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Flashcards in GI Deck (141):
1

Drugs that can cause GERD

BB, CCB, nirates, anticholinergics

2

S/S of GERD

heartburn, dysphagia, cough, laryngitis

3

DX of GERD

pH monitoring, endoscopy w/ biopsy

4

TX of GERD

: lifestyle mod, antacids, metoclopramide,
H2 blockers, proton pump inhibitors

5

what type cancer is esophageal carcinoma usually

squamous cell carcinoma (du to smoking and ETOH)

6

what causes adenocarcinoma in the esophagus?

barretts esophagus

7

Risk factors for esophageal carcinoma

Vit A/C deficiency, achalasia, celiacs,

8

symptoms of esophageal carcinoma

progressive dysphagia for solid foods

9

found in upper 1/3 os esophagus, associated with iron deficiency anemia

Esophageal Webs

10

neural defect with fibrosis and
scarring with decreased peristalsis causing
dysphagia for solids & liquids, weight loss, chest
pain, nocturnal cough

Achalasia

11

how to Dx achalsia

manometry showing decreae peristalsis
radiography showing birds beak deformity

12

TX for achalasia

balloon dilatation, botox, nitrates , BB, CCB< prostaglandins

13

– systemic collagen vascular disease
with dysphagia for solids & liquids

scleroderma

14

Mucosal herniation causing regurgitation of undigested food

zenker's diverticulum

15

– Mucosal tear causing significant hematemesis (but painless)
after initial nonbloody vomitus/retching

Mallory Weiss syndrome

16

– Mucosal tear causing significant hematemesis (but painless)
after initial nonbloody vomitus/retching

Boerhaave's syndrome

17

Tx for boerhaave's syndrome

surgery

18

does H. pylori more commonly cause duodenal ulcers or gastric ulcers?

duodenal

19

what type cancer of the stomach is H. pylori associated w/?

adenocarcinoma

20

Risk factors for gastroparesis

T1DM, systemic sclerosis, Parkinson's, anticholinergics

21

Tx for gastroparesis

metroclopramide, domperidone, erythromycin

22

Constriction of the circular muscle of the
pylorus

pyloric stenosis

23

RF for pyloric stenosis

first born males, macrolides, maternal smoking during pregnancy

24

S/S of pyloric stenosis

projectile vomiting of nonbilious material, palpalbe olive sized mass in epigastrium

25

DX for pyrloci stenosis

Ultrasound > UGI contrast study

26

TX for pyloric stenosis

surgery (pyloromyotomy)

27

associated conditions with peptic ulcer disease

RA
COPD
hepatic/ renal failure
Type A personality

28

in what type ulcer does eatign diminish the pain?

duodenal ulcer

29

in what type ulcer does eating exacerbate the pain

gastric

30

gold standard for dx of PUD

endoscopy

31

Tx for H. pylori

PPI + amoxicillin _ clairthyromycin

32

• Gastrin hypersecreting tumor associated with PUD

Zollinger-Ellison syndrome

33

what other organs can zollinger-ellison syndrome involve?

pancreas

34

Symptosm w/ zollinger Ellison syndrome

Pain, diarrhea, increased parathyroidism

35

Dx of Zollinger Ellison syndrome

gastrin levels >150

36

Tx for Zollinger Ellison syndrome

H2 blockers, PPI, total gastrectomy

37

symptoms of gastric carcinoma

anorexia, weight loss, epigastric pain, vomiting, possible GI bleeding

38

what is a common water borne diarrhea that is treated with metronidazole?

giardia lamblia

39

diarrhea found in AIDS patients that is watery and profuse

cryptosporidium

40

DX of a small bowel obstruction

air fluid levels above the obstruction on x-ray

41

TX for SBO

IV fluids, NG decompression, surgery

42

where is Meckel's diverticulum found

terminal ileium

43

Inflammatory bowel disease with an abnormal
sensitivity to gluten
• S/Sx : diarrhea, steatorrhea, weight loss, IDA,
abdominal bloating

celiac sprue

44

Dx of celiac

– Small bowel biopsy on gluten : villous atrophy
– Antigliadin antibodies (90%)

45

Chronic granulomatous disease occurring
anywhere from mouth to anus with ileum most
often involved

Crohns disease

46

what will be seen on colonoscopy with crohn's

Cobblestone filling defects with segmental areas of
involvement
– Deep ulcerations (collar button)
– Long strictured segments (string sign)
– Skip areas

