CISes Flashcards
(177 cards)
1
Q
primary lesion of SCC from HPV is…
A
tonsillar crypts, base of the tongue, posterior oropharynx
2
Q
p16, SCC LN in the neck is caused by
A
HPV,
3
Q
oncogenic viruses
A
EBV
HIV
HPV
Hep B + Hep C
4
Q
viruses that can cause mono, with grey white exudeate, pharyngitis, tonsillitis
A
EBV
5
Q
histo changes with EBV-mono
A
atypical lymphocytes
6
Q
what are the infections of the oral cavity
A
mucormucosis (necrotic ulcer in mouth, move up to eye/brain)
diptheria= tough grey white membrane
candida
7
Q
histo of pyogenic granuloma
A
organizing granulation tissue
8
Q
histo of traumatic/irritative fibroma
A
submucosal fibrous deposition
9
Q
associates with aphthous ulcers
A
reactive
can be increased in certain families, celiac, IBD, behcet
10
Q
air fluid levels in the GI system is associated with
A
SBO
11
Q
papillary cystadenoma lymphomatosum
A
warthin tumor
12
Q
causes and trx of primary peritonitis
A
ascities, cirrhosis, E Coli
3rd gen cephalospoin, pipercillin, thizobactum
13
Q
causes and trx of secondary peritonitis
A
bacteria from a viscus
abx and surgery
14
Q
what infection can be from a swimming pool
A
cryptosporidium
15
Q
what infection is associated with guillan barre
A
campylobacter
16
Q
what infection increases risk of strongyloides infection
A
HTLV risk factor
17
Q
emergent complication of C Dif
A
toxic megacolon –> perforation
18
Q
sx of diverticulitis
A
LLQ + constipation + liquid stools
fever
leukocytosis
19
Q
what is boas sign
A
GB, pain on R shoulder and scap
20
Q
what pathologies can you use ablation for
A
barrett’s esophagus and PUD
adenocarcinoma (w EGD)
21
Q
who do you screen for Hep C
A
anyone between 1945-1965 at least once
22
Q
what things can you see with a barium swallow
A
webs, strictures, diffuse spasm, zenkers, achalasia
23
Q
what pathologies will you use an urgent EGD
A
varices, PUD
24
Q
a ______ state, as seen in ____ ds, can lead to clotting seen in Budd Chiari syndrome. initial trx is ____, and when you eventually do a liver biopsy you will see ___
A
hypercoagulable
crohn
CE US
nutmeg liver
25
infant with intestinal obstruction and down syndrome
hirschsprung
26
between 3rd to 5th week of life in a male, regurge, projectile vomiting, frequent demands for refeeding
pyloric stenosis
27
what is an omphalocele
congenital incomplete formation of the diaphragm allows the abdominal viscera to herniate into the thoracic activity
28
diverticulitis trx
NPO (--> progress to liquid diet) , start abx
29
what things you can treat with esophageal ablation
barrett's esophagus, PUD
30
trx if there is pnueumomediastinum
air in the mediastinum
emergent surgery
UNLESS THEY JUST HAD A LAPROSCOPY, WE DID THAT TO THEM
31
trx for acute pancreatitis
aggressive IV hydration
32
trx for ascending cholangitis
urgent ERCP
33
what kind of anemia do you have with vit B12 def
hypoblastic (NOT iron defiecient)
34
lost Hgb and low Hct
iron deficient anemia
35
what is the trx for SBO
NG tube to suction
36
infection associated with 'trip to mexico'
travelers diarrhea, ETEC
37
HFE mutation is associated with what infection
yersinia bc of iron overload
38
perforation of what will cause a hemoperitonium
liver and spleen
39
xray for hemo vs pneumo peritonium
pnuemo: upright, black on top
hemo: lat decubitus = black on bottom
40
obstructing distal mass in barrett's is caused from
stress related change in phenotype of squamous epithelium
41
increased risk of what with polyp>10 mm in GB
GB CA
42
what is CA 19-9 used to look for
pancreatic CA
| or cholangiocarcinoma
43
what leads to cholangiocarcinoma and how does the latter present
primary sclerosing cholangitis
itching, jaundice, RUQ, beads on a string, UC
44
clinical presentation of hepatocellular carcinoma
alpha fetoprotein
| RUQ pain
45
painless jaundice = ___
| can be associated with
pancreatic CA
| new onset DM, alcoholism/cirrhosis, enlarged GB
46
high MCV levels is indicative of
normal range for MCV
macrocytic anemia (B12 deficiency)
80-96
47
subcutaneous emphysema suggests what
Boerhave + iatrogenic esophageal perforation
48
bamboo spine, lead pipe sign presents in
ulcerative colitis
49
creeping fat and string sign on xray
crohn ds
50
calprotectin presents in
crohn ds
51
+ grey turner sign points towards
acute pancreatitis
| retroperitoneal bleed
52
'sigmoid dilation of the esophagus'
achalasia
53
ankylosing spondylitis is associated with?
