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Flashcards in Gastrointestinal Review Deck (116)
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1
Q

What is the term for difficulty swallowing?

A

Dysphagia

2
Q

Birds beak esophagus on barium swallow should make you think of what diagnosis?

A

Achalasia

3
Q

What is the most common location for an anal fissure?

A

Posterior midline

4
Q

Crohn’s is found where in the GI tract?

A

It can be from esophagus to anus.

5
Q

What does HBsAG (hep B surface antigen) indicate?

A

Active Hep B infection

6
Q

How do you treat achalasia?

A

Loosen up the muscle - botox, dilation or surgery.

7
Q

A corkscrew appearance on barium study should make you think of what diagnosis?

A

Esophageal spasms

8
Q

Epigastric abdominal pain which radiates to the back should make you think of what diagnosis?

A

Pancreatitis

9
Q

In order to contract hepatitis D what must you already have?

A

Hepatitis B

10
Q

Left lower quadrant pain and tenderness should make you think of what diagnosis?

A

Diverticulitis

11
Q

What is the treatment for most Mallory-Weiss tears?

A

Watchful waiting, these will typically resolve within 48 hours.

12
Q

Thumbprint sign on abdominal film should make you think of what diagnosis?

A

Intestinal ischemia

13
Q

What will the bowel sounds be early on in a small bowel obstruction? What will they be later on?

A

Early they are hyperactive. Late they are absent.

14
Q

A patient has had GERD for years. Over the past year he has noticed an increase in difficulty swallowing his food. This should make you think of what diagnosis?

A

Esophageal strictures

15
Q

What are two treatments you should consider for esophageal strictures?

A

Dilation of the esophagus and long term PPIs.

16
Q

What are two common predisposing factors for esophageal varices?

A

Portal HTN and cirrhosis often caused by alcoholism.

17
Q

What is a common symptom that goes along with chest pain for GERD patients?

A

Dry cough

18
Q

What medication is most commonly used for long term treatment of GERD?

A

Proton pump inhibitors - omeprazole, lansoprazole, pantoprazole.

19
Q

What is the imaging modality of choice for pancreatitis?

A

CT

20
Q

What is the best test to check for H. pylori?

A

Urea breath test

21
Q

Is peptic ulcer disease more common in the duodenum or the stomach?

A

Duodenum

22
Q

What is the most common location for a pancreatic tumor?

A

75% occur in the head of the pancreas.

23
Q

With a gastric ulcer are the patient’s symptoms exacerbated or relieved with food?

A

Exacerbated

24
Q

Fasting gastrin will be above what level with gastrinoma?

A

> 150 pg/ml

25
Q

Projectile vomiting should make you think of what diagnosis?

A

Pyloric stenosis

26
Q

Most gallstones are made of what substance?

A

Cholesterol

27
Q

What is the name of the sign when a patient shows inhibited inspiration with pressure over the RUQ? What diagnosis does it suggest?

A

Murphy’s sign, Cholecystitis

28
Q

What is the most specific test for acute cholecystitis?

A

HIDA

29
Q

What is the gold standard for diagnosis and treatment of bile duct stones?

A

ERCP

30
Q

What is Charcot’s triad?

A

RUQ pain, fever, jaundice

31
Q

What is Reynold’s pentad and why does it matter?

A

Charcot’s triad + hypotension + altered mental status. It indicates high risk of sepsis.

32
Q

What disease is defined as an immunologic response to gluten?

A

Celiac

33
Q

What is the main risk factor for esophagitis?

A

Immunocompromised patient

34
Q

An endoscopy for presumed esophagitis shows multiple shallow ulcers. What is the most likely diagnosis?

A

Herpes simplex virus

35
Q

List two common offending agents for pill induced esophagitis?

A

NSAIDS, KCL, iron, antibiotics

36
Q

A thirty year old African American woman presents with dysphagia. You notice she also has thickened skin. A barium swallow demonstrates the absence of peristalsis. What is the most likely diagnosis?

A

Scleroderma

37
Q

A patient complains of regurgitating undigested food several hours after a meal. What is the most likely diagnosis?

A

Zenker’s diverticulum

38
Q

What is the most common cause of peptic ulcer disease?