47

most common type of small bowel tumor

adenocarcinoma

48

Chronic inflammatory disease of colon that
starts distally at the rectum and gradually
progresses proximally
• Continuous lesion

ulcerative colitis

49

Tx for ulcerative colitis

– Mesalamines > Sulfasalazine > Corticosteroids

50

most common type of colon cancer

adenocarcinoma

51

s/s colon cancer

fatigue, pain, change in stool size, blood in stool

52

lab used to monitor colon caner

CEA (carcinoembryonic antigen) –

53

perianal pruritus, rectal bleeding, anal pain
& palpable mass in the anal region

hemorrhoids

54

tx for hemorrhoids

stool softeners, sitz bath, surgery

55

4 drugs that can cause acute pancreatitis

azathioprine, furosemide, estrogens, steroids

56

symptoms of acute pancreatitis

epigastric or periumbilical pan radiates to back. Worse with walking, lying supine. Better sitting and leaning forward

57

PE signs with acute pancreatitis

Cullen's sign, Gray turner's sign

58

DX of acute pancreatitis

upper EUS, CT scan

59

Tx for acute pancreatitis

NPO, bowel rest, IV fluids, NG suction, TPN

60

what will ERCP show with chronic pancreatitis

irregular beading

61

what may an abdominal film show with chronic pancreatitis

pancreatic calcification

62

what type carcinoma are most pancreatic carcinomas?

adenocarcinoma

63

S/S of pancreatic adenocarcinoma

post prandial epigastric pain for 3-4 months, radiate to back. relieved by sitting or bending both knees Jaundice, weight loss

64

RF for gallstones

OCPs, pregnancy, rapid weight loss, FMHx DM< crohn's TPN

65

what drugs can cause cholesterol gallstones

clofibrate, cetriaxone, octerotide

66

who are pigment gallstone found ine (made of calcium bilirubinate)

chronic hemolysis (SS diseae) and asians

67

crampy postprandial pain in epigastrium or
RUQ that may radiate to back near right scapular
tip, fever, N/V, ileus, ↑ WBC

acute cholecystitis

68

what percent of gallstones are radiopque?

15%

69

Tx for acute cholecystitis

IV fluid, NG suction , surgery

70

Gallstone stuck in the common bile duct
• Sx : intermittent colicky pain in RUQ, fevers,
chills, jaundice, possible sepsis

choledocholithiasis

71

Tx for choledocholithiais

ABX conrol, surgical extraction of stone

72

What is Charcot's triad

Fever >40, RUQ pain, jaundice

73

Rare disease causing progressive narrowing of
the bile ducts, M > F, dx in 3rd to 4th decade

sclerosing cholangitis

74

70% of people with sclerosing cholangitis also have what?

IBD (usually ulcerative colitis)

75

Tx for sclerosing cholangitis

steroids, methotreate, long term abx, stens, surgery

76

what type cancer is found in the gallbladder (typically older women)

adenocarcinoma

77

genetic & rather benign
condition that affects 7% of US population,
decreased uridine diphosphate (UDP)
glucuronyl transferase activity leads to mild
unconjugated hyperbilirubinemia

Gilbert's syndrome

78

genetic absence of
hepatic UDP enzyme activity. Pts usually die in
infancy with Type I.

Crigler-Najjar syndrome

79

what type of hepatitis is post-transufion, lead sto chronic hepatitis and cirrhosis and puts an individual at an increased risk of hepatocellular carcnioma

Hepatitis C

80

symptoms of hepatitis

malaise, anorexia, fatigue, abd pain, arthritis, urticaria, flu like syndrome, juandice, heaptic enlargement, splenomegaly, tea colored urine

81

Dx of hepatitis

increase in ALT>AST, increased bilirubin, i> ALP

82

with hepatitis A which Ig rises quickly

IgM

83

What is diagnostic of hepatitis B?

positive surface antigen

84

what is diagnostic for hepatitis C

positive antibiotics to hepatitis C

85

Tx for hepatitis (supportive)

supportive, IV fluitds, correct electrolyte abnormalitites, claories for N/V, Vitamin K for elevated Pt/INR

86

Drug treatment for hepatitis B

interferon in combination with lamivudine (HBV) and

87

drug treatment for hepatitis C?

interferon in combination with ribavirin

88

progressive jaundice, hepatic
encephalopathy and ascites. Mortality rate varies
with age and approaches 90‐100% in patients older
than 60 years of age (HBV, HCV and rarely HAV)

fulminant hepatitis

89

complication of HBV,HCV, & HDV,
with liver enzymes elevated for > 6 months.
Inflammation , necrosis, fibrosis bridge portal areas
and disease may progress to cirrhosis.

chronic hepatitis

90

what hepatitis' can lead to hepatocellular carcinoma?

HBV, HCV, HDV

91

what will be seen on PE with hepatitis complications

splenomegaly, spider angiomas, caput medusa

92

how is hepatitis A transmitted?

RNA virus, fecal oral

93

incubation time for hepatitis A?

30 days

94

when will jaundice appear with hepatitis A?

after 5-10 days

95

What lab will be positive with hepatitis A?

+IgM anti-HAV

96

incubation period for hepatitis b?

