding varices?

A

Non-selective beta blockers (propanolol, nadolol) to reduce progression to large varices

54
Q

VIPoma location? Symptoms?

A

“Pancreatic cholera”

Head of the pancreas. Diarrhea and hypoK

55
Q

Glucagonoma presents with?

A
  1. Necrotizing dermatitis
  2. Weight loss
  3. Anemia
  4. Hyperglycemia
56
Q

Cullen Sign? Grey-Turner sign?

A

Both seen in pancreatitis

Periumbilical bluish coloration indicating hemopericardium

Reddish brown coloration around flanks indicating retroperitoneal bleed

57
Q

Clues to inflammatory diarrhea?

A

Weight loss
Anemia
Reactive thrombocytosis
Elevated ESR

58
Q

Extra pancreatic complications of pancreatitis?

A

Plural effusion
Ileus
ARDs
Renal failure

59
Q

G.I. pathology that is alleviated by nitroglycerin? Test?

A

Diffuse esophageal spasm. Manometry

60
Q

Manometry shows absent peristaltic waves in lower ESO and absent LES?

A

Scleroderma

61
Q

Chlamydia vs gonorrhea?

A

Mucopurulent discharge, absent bacteriuria vs purulent and gram-staining

62
Q

Lengthy history of OCP increases chance of?

A

Hepatic adenoma

63
Q

Gastric pain alleviated by nitrates? Test to confirm?

A

Diffuse esophageal spasm; motility studies

64
Q

Initial treatment for anal fistulas?

A

Stool softeners

65
Q

Non-transaminase signs of alcoholic hepatitis?

A 
#Elevated GGT
#Elevated Billy Rubin
#Elevated INR
#Neutrophil predominant leukocytosis
66
Q

Early test patient with newly diagnosed hepatitis C?

A

Liver biopsy – for prognosis and likely response to therapy

67
Q

Infection that affects liver and kidney?

A

Cryoglobulinemia from hepatitis

68
Q

yellow red papules on arms and shoulders?

69
Q

D-xylose test assesses for?

A

Celiac’s

70
Q

+ Anti-mitochondrial bodies?

Symptoms without positive anti-mitochondrial antibodies?

A

Primary sclerosing cholangitis

Malignant biliary stricture

71
Q

Acute erosive gastritis? Seen with intake if?

A

Severe hemorrhagic erosive lesions after exposure to substances (large doses of aspirin)

Medicine (106 decks)

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