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Uworld Step 2 > Block 51, 52, 53: GI > Flashcards

Block 51, 52, 53: GI Flashcards

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1
Q

clinical presentation for acute choledocholithiasis

A

acute-onset right upper quadrant or epigastric pain

- pain worse in supine position and at night

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2
Q

painless jaundice in a patient with conjugated hyperbilirubinemia and marked elevated alkaline phosphatase

A

biliary obstruction due to pancreatic or biliary cancer

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3
Q

does hepatitis C have elevated alkaline phosphatase

A

no

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4
Q

does autoimmune hepatitis have elevated alkaline phosphatase

A

no

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5
Q

define acute liver failure

A
  • elevated aminotransferase
  • encephalopathy
  • INR greater than 1.5
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6
Q

risk of what cancer is increased with UC

A

colorectal cancer

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7
Q

complication of UC

A
  • toxic megacolon
  • uveitis
  • primary sclerosing cholangitis
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8
Q

when should patients with an affected first- degree relative be screened for colon cancer

A

age 40 or 10 years before the age of the relative’s diagnosis

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9
Q

hallmarks of secretory diarrhea

A
  • larger daily stool volumes
  • occurs during fasting or sleep
  • reduced stool osmotic gap
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10
Q

what is most consistent reversible risk factor for pancreatic cancer

A

cigarette smoking

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11
Q

active erosive gastropathy

A

development of hemorrhagic lesions after ischemia or exposure of gastric mucosa to various injurious agents ( alcohol, aspirin, cocaine)

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12
Q

epigastric pain and intermittent melena

A

duodenal ulcer

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13
Q

2 main causes of duodenal ulcer

A

H. pylori infection

NSAID

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14
Q

management for duodenal ulcer

A

antibiotics and acid suppression

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15
Q

features that distinguish biliary colic from cholecystitis are

A

pain resolves within 4-6 hours

absence of abdominal tenderness, fever and leukocytosis

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16
Q

where can pain occur for biliary colic secondary to gallstones

A
  • RUQ or epigastric region
  • right-sided shoulder pain
  • subscapular discomfort
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17
Q

initial evaluation and management of patients with variceal hemorrhage is

A

mainting circulation
preventing and treating complications
stop cause of bleeding

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18
Q

if a patient has continuous hematemesis and depressed level of consciousness, what is a major risk

A

aspiration

- endotracheal intubation

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19
Q

burning, localized pain and regional hyperesthesia/allodynia, in the context of recent cancer treatment?

A

herpes zoster ( shingles)

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20
Q

unexplained chronic abdominal pain, weight loss and food aversion, postprandial epigastric pain

A

chronic mesenteric ischemia

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21
Q

positive urine bilirubin assay is indicative of

A

conjugated bilirubin

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22
Q

Rotor’s syndrome

A

chronic or fluctuating conjugated hyperbilirubinemia due to defect in hepatic secretion of conjugated bilirubin into biliary system

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23
Q

Besides alcohol and gallstones causing acute pancreatitis, what else can cause it

A

medication

  • diuretics
  • anti seizure ( valproic acid)
  • antibiotics ( metronidazole)
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24
Q

