Gastroenterology Flashcards
(132 cards)
1
Q
infectious agent causing food poisoning as a result of mayo sitting out too long
A
s aureus
2
Q
infectious agent causing rice water stools
A
v cholera
3
Q
infectious agent causing diarrhea transmitted from pet feces
A
y enterocolitis
4
Q
infectious agent causing food poisoning resulting from reheated rice
A
b cereus
5
Q
infectious agent causing travelers’ diarrhea
A
e coli (ETEC)
6
Q
infectious agent causing diarrhea after course of abx
A
c diff
7
Q
infectious agent causing diarrhea and recent ingestion of water from a stream
A
giardia, e histolytica
8
Q
infectious agent causing mild intestinal infection that can become neurocysticercosis
A
t solium
9
Q
infectious agent causing food poisoning from undercooked hamburger
A
e coli (EHEC)
10
Q
infectious agent causing diarrhea from seafood
A
v parahaemolyticus
11
Q
infectious agent causing bloody diarrhea from poultry
A
salmonella
12
Q
infectious agent causing diarrhea and pink eye
A
adenovirus
13
Q
infectious agent causing bloody diarrhea and liver abscess
A
e histolytica
14
Q
infectious agent causing diarrhea in AIDS patient
A
crypto
15
Q
infectious agent causing dehydrated child with greenish diarrhea in winter months
A
rotavirus
16
Q
treatment of e histolytica
A
metronidazole
17
Q
treatment of giardia lamblia
A
metronidazole
18
Q
treatment of salmonella
A
fluoroquinolones
19
Q
treatment of shigella
A
fluoroquinolones, TMP-SMX
20
Q
treatment of campylobacter
A
erythromycin
21
Q
hepatitis virus confers a high risk of chronic hepatitis
A
hep C
22
Q
hepatitis virus confers high risk of hepatocellular carcinoma
A
hep B
23
Q
treatment of hep C
A
interferon alpha
ribavirin
24
Q
Hep BsAg negative
HepBsAb negative
Hep BcAb positive (IgM)
A
window period
25
Hep BsAg positive
Hep BsAb negative
Hep BcAb positive (IgG)
chronic infection
26
Hep BsAg negative
Hep BsAb positive
Hep BcAb negative
vaccine
27
Hep BsAg negative
Hep BsAb positive
Hep BcAb positive (IgG)
past infection
28
next step after H&P for patient complaining of dysphagia
barium swallow
29
treatment for diffuse esophageal spasm differ from that of achalasia
DES - medically, nitrates and CCBs
achalasia - surgical intervention, dilation, botox, myotomy
30
esophageal disorder which involves CP; uncoordinated contractions; corkscrew pattern on barium swallow
diffuse esophageal spasm
31
esophageal disorder which involves inability to relax the LES; bird's beak on barium swallow
achalasia
32
esophageal disorder which involves bad breath; regurgitation of food eaten days ago
zencker diverticulum
33
common symptoms of GERD
heartburn
bad taste in mouth
persistent cough
34
gastric ulcer timing and effect of eating
right after intake of food
worse with nausea and vomiting
35
duodenal ulcer timing and effect of eating
2-4 hours after food
better with food
36
effective treatment of duodenal ulcer, not from zollinger ellison syndrome
PPI
amox
clarithromycin
37
treatment for gastric cancer
distal 1/3 - subtotal gastrectomy
middle/upper - total gastrectomy
chemo/radiation as needed
38
female patient has known duodenal ulcer refractory to high dose PPI therapy. What two tests may diagnose her disease?