A

H. pylori

39
Q

What is most specific diagnostic test for peptic ulcer disease?

A

Endoscopy

40
Q

What is the only curative therapy for gastric adenocarcinoma?

A

Surgical resection

41
Q

A patient presents complaining of right upper quadrant pain 20 minutes after meals. What is the most likely diagnosis?

A

Cholecystitis

42
Q

What does ERCP stand for?

A

Endoscopic retrograde cholangiopancreatography

43
Q

What is the most common cause of acute bacterial cholangitis?

A

Choledocholithiasis

44
Q

Onion ring fibrosis from a bile duct biopsy should make you think of what diagnosis?

A

Primary sclerosing cholangitis

45
Q

What two viral hepatitis infections are self limiting?

A

Hepatitis A and hepatitis E

46
Q

Pica is often related to what type of anemia?

A

Iron deficiency anemia

47
Q

What does an Anti-HBc (hep B core antibody) indicate?

A

Previous or ongoing hepatitis B infection.

48
Q

What does Anti-HBs (hep B surface antibody) indicate?

A

Recovery from infection or immunization to hepatitis B.

49
Q

What it is the recommended treatment for hepatitis C infection?

A

Pegylated interferon alpha-2

50
Q

What medication used in hepatitis B infection helps prevent the need for liver transplant?

A

Lamivudine

51
Q

There are vaccines for which two versions of hepatitis?

A

Hepatitis A and hepatitis B

52
Q

Will a patient with achalasia have dysphagia to liquids, solids or both?

A

Both

53
Q

If you have heartburn that does not improve with medication what is the most likely diagnosis?

A

Gastrinoma

54
Q

What are the two main complications of cirrhosis?

A

Portal HTN & liver insufficiency

55
Q

What is a good beta blocker to reduce portal HTN?

A

Propranolol

56
Q

What tumor marker may be used for liver cancer?

A

alpha-Fetoprotein

57
Q

What are the two most common causes of pancreatitis?

A

Cholelithiasis and ETOH

58
Q

Describe Cullen’s sign.

A

Umbilical ecchymosis often related to pancreatitis.

59
Q

What are the 5 points of Ranson’s criteria on admission?

A

older than 55, WBC>16, glucose>200, LDH>350, AST>250

60
Q

What is the first step in treating GERD?

A

Lifestyle modification

61
Q

Steatorrhea should make you think of what diagnosis?

A

Pancreatitis

62
Q

Describe Courvoisier’s sign.

A

Nontender, palpable gall bladder which may indicate pancreatic neoplasm.

63
Q

What tumor maker can be used to follow pancreatic cancer?

A

CA-19-9

64
Q

A patient complains of periumbilical pain which has now moved over McBurney’s point. What is the most likely diagnosis?

A

Appendicitis

65
Q

Describe how to perform the psoas sign.

A

The patient is supine and attempts to raise right leg against resistance.

66
Q

What is the term for painful swallowing?

A

Odynophagia

67
Q

Describe how to perform the obturator sign.

A

The patient is supine and attempts to flex and internally rotate right hip.

68
Q

What is the best imaging study for acute appendicitis?

A

CT

69
Q

What two blood test can be used to diagnose celiac?

A

IgA endomysial antibody and IgA tTG antibody.

70
Q

How much fiber should you normally get in a day?

A

About thirty grams

71
Q

What treatment should be started for asymptomatic diverticulosis?

A

None

72
Q

Is surgery curative for Crohn’s or ulcerative colitis?

A

Ulcerative colitis

73
Q

What causes Mallory-Weiss tears?

A

Forced vomiting or retching (often involving alcohol)

74
Q

A colonoscopy that shows cobblestone or skip lesions should make you think of what diagnosis?

A

Crohn’s disease

75
Q

What class of medication is first line to treat inflammatory bowel disease in the maintenance phase?

A

5-ASA products - sulfasalazine, mesalamine.

76
Q

Currant jelly stool should make you think of what diagnosis?

A

Intussusception

77
Q

Severe abdominal pain 30 minutes after a meal should make you think of what diagnosis?

A

Intestinal ischemia

78
Q

What is the most common cause of lower GI bleed?

