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Flashcards in Gastro Deck (103)
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What disease has a corckscrew xray?

Esophageal spasm

1

What disease has an apple core xray?

Cancer

2

What disease has a stacked coin xray?

Intussusception

3

What disease has a thumbprint xray?

Toxic mega colon

5

What disease has a abrupt cutoff xray?

Volvulus

6

What disease has a barium clumping x-ray?

Celiac Sprue

7

What disease has a bird's beak x-ray?

Achalasia

8

What disease has a string sign x-ray?

Pyloric Stenosis

9

What disease have solid dysphagia?

Schatzki rings, stricture, cancer

10

What diseases have solid and water dysphagia?

Esophageal spasm, scleroderma, achalasia

11

What is Barret's Esophagus?

Metaplasia, ^ Adeno CA risk

12

What are Esophageal Varices?

Vomit blood everywhere, portal HTN

13

what is Mallory Weiss?

Tear LES mucosa, chronic vomiters

14

What is Boerhaave´s?

Tear all layers of esophagus, left sided pneumo/pain/effusion

15

what is Achalasia?

lost LES auerbach´s. bird beaks, Chaga´s, choke on solids

16

What is Hirchsprung´s?

Lost rectum Auerbach´s, no meconium passage

17

What is a Zenker´s diverticulum?

Cough undigested food from above UES, halitosis

18

What is a tractiom diverticulum?

Eat big bolus => gets stuck above LES

19

What is Plummer-Vinson Syndrome?

esophageal webs, spoon nails, Fe deficiency anemia

20

What are Schatzki rings?

Esophageal webs in lower esophagus

21

What is a TE fistula?

Choke with each feeding

22

What is Esophageal atresia w/ TE fistula?

Vomit w/1st feed, doublé bubble, Downs

23

What is Pyloric Stenosis?

Projectile vomiting (3-4 wk old), RUQ olive mass

24

How does Choanal atresia presents?

turn blue with feeding

25

How is Tetrology of Fallot presentation different?

turn blue with crying

26

What makes Scleroderma unique?

low LES pressure

27

What makes Esophageal spasms unique?

high peristalsis

28

What makes Achalasia unique?

low peristalsis and high LES pressure

29

What disease has a RUQ olive mass?

Pyloric stenosis

30

What disease has a RLQ sausage mass?

Intussusception

31

What is a Bezoar?

Mass of hair or vegetables => antrum obstruction

32

What is Gastritis type A?

Upper GI bleed, anti parietal cell Ab

33

What is Gastritis type B?

Upper GI bleed, spicy foods, H. pylori

34

What is a duodenal ulcer?

Too much acid: pain after meal/ at night, type O blood, H. pylori, pain relieved by eating

35

what is a gastric ulcer?

Broken mucus layer: pain during meal, NSAIDs, type A blood

36

What is a sliding hiatal hernia?

Fundus slides from esophageal hiatus to thorax => sucks acid into thorax

37

What is Rolling hiatal hernia?

Fundus sticks trough hole in diaphragm, strangulates bowel "rolls through a hole"

38

What is Menetrier's disease?

Protein losing, thick stomach rugal folds

39

What defines Constipation?

< 3 BM per week

40

What defines diarrhea?

> 200g per day

41

What is Osmotic diarrhea?

watery

42

what is secretory diarrhea?

laxative use

43

What is inflammatory diarrhea?

Blood, pus

44

what is Celiac sprue?

Jejunum, wheat allergy, villous atrophy, anti-gliadal Ab

45

What is tropical sprue?

Ileum celiac sprue

46

What is Mesenteric Ischemia?

Pain out of proportion to exam

47

What bugs cause bloody diarrhea?

"CASES"

Campylobacter
Amoeba (E. histolytica)
Shiguella
E. coli
Salmonella

48

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

49

What is Ascending cholangitis?

common duct stone gets ingected

50

what are the signs of alcoholic cirrhosis?

spider angioma, palmar erythema, Dupuytren's contractions, gynecomastia

51

What is Hepatorenal Syndrome?

Pts w/lver disease build up liver toxins that cause renal failure

52

What is Cholangitis?

