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Undeleted > Gastroenterology/Endocrine > Flashcards

Gastroenterology/Endocrine Flashcards

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1
Q

Risks for CRC (4)

A

over 50yrs
villous adenomas
UC/Crohns
high fat and low fiber diet

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2
Q

Major polyposis syndromes (5)

A 
FAP-pancolonic
Gardner's-soft tissue tumors + FAP
Turcots-polyps + CNS tumors
Peutz-Jeghers-hamartoms of GI, pigmented lips/genitals
Lynch syndrome-early onset CRC
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3
Q

Mgt of CRC

A

CEA every 3-6 months
annual colonoscopy
annual CT of abd for 5 years

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4
Q

Structure most affected in acute mesenteric ischemia

A

SMA

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5
Q

Dx of acute mesenteric ischemia

A

mesenteric angiography

thumbprinting on barium enema

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6
Q

Sx of chronic mesenteric ischemia

A

dull abd pain after meals

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7
Q

Causes of Ogilvie’s syndrome

A

surgery/trauma
sepsis
narcotics/anticholinergics

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8
Q

Drugs assc with Pseudomembranous colitis (3)

A

clindamycin
ampicillin
cephalosporins

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9
Q

Complications of cirrhosis

A 
Portal HTN
varices
HCC
hepatic encephalopathy
hepatorenal/hepatopulmonary syndrome
Spontaneous bacterial perotinitis
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10
Q

Portal HTN dx

A

serum/ascites albumin gradient (SAAG)
>1.1g/dL=portal HTN
<1.1g/dL=something else

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11
Q

Dx of spontaneous bacterial perotinitis

A

> 250 WBCs on paracentesis

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12
Q

Tx for Wilson’s disease

A

D-penicillamine

Zn (competes for uptake)

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13
Q

Complications of hemachromatosis (6)

A 
cirrhosis
cardiomyopathy
DM
hypothyroidism
arthritis
hyperpigmentation
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14
Q

Asscs with hepatic adenomas (2)

A

oral contraceptives

anabolic steroids

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15
Q

Assc with hepatocellular carcinoma (4)

A

Hep B/C
cirrhosis
aflatoxin/vinyl chloride/thorotrast
schistosomiasis

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16
Q

Marker for HCC

A

AFP

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17
Q

Assc with cysts of the liver (2)

A

poylcystic kidney disease

hydatid liver disease (echinococcus)

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18
Q

Dx of entamoeba histolytica

A

bloody diarrhea
stool Ag
increased LFTs

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19
Q

Sx of conjugated hyperbilirubinemia

A

dark urine/pale stools

nontoxic

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20
Q

Sx of unconjugated hyperbilirubinemia

A

neuro deficits
crosses BBB
toxic

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21
Q

Causes of conjugated hyperbilirubinemia (5)

A 
Rotors/Dubin Johnson
biliary obstruction
cirrhosis
oral contraceptives
PBC/PSC
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22
Q

Causes of unconjugated hyperbilirubinemia (4)