A

Diverticulosis

79
Q

What is the most common location of colorectal cancer?

A

Cecum about 38%

80
Q

Colorectal cancer patients are almost all older than what age?

A

90% of patients are older than 50.

81
Q

An epigastric olive shaped mass should make you think of what diagnosis?

A

Pyloric stenosis

82
Q

An elevated serum amylase and lipase should make you think of what diagnosis?

A

Pancreatitis

83
Q

Under routine circumstances when should patients begin getting screening colonoscopies?

A

Age 50

84
Q

What is the #1 cause of small bowel obstruction?

A

Postoperative adhesions

85
Q

Air fluid levels on abdominal x-ray should make you think of what diagnosis?

A

Bowel obstruction

86
Q

Which is more likely to pass into the scrotum, a direct or indirect hernia?

A

Indirect

87
Q

A string sign on barium swallow should make you think of what diagnosis?

A

Pyloric stenosis

88
Q

What is the first line of treatment for an anal fissure?

A

Fluid and fiber

89
Q

What are two things that an anal fissure off midline might suggest?

A

Crohn’s, syphilis, HIV, neoplasm

90
Q

What medical treatment is given for a gastrinoma?

A

Proton pump inhibitors

91
Q

What is the term for an abscess in the sacrococcygeal cleft?

A

Pilonidal disease

92
Q

How do you treat an H. pylori infection?

A

PPI + 2 Abx, commonly omeprazole + clarithromycin and amoxicillin or PPI +metronidazole + tetracycline.

93
Q

Painless bright red blood per rectum should make you think of what diagnosis?

A

Hemorrhoids

94
Q

A patient on sulfasalazine for an inflammatory bowel disease should be supplemented with what vitamin?

A

Folate

95
Q

What is the most common anorectal problem affecting patients over 50?

A

Hemorrhoids

96
Q

A gastrinoma is also known as what syndrome?

A

Zollinger-Ellison syndrome

97
Q

Salivary amylase breaks down what macronutrient?

A

Carbohydrates

98
Q

What is the medical term for feeling like there is a lump in your throat?

A

Globus

99
Q

What is the most common vessel blocked with intestinal ischemia?

A

Superior mesenteric artery

100
Q

Describe Grey-Turner’s sign.

A

Flank ecchymosis often related to pancreatitis.

101
Q

What are the first three steps of managing pancreatitis?

A

NPO, pain control, fluids

102
Q

A patient presents with unproductive retching, acute localized epigastric distention and inability to pass a nasogastric tube. What is the most likely diagnosis?

A

Gastric volvulus

103
Q

What is the most common cause of a folate deficiency?

A

Alcoholism

104
Q

Should diverticulitis always be admitted?

A

No mild cases can be treated as outpatients with rest and clear fluids.

105
Q

Which NSAID has the highest rate of peptic ulceration?

A

Naproxen

106
Q

What is the diagnostic test of choice for Zenker’s diverticulum?

A

Barium swallow will show the diverticulum.

107
Q

What is the leading cause of iron deficiency anemia?

A

Chronic GI bleed

108
Q

At what age and how often should fecal occult blood tests be performed as a screening tool?

A

Beginning at age 50 and they should be done every year.

109
Q

How often should patients with pernicious anemia have a screening endoscopy performed?

A

Every 5 years looking for signs of gastric carcinoma.

110
Q

Are one half of all adult hernias direct or indirect inguinal hernias?

A

Indirect inguinal hernias makeup 50% of all adult hernias.

111
Q

How is celiac disease most commonly diagnosed?

A

Endoscopic biopsy

112
Q

Define pellagra?

A

Niacin (B3) deficiency

113
Q

An endoscopy for presumed esophagitis shows several solitary deep ulcers. What is the most likely diagnosis?

A

Cytomegalovirus

114
Q

Which are more painful, hemorrhoids above or below the dentate line?

A

Below, internal hemorrhoids are not painful.

115
Q

An abdominal exam with pain out of proportion to the exam should make you think of what diagnosis?

A

Intestinal ischemia

116
Q

Does adenocarcinoma arises from the proximal or distal esophagus?

A

Distal