Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3rd Year (Step 2) > G/I 1 > Flashcards

G/I 1 Flashcards

1
Q

Colorectal cancer is the ____ most common cancer in men & women in the US.

A

3rd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common colorectal cancers?

A

Adenocarcinomas arising from the mucosa (endoluminal ; arising from adenomas)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which has higher incidence of CRC: Crohn’s Disease or UC?

A

UC

though both have inc’d risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Familial Adenomatous Polyposis - inheritance pattern?

A

Autosomal Dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Familial Adenomatous Polyposis - bowel regions that are involved?

A

Colon - always
Duodenum - 90%

  • Polyps may also form in stomach, jejunum, & ileum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Familial Adenomatous Polyposis - risk of CRC?

A

100% by 3rd or 4th decade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is Gardner’s Syndrome?

A

Polyps + Osteomas, dental abnormalities, benign soft tissue tumors, desmoid tumors, sebaceous cysts

  • Risk of CRC 100% by 4th decade
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Turcot’s Syndrome?

A

Polyps + Cerebellar Medulloblastoma or Glioblastoma Multiforme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Peutz-Jeghers?

A

Single or multiple hamartomas (low malig pot’l) scattered through entire GI tract (SI > LI&raquo_space; stomach)

  • Pigmented spots around lips, oral mucosa, face, genitalia, & palmar surfaces
  • Slightly inc’d incidence in various other carcinomas
  • Intussusception or GI bleeding may occur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Familial Juvenile Polyposis Coli - risk of CRC?

A

Small risk of CRC

  • presents in childhood; rare
  • 10-100 juvenile colonic polyps
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Lynch Syndrome?

A

Hereditary Nonpolyposis CRC

w/o adenomatous polyposis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most common cause of large bowel obstruction in adults?

A

CRC

colonic perforation can lead to peritonitis & is the most life-threatening complication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Essential Sx of most esophageal disorders?

A

Dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Alarm esophageal Sx that indicate endoscopy? (3)

A

Weight loss
Blood in stool
Anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Achalasia

A

Inability of LES to relax (due to loss of nerve plexus w/in the LE)
- Aperistalsis of the esophageal body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Achalasia – presentation?

A 
Young patient (< 50)
- Progressive dysphagia to both solids & liquids @ same time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Is endoscopy useful in achalasia?

A

Only to exclude malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Achalasia – most accurate Dx test?

A

Manometry
(shows failure of LES to relax)

  • could do a Barium esophagram as 1st test, but not very specific
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Achalasia – Tx?

A
  1. Pneumatic dilation (endoscope w/ ability to dilate a device that enlarges esophagus)
  2. Botulinum Toxin injection (relaxes LES, lasts 3-6 months)
  3. Surgical sectioning or myotomy (more effective than #1, & more dangerous)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Potential complication of Pneumatic Dilation?

A

Leads to perforation in less than 3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Esophageal cancer – presentation?

A
  • Age > 50
  • Dysphagia 1st to solids, then progressing to liquids
  • Ass’d w/ prolonged alcohol & tobacco use
  • > 5-10 yrs of GERD symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Esophageal Biopsy – uses?

A

Cancer & Barrett Esophagus ONLY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What test is NEVER the most accurate in testing for cancer?

A

Radiologic testing is never the most accurate test for cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Esophageal cancer – Dx tests?

A
  1. Endoscopy – most accurate
  2. Barium might be “best initial” but does NOT diagnose cancer
  3. CT & MRI determine extent of spread into surrounding tissues
  4. PET scan determines contents of anatomic lesions if not sure whether they’re cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Esophageal cancer – Tx?

A

Resection (only cure)

  • Chemo/radiation used in addition to surgical removal
  • Stent placement – palliative for dysphagia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What unique feature may cause DES episodes?

A

Drinking cold liquids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

DES – findings on esophagram? Endoscopy

A

Both normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

DES – Dx test?

A

Manometry – random contractions

  • Barium studies can show a corkscrew appearance @ time of spasm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

DES – Tx?

A

Calcium-channel blockers & Nitrates

similar to Prinzmetal’s angina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

3 pills that cause esophagitis if in prolonged contact?

A

Doxycycline
Alendronate
KCl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Esophageal infection in AIDS pt – Dx & Tx?

A

Dx = Candida

Tx = Oral Fluconazole
(if this doesn’t work, do endoscopy – if confirms candidiasis, use IV amphotericin)

**nystatin swish/swallow treats ORAL candidiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

2 possible complications of chronic hepatitis?

A
  • Cirrhosis

- Hepatocellular Carcinoma (HCC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

% of acute Hepatitis C infections that become chronic?

A

85-90%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

% of acute Hepatitis B infections that become chronic?

A

5-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

General clinical features of Hepatitis?

