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GI II > Week 1 (Exam 1) > Flashcards

Week 1 (Exam 1) Flashcards

1
Q

What are Signet Ring Cells and Lintis Plastica indicative of?

A

Gastric Adenocarcinoma

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2
Q

How can you get an Acquired Esophageal Web?

A

Eosinophilic Esophigitis

Plummer Vinson Syndrome

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3
Q

What are the major anti-DA drugs?

A

Phenothiazines (Chlorpromazine, Perphenazine, Prochlorperazine) and metoclopramide

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4
Q

What secretory products would tell you that a carcinoid tumor in the gut is aggressive?

A

Serotonin, Substance P, Polypeptide YY

This is in the ilium and jejunum

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5
Q

What drug is exclusively given to patients on permanent NSAID treatment?

A

Misoprostol

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6
Q

What key histological finding would you look for to identify Candida?

A

Pseudohyphae

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7
Q

What do GIST tumors arise from?

A

Cajal cells (Kit mutation)

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8
Q

What are the different clinical features between duodenal and gastric ulcers?

A

Duodenal: Gnawing 1-3 hours after eating, relieved by food
Gastric: Worse within 30 minutes of eating, food doesn’t help. DO ENDOSCOPY

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9
Q

How is PUD diagnosed?

A

Urea Breath Test (stop PPI for 14 days first)

Fecal Antigen Test

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10
Q

What do -petant drugs block?

A

Substance P aka Neurokinin 1

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11
Q

What part of the stomach is most commonly affected by H Pylori?

A

antum

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12
Q

If a patient has Clarithromycin resistance, what should you substitute it with?

A

Amoxicillin

Tetracycline

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13
Q

What do you add to the triple therapy if a patient’s H Pylori isn’t responding to it?

A

Bismuth

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14
Q

What other effects do anti-histamine drugs have on the body?

A

Anti-cholinergic to the CNS

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15
Q

What is the initial therapy for nausea and vomiting associated with pregnancy?

A

Doxylamine (with some B6)

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16
Q

What fungus is associated with 45 degree angle branching?

A

Aspergillus

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17
Q

What part of a patients history would clue you in that they have an esophageal stricture?

A

Their acid reflux improves as the stricture progresses

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18
Q

How is Gastroparesis diagnosed?

A

Gastric Scintigraphy

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19
Q

Osler Weber Rendu Disease

A

Vascular Dysplasia leading to bleeding

Severe Epistaxis

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20
Q

What proteins are responsible for squamous differentiation?

A

P63 and NOTCH1

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21
Q

What are the two pharmaceutically administered cannabanoids?

A

Dronabinol (one metabolite)

Nabilone (many metabolites)

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22
Q

What do -setron drugs block?

A

5HT3 receptors at the Vagal N

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23
Q

How do you treat a patient with red wale markings on endoscopy?

A

Variceal Banding
Give Non-Selective Beta blockers and maybe ligation to prevent more.
This is Esophageal Varices

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24
Q

What are the drugs found in Prevpac?

A

Amoxacillin
Clarithromycin
Lansoprazole

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25
Q

What is the prototypical PPI CYP450 inhibitor?

A

Omeprazole

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26
Q

A Patient has thickened gastric folds and chronic protein loss. What is this person at greater risk of?

A

Gastric Adenocarcinoma (this is Menetrier disease)

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27
Q

What is the major side effect of Bismuth Compounds?

A

Dark, Tarry Stool

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28
Q

Where is the source of an Upper GI Bleed?

A

Proximal to the Ligament of Treitz (D-J Junction)

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29
Q

What adverse effect would you worry about if giving a patient a -setron drug?

A

QT prolongation (torsade de pointe)

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30
Q

How would you define Nutcracker Esophagus?

A

Swallowing is too powerful

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31
Q

Cimetidine is a Histamine Antagonist used to treat ulcers. What are the major side effects?

A

Anti-Testosterone: Gyno (m) Galactorrhea (w)

Neutropenia, Thrombocytopenia

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32
Q

What would you give for vertigo?