fasting gastrin
secretin stimulation test
39
oral infection has branching rods when examined microscopically
actinomyces
40
malabsorption in a patient with (+) sudan stain in stool sample and normal D-xylose test
pancreatic insufficiency
41
treatment for whipple disease
ceftriaxone
| TMP-SMX
42
tumors causing secretory diarrhea
VIPomas
gastrinoma
med thyroid
carcinoid
43
two most common food borne bacterial GI tract infections in US
salmonella, c jejuni
44
Which form of IBD causes perianal fissures and fistulas
Crohn's
45
serum lab findings might help distinguish Crohn's from UC
antisaccharomyces cerevisiae - Crohn
pANCA - UC
46
most common cause of large bowel obstruction
neoplasm
47
treatment for Crohn's disease
steroids
azathioprine
anti TNFalpha agents
48
signs and symptoms NOT associated with IBS
weight loss, fever, rectal bleeding, anorexia, worsening pain
49
Characteristic symptom of acute mesenteric ischemia
pain out of proportion to exam
50
CT scan imaging shows what for ischemic colitis
pneumatosis coli
bowel wall thickening
51
time frame in which post-op ileus resolves for small bowel
24 hours
52
time frame in which post-op ileus resolves for stomach
53
time frame in which post-op ileus resolves for colon
3-5 days
54
risk factors for diverticulosis
low fiber, high fat diet
increased age
55
treatment for mild diverticulitis
bowel rest
abx: cipro + metro
56
treatment for diverticulitis with abscess formation
perc drainage
IV abx
57
next step in management of patient younger than 50 with minimal bright red blood per rectum
anoscopy
58
cause of acute pain and swelling of midline sacrococcygeal skin and subq tissues
pilonidal cyst
59
gene responsible for familial adenomatous polyposis
APC
60
Common etiologies of upper GI bleeds
```
ulcer
esophageal varices
AVM
tumors
erosions
mallory-weiss tears
```
61
common etiologies of lower GI bleeds
```
diverticulitis
neoplasms
ischemia
hemorrhoids
rectal fissures
```
62
volume status assessment in patient with GI bleed
vital signs
HR, BP, urine output
63
difference between mallory-weiss tear and boerhaave tear
mallory-weiss tear - laceration superficial in esophageal mucosa
boerhaave - perforation/tear, full thickness
64
ranson criteria for acute pancreatitis on admission
GA LAW
```
glucose > 200
AST > 250
LDH > 350
age > 55
WBC > 16,000
```
65
ranson criteria for acute pancreatitis in first 48 hours
CALvin and HOBBeS
calcium 10
pO2 4
BUN > 5
sequestration of fluid > 6
66
treatment for chronic pancreatitis
stop alc/smoking
pancreatic enzymes
fix nutrition
surgical repair
67
two most common cause of acute pancreatitis in US
gallstones
alcohol
68
procedure to treat cancerous tumor in head of pancrease
whipple procedure
69
signs and symptoms suggestive of pancreatic adenocarcinoma
painless jaundice, anorexia, wt loss, nausea, vomiting, palpable nontender GB
70
medication used to stop insulin production in patient with insulin producing pancreatic tumor
octreotide
71
symptom is the most common presentation of a patient with VIPoma
watery diarrhea
72
patient presents with dysphagia and the barium swallow shows a corkscrew pattern of esophagus. Dx?
diffuse esophageal spasm
73
patient presents with dysphagia and barium swallow shows bird's beak sign in distal esophagus. Dx?
achalasia
74
type of patient at risk for acalculous cholecystitis?
TPN
critically ill
75
What is charcot's triad? What is reynold's pentad?
Charcot: RUQ pain, jaundice, fever
Reynold's: RUQ pain, jaundice, fever, AMS, hypotension
76
treatment of cholecystitis
cholecystectomy
77
treatment of cholangitis
drain bile ducts, fluids and IV abx, wait for cholecystectomy
78
most common cause of travelers diarrhea
e coli (ETEC)
79
medical treatment for ulcerative colitis
5 ASA (mesalamine, sulfasalazine)
acute: steroids
80
what distinguishes primary biliary cirrhosis from primary sclerosing cholangitis?
PBC: women, autoimmune with RA, Sjogrens, CREST, intrahepatic bile duct, treatment ursodeoxylic acid, labs AMA, ANA
PSC: men, associated with UC, intra/extrahaptic bile duct, treatment liver transplant, labs pANCA, associated with cholangiocarcinoma, ERCP shows beads on a string
81
treatment for primary biliary cirrhosis
ursodeoxycholic acid, liver transplant
82
Sign and disease with deep palpation of RUQ, arrest of inspiration due to pain
murphy sign
cholecystitis
83
Sign and disease with charcot's triad, hypotension, AMS
reynold's pentad
cholangitis
84
Sign and disease with RLQ pain on passive extension of hip
psoas sign
appendicitis
85
Sign and disease with RLQ pain on passive internal rotaiton of flexed hip
obturator sign
appendicitis
86
Sign and disease with LUQ and referred left shoulder pain
Kehr's sign
splenic rupture
87
Sign and disease with ecchymosis of skin overlying flank
gray turner sign
pancreatitis
88
Sign and disease with ecchymosis of skin overlying periumbilical area
cullen's sign
pancreatitis
89
treatment for hepatic encephalopathy
lactulose, rifaximin
90
antibiotics used to treat spontaneous bacterial peritonitis
cefotaxime, ceftriaxone
91
two diuretics used in conjunction for the treatment of ascites/portal HTN
furosemide and spironolactone
92
symptoms of budd-chiari?
ascites
hepatomegaly
jaundice
RUQ pain
93
25 year old man with abdominal pain, watery diarrhea after meals. Exam shows fistulas between bowel and skin as well as nodular lesions on tibias. Dx?