IBD
54
papilovesicular rash is associated with what entity
celiac
55
microbio and sx of whipple ds
G+, we PAS + Mø
joint pain, heart murmur, chronic diarrhea
56
crohn can lead to what systemic condition
decreased Vit K, --> decreased coag
57
what lab values will present with chronic pancreatitis
decreased fecal chemotrypsin, decreased fecal elastase
hypokalemia with chronic diarrhea
58
pencil thin stools, benign skin lesions showing up all of a sudden on back
colon CA
59
link IBD to choleangiocarcinoma
ulcerative colitis --> pulmonary sclerosing cholangitis --> choleangiocarcinoma
60
clinical presentation of angioectasia
painless bleeding, FOBT
61
sx presentation of eosinophilic esophagitis
food impaction
62
what is asterixis and what is it used for
hand flapping
liver failure
63
signet ring cells + virchows node + krukenburg
gastric adenocarcinoma
64
xray presentation differences between emphysematous and porcelain gallbladder
black air around the GB and liver = emphysematous gallbladder
white calcification of the GB = porcelain GB
65
what are adenomatous polyps associated with
adenocarcinoma of the STOMACH
66
what hx can lead to fundic gland polyp
PPI
67
trx for a variceal bleed
IV octeotide
68
80% of chronic pancreatitis patients develop
DM
69
risk factors for chronic pancreatitis
TIGER-O
```
toxic metabolite= alc
idiopathic
genetic= i.e. CFTR
autoimmune= IgG4
obstructive= stricture, stone, tumor
```
70
previous abd surgery and now obstruction
fibrous adhesion
71
really fat air filled colon on left, with super thin right colon
coffee bean sign,
sigmoid volvulus
72
lactic acidosis in GI obstruction
ischemia with sigmoid volvulus
73
what is the first episode of IgG4 mediacted acute pancreatitis called
sentinal acute pancreatic ecent
74
IPEX syndrome
super severe abd enteropathy, presents with days old baby with severe diarrhea
,
defected CD4, FOXP3 mutation
X linked
75
trx for PUD stomach ulcer
pantoprazole IV
76
trx for cholangitis
emergent ERCP
77
clinical presentation for acute pancreatitis
trx
epigastric pain with lipase 3x ULN
vigorous rehydration, IV NS @ 250 cc/hr
78
what is the Ranson Criteria and what is it used for
acute pancreatitis
```
admission= age >55
WBC >16k
LDH>350
AST>250
glucose >200
```
```
@48 hours= hCt decreased by 10%
BUN >5
Ca <8
PO2 <60
base deficit > 4
fluid sequestration >6
```
79
what is BISAP used for and what is it
acute pancreatitis
```
BUN >25
impaired mental status
SIRS (WBC, tachy, tachypnea)
Age>60
pleural effusion (check w auscultation)
```
80
what is HAPS used for and what is it
acute pancreatitis- for when not a big deal
no abd tend, normal hematocrit, normal serum Creatinine
81
E Coli can lead to what complications
HUS
scattered bruising, mucosal hemorrhage, LE edema, hypotension
82
bloody diarrhea associated with recently quit smoking
ulcerative colitis
83
migrating thrombophlebitis w pancreatic CA
Trousseau sign of malignancy
84
what is the rome criterion for
IBS
| >8= bad
85
what are diagnostic tests for acute hepatitis
acetaminophen levels,
| Rumack-Matthew
86
most common location for crohn
ileocecal calves
87
____ is always involved in ulcerative colitis
rectum
88
biopsy finding with ulcerative colitis
crypt abscess
89
broad based ulcer and pseudopolyp formation is what IBD
ulcerative colitis
90
transmural inflammation is what IBD
crohn
91
what is biliary dyskinesia
| dx testing?
