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Uworld Step 2 > Block 49,50: GI > Flashcards

Block 49,50: GI Flashcards

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1
Q

how can you clinical determine lactose intolerance

A
  1. positive hydrogen breath test
  2. positive stool test for reducing substances
  3. low stool pH
  4. increased stool osmotic gap
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2
Q

typical clinical features of Carcinoid syndrome

A
  • episodic flushing
  • secretory diarrhea
  • wheezing
  • murmur of tricuspid regurgitation
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3
Q

diagnostic tool for Carcinoid syndrome

A

elevated 24-hour urinary 5-hydroxyindoleacetic acid

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4
Q

“pounding” sensation in neck and lower extremity edema is what type of clinical symptoms

A

flushing

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5
Q

First step in management of oropharyngeal dysphagia

A

videofluoroscopic modified barium swallow

  • evaluate swallowing mechanics
  • degree of dysfunction
  • severity of aspiration
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6
Q

what is oropharyngeal dyspagia

A

difficulty initiating swallowing

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7
Q

Spontaneous rupture of esophagus

A

Boerhaave syndrome

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8
Q

X-ray of Boerhaave syndrome

A
  • unilateral pleural effusion with or without penumothorax
  • subcutaneous or medatstinal emphysema
  • widened medastinum
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9
Q

pleural fluid analysis for boerhaave syndrome

A
  • low pH

- high amylase

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10
Q

chronic GERD and new dysphagia and symmetric lower esophageal narrowing suggests

A

esophageal peptic stricture

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11
Q

What can cause pellagra

A

niacin deficiency

- prolonged isoniazid therapy can interfere with niacin metabolism

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12
Q

clinical features of pellagra

A
  • dermatitis
  • diarrhea
  • dementia
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13
Q

Niacin can be synthesized endogenously from what

A

tryptophan

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14
Q

Associated skin findings for UC

A
  • erythema nodosum

- pyoderma gangrenosum

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15
Q

diagnosis and treatment for Zenker’s diverticulum

A

Contrast esophagram

surgery

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16
Q

Most common malignancy of liver

A

metastasis from another primary source

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17
Q

who usually gets hepatic adenoma

A
  • benign liver tumors in young women

- associated with OCP use

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18
Q

Diagnosis for esophageal cancer

A

esophageal endoscopy with biopsy

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19
Q

where does esophageal adenocarcinoma occur? Risks for getting it

A

area of barrett esophagus

- smoking and GERD

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20
Q

where does esophageal squamous cell carcinoma occur? risks for it?

A
  • anywhere

- alcohol

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21
Q

2 common causes of ascities

A
  1. cirrhosis due to alcoholic liver

2. chronic viral hepatitis

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22
Q

who develops hepatic hydrothorax and what is it

A
  • cirrhosis and portal hypertension who have abdominal ascites and peripheral edema
  • pleural effusion
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23
Q