Crohns
94
most widely used screening test for hemochromatosis
ferritin (increased)
95
what copper related lab value would you order with someone with wilson disease?
serum ceruloplasmin (low)
96
treatment for hemochromatosis?
phlebotomy, avoid excess alcohol, deferoxamine
97
location of zenker diverticulum, epiphrenic diverticulum, traction diverticulum
zenker: above UES
epiphrenic: above LES
traction: mid esophagus
98
most common type of TE fistula
upper esophagus ends in blind pouch
lower esophagus attached to trachea
99
classic presenting scernario for NEC
poor feeding, abd distention, bloody stools, pneumatosis intestinalis
100
physiologic jaundice - age, t bili, cause, tx
2-3 d,
101
breastfeeding - age, t bili, cause, tx
102
breast milk - age, t bili, cause, tx
> 1 week, > 5.5, unknown factor in milk, resolves on own
103
tx for a rectal fistula
fistulotomy
104
patient with cirrhosis presents to the ER to have his recurrent ascites drained. Analysis of the ascites fluid reveals an absolute neutrophil count > 250. What is the diagnosis?
SBP
105
What is light's criteria? What is it for?
exudative effusion
pleural fluid protein: serum protein > 0.5
pleural fluid LDH: serum LDH > 0.6
protein > 3 g
106
tumor marker used in colon cancer
CEA
107
which type of esophageal cancer is most prevalent in the US?
adenocarcinoma
108
Next step in diagnosis of cholecystitis when the ultrasound is equivocal?
HIDA
109
45 year old obese woman with pruritus, clay colored stools and dark urine has an elevated alk phosph and elevated bili. What is the most likely cause?
biliary obstruction
110
24 year old woman with elevated BP. Good BMI, good diet, exercises, and does not smoke or use BC. What might be the cause of her HTN? What might be seen on radiological imaging?
fibromuscular dysplasia
beads on a string
111
tumor marker most useful in diagnosis of pancreatic cancer
CA 19-9
112
which form of IBD would you see a "lead pipe" appearance on barium enema?
UC
113
Ranson criteria for pancreatitis on admission
GA LAW
```
glucose
AST
LDH
age
WBC count
```
114
Ranson criteria for pancreatitis
CALvin and HOBBeS
```
calcium
Hct
O2
BUN
base deficit
sequestration of fluid
```
115
2 disorders should come to mind when a neonate has meconium ileus
CF
hirschsprung
116
tx for entamoeba histolytica
metronidazole
117
tx for giardia lamblia
metronidazole
118
tx for salmonella
quinolone or TMP-SMX
119
tx for shigella
quinolone or TMP-SMX
120
tx for campylobacter
erythromycin
121
what is charcot's triad in cases of cholangitis?
fever, RUQ pain, jaundice
122
Patient suspected of having gastric cancer. During the physical exam you palpate in two places for enlarged lymph nodes associated with this disease. Where will you palpate and what are the names of the enlarged nodes?
virchow's node - left supraclavicular
sister mary joseph - periumbilical
123
2 year old boy presents with painless rectal bleeding. What diagnosis do you suspect and what study would you order to confirm the diagnosis?
meckel's diverticulum
meckel's scan
124
what is the treatment for mild unconj hyperbilirubinemia in a neonate? Sever unconj hyperbilirubinemia in a neonate?
phototherapy
phototherapy or exchange transfusion
125
3 year old girl presents with abdominal mass, hematuria, HTN. What is the most likely diagnosis?
wilms tumor
126
cuban immigrant presents with symptoms of malabsorption is found to have megaloblastic anemia. Dx and tx?
tropical strue
treatment: folate, tetracycline
127
Elderly woman with a history of cholelithiasis presents with a 5 day history of vague intermittent abdominal pain and vomiting. Dx?
gallstone ileus
128
Treatment for whipple disease?
TMP-SMX for 1 year, ceftriaxone
129
Medications are used in the treatment of ileus?
metoclopromide, erythromycin, neostigmine
130
What is the most sensitive and specific lab test for the diagnosis of chronic pancreatitis?
low fecal elastase
131
Antibiotic combinations used in outpatient treatment of diverticulitis?
cipro/metro
bactrim + metro
amox-clav
132
Elevated lab in patients with an upper GI bleed?
BUN