all normal tests but pain with eating + sx of GB
HIDA scan w CCK show low ejection fraction
92
ASCA Ab associated with what
crohn ds
93
risk factor for cholangiocarcinoma and bile duct CA
primary sclerosing cholangitis, ulcerative colitis
94
lab associated with pancreatic insufficiency
trypsinogen
95
labs to order for acute pancreatitis
fasting lipid panel
96
labs to look for acute hepatitis
tylenol levels/acetominophen
increased AST/ALT
97
with hepatic encephelopathy, coming in with confusion, what labs do you check
ammonia levels
98
what is charcots triad
for ascending cholangitis
fever + jaundice + RUQ
99
what is raynauds pentad
what do you do with it
for ascending cholangitis
= v sick, may die
charcots triad + confusion + hypotension
CT= fever + jaundice + RUQ
get blood cultures, bacteremia could happen so look out for it
100
trx for ascending cholangitis
FIRST GET INR
then get an ERCP
101
pancreatic pseudocyst is full of
when do you get one
necrotic material
chronic pancreatitis or trauma
102
PanIN
precursor for pancreatic adenocarcinoma
103
aflatoxin associated with
hepatocellular CA
104
differentiate between labs for hepatobiliary vs cholestatic syndrome
hepatobiliary = increased AST/ALT
cholestatic syndrome= increased bilirubin, alkaline phosphate
105
McBurney=
appendicitis
106
rovsing sign=
appendicitis
| push on L, get pain on R
107
most common CA for the pancreas
adenocarcinoma = gland forming
108
acholic stools and tea colored urine
gallblader stones (acute cholelithiasis--> acute cholecystitis)
109
courvoisier sirn
no pain and jaundice
pancreatic CA
110
hx associated with nonbenign gallstones
beriatric surgery + weight loss + RUQ pain
111
imaging for choledocolithiasis
```
emergent ERCP (dx+trx)
US (dilate common bile duct)
```
112
labs for proximal vs distal gall stones
proximal = increased ALT/AST, alkaline phosphate, leukocytes
distal= increased ALT/AST, alkaline phosphate, pancreatitis, leukocytosis
113
Murphy's sign
acute cholecystitis in the cystic duct
114
complications of acute cholecystitis
gangrene, perforation, DM, emphysematous GB
115
GERD can lead to what kind of CA
esophageal adenocarcinoma
116
complication of eosinophilic esophagitis
clinical presentations
esophageal perforation
=subQ emphysema and crepitus, Haman's sign
corrogated rings in the esophagus--> trachealization (feline)
117
what GB stones show with hemolytic anemia
pigment stones
118
rokitansky-aschoff sinuses are associated with what
chronic pancreatitis
119
what organisms can be seen with a urine Ag
strep pneumoniae
| legionella pnuemonia
120
colon CA screening?
colonoscopy
| FOBT
121
what pathology in the GI system can lead to RLL lung changes
gallstones
122
top causes of esophageal varices
cirrhosis
shistosoma mansoni
123
schatzki's rings vs esophageal webs
a single ring going around the whole esophagus
vs webs are thin-diaphragm like membranes of squamous mucosa
124
warthy starry silver stain
H. pylori
125
prussian blue stain
iron
126
chronic, erythema and nodularity in the antrum with numeral spiral organisms on the surface, and lymphoepithelial lesions
MALToma associated with
127
in what setting do you see granulomatous gastritis
crohn ds
=erythema nodosum, clubbing, pericholangitis
128
what etiology leads to signet ring cells, seen in what pathologies
CDH1 loss
whipple ds, adenocarcioma
129
what skin lesions can be seen with celiac ds
dermatitis herpetiformis
130
spindle/epithelial tumors
stromal tumors
131
etiology of hirschsprung ds
aganglionic megacolon
132
associations with necrotizing enterocolitis
premature babies, present upon feeding
=transmural necrosis
133
anal squamous cell carcinoma is associated with what hx
maternal HPV
134
high pitched bowel sounds
SBO
135
air in the bowel, sudden onset, abd distension
most likely location of the etiology
complication
intestinal volvulus
sigmoid colon
infarction from twisting, vasc change bc mesentery is pulled
