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MJ- Family Med EOR > GI misc 2 > Flashcards

GI misc 2 Flashcards

1
Q

Involves protrusion of the stomach through the diaphragm via the esophageal hiatus.

It can cause symptoms of GERD

A

Hiatal hernia

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2
Q

Cause of travelers diarrhea

A

e-coli

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3
Q

cause of diarrhea after a picnic and egg salad

A

staph aureus

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4
Q

cause of diarrhea from shellfish

A

vibrio cholerea

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5
Q

cause of diarrhea from poultry or pork

A

salmonella

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6
Q

cause of diarrhea from poorly canned home foods

A

C. perfringens

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7
Q
A
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8
Q

cause of diarrhea breakout in daycare

A

Rotavirus

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9
Q

cause of diarrhea on a cruise ship

A

Norovirus

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10
Q

Diarrhea after drinking fresh mountain stream water?

Incubation time?

A

Giardia lamblia

incubation: 1-3 wks

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11
Q

Diarrhea caused by what?

foul-smelling bulky stool and may wax and wane over weeks before resolving

A
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12
Q

What composition is recommended by WHO for oral rehydration therapy?

Na, K, Cl, Citrate, glucose?

A

90mmol Na

20mmol K

80mmol Cl

10mmol citrate

111mmol glucose

Rehydralyte is closest to this recommendation!

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13
Q

What is the MCC bacterial gastroenteritis in children and adults

A

Campylobacter jejuni

(starts with fever and malaise, followed by N/V/D, fever and abdominal pain. D may contin blood)

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14
Q
A
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15
Q

3 classic sxs of enterohemorrhagic E. coli

A

no fever

bloody stool

+abdominal tenderness

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16
Q

What is hemolytic uremic syndrome and what is it a/w

A

Enterohemorrhagic E. coli a/w hemolytic uremic syndrome

  • Hemolytic anemia
  • Renal failure
  • Thrombocytopenia
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17
Q

MC type of rectal cancer

A

adenocarcinoma

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18
Q

MC site for blood borne mets of rectal cancer is where

A

liver

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19
Q

sxs of what

hematochezia, tenesmus, rectal mass, feeling of incomplete evacuation of stool

A

rectal cancer

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20
Q

6 risk factors of rectal cancer

A

receptive anal intercourse

  1. HPV
  2. Chronic fistulas
  3. Irradiated anal skin
  4. Leukoplakia
  5. lymphogranuloma venereum
  6. condyloma acuminatum
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21
Q

painless rectal bleeding and a change in bowel habits in a pt 50-80 y/o

A
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22
Q

When is colon cancer screening recommended

What are screening options

A

50-75y/o

  • Stool tests: guaic based fecal occult blood (gFOBT), Fecal immunochemic test (FIT)–> both once a year
  • FIT-DNA test- q1-3yrs
  • colonoscopy q10yrs
  • flex sig q5yrs or q10yrs w/ a FIT yearly
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23
Q

carcinoma of the colon most commonly originates from what

A

adenomatous polyp

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24
Q

What is the role of CEA in colon cancer

A

Not diagnostic for colorectal cancer

elevated preop CEA levels correlate wtih postop recurrance rate

Help detect recurrance after surgical resection

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25
Q

Apple core lesion on barium enema

A

adenocarcinoma of the colon

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26
Q

What is the MC GI cancer and 2nd MC cancer in US

A

colorectal cancer

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27
Q

What is the second MCC of cancer deaths

A

colorectal cancer

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28
Q

risk factors for colorectal cancer

A

low fiber, high fat diets

FHx Lynch syndrome

h/o IBD

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29
Q

Grey Turners sign and cullens sign

A

acute panreatitis

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30
Q

2 etiologies of acute pancreatitis

A

cholelithiasis

alcohol abuse

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31
Q

What is Ranson’s criteria for poor prognosis of acute pancreatitis

(>3= severe prognosis)

A

At admit:

  • Age >55
  • Leukocyte >16k
  • Glucose >200
  • LDH >350
  • AST >250

At 48 hrs:

  • Arterial PO2 <60
  • HCO3 <20
  • Ca <8
  • BUN: inc by 1.8+
  • Hct: decr by >10%
  • Fluid sequestration >6L
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32
Q

Tx for acute pancreatitis

A

IVF

analgesics

bowel rest

33
Q

What is the classic triad of chronic pancreatitis

A

pancreatic calcification

steatorrhea

DM

34
Q

Tx for chronic pancreatitis

A

no alcohol

low fat diet

35
Q

Tumor marker for pancreatic cancer

A

CA 19-9

36
Q

What criteria is used to predict mortality in acute pancreatitis

A

Ransons

37
Q

Painless jaundice and a palpable non-tender GB (Courvoisier’s sign)

A

pancreatic cancer

38
Q

Pancreatic cancer is MC located at which part of pancreas

A

head

39
Q

What is the most sensitive test for chronic pancreatitis

A

ERCP

40
Q

MC etiology of appendicitis

A

Fecalith

41
Q

Sxs of small bowel obstruction

A

colicky abd pain

N

bilious vomiting

obstipation

abdominal distention

42
Q

6 MCC small bowel obstruction

A

adhesions

hernias

cancer

IBD

volvulus

intussusception

43
Q

Are polyps in the distal or proximal colon more likely benign

A

distal colon are commonly benign

44
Q

Colonic polyps:

