CIS McGowan

Question 1

what is eructation?

edentulous

dysphagia?

odynophagia

Mittelschmerz

Answer 1

burping

no teeth

hard to swallow

painful swallowing

feeling ovulation

Question 2

Melana?

hematochesia?

hematemesis

Answer 2

melanic stools. Black tar sticky stool. UPPER GI BLEED

maroon stool

coffee ground like material. Upper GI bleed

Question 3

Caput Madusae?

Answer 3

protuberant abdomen. liver disease but portal hypertension technically.

Question 4

Cakecksia

Answer 4

muscle wasting

Question 5

what medicine can cause black or red stools?

Answer 5

Beets

Pepto Bismol (but not tarry sticky stools)

black licorice, blood sausage, iron pills… etc.

Question 6

What can cause lower quadrant abdominal pain?

Answer 6

appendicitis

ectopic pregnancy

cyst

hernia

Question 7

Vindicate mnemonic for differential?

Answer 7

vascular
infectious/inflammatory
neoplasm
drugs/degenerative
Iatrogenic/Idiopathic
Congenital
Autoimmune/allergic/anatomic
Trauma
Endemic

Question 8

no bowel movement or flatus term?

Answer 8

obstipation

Question 9

most common risk factor for small bowel obstruction?

Answer 9

prior surgeries!

Question 10

What could present as oropharyngeal dysphagia?

Parkinsons
Schatzki ring
Esophageal cancer
Achalasia
Scleroderma

Answer 10

Parkinsons = oropharyngeal (action of swallowing neurologically)

Schatzki ring = esophageal (distal esophagus)

Esophageal cancer = esophageal (usually lower esophagus)

Achalasia = esophageal

Scleroderma = esophageal

Question 11

What is Schatski ring?

Answer 11

extra sphincter like thing before the LES happens

Question 12

what is the term used to describe dysphagia symptoms that are getting worse over time?

Answer 12

Progressive dysphagia

Question 13

Trypanosoma Cruzi?

Answer 13

causes secondary achalasia, which is CHAGAS DISEASE from this parasite.

esophageal dysphagia ==> motility disorder!

LES isn’t relaxing so we have abnormal peristalsis.

Question 14

what are some examples of mechanical obstruction of esophageal dysphagia?

Answer 14

Cancer, 50+ age

Food bolus (foreign body)

Eosinophilic Esophagitis –> allergic reaction that makes it hard to swallow food bolus

Question 15

Oropharyngeall metabolic disorder?

Answer 15

medicines. Anti cholinergic, thyroid disease

Question 16

Oropharyngeal Neurlogoic

Answer 16

MS, parkinsons

Question 17

Oropharyngeal structural disorder?

Answer 17

Zenker’s Diverticulum

Question 18

Cause of primary achalasia?

Answer 18

Loss of nitric oxide-producing inhibitory neurons in the myenteric plexus?

Question 19

examples of alarm symptoms?

Answer 19

dysphagia, odynophagia, hematemesis, melena, unintential weight loss, persistent vomiting.

constant/severe pain

Question 20

pituitary neoplasm. elevated calcium level and a 1cm tumor on the pancreas. which would definitively diagnose the suspected dx?

Answer 20

positive secretin stimulation test

Zollinger Ellison syndrome (ZES)

Question 21

elevated calcium causes what usually?

Answer 21

constipation

Question 22

fasting gastrin for ZES?

positive urea breath test?

Answer 22

greater than 1000 ng/L

H. Pylori

Question 23

coffee ground emesis is where at?

NSAIDs give you a higher risk of what?

Answer 23

antrum of the stomach

gastric ulcer.

Question 24

Rovsing’s sign?

Answer 24

pain in the RLQ when the LLQ is palpated!

Question 25

shows loss of ulcers and regardless of treatment nothings getting better, what are you thinking?

Answer 25

ZES

Question 26

H Pylori has a large association with what?

how do we treat that?

Answer 26

malt lymphoma

we get rid of the h pylori and it goes away.