A
  • Jaundice (sclera first)
  • Dark urine (conjugated hyperbilirubinemia)
  • RUQ pain
  • Nausea & vomiting
  • Fever & malaise
  • Hepatomegaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Complications of severe or acute hepatitis (liver dysfunction, basically)?

A
  • Hepatic encephalopathy (asterixis & palmar erythema)
  • Hepatorenal syndrome
  • Bleeding diathesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Best Dx test for Zollinger-Ellison Gastrinoma?

A

Secretin challenge

though can also just look for high Gastrin levels off PPI or in combo w/ high acid levels

38
Q

Next step after confirmation of Gastrinoma?

A
  1. CT/MRI – if negative, then do
  2. Somatostatin receptor Scintigraphy (nuclear octreotide scan)
    combined w/ endoscopic U/S

– both to exclude metastatic disease

39
Q

Cause of Diabetic Gastroparesis?

A

Autonomic neuropathy leading to GI dysmotility 2/2 loss of “stretch” receptors that normally sense distention of intestines & stomach & stimulate motility

40
Q

Upper GI bleed – causes?

A

Most common = Ulcer Disease

Others = gastritis, esophagitis, duodenitis, cancer, varices (2/2 liver disease)

41
Q

Lower GI bleed – causes?

A

Most common = Diverticulosis

Others = Angiodysplasia (AVM), Polyps/cancer, Inflammatory bowel disease, Hemorrhoids, Upper GI bleed w/ rapid transit from high volume

42
Q

What is “Ascites”?

A

Excessive amounts of fluid in the peritoneal cavity

– most frequently develops in liver cirrhosis

43
Q

Cause of hepatic encephalopathy?

A

Ammonia buildup due to the liver’s inability to convert it to urea (urea/ornithine cycle)
- ammonia then binds α-ketoglutarate, a molecule normally used in the Krebs cycle

Sx: Flapping tremor, social disinhibition, inability to concentrate, daytime somnolence

44
Q

Jaundice indicates 1 or what 4 problems?

A
  1. increased RBC breakdown
  2. failure of hepatocyte conjugation
  3. failure of hepatocyte excretion of conjugated bilirubin into the bile canaliculi
  4. extrahepatic obstruction
45
Q

Esophageal & gastric varices – Tx?

A
  1. Fluids, blood, platelets, plasma
  2. Octreotide (dec’s portal pressure)
  3. Banding via endoscopy obliterates esophageal varices
  4. Transjugular Intrahepatic Portosystemic Shunting (TIPS) to decrease portal pressure if needed still
  5. Propranolol to prevent further bleeding (not current)
  6. ABX to prevent SBP w/ ascites
46
Q

ABX w/ highest rate of ABX-ass’d diarrhea?

A

Clindamycin

starts days-weeks after starting ABX

47
Q

ABX-ass’d diarrhea – best test?

A

C. diff toxin test or PCR

NOT culture – will not grow

48
Q

ABX-ass’d diarrhea – Tx?

A

Metronidazole

- if no response, switch to oral Vancomycin or Fidaxomicin

49
Q

Fat malabsorption – diff. Dx?

A
  • Celiac disease
  • Chronic pancreatitis
  • Tropic sprue
  • Whipple disease
50
Q

Vitamin D deficiency Sx?

A

Hypocalcemia, Osteoporosis

51
Q

Vitamin K deficiency Sx?

A

Bleeding, easy bruising

52
Q

Vitamin B12 deficiency Sx?

A

Anemia, Hypersegmented neutrophils, neuropathy

53
Q

Whipple Disease presentation?

A
  • Fat malabsorption
  • Arthralgias
  • Ocular findings
  • Neuro abnormalities (dementia, seizures)
  • Fever
  • Lymphadenopathy
54
Q

Whipple Disease – Tx?

A

Ceftriaxone, followed by TMP/SMZ

55
Q

Clinical distinction Chronic pancreatitis vs. gluten sensitivity?

A

Gluten sensitivity has iron deficiency, CP doesn’t

b/c iron needs intact bowel wall for absorption, not pancreatic enzymes

56
Q

Celiac disease – first test? Most accurate?

A

1st test = anti-tissue transglutaminase

Most accurate = Small bowel biopsy that shows flattening of the villi
– essential to exclude lymphoma

Others:

  • antiendomysial antibody
  • IgA antigliadin antibody
57
Q

Whipple disease – Dx test?

A

Small bowel biopsy showing specific organism

58
Q

Tropic sprue – Dx test?

A

Small bowel biopsy showing specific organism

59
Q

Chronic Pancreatitis – Dx tests?

A

Abdom X-ray or CT – looking for calcifications of pancreas (CT more sensitive & specific)

Most accurate = Secretin stimulation testing
– unaffected person will secrete large volume of bicarbonate-rich fluids after IV injection of secretin

60
Q

Chronic Pancreatitis – Tx?

A

Enzyme replacement

61
Q

Celiac Disease – Tx?

