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MJ- Family Med EOR > GI misc > Flashcards

GI misc Flashcards

1
Q

What is seen on labs for cholecystitis

A

leukocytosis

Incr. alk phos

Incr. GGT

Incr. conj. bilirubin

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2
Q

Pocelain gallbladder= ?

A

chronic cholecystitis

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3
Q

Gold standard for diagnosing choledocholithiasis

A

ERCP

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4
Q

What is the Boas sign?

A

Referred right subscapular pain seen in cholelithiasis

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5
Q

what condition is sentinel pile seen in

A

anal fissure

(sentinel pile= thickened mucosa/skin at the distal end of an anal fissure, often confused w/ a sm. hemorrhoid)

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6
Q

What is the MC site of an anal fissure

A

posteroir midline (comparatively low blood flow)

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7
Q

which type of hemorrhoid is painful?

Which bleeds?

A

painful- external, below dentate line

Bleed- internal

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8
Q

Which IBD is limited to the mucosa and submucosa

A

UC

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9
Q

Which IBD is transmural

A

chrons

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10
Q

IBD: MC site is rectum

A

UC

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11
Q

How do you dx Ulcerative colitis

A
  • by barium enema LEAD PIPE APPEARANCE
  • and colonoscopy with bx–> continuous inflammation starting from rectum and extending proximally w/ loss of haustral makings and lumen narrowing
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12
Q

2 compliactions of ulcerative colitis

A

toxic megacolon

colorectal cancer

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13
Q

What does antibody test show in ulcerative colitis

A

Antineutrophil cytoplasmic antibodies (pANCA)

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14
Q

Which IBD do you see apthous ulcers in

A

Chron’s disease

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15
Q

What 3 things might be seen in long standing chron’s disease

A

anemia

polyarthralgia

fatigue

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16
Q

Which IBD?

Distribution from mouth to anus

A
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17
Q

Obstruction, abscess, fistula and sinus tracts are common in which IBD?

A

Chrons

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18
Q

Low or high cancer risk in chrons

A

low

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19
Q

What does antibody test show in Chrons

A

+Anti-Saccharomyces cerevisiae antibodies (ASCA)

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20
Q

What criteria is used in dx of IBS

A

Rome III criteria

(The American college of gastroenterologists doesn’t recommend lab testing or diagnostic imaging in patients younger than 50 y/o w/ typical sxs of IBS w/o ALARM sxs)

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21
Q

Which infection has been associated with increased prevalence of IBS

A

Giardia Lamblia

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22
Q

What GI condition is associated with postprandial urgency

A

IBS

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23
Q

What are the ALARM features of IBS

A

Weight loss

Iron deficiency anemia

FHx of organic GI illness (IBD, celiac sprue, colorectal cancer)

rectal bleeding

norcturnal sxs

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24
Q
A
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25
Q

MCC Large bowel obstructions in adults? MCC of all bowel obstructions

A

colon cancer= MCC in elderly people

Adhesions= MCC of all bowel obstructions

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26
Q

4 causes of large bowel obstruction

A

volvulus

adhesions

hernias

colon cancer

27
Q

dx of what?

Abdominal x-ray (KUB) demonstrating distended proximal colon with haustra, air-fluid levels, no gas in rectum

A

Large bowel obstruction

28
Q

What is reflux esophagitis

A

mechanical or functional abnormality of the LES*

29
Q

which 2 groups of meds commonly cause medication induced esophagitis

A

NSAIDs or bisphosphonates

30
Q

what is seen with barium swallow in eosinophilic esophagitis

A

ribbed esophagus and multiple corrugated rings

31
Q

Which esophagitis:

Shallow punched out lesions on EGD

A
  • HSV
32
Q

Which esophagitis:

Large solitary ulcers or erosions on EGD

A

CMV

33
Q

What is the GOLD standard for diagnosing GERD?

A

PH monitoring with intra-esophageal electrode

34
Q

What condition?

Outpouching of the hypopharynx which causes foul smelling breath and regurgitation of solid foods

A
35
Q

Once pt is diagnosed with Barrett’s esophagus, how should you screen and what are you screening for?

