Gastroenterology Flashcards Preview

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Flashcards in Gastroenterology Deck (59):
1

How can you improve O&P sensitivity?

Loosen the bowels - herbs, water, magnesium

2

Which Ig rises with infxn and reduces with remission and is often specific to mucus membranes?

IgA

H. pylori often

3

Name the referred pain pattern: 5th left rib to mid lumbar region, midline to left lateral border: dorsal and ventral epigastric areas

Stomach

4

Name the referred pain pattern: same position as stomach on right half of body. Dorsal and ventral. Right scapula.

Liver

5

Name the referred pain pattern: Murphy's point, RUQ, right scapula

GB

6

Name the referred pain pattern: McBurney's point, RLQ, Right dorsal flank, celiac area

Appendix

7

Name the referred pain pattern: Celiac, local area of lg intestine

Colon, Sm intestine

8

Name the referred pain pattern: suprapubic area, sacral area

Rectum

9

Name the referred pain pattern: Costovertebral area, bilateral dorsal flanks, R and L dorsal iliac crests

Kidneys

10

Name the referred pain pattern: left inferior iliac crest, left inguinal area, left labia/testicle

Ureter

11

T/F: Initial abd pain is often remote to the organ.

T

12

DDX Central/Celiac pain

Acute/early appy, acute small bowel obs, gastritis, pancreatitis, intestinal colic

13

DDX RUQ pain

Pleuritic pain, acute appy, cholecystitis, leaking duodenal ulcer, subphrenic abscess (hx of laparoscopic procedure)

14

DDX LUQ pain

Subphrenic abscess, perforated gastric ulcer, jejunal diverticulitis, splenic pain

15

DDX RLQ pain

Crohns, Appy, Mesenteric adenitis, leaking duodenal ulcers
less common: cholecystitis, biliary peritonitis, acute pancreatitis, inflamed Meckel's diverticulum

16

DDX LLQ pain

Diverticulitis, peritonitis, pericolitis

17

DDX left inguinal/iliac pain

Back: ureteric pain, kidney pain

18

Term: motility disorder of the esophagus secondary to loss of neurons from mesenteric plexus. LES fails to relax with swallowing.

Achalasia

19

T/F: Gastric ulcer is better w/ eating. Duodenal ulcers are worse w/ food.

F - Gastric worse w/ food. Duodenal better w/ eating

20

What should you consider when a pt presents with recurrent ulcer-like symptoms that do no respond to treatment?

CA - do endoscopy

21

Two of the MC etiology for pancreatitis?

Alcohol, gallstones

22

Lab tests to run with pancreatitis.

Amylase and lipase.

23

If tot bili is elevated, MUST check direct and indirect. If indirect is elevates, what is the cause? Direct?

Indirect/Unconjugated - Gilbert's syndrome, poor glucuronidation, or excessive lysis

Direct - hepatocellular dz, biliary obs

24

What is the only DNA virus of the Hepatitis family?

Hep B

25

Lab findings in cirrhosis.

Decreased serum albumin and prolonged PT

26

MC gastric cancer.

Adenocarcinoma

27

Which imaging is more sensitive in pancreatic cancer?

What symptom occurs in 25-50% of patients w/ pancreatic CA?

CT

Hyperglycemia

28

Which two genetic conditions run in families and highly inc the risk of colon CA esp before the age of 40?

Familial polyposis and Lynch syndrome

29

When do you start screening colonoscopies? What does screening include?

50-75

Colonoscopy, sigmoidoscopy, and fecal occult blood.

30

Name the etiologic agent (bacteria/virus/ameoba):
Inc time: 4-12 hr
Diarrhea: Watery, profuse
Emesis: Pronounced
Abd pain: Mild
Fever: Absent

Staph aureus, Clostridium perfringens

31

Name the etiologic agent (bacteria/virus/ameoba):
Inc time: 8-72 hr
Diarrhea: Watery, profuse
Emesis: Moderate
Abd pain: Mild
Fever: Absent

Vibrio cholera, enterotoxigenic E. coli

32

Name the etiologic agent (bacteria/virus/ameoba):
Inc time: 2-7 d
Diarrhea: variable, watery
Emesis: mild
Abd pain: moderate
Fever: variable

E. coli, giardia

33

Name the etiologic agent (bacteria/virus/ameoba):
Inc time: 1-3 d
Diarrhea: variable, often bloody
Emesis: mild
Abd pain: severe
Fever: mild

Hemorrhagic e. choli, clostridium difficile

34

Name the etiologic agent (bacteria/virus/ameoba):
Inc time: 1-4 d
Diarrhea: often bloody
Emesis: milde
Abd pain: severe
Fever: moderate to high

Salmonella, campylobacter, Shigella, enteroinvasive E. coli, entamoeba histolytica

35

Which is the enterohemorrhagic strain of E. coli?

O157:H7

Hemolytic-uremic syndrome can cause death via renal failure due to toxins produced.

36

T/F: Cryptosporidiosis can be found in municipal water sources while Giardia is acquired by feces in water.

T

37

Crohns or UC: "skip" lesions/irregular that are transmural

Crohn's

38

Crohns or UC: lead pip on barium xray

UC

39

Crohns or UC: can be complicated by hemorrhage or toxic megacolon

UC

40

Crohns or UC: can be complicated by fistula, abscess, or obstruction

Crohn's

41

Crohns or UC: string sign on barium xray

Crohn's - due to strictures

42

Crohns or UC: proximally contiguous from the colon only affecting the submucosa and mucosa

UC

43

What are some extraintestinal manifestation of IBD?

Erythema nodosum, pyoderma gangrenosum, arthritis, AS, uveitis, fatty liver, primary sclerosing cholangitis

44

What skin condition is associated with celiac's dz?

Dermatitis herpetiformis

45

What vitamin/mineral deficiencies often coincide with celiac sprue?

Vit B12, folate, iron

46

What lab tests are performed to assess for celiac dz?

Serum IgA antiendomysial and tissue transglutaminase
Anti-gliadin (less specific can indicate intolerance)

Intestinal biopsy is gold standard

47

What are two visible signs of pancreatitis?

Cullen's sign - periumbilical hemorrhage visible as bruise
Grey-Turner sign - flank hemorrhage - producing visible bruise

48

T/F: Must biopsy gastric ulcers for CA.

T

49

What is the tumor marker for hepatocellular carcinoma?

alpha - fetoprotein

50

What ratio of AST to ALT indicates alcoholic cirrhosis?

AST>ALT, greater than one

51

What ratio of AST to ALT indicates viral hepatitis?

ALT>AST

52

Which Hepatitis B antibody persists > 6mo if the infxn becomes chronic?

Hepatitis B Surface Antigen (HBsAg)

53

What two liver markers are elevated in hepatocellular carcinoma?

ALT and GGT

54

What tumor marker is elevated in gallbladder adenocarcinoma?

CA19-9

55

For which GI infxn would you run a stoll culture and sensitivity?

Shigella, Salmonella, Campylobacter, and E. Coli

56

What gene is a marker for Celiac's Dz?

HLA-DQ2

57

What imaging is best used in acute diverticulitis?

CT scan

58

T/F: Smoking increase the risk of UC and decreases risk for Crohn's.

F. Smoking inc risk for Crohn's and lowers risk for UC.

59

What is the tumor marker for colon CA?

CEA