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Casey: Panre > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

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1
Q

Term for difficulty swallowing

A

Dysphagia

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2
Q

Bird beak esophagus on barium swallow should make you think of what dx

A

Achalasia

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3
Q

What is the most common location for an anal fissure?

A

Posterior midline

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4
Q

Crohn’s disease is found where in the GI tract?

A

It can be from the esophagus to the anus

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5
Q

What does HBsAg (hep B surface antigen) indicate?

A

Active hep B infection

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6
Q

How do you treat achalasia?

A

Loosen up the muscle–Botox, dilation or surgery

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7
Q

A corkscrew appearance on barium study should make you think of what dx?

A

Esophageal spasms

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8
Q

Epigastric abdominal pain which radiates to the back should make you think of what dx?

A

Pancreatitis

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9
Q

IOT contract hepatitis D what must you already have?

A

Hep B

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10
Q

Left lower quadrant pain and tenderness should make you think of what dx?

A

Diverticulitis

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11
Q

What is the treatment for most Mallory-Weiss tears?

A

Watchful waiting, these will typically resolve within 48 hours

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12
Q

A thumbprint sign on an abdominal film should make you think of what dx?

A

Intestinal ischemia

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13
Q

What will the bowel sounds be early on in a small bowel obstruction? What will they be later on?

A

Early they are hyperactive. Late they are absent.

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14
Q

A pt has had GERD for yrs. over the past year, he has noticed an increase in difficulty swallowing his food. This should make you think of what dx?

A

Esophageal strictures

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15
Q

What are two tx you should consider for esophageal strictures?

A

Dilation of the esophagus and long term PPIs

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16
Q

What are 2 common predisposing factors for esophageal varices?

A

Portal HTN and cirrhosis often caused by alcoholism

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17
Q

What is a common symptom that goes along with chest pain for GERD pts?

A

Dry cough

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18
Q

What medication is most commonly used for long term treatment of GERD?

A

Proton pump inhibitors
Omeprazole
Lansoprazole
Pantoprazole

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19
Q

What is the imaging modality of choice for pancreatitis?

A

CT

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20
Q

What is the best test to check for H. Pylori?

A

Urea breath test

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21
Q

Is peptic ulcer disease more common in the duodenum or the stomach?

A

Duodenum

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22
Q

What is the most common location for a pancreatic tumor?

A

75% occur in the head of the pancreas

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23
Q

With a gastric ulcer are the patient’s symptoms exacerbated or relieved with food?

A

Exacerbated

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24
Q

Projectile vomiting should make you think of what dx?