A

upper endoscopy q3-5yrs for dysplasia or adenocarcinoma

36
Q

What 6 drugs lower LES pressure (“CAPTAN”)

A

CCBs

anticholinergics

progesterone

Tricyclic antidepressants

antihistamines

Nitrates

37
Q

Patients with unremarkable endoscopy findings who have typical sxs despite tx w/ PPI should undergo what

A

24-h pH testing

38
Q

Sxs of what?

Belching, bloating, distention and heartburn, abdominal pain

A

gastritis

39
Q

3 causes of gastritis

A
  1. H. pylori (MC)
  2. Inflammation of the stomach lining (NSAIDs and alcohol)
  3. Autoimmune or hypersensitivity rxn (pernicious anemia)
40
Q

location of H. pylori gastritis

A

antrum and body

41
Q

location of autoimmune or hypersensitivity rxn (pernicious anemia)

A

body of the fundus

42
Q

Autoimmune or hypersensitivity rxn as cause of gastiritis- dx of pernicious anemia

A

+schilling test + decr. intrinsic factor and parietal cell antibodies

43
Q
A
44
Q
A
45
Q

Which type of ulcer:

Pain IMPROVES with food

Pain WORSENS with food

A

Improves- dueodenal ulcer

Worsens- Gastric ulcer

46
Q

Which type of ulcer:

Pain WORSENS with food

A

Gastric ulcer

47
Q

Gold standard for dx of Peptic ulcer disease

A

endoscopy with biopsy

48
Q

What best describes H. pylori? (description of bacteria)

A

gram-negative spiral-shaped bacillus

49
Q

GOLD standard for diagnosing Gastritis

A

Endoscopy w/ 4 biopsies along stomach lining

50
Q

What is the result of an unregulated release of gastrin resulting in gastric acid hypersecretion

A

Zollinger-Ellison syndrome (gastrinoma

51
Q

how do you dx Zollinger-Ellison syndrome (gastrinoma)

A

gastrin levels (>150 is suggestive, >200 is diagnostic

52
Q

What should you look for if there is a patient with suspected PUD but has persistent or increased sxs after PPI

A

H. pylori

53
Q

What 4 meds may result in false-neg urea breath test in a patient w/ H. pylori?

A

PPI

H2 blockers

Bismuth

Antibiotics

54
Q

What are 3 pulmonary sxs of GERD

A

hoarsness

cough

wheeze

55
Q

What type of hernia can worsen GERD sxs

A

Hiatal hernia

56
Q

What is the 2 MCC of cirrhosis in US

A

1- Hep C

57
Q

What are 7 classic skin changes seen in cirrhosis

A
  • spider angiomata
  • palmar erythema
  • jaundice
  • scleral icterus
  • ecchymoses
  • caput medusae
  • hyperpigmentation
58
Q

What 8 physical exam findings might be seen in ESLD

A
  • Hepatomegaly (small, fibrotic liver in ESLD)
  • Terry’s nails (white nail beds)
  • Splenomegaly
  • central obesity
  • abdominal fluid wave, shifting dullness (ascites)
  • gynecomastia
  • Esophageal varices
  • Pulm edema/effusion
  • skin changes
59
Q

Asterixis (flapping tremor), dysarthria, delirium and coma are signs of what

A

Hepatic encephalopathy

60
Q

What should be used to screen for hepatocellular carcinoma in pt w/ progressive cirrhosis

A

alpha fetoprotein (if elevated then MRI)

Abd US q6-12 mo

61
Q

what should you think if a pt with cirrhosis has fever and abdominal pain

A

Spontaneous bacterial peritonitis

62
Q

What triad?

  1. abdominal pain
  2. ascites
  3. hepatomegaly
A

Budd Chiari (hepatic vein thrombosis)

63
Q

Elevated alk phos, GGT and total/direct bilirubin indicates what

A

cholestasis

64
Q

Cirrhosis labs

A
  • AST>ALT
  • Elevated alk phos, GGT and total/direct bili (cholestasis)
  • anemia
  • Decr. platelet
  • Low albumin
  • low cholesterol
  • Prolonged PT, PTT and INR

MJ- Family Med EOR (17 decks)

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