how are hepatic hydrothorax created

A

small defects in the diaphragm

- more common on right side due to less muscular hemidiaphragm

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24
Q

clinical feature of hepatopulmonary syndrome

A
  • platypnea: increased dyspnea while upright

- orthodeoxia: oxygen desaturation while upright

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25
2 causes of acute pancreatitis
gallstones | chronic alcohol abuse
26
first step in diagnosis for gallstone-indueced pancreatitis
abdominal ultrasound
27
patient with acute pancreatitis with no alcohol history and no gallstones presents but had a recent heart cath. had what to cause the acute pancretitis
cholesterol emboli
28
management of uncontrollable cause of acute pancreatitis
supportive care
29
drugs that are most common causes of pill esophagitis
tetracyclines potassium chloride bisphosphonates NSAIDS
30
clinical feature of pill esophagitis
sudden-onset odynophagia and retrosternal pain | - difficult swallowing
31
what should be suspected with history of chronic pancreatitis who develop abdominal pain and weight loss
pancreatic cancer
32
pancreatic cancer patients with jaundice should have what initial work up
Abdominal ultrasound
33
pancreatic cancer patients without jaundice should have what initial work up
abdominal CT
34
what should be suspected in a patient with cirrhosis and ascites accompanied by either fever or a change in mental status
bacterial peritonitis
35
diagnostic test for bacterial peritonitis
paracentesis
36
Common causes of cirrhosis in the united states
- viral hepatitis - chronic alcohol abuse - nonalcoholic fatty liver disease - hemochromatosis
37
treatment for actively bleeding esophageal varices
- hemodynamic support - octreotide - endoscopic therapy - prophylactic antibiotics
38
when do you use temporary balloon tamponade in varices
uncontrollable bleeding
39
lab values for alcoholic hepatitis
increase: gamma-glutamyltransferase and ferritin | AST and ALT always less than 500
40
patient with chronic abdominal pain, diarrhea, weight loss and evidence of inflammation likely has
crohn disease
41
where can crohn disease occur
mouth to anus | - ulcers in mouth can be present (aphthous ulcers)
42
treatment for hepatic encephalopathy
nonabsorbable disaccharides ( lactulose, lactitol)
43
astreixis
flapping tremor with outstretched hands
44
what is chlordiazepoxide
long-acting benzodiazepine | - treat alcohol withdrawal
45
for gastric adenocarcinoma, what determines treatment options and prognosis?
CT scan of abdomen and pelvis
46
standard of care for familial adenomatous polyposis
- frequent colonoscopic screening starting in childhood | - elective proctocolectomy
47
patient with a family history of colonic polyps and osteomas and alteration in tumor suppressor gene adenomatous polyposis coli has what
familial adenomatous polyposis
48
explain aspirin and NSAID role in colon cancer
reduced risk for colon cancer but not if you have FAP
49
patient has recurrent peptic ulcer disease with multiple ulcer and jejunal ulceration and gastric folds. what should you suspect
Zollinger-Ellison syndrome
50
what is the next step in managment for suspected gastrinoma
fasting serum gastrin level greater than 1000 pg/mL - if negative then secretin stimulation test - if negative then calcium infusion study
51
serum chomogranin A is a marker for
neuroendocrine tumors
52
what does esophagram for diffuse esophageal spasm show
"crockscrew" pattern
53
first line treatment for diffuse esophageal spasm
calcium channel blockers
54
patients with resolved hepatitis B infection are positive for
anti-HBs anti-HBc negative: HBsAg
55
patients who are immunized with hep B are positive for
anti-HBs negative: HBsAg anti-HBc
56
what mode of management is chronic pancreatitis diagnosed
pancreatic calcifications on CT scan or plain film
57
chronic epigastric abdominal pain that can radiate to the back and is partially relieved by sitting upright or leaning forward
chronic pancreatitis
58
what is the diagnosis to confirm primary biliary cholangitis
anti-mitochondrial antibody titer
59
cholestasis
impaired biliary flow
60
autoimmine hepatits is associated with what elevated titers
antinuclear antibodies | anti-smooth muscle antibodies
61
when should patients with UC be screened for colonoscopy
- colonoscopy 8 years after initial diagnosis of UC | - repeat 1-2 years thereafter
62
acalculous cholecystitis
an acute inflammation of the gallbladder in the absence of gallstones
63
acute cholangitis is usually due to what
common bile duct obstruction by a gallstone or malignancy
64
who usually get nonalcoholic fatty liver disease
obesity and diabetes
65
AST/ALT ratio for nonalcoholic fatty liver disease
less than 1
66
2 major risk factors for c. diff
1. antibiotic use | 2. gastric acid suppression
67
most common cause of iron deficiency anemia
GI blood loss
68
what heart changes can occur from anemia
- tachycardia from hypoxemia | - systolic murmur due to hyperdynamic circulation
69
Mallory-Weiss tear
incomplete mucosal tear at the Gastroesophageal junction, usually due to protracted vomiting
70
Boerhaave syndrome
spontaneous rupture of esophagus
71
Charcot triad? diagnosis
fever jaundice right upper quadrant abdominal pain Acute cholangitis
72
ultrasound of acute cholangitis
common bile duct dilation
73
short, annular stricture alternating with normal bile duct
primary sclerosing cholangitis
74
Gilbert syndrome
reduced bilirubin glucuronidation | - intermittent jaundice due to mild, unconjugated hyperbiliruibinemia
75
when is D-penicillamine used
wilson disease
76
Ursodeoxycholic acid treats
primary biliary cholangitis | gallstone disease
77
Lynch syndrome causes what? and has a high risk for waht
colorectal cancer | - endometrial carcinoma

Uworld Step 2 (30 decks)

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