A

Meclizine or Cyclizine

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33
Q

How does Scopolamine work to treat motion sickness?

A

72 hour patch of M1 blockade

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34
Q

What is the Achalasia Triad?

A

Incomplete LES relaxation
Increased LES tone
Aperistalsis of the esophagus

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35
Q

What drugs are found in Helidac?

A

Bismuth
Metronidazole
Tetracycline
+PPI Omeprazole (not in pack)

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36
Q

What does Emphysema sound like?

A

Hamman’s Sign: Crunching, rasping sound with heartbeat during systole and in the left lateral decubitus position.

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37
Q

What symptoms would you expect to present in a Zenker Diverticulum?

A

Oropharyngeal Dysphagia

Halitosis, Regurgitation, Protrusion in neck

38
Q

What is the risk of giving Metoclopramide to a patient with Gastroparesis?

A

Tardive Dyskinesia

39
Q

What are the Histamine Receptor Antagonists?

A 
Diphenhydramine
Dimenhydrinate 
Hydroxyzine
Promethazine
Meclizine and Cyclizine
40
Q

How would you differentiate the inflammatory infiltrate of H. Pylori vs Auto-immune Gastritis?

A

Autoimmune has increased lymphocytes and Macrophages, H. Pylori has neutrophils and plasma cells

41
Q

What PPI would you recommend for a pregnant patient?

A

Pantoprazole or Lansoprazole

42
Q

What would you give for pregnancy-induced NV?

A

B6 w/w/o histamine blocker or 5HT blocker
+DA antagonist
+Steroid or another DA antagonist

43
Q

How would you characterize a tumor caused by a PLAG1 mutation?

A

Pleomorphic / mixed:
Well Demarcated
Histological heterogeneity

44
Q

What do HPV strains E6 and E7 act on, respectively?

A

E6: P53 and TERT (increased telomerase)
E7: P21 and RB-E2F

45
Q

Blood supply to the trachea is divided into thirds. What arteries supply the upper, middle, and lower thirds, respectively?

A

Upper: Inferior Thyroid A
Middle: Thoracic Aorta (branches)
Lower: Left Gastric A

46
Q

What is the prototypical CYP450 inhibitor?

A

Cimetidine

47
Q

What two Serotonin antagonists would you give for a delayed onset?

A

Palonosetron

Granisetron

48
Q

Peutz-Jeghers Syndrome

A

Multiple GI Hamartomatous Polyps

Mucal Macules and Hyperpigmentation

49
Q

Zollinger Ellison Syndrome

A

Make too much Gastrin

50
Q

How does Oropharyngeal Dysphagea present?

A

Difficulty Initiating Swallowing

Food stuck at Suprasternal Notch

51
Q

What key step must be undertaken in the development of diffuse gastric cancer?

A

Loss of E-Cadherin

52
Q

What are the possible side effects of Substance P blockers?

A

CYP450 interactions

CNS and GI

53
Q

What is the Misoprostol MOA?

A

Prostaglandin E1 analog (increases mucous and bicarb for cytoprotection)

54
Q

What would you give for Diabetic Gastroparesis?

A

Metoclopramide

55
Q

What are the two sets of risk factors for Pyloric Stenosis?

A

Turner and Edward Syndrome

Erythromycin and Azithromycin during pregnancy

56
Q

When esophageal perforation is spontaneous, its called Boerhaave’s. Where does this occur?

A

Trans mural rupture at the Gastroesophageal Junction

57
Q

An infant has food impaction and feeding intolerance, as well as rashes on their chest, joint extremities, and scalp. What is the likely dx?

A

Eosinophilic Esophagitis

58
Q

How do you diagnose an upper GI bleed?

A

EGD

59
Q

What two tumors are indicative of GI metastasis?

A

Virchow: just above the clavicle
Krukenberg: ovarian

60
Q

How would you prevent perforating a suspected Zenkers Diverticulum during a diagnostic exam?

A

Video Esophagography or barium swallow is done BEFORE EGD

61
Q

What disease has Corkscrew and Rosary Bead Esophagus on barium swallow?