A

Pyloric stenosis

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25
Most gallstones are made of what substance?
Cholesterol
26
What is the name of the sign when a pt shows inhibited inspiration with pressure over the RUQ? What dx does it suggest?
Murphy's sign | Cholecystitis
27
What is the most specific test for acute cholecystitis?
HIDA
28
What is the gold standard for dx of and tx of bile duct stones?
ERCP
29
What is Charcot's triad?
RUQ pain Fever Jaundice
30
What is Reynold's Pentad and why does it matter?
Charcot's triad plus Hypotension Altered mental status It indicates sepsis and is endoscopic emergency
31
What diseas is defined as an immunologic response to gluten?
Celiac
32
What is the main risk factor for esophagitis?
Immunocompromised pt
33
An endoscopy for presumed ulcers shows multiple shallow ulcers. What is the most likely dx?
Herpes simplex virus
34
List 2 common offending agents for pill induced esophagitis?
NSAIDS, KCl, iron, antibiotics
35
A 30 yr old AA woman presents with dysphagia. You notice she also has thickened skin. A barium swallow demonstrates the absence of peristalsis. What is the most likely dx?
Scleroderma
36
What is the most common cause of peptic ulcer disease?
H. Pylori
37
What is the most specific diagnostic test for peptic ulcer disease?
Endoscopy
38
What is the only curative tx for gastric adenocarcinoma?
Surgical resection
39
A pt c/o right upper quadrant pain :20 after meals. What is the most likely dx?
Cholecystitis
40
What does ERCP stand for?
Endoscopic retrograde cholangiopancreatography
41
What is the most cause of acute bacterial cholangitis?
Choledocolithiasis
42
Onion ring fibrosis from a bile duct bx should make you think of what dx?
Primary sclerosing cholangitis
43
What two viral hepatitis infections are self limiting?
Hepatitis A & E
44
Pica is often related to what type of anemia?
Iron deficiency
45
What does an Anti-HBc (hep B core antibody) indicate?
Previous or ongoing hepatitis B infection
46
What does Anti-HBs (hep B surface antibody) indicate?
Recovery from infection or immunization to hepatitis B
47
What is the recommended tx for hepatitis C infection?
Pegylated interferon alpha-2
48
What medication used in hepatitis B infection helps prevent the need for liver transplant?
Lamivudine
49
There are vaccines for which 2 versions of hepatitis?
Hepatitis A and B
50
Will a pt c achalasia have dysphagia to liquids, solids or both?
Both
51
If you have heartburn that does not improve with medication, what is the most likely dx?
Gastrinoma
52
What are the 2 main complications of cirrhosis?
Portal HTN and liver insufficiency
53
What is a good beta blocker to reduce portal HTN?
Propranolol
54
What tumor marker may be used for liver cancer?
Alpha-Fetoprotein
55
What are the two most common causes of pancreatitis?
Cholelithiasis and ETOH
56
Describe Cullen's sign
Umbilical ecchymosis often related to pancreatitis
57
What are the 5 points of Ranson's criteria on admission?
``` Older than 55 WBC>16 Glucose >200 LDH>350 AST>250 ``` Acute/chronic pancreatitis
58
What is the first step in treating GERD?
Lifestyle modification
59
Steatorrhea should make you think of what dx?
Pancreatitis
60
Describe Courvoisier's sign
Nontender palpable gallbladder which may indicate pancreatic neoplasm
61
What tumor marker may be used to follow pancreatic cancer?
CA-19-9
62
A pt c/o periumbilical pain which has now moved over McBurney's point. What is the most likely dx?
Appendicitis
63
Describe the psoas sign
The pt is supine and attempts to raise the right leg against resistance
64
What is the term for painful swallowing?
Odynophahia
65
Describe how to perform the obturator sign.
The pt is supine and attempts to flex and internally rotate the right hip
66
What is the best imaging study for acute appendicitis?
CT
67
What 2 blood tests can be used to dx celiac?
IgA endomysial antibody and IgA tTG antibody
68
How much fiber should you normally get in a day?
About 30 grams
69
What tx should be started for asymptomatic diverticulosis?
None
70
Is surgery curative for Crohn's or ulcerative colitis?
Ulcerative colitis
71
What causes Mallory-Weiss tears?
Forced vomiting or retching (often involving alcohol)
72
A colonoscopy that shows cobblestone or skip lesions should make you think of what dx?
Crohn's disease
73
What class of medication is the first line to tx inflammatory bowl disease in the maintenance phase?
5-ASA products: Sulfasalazine Mesalamine
74
Currant jelly stool should make you think of what dx?
Intussusception
75
Severe abdominal pain :30 after a meal should make you think of what dx?
Intestinal ischemia
76
What is the most common cause of lower GI bleed?
Diverticulosis
77
What is the most common location of colorectal cancer?
Cecum about 38%
78
Colorectal pts are almost all older than what age?
90% are older than 50
79
An epigastric olive-shaped mass should make you think of what dx?
Pyloric stenosis
80
An elevated serum amylase and lipase should make you think of what dx?
Pancreatitis
81
Under routine circumstances when should pts begin getting screening colonoscopies?
Age 50
82
What is the #1 cause of small bowel obstruction?
Postoperative adhesions
83
Air fluid levels on abdominal x-ray should make you think of what dx?
Bowel obstruction
84
What is more likely to pass into the scrotum, a direct or indirect hernia?
Indirect
85
A string sign on barium swallow should make you think of what dx?
Pyloric stenosis
86
What is the first line tx for an anal fissure?
Fluid and fiber
87
What 2 things that an anal fissure off midline might suggest?
Crohn's, syphilis, HIV, neoplasm
88
What medical tx is given for a gastrinoma?
Proton pump inhibitors
89
What is the term for an abscess in the sacrococcygeal cleft?
Pilonidal disease
90
How do you tretH. Pylori infection?
PPI + 2 antibiotics, Commonly omeprazole & clarithromycin & amoxicillin Or PPI & metronidazole & TCN
91
Painless bright red blood per rectum should make you think of what dx?
Hemorrhoids
92
A pt on sulfasalazine for an inflammatory bowel disease should be supplemented with what vitamin?
Folate
93
What is the most common anorectal problem affecting pts over 50?
Hemorrhoids
94
A gastrinoma is also known as what syndrome?
Zollinger-Ellison syndrome
95
Salivary amylase breaks down what macronutrient?
Carbohydrates
96
What is the medical term for feeling like there is a lump in your throat?
Globus
97
What is the most common vessel blocked with intestinal ischemia?
Superior mesenteric artery
98
Describe Grey-Turner's sign
Flank ecchymosis often related to pancreatitis
99
What are the first 3 steps of managing pancreatitis?
NPO Pain control Fluids
100
A pt presents with unproductive retching, acute localized epigastric distention and inability to pass a nasogastric tube. What is the most likely dx?
Gastric volvulus
101
What is the most common cause of a folate deficiency?
Alcoholism
102
Should diverticulitis always be admitted?
No, mild cases can be treated as outpatients with rest and clear fluids
103
Which NSAID has the highest rate of peptic ulceration?
Naproxen
104
What is the diagnostic test of choice for Zenker's diverticulum?
Barium swallow will show the diverticulum
105
What is the leading cause of iron deficiency anemia?
Chronic GI bleed
106
At what age and how often should fecal occult blood tests be performed as a screening tool?
Beginning at age 50, and they should be performed annually.
107
How often should pts with pernicious anemia have a screening endoscopy performed?
Every 5 yrs looking for signs of gastric carcinoma
108
Are one half of all adult hernias direct or indirect inguinal hernias?
Indirect inguinal hernias make up 50% of all adult hernias.
109
How is celiac disease most commonly diagnosed?
Endoscopic biopsy
110
Define pellagra
Niacin (B3) deficiency
111
An endoscopy for presumed esophagitis shows several solitary deep ulcers. What is the most likely dx?
Cytomegalovirus
112
Which are more painful--hemorrhoids above or below the dentate line?
Below, internal hemorrhoids are not painful.
113
An abdominal exam with pain out of proportion to the exam should make you think of what dx?
Intestinal ischemia
114
Does adenocarcinoma arise from the proximal or distal esophagus
Distal

Casey: Panre (12 decks)

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