136
intussusception + peri/intraoral mucocutaneous lesions + hamartomatous polyps + gelatinous stools
=dx and etiology
peutz jegher
STK11 gene mutation
137
what can a DNA MMR be used in
lynch syndrome
138
x APC is seen in what
adenocarcinoma
FAP
sporadic colon CA
139
how can CAD/hx of aneurysm/embolism related to LUQ pain
--> blood vessel occlusion --> ischemic bowel ds most likely at the splenic flexure --> LUQ pain
140
dx tests for a fungal cecal mass
(+) DRE hemooccult and anemia
141
mucosal thickening on cecum, significant bleeding w biopsy
angiodysplasia
142
presentation of IgA deficiency
related to what pathology in the GI system
anaphylactic rxns w blood transfusions
no skin rxns
IgA nephropathy
associated with celiac
143
what neoplasms are associated with celiac ds
small intestine adenocarcinoma
| T cell lymphoma
144
volcano of pus in colon
c dif
145
what is the clinical presentation of herpes simplex
more than one lesions both inside and outside of the mouth
start as a vesicle turn into an abscess
146
hyperchromasia and more cytoplasm than nucleus in a cell, highly pleimorphic
= what kinds of changes
dysplastic
precancerous
147
examples of neurofilaments
```
cytokeratin
mucin
vimentin
desmin
p16
```
148
differentiate between the location of HPV-associated and classic SCC
HPV associated= in tonsillar crypts, base of tongue, or oropharynx
classic= floor of the mouth, buccal and vestibule of tongue
149
what CA metastasizes to virchow's node
gastric CA
150
microbio of agent that causes scarlett fever
group A beta hemolytic strep
151
H pylori and smoking have a synergistic risk for
ulcers
152
NSAIDS+methotrexate + h pylori
risk for ulcer
153
uncontrolled DM is a risk factor for
candidiasis
| gastroparesis
154
what do you do next for GERD sx that DON'T improve with meds
get gastrin levels to rule out zollinger ellison
155
Ab to parietal cells
autoimmune gastritis
156
when is a KUB indicated
suspectied SBO
157
what is the primary lesions that leads to krukenberg tumors
gastric CA
158
increased levels of amylase are seen in
when do you check
```
MUMPs
ectopic pregnancy
opioids
post abd surgery
intestinal obstruction
gastroenteritis
```
check for ethanol hx
159
differentiate between the neoplasms that can be caused by h pylori vs autoimmune gastritis
h pylori -->MALToma and adenocarcinoma
autoimmune gastritis --> adenocarcinoma and carcinoid tumor
160
which IBD is a risk factor for cholelithiasis
crohn
161
cullen sign is assocaited with what
periumbilical redness,
acute pancreatitis
162
portal HTN + ascites --> ?
spontaneous bacterial peritonitis
the bacteria from the intestine can flow out into ascites
163
BUN:Cr > 30 --> ?
UGIB
164
what is a minnesota tube used for
esophageal dilation for esophageal varices
165
which As are most likely to be effected with stomach acid leak
splenic and gastroduodenal
166
next dx step if IBS sx with alarm sx
stool culture
alarm sx= fever, weight loss, acuteness, nocturnal diarrhea, hematochezia, fam hx,
167
fecal elastase can be indicative of what
chronic pancreatic insufficiency
168
fecal calprotectin can be indicative of what
crohn or UC
169
Mg med use can result in what
osmotic diarrhea
170
cirrhotic ds can lead to what complications
```
rectal varices
hepatic encephalopathy (--> ammonia build up --> osmotic diarrhea)
```
171
hyerkalemia and hypernatremia -->
constipation
172
common sideeffect of metformin
watery diarrhea
173
sx of flushing, malaise, M cramps
```
carcinoid tumor
or VIPoma (pancreatic)
```
174
omeprazole can increase risk for
c dif
175
sx of toxic megacolon
perforation
met acidosis
respo distress
176
risk factors for ischemic colitis
sx
CAD, vascular ds, vasoconstrictive drugs, marathon runners
acute severe cramping pain followed and relieved by bloody diarrhea
177
mixed anemia with loss of duodenal villi --> __
how do you scan for this etiology
celiac ds
DEXA scan
