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IM_GI > UWORLD GI > Flashcards

UWORLD GI Flashcards

1
Q

massive increase in AST/ALT with modest increase in bili + alkphos

A

ischemic hepatic injury (i.e. “shock liver” from septic shock)

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2
Q

In management of cirrhotic patient, always check for…

A

VARICES

it’s a common and potentially deadly complication

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3
Q

jaundice, anorexia, fever, RUQ pain, tender hepatomegaly, AST=2xALT

A

alcoholic hepatitis

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4
Q

hematemesis + aspirin/cocaine/alcohol

A

acute erosive gastropathy

if hx doesn’t mention FREQUENT VOMITING, probably not MW tear

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5
Q 
pleural effusion (usu. left), acute chest pain, tachypnea, post EGD, subacute emphysema and suprasternal crepitus
DX, how to dx, AND TREATMENT
A

esophageal rupture

diagnose with contrast esophagram, treat with surgery and drainage of mediastinum

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6
Q

how to dx Zenker’s diverticulum?

A

contrast esophagram

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7
Q

calcified rim of gallbladder on CT

A 
porcelain gallbladder (usu. from chronic cholestasis)
associated with gallbladder carcinoma
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8
Q

difficulty initiating swalling + cough/choking + nasal regurgitation + aspiration pneumonia

A

oropharyngeal dysphagia,

dx with videofluorescent barium swallow

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9
Q

multiple liver lesions vs single liver lesions

A

metastases (usu. colon) -> multiple

HCC (single lesion) , dx with AFP

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10
Q

feared complication of acetominophen toxicity + treatment

A

acute liver failure = transaminases (>1000), hepatic encephalopathy, decreased liver synthesis, treat with transplant

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11
Q

elevated alk phos, normal RUQ, normal transaminases

positive AMA, diagnosis and treatment?

A

PBC, treat with ursodoxycholic acid and possibly liver transplant

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12
Q

UGIB + HDS + Hgb<7 (what to do)?

A

transfuse pRBCs, not whole blood or FFP

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13
Q

fever + jaundice + RUQ pain? dx, imaging, treatment?

A

CHARCOT’S triad
acute cholangitis
dx with u/s, CT abd - will show CBD dilation
treat with abx w/ ERCP with drainage/relief of obstruction

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14
Q

burning, localized pain + regional hyperesthesia/allodynia esp after physical stress (i.e. chemo)

A

herpes zoster (shingles)

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15
Q

how to dx pancreatic cancer (STEPS)

A

US, CT, CA 19-9/ERCP

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16
Q

common association of non-met gastric MALT lymphoma and how to treat?

A

h pylori!

treat with triple therapy

17
Q

Increased risk of what 3 cancers in lynch syndrome?

A
  • colon
  • ovarian
  • endometrial
18
Q

acute pancreatitis + yellow/red papules on skin

A

hypertriglyceridemia

19
Q

intermittent increase in transaminasess + porphyria tarda (vesicles/erosions on dorsum of hand)

A

essential mixed cryoglobulinemia (assoc with hepC)

20
Q

abd distension + fever + leukocytosis + hypotension + tachycardia (how to dx and often first presentation of what?)

A

toxic megacolon

dx with abdominal x-ray; often 1st presentation of IBD

21
Q

complications of PBC

A

increased risk HCC
severe HLD (xanthelesma)
fat malabsorption
metabolic bone disease (osteoporosis/malacia)

22
Q

another name of Wilson’s disease

A

hepatolenticular degeneration

23
Q

abdominal pain + microcytic anemia + positive FOBT + hard/firm hepatomegaly

A

GI malignancy (MCC site of mets to liver)

24
Q

chronic abdominal pain + elevated ESR + anemia + water diarrhea + weight loss + mouth ulcers

A

Crohn’s disease

25
Q

What features does Chron’s have that UC doesn’t

A
  • noncaseating granulomas on biopsy
  • skip lesions (rectal sparing)
  • fistula formation
  • transmural inflammation/cobblestoning
26
Q

What two markers are most useful in dx ACUTE hep B

A

HbsAG and IGM antiHBc

both will remain elevated during window period (anti HbS happens after window period)

27
Q

multiple refractory peptic ulcers (usu. distal to duodenum), chronic diarrhea with bloody and fatty…dx and work up

A

Zollinger ellison syndrome (fatty diarrhea due to inactivation of pancreatic enzymes due to excess stomach acid)…dx with endoscopy and somatostatin receptor scintigraphy to look for tumor…gastrin level >1000 diagnostic

28
Q

After positive finding for gastric adenocarcinoma on biopsy, what to do next?

A

CT abdomen for staging…then PET/CT/laparoscopy to determine if resectable or chemo

29
Q

pharmacologic rx for bleeding varices vs non bleeding varices (esophageal(

A

bleeding - octreotide + abx

non-bleeding - control BP with BETA BLOCKERS

30
Q

first line treatment for diffuse esophageal spasm

A

CCBs

31
Q

LLQ pain, leukocytosis, fevers/v/v, hx of chronic constipation, urinary frequency…dx and best test

A

acute diverticulitis, CONTRAST CT ABDOMEN

treat with cipro/metro

32
Q

pica (craving for nonedible objects) is usually associated with…

A

iron deficiency anemia…check for GI bleed

33
Q

sudden onset epigastric pain, nausea/vomiting, negative murphy sign, no abdominal tenderness on exam…what test to order first

A

ECG NIGGA

rule out ACS first

34
Q

bulky foul smelling stools, weight loss, occasional joint pains, loss of muscle mass/weight loss, iron def anemia, villous atrophy on biopsy, positive tissue transglut OR NEGATIVE WATCH OUT

A

celiac

35
Q

bulky foul smelling stools, weight loss, occasional joint pain, generalized lymphadenopathy, fever, skinhyperpigmentation, diastolic murmur in aortic area, PAS POSITIVE materials in lamina propria

A

whipple disease

36
Q

multiple stomach ulcers (even in the jejunum), thickened gastric folds, diarrhea…what to do next

A

check gastrin for gastrinoma (ZE snydrome)

37
Q

lab findings in lactose intolerance

A

increased stool osmolar gap, low stool pH, positive hydrogen breath test

38
Q

positive urobilinogen in urine

positive bilirubin in urine

A

uro - unconj = intravascular hemolysis
bili - conjugated = defect in hepatic secretion of bili
(Rotor’s syndrome if LFTs are normal)

39
Q

carcinoid syndrome is linked to what vitamin deficiency

A

pellagra
NIACIN….dermatitis, diarrhea, dementia

linked with serotonin metabolism

IM_GI (1 decks)

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