Flashcards in Gastro Deck (103)
What disease has a corckscrew xray?
What disease has an apple core xray?
What disease has a stacked coin xray?
What disease has a thumbprint xray?
Toxic mega colon
What disease has a abrupt cutoff xray?
What disease has a barium clumping x-ray?
What disease has a bird's beak x-ray?
What disease has a string sign x-ray?
What disease have solid dysphagia?
Schatzki rings, stricture, cancer
What diseases have solid and water dysphagia?
Esophageal spasm, scleroderma, achalasia
What is Barret's Esophagus?
Metaplasia, ^ Adeno CA risk
What are Esophageal Varices?
Vomit blood everywhere, portal HTN
what is Mallory Weiss?
Tear LES mucosa, chronic vomiters
What is Boerhaave´s?
Tear all layers of esophagus, left sided pneumo/pain/effusion
what is Achalasia?
lost LES auerbach´s. bird beaks, Chaga´s, choke on solids
What is Hirchsprung´s?
Lost rectum Auerbach´s, no meconium passage
What is a Zenker´s diverticulum?
Cough undigested food from above UES, halitosis
What is a tractiom diverticulum?
Eat big bolus => gets stuck above LES
What is Plummer-Vinson Syndrome?
esophageal webs, spoon nails, Fe deficiency anemia
What are Schatzki rings?
Esophageal webs in lower esophagus
What is a TE fistula?
Choke with each feeding
What is Esophageal atresia w/ TE fistula?
Vomit w/1st feed, doublé bubble, Downs
What is Pyloric Stenosis?
Projectile vomiting (3-4 wk old), RUQ olive mass
How does Choanal atresia presents?
turn blue with feeding
How is Tetrology of Fallot presentation different?
turn blue with crying
What makes Scleroderma unique?
low LES pressure
What makes Esophageal spasms unique?
What makes Achalasia unique?
low peristalsis and high LES pressure
What disease has a RUQ olive mass?
What disease has a RLQ sausage mass?
What is a Bezoar?
Mass of hair or vegetables => antrum obstruction
What is Gastritis type A?
Upper GI bleed, anti parietal cell Ab
What is Gastritis type B?
Upper GI bleed, spicy foods, H. pylori
What is a duodenal ulcer?
Too much acid: pain after meal/ at night, type O blood, H. pylori, pain relieved by eating
what is a gastric ulcer?
Broken mucus layer: pain during meal, NSAIDs, type A blood
What is a sliding hiatal hernia?
Fundus slides from esophageal hiatus to thorax => sucks acid into thorax
What is Rolling hiatal hernia?
Fundus sticks trough hole in diaphragm, strangulates bowel "rolls through a hole"
What is Menetrier's disease?
Protein losing, thick stomach rugal folds
What defines Constipation?
< 3 BM per week
What defines diarrhea?
> 200g per day
What is Osmotic diarrhea?
what is secretory diarrhea?
What is inflammatory diarrhea?
what is Celiac sprue?
Jejunum, wheat allergy, villous atrophy, anti-gliadal Ab
What is tropical sprue?
Ileum celiac sprue
What is Mesenteric Ischemia?
Pain out of proportion to exam
What bugs cause bloody diarrhea?
Amoeba (E. histolytica)
What is the difference b/w 1 Cirrhosis and 1 Sclerosing Cholangitis?
1 Biliary Cirrhosis: anti mitochondrial Ab, bile ductules destroyed, xanthelasma
1Sclerosing Cholangitis: p-ANCA Ab, bile duct inflammation, beading, onion skinning, associated with UC
What is Ascending cholangitis?
common duct stone gets ingected
what are the signs of alcoholic cirrhosis?
spider angioma, palmar erythema, Dupuytren's contractions, gynecomastia
What is Hepatorenal Syndrome?
Pts w/lver disease build up liver toxins that cause renal failure
What is Cholangitis?
Inflammation of bile duct => charcots triad, Reynolds pentad
What is Cholecystitis?