hallmark lab values for ischemic hepatopathy

A
  • rapid and massive increase in transaminases

- modest elevations in total bilirubin and alkaline phosphatase

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25
name 2 granulomatous diseases
tuberculosis and sarcoidosis
26
barium contrast enema can detect what disease
UC and Crohn
27
can diverticulitis cause urine problems
yes frequency and urgency | - bladder irriation from inflamed sigmoid colon
28
chronic dysphagia to both solids and liquids, regurgitation, difficulty belching and mild weight loss
achalasia
29
esophageal webs are associated with what vitamin deficiency
iron
30
what is used to diagnose achalasia
manometry
31
prophylactic treatment for nonbleeding varices
beta blockers | - if contraindicated do endoscopic variceal ligation
32
acronym for causes of acute pancreatitis
I GET SMASHED - idiopathic - gallstones - ethanol - trauma - steroids - mumps - autoimmune - scorpion sting - hypercalcemia - ERCP - drugs
33
specific serum test for pancreatitis
serum lipase
34
what signs do you see on acute pancreatitis for PE
Grey turner sign: flank ecchymoses Cullen sign: periumbilical ecchymoses Fox sign: ecchymosis of inguinal ligament
35
yellow-red papules on patient's arm can suggest what
xanthomas.
36
3rd most common cause of acute pancreatitis
hypertriglycerides
37
noncaseating granulomas suggests
Crohn's
38
clinical feature of diverticulosis
chronic constipation
39
what can a patient do to lower the risk of diverticulosis
- high fiber intake
40
chronic, crampy abdominal pain; bloating and watery diarrhea after meals has
lactose intolerance
41
cigarette smoking, high salt intake and consumption of N-nitroso compounds are risk factor for
gastric adenocarcinoma
42
initial treatment for hepatic encephalopathy and hypokalemia
potassium repletion fluids lactulose
43
total parenteral nutrition can cuase what to the gallbladder
gallbladder stasis --> cholecystitis
44
UC vs. Crohn transmural inflammation
crohn
45
perianal manifestation of Crohn's
skin tags and fistulas
46
tuberculous enteritis presents similar to what
Crohn's disease
47
primary biliary cholangitis
destruction of intrahepatic bile duccts
48
complications of primary biliary cholangitis
malabsorption metabolic bone disease hepatocellular carcinoma xanthelasmas
49
what causes bile salt diarrhea
terminal ileal disease
50
primary sclerosing cholangitis
inflammatory disorder of intrahepatic and extrahepatic biliary tree
51
patient with abdominal pain, microcytic anemia, positive fecal occult blood, and hepatomegaly with a hard edge on liver palpation
GI malignancy mets to liver
52
signs of portal hypertension
esophageal varices spider nevi Palmar erythema caput medusa
53
next step in management for post cholecystectomy
ERCP | Endoscopic retrograde cholangiopancreatography
54
what can ursodeoxycholic acid treat
- cholesterol gallstones - primary biliary chirrhosis - primary sclerosing cholangitis
55
what are 2 signs of acute liver failure
encephalopathy | impaired synthetic function ( INR greater than 1.5)
56
what clinical feature differentiates between acute liver failure and viral hepatitis
acute liver failure has hepatic encephalopathy
57
what can cause red blood on toilet paper, few drops of blood in toilet after defecation,
hemorrhoids
58
management for patient 50 and older with bright red blood per rectum
colonoscopy
59
Management for patient less than 40 for bright red blood per rect
anoscopy
60
Do you treat asymptomatic gallstones
no
61
wha lab values are increased with patients who have upper GI bleed
BUN/Creatinine ratio
62
patients with multiple duodenal ulcers refractory to treatment or ulcers distal to the duodenum or associated with chronic diarrhea
Zollinger-Ellison
63
Zollinger-Ellison and pancreas
inactivation of pancreatic enzymes by increased stomach acid production
64
stethoscope over upper abdomen and rocking patient back and forth at hips looks for what
called abdominal succussion splash | gastric outlet obstruction
65
Irritable bowel syndrome
chronic abdominal pain with diarrhea and/or constipation | - passage of stool relieves pain
66
crypt abscess is characteristic of what
Ulcerative colitis
67
perianal fistulas are related to what
possible Crohn's disease
68
porcelain gallbladder increases the risk for
gallbladder adenocarcinoma | - associated with chronic cholecystitis
69
risk factors for renal cell carcinoma
smoking hypertension obesity
70
what sets pesudoachalsia different from achalasia
pseduo: significant weight loss - rapid symptom onset - greater than 60 years
71
bactericidial antibiotic reserved for recurrent colitis or as initial therapy for pts with severe colitis who cannot take oral vancymycin
Fidaxomicin
72
Most common source of liver metastases
Colorectal cancer
73
alpha-fetoprotein measures what
hepatocellular carcinoma which occurs in setting of chronic liver disease
74
skin hardening and telangiectasis may indicated
sclerosis
75
what criteria is used for irritable bowel syndrome
Rome criteria - recurrent abdominal pain/discomfrot 3 days or more/month for last 3 months and 2 or more of the following 1. improvement with bowel movement 2. change in frequency of stool 3. change in form of stool
76
clinical features of partial small-bowel obstruction
- postprandial abdominal discomfort - nausea - obstipation
77
Small-intestine bacterial overgrowth clinical features
abdominal bloating flatulence diarrhea
78
clinical features of zinc deficiency
``` hypogonadism impaired taste impaired wound healing alopecia skin rash with perioral involvement ```
79
patients who depend on parenteral nutrition are at risk for what
trace mineral deficiency
80
clinical features of copper deficiency
fragile hair skin depigmentation neurologic dysfunction siderblastic anemia
81
clinical features of Selenium deficiency
thyroid dysfunction | cardiomyopathy
82
clinical features of esophageal rupture
acute chest pain tachypnea pleural effusion - symptoms worse after endoscopy/trauma
83
next step in management for esophageal rupture
endoscopy

Uworld Step 2 (30 decks)

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