GI Flashcards
(113 cards)
1
Q
Corkscrew X-Ray
A
Esophageal spasm, volvulus
2
Q
Apple core X-Ray
A
Colorectal CA
3
Q
“Stacked coin” X-Ray
A
Intussusception
4
Q
Thumb Print on X Ray
A
Toxic Megacolon
5
Q
Coffee Bean sign on X Ray
A
Sigmoid Volvulus
6
Q
Bird’s Beak X Ray
A
Achalasia
7
Q
String Sign on X Ray
A
Pyloric Stenosis
Crohn’s
8
Q
Liquid Dysphagia causes
A
Scleroderma
Achalasia
9
Q
Traction diverticulum
A
Out-pouching between UES and LES
10
Q
Plummer Vinson
A
Esophageal webs at UES
Spoon nails from Fe-deficient anemia
11
Q
H-Type TE Fistula
A
Chokes with each feeding, congenital
12
Q
C-Type TE Fistula
A
Baby vomits with first feeding
Large gastric bubble
Distended abdomen
Failure of Apoptosis
13
Q
Duodenal Atresia
A
Bilious vomiting with first feeding
Double bubble on XRay
Associated with Down’s
14
Q
Choanal Atresia
A
Baby turns blue with feeding
Pinks when breast or bottle is removed
Blocked nasal passage
15
Q
RLQ Sausage mass
A
Intussusception
16
Q
Type A gastritis
A
Upper GI bleed
Auto-immune (Anti-parietal cell Abs)
Atrophic / Achlorhydria
Increased risk of Adeno in stomach body and fundus
17
Q
Type B gastritis
A
Upper GI bleed
Associated with eating spicy foods
Loss of barrier protection, H. Pylori
Antrum of stomach
18
Q
Menetrier’s Disease
A
Loss of protein through rural folds: General edema
CMV association in children, H. Pylori in adults
19
Q
Celiac Sprue
A
Jejunum, villous atrophy
Anti-gliadin abs
20
Q
Tropical Sprue
A
Distal ilium
Bacterial or viral, amoeba
21
Q
Bugs of bloody diarrhea
A
Campylobacter
Entamoeba Histolytica
Shigella
E. coli
Salmonella
22
Q
PBC
A
Anti-Mitochondrial Abs
Bile ducts destroyed
Xanthelasmas and pruritis
23
Q
PSC
A
P-ANCA, maybe anti-SM
Bile ducts scarred from inflammation
Beading and onion skinning
UC association (rectum)
24
Q
What kind of gallstone can be seen on X Ray
A
Calcium Bilirubinate
25
Type 1 hyperlipidemia
Defective LPL
Chylomicrons elevated
26
Type 2A hyperlipidemia
Defective LDL-Clathrin Pit or B-100
LDL elevated
27
Type 2B Hyperlipidemia
Deficiency of adipose receptors and LDL receptors
Increased LDL and VLDL
28
Type 3 Hyperlipidemia
Defective ApoE
Elevated IDL
29
Type 4 Hyperlipidemia
Defective Adipose LPL
Elevated VLDL
30
Type 5 Hyperlipidemia
Defective enzyme and co-receptor (C-II)
Elevated VLDL and chylomicrons
Associated with DM
31
Criggler-Najar I
Unconjugated bilirubin buildup
Newborn or infants
No UDP-GT
No change with phenobarbital
32
Gilbert's syndrome
Stress induced unconjugated hyperbilirubinemia
Overwhelmed glucoronyl transferase
33
Currant jelly sputum vs stool
Sputum is klebsiella, stool is intussusception
34
Turcot's Syndrome
FAP with brain tumors
35
Gardener's syndrome
FAP with bone tumors
36
UC
Continuously Ascending from rectum
IBD with pseudo polyps
Hematochezia, lead pipe colon, toxic megacolon
37
Crohn's
Transmural, cobblestoning, melena, creeping fat, fistulas, skip lesions
38
knees to chest for comfort in child
Intussusception
39
=IBS
Alternating diarrhea and constipation
Associated with stress, no abnormalities on colonoscopy
40
Whipple's disease
T Whipplei destroys the GI tract
Malabsorption, arthralgia
PAS+
41
Charcot triad
Jaundice, fever (usually with rigors), RUQ pain
42
Common ERCP side effect
Pancreatitis from blocking the pancreatic duct during the procedure
43
Reynolds Pentad
Jaundice, fever (usually with rigors), RUQ pain, HPTN, change in mental status
44
Sudan black stain
Steatorrhea: it visualizes lipids
45
Colon cancer bugs
Clostridium melanogosepticus
Strep Bovis
46
H2 Blocker MOA
Blocking H2 blocks H+ secretion
AE: prolactin release, cimetidine inhibits P450
"-tidine"
47
Misoprostol
PGE1 analog increases gastric mucous barrier
Protects against NSAID ulcers, induces labor, maintains PDA
48
Octreotide
Somatostatin analog
Tx vatical bleeds, acromegaly, VIPoma, carcinoid
49
Infliximab
binds TNF
Tx Crohn's, RA
AE: respiratory infection (Tb reactivation), fever, HPTN
50
Sulfsalazine
Antibacterial Sulfapyridine + 5-ASA (anti-inflammatory)
Activated by Colonic bacteria
Tx UC and Crohn's
AE: Malaise, nausea, reversible oligospermia, sulfonimide
51
Ondansetron
5-HT3 antagonist, powerful anti-emetic
Good for post-op, chemo
52
The osmotic laxatives
Mag Hydroxide, Mag Citrate, PEG, lactulose
53
Metoclopramide
D2 antagonist
Increases resting tone, contractility of LES, motility
Tx diabetic and post-surgery gastroparesis
AE: Parkinsonian, restlessness, drowsiness, fatigue, interacts with digoxin and DM drugs, c/I w/ SBO
54
