GI Disease- Ward

Question 1

alcohol abuse increases risk of what three cancers?

Answer 1

esophageal, colorectal, liver

Question 2

Most digestive diseaseses (blank) with age.
Except, what occurs in infants?
Young and middle aged adults?
What do women get more than men?

Answer 2

increase

gastroenteritis, appendicitis

Hemorrhoids, IBD, chronic liver disease

non ulcer dyspepsia and IBS

Question 3

What is sjorgrens syndrome?

Answer 3

autoimmne disease that attacks tears and saliva

-dry mouth and dry eyes

Question 4

What is the birds beak sign indicative of?
What are the characteristics of this?
What is the tx?

Is there a cure?

Answer 4

achalasia

• intra esophageal pressure
• failure of relaxation of LES

Nifedipine, endoscopic balloon dilation, laparascopic myotomy, peroral endoscopic myotomy and botulinum toxin

NOpe cuz none of them fix the loss of enteric nerves or ICC

Question 5

Whats the best tx for achalasia?

Answer 5

-laparascopic myotomy

Question 6

What is this:

esophageal squamos epithelium is replaced by metaplastic columnar epithelium w/ goblet cells and paneth cells

Answer 6

barretts esophagus

Question 7

What is this:
in-situ squamos carcinoma displays full thickness replacement of the epithelium with severely dysplastic cells. BM is intact w/ no evidence of invasion into the LP

Answer 7

Squamos cell carcinoma

Question 8

How do you test for GERD and baretts esophagus?

Answer 8

Manometry-pH probe, upper endoscopy, biopsies

barium swallow x ray

Question 9

What is average age of barretts esophagus?
What gender?
What is a risk factor?
prognosis?
tx?

Answer 9

• 55
• male (2X)
• GERD
• can progress to cancer where survival is less than 1 year
• benzimidazoles (PPI) block the final step of H/K ATPase in parietal cell. Aspirin and NSAIDs thought to prevent esophageal cancer in pnts with Barrett’s esophagus

Question 10

What is this:
A gastrointestinal motility disorder of the stomach.

Characterized by delayed emptying of food from the stomach into the small bowel in the absence of mechanical obstruction.

Answer 10

gastroparesis

Question 11

What are these associated with:
Alcohol.
Anticholinergic drugs.
Calcium channel blockers.
Dopamine agonists.
Histamine (H2) receptor antagonists.
Nicotine.
Proton Pump Inhibitors

Answer 11

Gastroparesis

Question 12

How do you identify gastroparesis?

Answer 12

• endoscopy (for bezoars)
• US distinguishers gall bladder from gastroparesis
• scintigraphy (egg meal)
• smart pill (cant have GI problems)
• paracetamol/acetaminophen testing
• octanoic acid breath test

Question 13

What drugs stimulate gastric emptying?

Answer 13

antiemetic
gastroprokinetic
metoclopramide

Question 14

Hydrogen breath test?
Urea breath test?
Octanoic acid breath test?

Answer 14

lactose intolerance
H. pylori
Gastroporesis

Question 15

What can lead to gastroparesis?

Answer 15

• DM
• Autonomic neuropathy
• Myopathy
• Viral infections
• Abnormalities interstitial cells of Cajal
• Nitric oxide synthase

Question 16

How do you treat gastroparesis?

Answer 16

optimize glycemic control
avoid exacerbating factors
dietary mod
prokinetics
intrapyloric botox
enteral nutrition
gastric pacing
surgery

Question 17

What is metoclopramide and what does it do?

Answer 17

dopamine antagonist-> increases tone and gastric contractions (only FDA approve)

Question 18

What is erythromycin?

Answer 18

motilin receptor agonist, stimulates migrating motor complex

Question 19

What is cisapride?

Answer 19

serotonin stimulation

Question 20

2 places you get PUD? Where is more common and what do you get a bigger risk of?

Answer 20

stomach and duodenum

duodenal -> risk of malignancy

Question 21

What is this:
Episodes of projectile, nonbilious vomiting.
Present any time in the first weeks to months of life and often gets progressively worse.
olive shaped mass. Lots of projectile vomiting. Hypokalemic, hypochloremic, metabolic alkalosis

Answer 21

Pyloric stenosis

Question 22

What is this:
The intestinal walls are hypomotile. The condition resembles a true obstruction, but no such blockage exists. Abdominal pain, vomiting, diarrhea, constipation, malabsorption of nutrients, weight loss and/or failure to thrive, enlargement of various parts of the small intestine or bowel also occur.

How do you treat?

Answer 22

Intestinal pseudoobstruction

surgical removal

Question 23

Secondary intestinal pseudoobstruction may be caused by (blank x 3)

Answer 23

scleroderma, muscular dystrophy, MS

Question 24

What causes gall stones?

Answer 24

too much cholesterol
too much bilirubin
not enough bile salts

Question 25

What are the 2 types of gallstones?

Answer 25

cholesterol and pigment stones

Question 26

Gallstones affect which gender more?
What are they stones usually?
how do you treat?

Answer 26

women
cholesterol
laparoscopic cholecystectomy

Question 27

(blank) are outpocketings of the mucosa through weaknesses of muscle layers in the wall.

Answer 27

diverticula

Question 28

What is this:
A bulge in the small intestine present at birth. Avestigial remnant of the yolk stalk, and the most frequent malformation of the GI tract being present in 2% of the population.

Answer 28

Mickels diverticulum

high fiber and increased bowel movements put you at risk

Question 29

Possible causes of IBS?

Answer 29

• brain gut signal problems
• GI motor problems
• Hypersensitivity
• mental health problems
• bacterial gastroenteritis
• small intestinal bacterial overgrowthh
• altered neurotransmitter

Question 30

What is IBD?
When is onset?
What are other complications?

Answer 30

chrohns and UC
young adulthood
-anemia, skin rashes, arthritis, eye inflammation

Question 31

Tx for IBD?

Answer 31

• cyclosporine
• biologics (infliximab
• corticosteroids
• immunosuppressants
• antibiotics
• aminosalicyates
• surgery

Question 32

(blank) (also known as congenital aganglionic megacolon) is the MOST COMMON cause of lower intestinal blockage (obstruction) in the newborn and later a cause of chronic constipation or chronic diarrhea.

What causes it?
What gender is more common in?

Answer 32

Hirschsprung Disease

absence of enteric nerves (ganglia) in the bowel wall

white males

Question 33

How can you tell the difference between anal fissures and hemorrhoids?

Answer 33

anal fissures hurt with bowel movements