Inflammation of gall bladder => Murphy's sign
What is Cholelithiasis?
Formation of gallstones => RUQ colic
What is Choledocholithasis?
Gallstones obstructs bile duct
What is Cholestasis?
Obstruction of bile duct => pruritis, ^ alkaline phosphatase, jaundice
What is Conjugated bilirubin?
Water soluble "direct"
What is unconjugated bilirubin?
Fat soluble "indirect"
What is the most common type of gallstone?
Cholesterol (can't see on x-ray)
What type of gallstones can be seen on x-ray?
What is Xanthoma?
Cholesterol buildup (elbow or Achilles)
What is Xanthelesma?
Triglyceride build up (under eye)
What does high cholesterol cause?
What does high triglycerides cause?
What is type 1 Hyperlipidemia?
Bad Liver LL (CM)
What is type 2a Hyperlipidemia?
Bad LDL or B-100 receptors: trapped in ER (LDL only)
What is type 2b Hyperlipidemia?
Less LD/VLDL receptors (LDL/VLDL)
What is type 3 Hyperlipidemia?
Bad Apo E (IDL/VLDL)
What is type 4 Hyperlipidemia?
Bad Adipose LL (VLDL only)
What is type 5 Hyperlipidemia?
Bad C2 (VLDL/CM) b/c C2 stimulates LL
What is Crigler-Najjar?
Unconjugated bilirubin, usually in infants
What is Gilbert syndrome?
Glucuronyl transferase is saturated => stress unconjugated bilirubin
What is Rotor's?
Bad bilirubin storage=> conjugated bilirubin
What is Dubin-Johnson?
Bad bilirubin excretion => black liver
What is Cullen's sign?
Bleed around umbilicus => hemorrhagic pancreatitis
What is turner's sign?
Bleed into flank => hemorrhagic pancreatitis
What test is used for following pancreatitis?
Amylase- sensitive, breaks down carbs
Lipase- specific, breaks down TGs
What does Ranson's criteria tell you?
Poor prognosis for pancreatitis patients
What is Ranson's criteria at presentation?
WBC: >16k/ul (infection)
Age: >55 (usually multiple illness)
Glucose: >200 mg/dL (islet cells are fried)
LDH: >350 IU/L (cell death)
AST: >250 IU/L (cell death)
What is Ranson's criteria at 48 hr?
"BuCH was a SOB"
BUN: ^ >5 mg /dL (v renal blood flow)
Ca: 10% (bleed into pancreas)
Sequester >6 L fluid => 3rd spacing
Base deficit >4 mEq/L (diarrhea => pancreatic enzymes are dead)
What is Carcinoid syndrome?
Diarrhea, flushing, wheezing
What produces Currant Jelly sputum?
What produces Currant Jelly stool?
What is Gardener's syndrome?
Familial polyposis w/bone tumors
What is Turcots syndrome?
Familial polyposis w/brain tumors
What is familial polyposis?
100% risk of colon cancer, APC defect=> annual colonoscopy at 5y/o
What is Peutz-Jegher syndrome?
Hyperpigmented mucosa => dark gums/vagina
What is Chron's disease?
IBD w/ cobblestones, melena, creeping fat, fistulas
What is ulcerative colitis?
IBD w/pseudopolyps, hematochezia, lead pipe colon, toxic megacolon
What is Intussusception?
Currant jelly stool, stacked coin enema, sx come and go
How does Diverticulosis present?
How does Diverticulitis presents?
How does spatic colon presents?
Intermittent severe cramps
How does IBS presents?
Alternating diarrhea /constipation
How does external hemorrhoids present?
How does Internal Hemorrhoids present?
What is pseudo membranous colitis?
Overgrowth of C. Difficile due to normal flora being killed off, usually by Clindamycin use
What is whipple's disease?
T. Whippleii destroy GI tract, then spread causing malabsorption, arthralgia
What color is an upper GI bleed?
What color is a lower GI bleed?
What adds color to stool?
What is the default color of stool?