____ adenomas have a 30-70% risk of malignant transformation

A

villous

45
Q

Once a colonic polyp is identified, how often should you follow-up with colonoscopy

A

q3-5yrs

46
Q
  • What is characterized by the development of hundreds to thousands of adenomatous polyps
  • Colorectal polyps develop by age 15 and cancer at 40
  • Fam should undergo yearly sigmoidoscopy at 12 y/o
  • 1st deg rel should undergo genetic screening after 10
A

Familial adenomatous polyposis

47
Q
A
48
Q

Which of the following is NOT a cause of paralytic ileus

a. GI surgery
b. hypokalemia
c. intra-abdominal sepsis
d. hyperkalemia

A

d. hyperkalemia

49
Q

large or small bowel obstruction?

distention is early and pronounced. Pain is mild and vomiting and dehydration are late

A

Large bowel obstruction

50
Q

What is the MCC small bowel obstuction

A

postoperative adhesions

51
Q

What is the MCC of small bowel obstruction in children

A

intussusception

52
Q

MC location of large bowel obstruction

A

sigmoid colon

due to neoplasms, fecal impaction and diverticulitis

53
Q

currant jelly stool

A

intussuception

54
Q

physical exam:

abdominal distention and tenderness

sausage shaped abd mass in RUQ

A

Intusussception

55
Q

What can be used for both dx and treatment for intussusception in children

A

barium or air enema

(barium enema should not be used in adults)

56
Q

Target sign on abdominal ultrasound

A

intussusception

57
Q

in adults, intussusception is almost always caused by what

A

neoplasm

58
Q

Causes of lower GI bleed (6)

A
  1. Hemorrhoids (painless bleeding with wiping)
  2. Anal fissures (severe rectal pain w/ defecation
  3. Proctitis (rectal bleeding and abdominal pain
  4. Polyps (painless rectal bleeding, no red flag signs
  5. Colorectal cancer (painless rectal bleeding and chnage in bowel habits in 50-80y/o
  6. rectal ulcers
59
Q

5 causes of upper GI bleed

A
  1. Peptic ulcer
  2. Esophageal ulcer
  3. Mallory-Weiss tear
  4. Variceal hemorrhage or portal hypertensive gastropathy (jaundice, abd. distention)
  5. Malignancy
60
Q
A
61
Q

What diagnostic studies do you use to evaluate hematochezia vs melena

A

hematochezia= colonoscopy

melena= EGD

62
Q

What are the 4 cardinal signs of strangulated bowel?

A
  1. Fever
  2. Tachycardia
  3. Leukocytosis
  4. Localized abdominal tenderness
63
Q

what lab abnormalities (renal and electrolytes, etc) are ssen in bowel obstruction

A

ongoing emesis and third spacing lead to dehydration,

prerenal azotemia

hypochloremic hypokalemic metabolic acidosis

64
Q

Causes of SBO

“GIVES BAD CRAMPS”

A
  • Gallston Ileus
  • Intussusception
  • Volvulus
  • External Compression
  • SMA syndroms
  • Bowel wall hematoma
  • Abscess
  • Diverticulosis
  • Chrons
  • Radiation enteritis
  • Annular pancreas
  • Meckel’s diverticulum
  • Peritoneal adhesions
  • Stricture
65
Q

When does Gilbert syndrome cause jaundice

A

during stress like severe infection, otherwise asxs

66
Q

Causes of biliary tract obstruction

A

gallstones

pancreatic carcinoma

liver fluke

cholangiocarcinoma

67
Q

Signs of biliary tract obstruction

A
  • JAUNDICE
  • incr alk phos
  • decr urine urobilinogen
  • dark urine
  • pale stool
  • pruritis
68
Q

What is charcot’s triad

A

COLANGITIS

fever

jaundice

RUQ

69
Q

What is Reynold’s pentad?

A

CHOLANGITIS

Charcot’s tirad (fever, jaundice, RUQ pain)

+ mental confusion + hypotension

70
Q
A
71
Q

What is the gold standard for imaging the biliary system

A

ERCP

72
Q

Cholangitis is commonly caused by what bacteria

A

E. coli

73
Q

pruritis w/ progressive jaundise= ?

cholangiography will show fibrosis of the bile ducts w/ dilation b/w strictures

A

Primary sclerosing cholangitis

(common in pt w/ h/o ulcerative colitis)

74
Q

What 4 conditions are cholangitis associated with

A

IBD

Cholangiocarcinoma

pancreatic cancer

Colorectal cancer

75
Q

which 2 GI pathogens can cause appendicitis-like presentation

A

Entamoeba histolytica

Yersiniosis enterocolitica

76
Q

Which bacteria can cause ileocecitis

(can get from pork)

A

Yersinia enterocolitica

77
Q

Which 3 HIV meds commonly cause pancreatitis

A

Tenofovir

didanosine

stavudine

78
Q

What is the MCC of bacterial foodborne dz in US? #2?

A

1- salmonella (milk products, poultry, eggs)

79
Q

Salmonellosis is affected with what type of arthritis

A

reactive arthritis

MJ- Family Med EOR (17 decks)

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