Electrolyte levels in hypovolemia
Increased net Na, decreased serum Na (dilution)
Decreased serum K+
Increased serum pH (From H/K exchanger)
55
Vit A deficiency
Poor night vision
Hypoparathyriodism
Dry Skin
56
B1 Deficiency
Thiamin
Beriberi, Wernicke, Korsakoff
57
B2 Deficiency
Riboflavin
Angular cheilosis
58
B3 Deficiency
Pellagra: Diarrhea, Dermatitis, Dementia, Death
59
B4
Lipoic Acid
No deficiency syndrome
60
B5
Pantothenic Acid
No deficiency syndrome
61
B6 Deficiency
Pyridoxine
Peripheral neuropathy
62
B9 Deficiency
Folate
Megaloblastic anemia
Hypersegmented Neutrophils
Neural Tube Defects
63
B12 Deficiency
Cyanocobalamin
Megaloblastic anemia
Hypersegmented neutrophils
Neuropathy
64
Vitamin E Deficiency
Increased free radical damage
Hemolytic anemia
Ataxia gait
Impaired position and vibration sense
65
B7 deficiency
Biotin
Loss of carboxylase function
66
Mg deficiency
Hypoparathyroidism
Loss of kinase function
67
Zinc deficiency
Dysgeusia, anosmia, poor wound healing
68
Cu deficiency
Monkey Kinky Hair syndrome
69
Disease associated with chromium deficiency
DM
70
Disease associated with Selenium deficiency
Dilated cardiomyopathy
71
Tin deficiency
Poor hair growth
72
Deficiencies causing loss of xanthine oxidase function
Molybdenum and Manganese
Causes renal problems and kidney stones
73
Fluoride deficiency
Poor teeth and bone growth
74
Hunger
Lateral hypothalamus
Caused by ghrelin
75
Temperature regulation
Cooling: Anterior hypothalamus
Warning: Posterior hypothalamus
76
CFTR bugs
Staph aureus and Pseudomonas
77
Nucleus ambiguous
Innervates UES
Efferent vagus (motor CN X)
78
Dorsal motor nucleus
Innervates the rest of GI after UES (Motor CN X)
79
Treat Zenker's
Craico-pharyngeal myotomy
80
Screening in Barrets
PPI, Upper endoscopy every 2-3 years
81
When to use pH monitor
Persistent GERD after 4 week PPI trial
82
Testing for Dysphagia (painless)
Barium Esophagram
83
Corkscrew barium esophagram
Diffuse esophageal spasm
84
Gastric ulcer management
CLO (H Pylori) test
Endoscopy on all
85
Peptic Ulcer Dz management
Triple: PPI + Amox/metro + Clarythro/tetracycline
Positive CLO? Add bismuth or sucralfate
86
Pancreatic Pseudocyst
No epithelial lining
0-5cm, observe. Bigger? Drain it.
87
Virchow's Triad
Cholesterol gall stones
Cholesterol high
Bile Salts and Lethicin down
88
Dx Gallstones
U/S, HIDA scan (most specific)
89
Gallstone treatment
Symptomatic? Schedule a surgery
ASx? Ursodeoxycolic acid
90
Where are things absorbed in the small intestine?
Jejunum except for iron (duodenum), ADEKB12 (Ileum)
91
Screen for Celiac
Anti-tTG or anti-endomysium
92
Treat celiac sprue
Folate and abx for 6 mo
93
Treat Crohn's
Mild and on the Left: Prednisone
Ileum or on the Right: Budesinide
Moderate - severe: AZT or 6MP
94
Treat UC
Distal? Sulfsalazine
Becoming proximal? Mesalamine
Fails? Glucocorticoids. Fail? Infliximab
Surgery is curative
95
Head cancer types
Jaw and down: squamous
mouth and up: Basal
96
Ilium lymphoma
Early upper GI obstruction
Napkin ring lesion (Apple Core)
Melena, pencil-thin stools
97
Appendix cancer
Most common is leiomyoma, carcinoid
Causes tricuspid damage, does not metastasize
98
When to get FAP colectomy
19. It is 100% cancer by age 20.
99
Gardener syndrome
FAP and osteomas and sebaceous adenomas
100
Turcot syndrome
FAP and brain tumor (glioblastomas)
101
Hydatid liver cyst
From dogs
find eggshell calcifications, septations after a GI upset
102
Klebsiella liver cyst
Has air in it, travel
103
VACTRL
Vertebral abnormalities
Imperforate Anus
Cardiac defects
TE Fistula
Renal abnormalities
Limb abnormalities
104
Beckwith-Weideman
Omphalocele
Hemihypertrophy
Wilm's Tumor
Enlarged tongue
Insulinoma
105
Colonoscopy screening
10 years before direct family relative was dx
OR age 40, whichever comes first
106
Treat DM gastroparesis
Metaclopramide
Second line Erythromycin
107
Where does a carcinoid tumor come from
Small intestine
108
Biliary atresia
Cholestasis + Hepatomegaly + Direct hyperbilirubinemia
Tx w/ Kasai procedure (hepato-porto-enterostomy)
109
Manage gout
Acute: 1. NSAID 2. Colchicine 3. Glucocorticoids
Chronic: Allopurinol
110
Veins involved in hemorrhoids
Internal: superior rectal vein
External: Inferior rectal vein
111
Treat Fitz-Hugh-Curtis
Cefoxitin and Doxy IV
112
Acute Cholecystitis imaging
Wall thickening with fluid and stones
113
Labs by bile duct geography
Cystic duct: gallbladder only, nothing.
Alk phos: entire duct. Isolated elevation means Common bile duct
GGT: only above the gallbladder: Common hepatic duct.