A

Diffuse Esophageal Spasm

62
Q

What is the core of H Pylori treatment?

A

Triple therapy for 10-14 days:
Clarithromycin
+Amoxicillin / Metronidazole
+PPI

63
Q

What is most likely suspected with impaction of large, poorly chewed food bolus?

A

Schatzki Ring (steakhouse syndrome)

64
Q

What are the -prazole drugs?

A

PPIs

65
Q

What does H Pylori use to cause ulcer?

A

Can-A Positive Toxin

66
Q

What do you do about really persistent H Pylori, lasting beyond 14 days?

A

Consider PPI therapy

Switch to non-Metronidazole Quadruple Therapy

67
Q

What neurokinin-1 blocker can you give prophylactically for post-op nausea and vomiting?

A

Aprepetant ONLY

68
Q

What are the -tidine drugs?

A

H2 receptor antagonists (anti-ulcer)

69
Q

How is Acute Paralytic Ilius diagnosed?

A

Plain abdominal radiography or CT

Gas and fluid dissension in large and small bowels

70
Q

What would you diagnose when you see histological findings on Balloon Cells, Hyperkeratosis, and Acanthosis?

A

Hairy Leukoplakia

71
Q

Netupetant and FosNetupetant are only found in combo with which other drug?

A

Palonosetron

72
Q

What tumor suppressor is OVER-expressed in HPV?

A

P16 (encoded by CDKN2A)

73
Q

What is the likely diagnosis of palatine mass that isn’t a torus?

A

Adenoid Cystic Carcinoma:

Pain is common from growth along nerves

74
Q

Where are you most likely to find a Warthin tumor?

A

A Smoking Man’s Parotid

75
Q

What disease is characterized by Pernicious Anemia, adenocarcinoma, carcinoid tumor, and atrophy?

A

Auto-immune gastritis

76
Q

What disease is characterized by PUD, adenocarcinoma, and MALToma?

A

H. Pylori Gastritis

77
Q

What are the only indications for Histamine blockers Meclizine and Cyclizine?

A

Motion Sickness and Vertigo

78
Q

Lymphoepithelial lesions are diagnostic of what?

A

MALToma

79
Q

Where does a Zenker Diverticulum occur?

A

Between the cricopharyngeus muscle and the inferior pharyngeal constrictor muscle

80
Q

How does an SBO present physically?

A

Decreased or absent or high pitched bowel sounds

NV (possibly feculent)

81
Q

Meckel Diverticulum comes from a congenital abnormality of what structure?

A

Vitelline Duct

82
Q

What are the downstream effects of increased Wnt signaling?

A

Loss of APC tumor supressor
Gain of b-Catenin expression
Causes Intestinal Type Gastric Cancer

83
Q

What are the major effects of Metoclopramide?

A 
Anti cholinergic (drowsiness, urinary retention, etc)
Increased GI motility
84
Q

A patient has spoon nails, esophageal webs, angular chelitis and glossitis. What is this?

A

Plummer-Vinson

Comes with Fe-Deficient Anemia

85
Q

What is the translocation associated with MALTomas?

A

11;18

86
Q

What are the three parts of a high-emetogenic regimen for chemo-induced N/V?

A
  1. NK antagonist
  2. 5HT antagonist
  3. Corticosteroid
    (maybe add Olanzapine to block D2, or cannabinoid)
87
Q

What about Sucralfate makes it a relative contraindication for patients with renal disease?

A

It contains some aluminum

88
Q

How does Type A gastritis come about?

A

Loss of rural folds
Antibodies to Parietal Cells
Anti Intrinsic Factor Abs

89
Q

A patient has a dull, gnawing chest pain and coffee ground emesis. What do you think this is?

A

PUD

90
Q

What infection can cause Achalasia?

A

Chagas Disease (T Cruzi from Reduviid Bug)

91
Q

What set of symptoms occurs in disease associated with Sjogrens?

A

Keratoconjunctivitis:
Blurred vision
Burning, itching, secretions in conjunctiva

GI II (4 decks)

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