6 weeks-6 months

97

what serology will an individual vaccinated with hepatitis B have?

Anti-HGs

98

RNA virus spread by IV drug users, sex, tattoos. Incubation time of 6-7 weeks

hepatitis C

99

what drugs can cause liver disease through direct toxicity?

APAP, amiodarone, aspirin, ETOH, niacin, phosphorus, heavy metals

100

what drugs can cause viral like hepatitis?

isoniazid, dilantin, sulfonamides, halothane

101

lab values with cirrhosis of the liver

anemia (macroctic), thrombocytopenia (alcoholic BM suppression), increased LFTs, prolonged INR, decreased albumin

102

drug tx for hepatic encephalopathy

lactulose

103

what causes a liver abscess

entamoeba histolytica

104

who are liver abscess common in

homosexual men, institutionalized individuals

105

Tx for liver abscess

metronidazole

106

– genetic defect, homozygotes
usually have liver disease in childhood, no effective
therapy but transplant

A1 antitrypsin deficiency

107

genetic disorder with increased abosprtion of iron and deposition. Will have increased serum ferritin.

hemochromatotisis

108

tx for hemochromatosis

phelbotomy

109

how does sarcoidosis present in the liver

liver granulomas

110

genetic disorder of excess copper deposition (cornea will have Kayser Fleischer rings)

wilson's disease

111

treatment for wilson's disease

penicillamine

112

benign pruritus and jaundice in the third timester that goes away after delivery

cholestasis

113

pregnancy- hemolysis, increased liver enzymes, low platelets in the third trimester. tx is delivery

HELLP syndrome

114

rare liver condition in pregnancy- seen in eclamptic patients

hepatic rupture

115

common liver tumor in patients using OCPs. occasional RUQ fullness and if adenoma ruptures hemorrhage is fatal in 1/4 of patients

hepatic adenoma

116

dx of hepatic adenoma

CT scan and cold spot on liver scanning

117

Tx for hepatic adenomas

D/C OCPs and if regression doesn't occur do surgery

118

most common benign liver tumor, usually no symptoms, but can have decreased platelets

hemangiomas

119

Dx of hemangiomas

angiography, Ct/MRI

120

Tx for hemangioma

usually not needed , can do steroids, radiotherapy, embolization

121

associated with HBV, HCV, chronic hepatitis, alcoholic cirrhosis, hemochromatosis, gallbladder ancer

hepatocelluclar carcinoma

122

S/Sxs with hepatocellular carcinoma

pain, obstructive jaundice, anorexia, weiht loss, anemia

123

Lab present in hepatocellular carcinoma

alpha fetoprotein (AFP) serum trumor marker

124

etiology of ascitites

increase hydrostatis pressure, decreased colloid osmotic pressure (decrease proteins), increased permeability of peritoneal capillaries, leakage of fluid into peritoneal cavity

125

PE with ascitites

dullness to percussion + fluid wave . Diagnose by ultrasound

126

Gonococcal peritonitis typically in young women due to ascending infection originating in the pelvis

Fitz-Hugh-Curtis syndrome

127

Tx for gonococcal peritonitis

ceftriaxone, add tetracycline if chlamydia present

128

what are the most common peritoneal tumors

metastatic lesions

129

Decreased blood supply usually involving the
superior mesenteric artery. RF include atherosclerosis, CHF, AMI.

acute mesenteric ischemia

130

Tx for acute mesenteric ischemia

surgical removal of embolusor thrombus, stent or angioplasty

131

most common type of hernia

indirect in guinal hernia

132

most common vitamin deficiency, commonc ause of blindness (starting with night blindness)

vitamin A deficiency

133

Signs of vitamin A toxicity

dry, scaly skin, hair loss, vomiting, hypercalcemia, papilledema, HA, hepatomegaly

134

deficiency due to chronic alcoholism. ANorexia, muscle cramps, paresthesias, irritability

B1 thiamine

135

deficiency that presents with cheilosis, angular stomatitis, glossitis, seborrheic dermatitis, corneal vascularization and anemia

Riboflavin B2

136

Deficiency with pellagra (dermatitis, diarrhea, dementia)

niacin deficiency 9B3)

137

Deficiency that is common with ETHO and isoniazid, cycloserine, penicillamine, and OCPs. will have mouth soreness, glossitis, cheilosis, weakness, irritability

Vitamin B6 deficieicny (pyridoxine)

138

Advanced deficiency presents with scurvy- parafollicular hemorrhages, petechiae, purpura, bleeding gums, impaired wound healing

Vitamin C

139

Vitamin D deficiency presents as what?

oteomalacia

140

Symptoms of vitamin E deficiency

areflexia, gait disturbance, decreased proprioception, fibration, ophthalmoplegia

141

Symptom of vitamin K deficiency

bleeding dyscrasia