A

hemolytic anemia
Gilbert’s
Crigler-Najjar
physiologic jaundic of newborn

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23
Q

Dx of gallstones

A

Ultra sound

HIDA if US no conclusive

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24
Q

Dx of choledocholithiasis

A

US first

ERCP

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25
Reynolds Pentad of cholecystitis
``` jaundice fever RUQ pain shock altered mental status ```
26
Primary sclerosing cholangitis findings
intra and extrahepatic ducts involved bead like dilatations assc with UC
27
Primary biliary cirrhosis findings
intrahepatic duct narrowing xanthomata/xanthelasmata osteoporosis
28
Dx of PBC
(+) antimitochondrial Abs | increased cholesterol/HDL
29
Risk factors for cholangiocarcinoma (4)
PSC PBC clonorchis sinensis choledochal cysts
30
Causes of acute pancreatitis (6)
``` EtOH gallstones ERCP mumps/coxsackie B scorpion bites hypercalcemia/hyperlipidemia ```
31
Complications from acute pancreatitis
pancreatic pseudocyst (2wks after attack) ARDS pancreatic ascites
32
Tx for acute pancreatitis
IV fluids NPO meperidime/fentayl for pain enteral nutrition w/in 72hrs
33
Tx for chronic pancreatitis
analgesics pancreatic enzymes H2 blockers
34
Risk factors for pancreatic cancer (4)
smoking #1 chronic pancreatitis EtOH benzidine/naphthylamine
35
Sx of pancreatic cancer (3)
jaundice/palpable gallbladder DM migratory thrombophlebitis
36
Causes of lower GI bleed (6)
``` diverticulosis (#1 over 60yrs) angiodysplasia IBD CRC ischemic colitis hemorrhoids ```
37
Dx of GI bleeds
endoscopy/colonoscopy slow bleed-bleeding scan active bleed-arteriography
38
Causes of achalasia (3)
adenocarcinoma of stomach Chagas idiopathic
39
Tx for Zenker's diverticulum
criocpharyngeal myotomy
40
Gastric ulcer asscs (3)
type A blood smoking eating does NOT improve pain
41
Duodenal ulcer asscs (3)
type O blood NSAIDs eating relieves pain
42
Tx for H. pylori
clarithromycin amoxicillin PPI
43
Causes of chronic gastritis (2)
H pylori | autoimmune gastritis
44
Risks for gastric cancer (5)
``` H pylori pernicious anemia Menetrier's disease type A blood atrophic gastritis ```
45
Tx for small bowel obstruction
IV fluids K+ repletion abx surgery if complete obstruction
46
Extraintestinal sx of IBD (6)
``` anterior uveitis erythema nodosum pyroderma gangrenosum arthritis PSC aphthous ulcers ```
47
Complications of Crohn's disease (4)
fistulas small bowel obstruction VIt B12/bile acid malabsorption cholelithiasis/nephrolithiasis
48
Tx for Crohn's
sulfasalazine metronidazole AZA, 6-MP
49
Complications of ulcerative colitis (5)
``` iron deficiency anemia strictures CRC PSC toxic megacolon ```
50
Causes of hyperthyroidism (5)
``` Grave's multinodular toxic goiter thyroid adenoma Hashimoto's/subacute (transient) postpartum ```
51
Sx of hyperthyroid
arrhythmia/Afib increased DTR's pretibial myxedema
52
Dx of hyperthyroidism
low TSH | pregnancy has increased TBG
53
Tx for hyperthyroidism (4)
methimazole/PTU (agranulocytosis) beta blocker for sx ipodate/iopaniac acid 131 radioactive iodine
54
Tx for thyroid storm (5)
``` IV fluids/cooling blankets Glc PTU q2hr + iodine beta blocker dexamethasone ```
55
Tx for subacute thyroiditis
NSAIDs | ASA
56
Types of thyroid cancers (4)
papillary-most common, radiation risk medullary-calcitonin, assc with MENII follicular-Huerthle cells, spreads early anaplastic-bad
57
Causes of hyperprolactinoma (5)
``` prolactinoma H2 blocker/metoclopramide/estrogen pregnancy renal failure hypothyroidism ```
58
Tx for hyperprolactinemia
bromocriptine cabergoline for 2 yrs then taper
59
Sx of acromegaly
hypertrophic cardiomyopathy DM hyperhidrosis HTN
60
Dx of acromegaly
elevated IGF-1 | oral Glc suppression test
61
Sx of carniopharyngioma (4)
HA/papilledema hyperprolactinemia DM panhypopituitarism
62
Causes of hypopituitarism (3)
pituitary tumor (most common) Sheehan's syndrome trauma
63
Causes of Diabetes insipidus (4)
Li+ most common hypercalcemia pyelonephritis demeclocycline
64
Dx for diabetes insipidus
water deprivation test (urine osmolality does not increase)
65
Tx for diabetes insipidus
central-desmopression/chlorpropamide | nephrogenic-thiazides
66
Causes of SIADH (4)
neoplasms CNS disorders vincristine/SSRIs/oxytocin/morphine vents with positive pressure
67
Dx of SIADH
hyponatremia with elevated urine osmolality
68
Tx for SIADH
IV NS and loop diuretics
69
Sx of hypoparathyroid (3)
tetany prolonged QT cataracts
70
Tx for hypoparathyroid
IV Ca2+ | Vit D
71
Causes of primary hyperparathyroid
adenoma of parathyroid | parathyroid hyperplasia
72
Sx of hyperparathyroid
``` nephrolithiasis muscle pain/weakness gout constipation short QT ```
73
Causes of secondary hyperparathyroid (3)
CKD Vit D deficiency renal hypercalciuria
74
Causes of Cushing's syndrome (4)
excess exogenous steroids ACTH secreting pituitary adenoma adrenal adenoma ectopic ACTH (malignancy)
75
Dx of Cushing's syndrome
low dose dexamethasone test ACTH level high dose dexamethasone test
76
Tumors in MEN I
parathyroid pancreatic pituitary
77
Tumors in MEN IIA
medullary thyroid pheochromocytoma parathyroid
78
Tumors in MEN IIB
mucosal neuromas medullary thyroid pheochromocytoma also marfinoid habitus
79
Causes of primary hyperaldosteronism
adrenal adenoma | adrenal hyperplasia
80
Sx of primary hyperaldosteronism (3)
HTN metabolic alkalosis hypokalemia
81
Dx of primary hyperaldosteronism
aldosterone:renin >30
82
Tx for primary hyperaldosteronism
adrenal adenoma resection | spironolactone for adrenal hyperplasia
83
Causes of adrenal insufficiency (4)
autoimmune most common TB CMV/toxoplamosis malignancy mets
84
Sx of adrenal insufficiency (4)
hypoglycemia hyperpigmentation hyperkalemia/hypovolemia abd pain
85
Dx of adrenal insufficiency
ACTH test | decreased plasma cortisol
86
Tx for adrenal insufficiency
daily glucocorticoids and fludrocortisone
87
Dx of congenital adrenal hyperplasia
elevated 17-hydroxyprogesterone
88
Tx for congenital adrenal hyperplasia
cortisol + mineralocorticoids | correct female genitalia
89
Dx of DKA
Glc between 450-850 metabolic acidosis with AG ketonemia
90
Tx of DKA
IV fluids, D5W once Glc<250 IV insulin (0.1U/kg/hr) + bolus to start K+ (as insulin will decrease) subq insulin once AG closes
91
Causes of hypoglycemia (5)
``` exogenous insulin adrenal insufficiency insulinoma EtOH liver failure ```
92
Sx of glucagonoma (3)
necrotizing migratory erythema glossitis/stomatitis hyperglycemia
93
Sx of somatistatinoma (3)
gallstones DM steatorrhea
94
Sx of VIPoma (4)
watery diarrhea achlorhydria hyperglycemia hypercalcemia

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