Inflammation of bile duct => charcots triad, Reynolds pentad

53

What is Cholecystitis?

Inflammation of gall bladder => Murphy's sign

54

What is Cholelithiasis?

Formation of gallstones => RUQ colic

55

What is Choledocholithasis?

Gallstones obstructs bile duct

56

What is Cholestasis?

Obstruction of bile duct => pruritis, ^ alkaline phosphatase, jaundice

57

What is Conjugated bilirubin?

Water soluble "direct"

58

What is unconjugated bilirubin?

Fat soluble "indirect"

59

What is the most common type of gallstone?

Cholesterol (can't see on x-ray)

60

What type of gallstones can be seen on x-ray?

Ca-bilirubinate

61

What is Xanthoma?

Cholesterol buildup (elbow or Achilles)

62

What is Xanthelesma?

Triglyceride build up (under eye)

63

What does high cholesterol cause?

Atherosclerosis

64

What does high triglycerides cause?

Pancreatitis

65

What is type 1 Hyperlipidemia?

Bad Liver LL (CM)

66

What is type 2a Hyperlipidemia?

Bad LDL or B-100 receptors: trapped in ER (LDL only)

67

What is type 2b Hyperlipidemia?

Less LD/VLDL receptors (LDL/VLDL)

68

What is type 3 Hyperlipidemia?

Bad Apo E (IDL/VLDL)

69

What is type 4 Hyperlipidemia?

Bad Adipose LL (VLDL only)

70

What is type 5 Hyperlipidemia?

Bad C2 (VLDL/CM) b/c C2 stimulates LL

71

What is Crigler-Najjar?

Unconjugated bilirubin, usually in infants

72

What is Gilbert syndrome?

Glucuronyl transferase is saturated => stress unconjugated bilirubin

73

What is Rotor's?

Bad bilirubin storage=> conjugated bilirubin

74

What is Dubin-Johnson?

Bad bilirubin excretion => black liver

75

What is Cullen's sign?

Bleed around umbilicus => hemorrhagic pancreatitis

76

What is turner's sign?

Bleed into flank => hemorrhagic pancreatitis

77

What test is used for following pancreatitis?

Amylase- sensitive, breaks down carbs

Lipase- specific, breaks down TGs

78

What does Ranson's criteria tell you?

Poor prognosis for pancreatitis patients

79

What is Ranson's criteria at presentation?

"WAGLA"

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)

80

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
pO2: ARDS)
Base deficit >4 mEq/L (diarrhea => pancreatic enzymes are dead)

81

What is Carcinoid syndrome?

Diarrhea, flushing, wheezing

82

What produces Currant Jelly sputum?

Klebsiella

83

What produces Currant Jelly stool?

Intussusception

84

What is Gardener's syndrome?

Familial polyposis w/bone tumors

85

What is Turcots syndrome?

Familial polyposis w/brain tumors

86

What is familial polyposis?

100% risk of colon cancer, APC defect=> annual colonoscopy at 5y/o

87

What is Peutz-Jegher syndrome?

Hyperpigmented mucosa => dark gums/vagina

88

What is Chron's disease?

IBD w/ cobblestones, melena, creeping fat, fistulas

89

What is ulcerative colitis?

IBD w/pseudopolyps, hematochezia, lead pipe colon, toxic megacolon

90

What is Intussusception?

Currant jelly stool, stacked coin enema, sx come and go

91

How does Diverticulosis present?

Bleeds

92

How does Diverticulitis presents?

Hurts

93

How does spatic colon presents?

Intermittent severe cramps

94

How does IBS presents?

Alternating diarrhea /constipation

95

How does external hemorrhoids present?

Pain

96

How does Internal Hemorrhoids present?

No pain

97

What is pseudo membranous colitis?

Overgrowth of C. Difficile due to normal flora being killed off, usually by Clindamycin use

98

What is whipple's disease?

T. Whippleii destroy GI tract, then spread causing malabsorption, arthralgia

99

What color is an upper GI bleed?

Black

100

What color is a lower GI bleed?

Red

101

What adds color to stool?

Bilirubin

102

What is the default color of stool?

Clay-colored

103

What is the default color of urine?

Tea-colored