A

Avoid gluten-containing foods such as wheat, oats, rye, barley

62
Q

Tropical Sprue – Tx?

A

TMP/SMX, Tetracycline

63
Q

Carcinoid Syndrome – presentation?

A

Intermittent diarrhea in association w/:

  • Flushing
  • Wheezing
  • Cardiac abnormalities of right-side of heart
64
Q

Carcinoid Syndrome – best 1st test?

A

Best initial = Urinary 5-hydroxyindoleacetic acid

65
Q

Carcinoid Syndrome – Therapy?

A

Octreotide

synthetic somatostatin used to control diarrhea

66
Q

Gluten vs. Lactose intolerance – which ass’d w/ weight loss?

A

Gluten intolerance only

lactose is only one sugar & there’s no deficiency of calories absorbed

67
Q

Lactose intolerance – Tx?

A

Avoid all milk products, except yogurt

- can add oral lactase replacement also

68
Q

Irritable Bowel Syndrome (IBS) – presentation?

A

Pain syndrome that can have diarrhea, constipation, or both

Pain of IBS is:

  • relieved by bowel movement
  • less at night
  • relieved by a change in bowel habit such as diarrhea
69
Q

IBS – Tx?

A
  • Fiber in the diet
  • Antispasmotic agents: Dyoscyamine, Dicyclomine
  • TCAs (Amitriptyline or SSRIs)
  • Antimotility agents (ex: Loperamide) for diarrhea
  • Lubiprostone (Cl- channel activator that increases bowel movement frequency)
70
Q

Inflammatory Bowel Disease (IBD) – presentation?

A
  • Diarrhea
  • Blood in stool
  • Weight loss
  • Fever
  • Anemia
71
Q

Extraintestinal manifestations of BOTH Crohn’s Disease & Ulcerative Colitis?

A
  • Arthralgias
  • Uteitis, Iritis
  • Skin manifestations (erythema nodosum, pyoderma gangrenosum)
  • Sclerosing cholangitis (more common in UC)
72
Q

Which extra intestinal manifestation of CD & UC is an indicator of disease activity?

A

Erythema Nodosum

73
Q

Skip lesions – CD or UC?

A

CD

74
Q

Curable by surgery – CD or UC?

A

UC

75
Q

Transmural granulomas – CD or UC?

A

CD

76
Q

Entirely mucosal – CD or UC?

A

UC

77
Q

Fistulas & abscesses – CD or UC?

A

CD

UC has neither

78
Q

Masses & obstruction – CD or UC?

A

CD

UC has no obstruction

79
Q

Perianal disease – CD or UC?

A

CD only

80
Q

When & how should screening occur in CD & UC?

A

After 8-10 yrs of colonic involvement, w/ colonoscopy every 1-2 yrs

81
Q

CD – Tx?

A

Acute exacerbations = Steroids

Chronic:

  • Mesalamine (5-ASA derivative)
  • Steroids = Prednisone or Budesonide
  • Azathioprine & 6-Mercaptopurine are used to wean pts off steroids when Sx occur whenever steroids are stopped
82
Q

Perianal CD – Tx?

A

Ciprofloxacin & Metronidazole

83
Q

Fistulae & severe unresponsive disease in CD – Tx?

A

anti-TNF agents such as Infliximab

  • surgery done for fistulae only if no response to anti-TNF agents or if there’s an obstruction
84
Q

Diverticulosis – presnetation?

A

Usually asymptomatic

  • LLQ abdominal pain
  • Constipation
  • Bleeding
  • sometimes, infection (diverticulitis)
85
Q

Diverticulosis – most accurate test?

A

Colonoscopy

Barium studies acceptable, but not as accurate

86
Q

Diverticulosis – Tx?

A

Bran, Psyllium, Methylcellulose, & inc’d dietary fiber are used to decrease the rate of progression of disease

87
Q

Diverticulitis – Presentation?

A

Most likely Dx when presented w/:

  • LLQ pain & Tenderness
  • Fever
  • Leukocytosis
  • Palpable mass sometimes occurs
  • Sx such as nausea, constipation, bleeding can be present but are nonspecific
88
Q

Diverticulitis – test?

A

Best initial = CT scan

(Colonoscopy & Barium enema are dangerous in acute diverticulitis b/c of inc’d risk of perforation. Infection weakens colonic wall)

89
Q

Diverticulitis – Tx?

A
  1. Make NPO
  2. ABX that cover E. coli & anaerobes:
    - Ciprofloxacin + Metronidazole (best initial)
    - Amoxicillin/Clavulanate, Ticarcillin/Clavulanate, or Piperacillin/Tazobactam
    - Ertapenem (Carbapenems)
  3. Surgery if no response to ABX, frequent recurrences, or perforation/fistulae/abscess/strictures/obstruction
90
Q

Colonoscopy screening in normal pt?

A

Every 10 years starting at age 50

3rd Year (Step 2) (44 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions