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Flashcards in GI Deck (41):
1

Most common environmental factor assoc with pancreatic cancer?

Smoking

2

Courvoisier Sign
D/t?

Obstruction causing the gallbladder to become palpable
Often malignant neoplasm obstructing CBD

3

Pathogen responsible for most hepatic abscess

Klebsiella pneumoniae. (Also associate with infections of biliary tract, fatty liver disease, and DM pts.)

4

Gastritis

gnawing epigastric pain, anemia, extremity paresthesia

5

GERD

persistent hoarseness, dry cough, dysphagia

6

Gastric ulcer

Left sided chest pain and anorexia

7

Esophagitis

Severe chest pain, nausea, bitter "water brash"

8

Duodenal ulcer

Abdominal pain, dyspepsia, weight gain

9

Glycogen Storage Disorder I (Von Gierke's disease)

Auto Rec deficiency in Glucose 6 Phosphatase
*Doll Like Face*
hypoglycemia when fasting --> lactic acidosis and Kussmaul resps

Tx: cornstarch feedings

10

What is the best test to evaluate biliary dilatation without gallstones on US?

CT of abd with contrast

11

What electrolyte abnormality is the hallmark of Refeeding syndrome?

HyPOPhosphatemia

12

Most effective treatment for Non-Alcoholic Steatohepatitis

Weight loss

13

Zenker's diverticulum is due to what?

motor dysfunction of cricopharyngeus allowing for herniation between its muscle fibers

14

What are the surgical indications for diverticulitis?

Tx?

Presence of a fistula
perforation
2+ attacks in the same region

Tx: Partial colectomy

15

What is a common cause of GI blood loss (manifesting as iron deficiency anemia) in elderly patients who have no other obvious source of bleeding?

Angiodysplasia

16

What should you always do for a new onset dysphagia?

Upper endoscopy

17

Booerhaave v. Mallory Weiss

Boerhaave is esophageal perforation after excessive vomiting/bulimia

Mallory Weiss is superficial mucosal tear seen in a weekend warrior

18

Dx. Boerhaave syndrome?

Gastrograffin swallow then Barium then EGD

19

Dx. Mallory Weiss?

EGD

20

Tx. Diffuse esophageal spasm?

CCB, Nitrates

21

Dx. for achalsia and zenker's diverticulum?

barium swallow

22

Schatski's ring keywords

steakhouse dysphagia
barium swallow
surgery to lyse ring

23

Gold standard for confirming reflux?

24 hr esophageal pH monitoring

24

Barret's Esophagus has a risk of developing what ca?

Adenocarcinoma

25

Ulcer types Curling v. Cushing

"burn from curling iron"
"cushion the brain"

26

Gastric ca. keywords

Mucosal cell metaplasia
Signet ring cells
Virchow's (left supraclavicular) node

27

Most common location of a VIPoma? Keywords?

@ pancreatic tail
tea-colored watery diarrhea
hypOkalemia, hypochlorhydria

28

Right sided colon ca. keywords

Bleed --> Iron Def. anemia
+ Melena

29

Left sided colon ca. keywords

Apple core
Obstructing
Pencil stool
Hematochezia

30

Angiodysplasia of colon is associated with?

Aortic Stenosis
Heyde's syndrome

31

If there's Upper GI Bleed, what's the next dx. step?

EGD if stable
NG tube and lavage

32

If there's Lower GI Bleed with no bleeding, what's the next dx. step?

Colonoscopy

33

If there's Lower GI Bleed with medium amount of bleeding, what's the next dx. step?

Tagged RBC scan

34

If there's Lower GI Bleed with high bleeding, what's the next dx. step?

Arteriogram

35

Labs in Biliary Tract obstruction

Increased ALKPHOS, GGT, Conjugated Bili
Jaundice, pruritus, clay stool, dark urine

36

Ulcerative Colitis keywords

Bloody diarrhea
Colon ca. (do annual colonoscopy after 8 yrs of disease)
Crypt Abscesses
Erythema nodosum
Lead Pipe
Mucosa and submucosa inflamm.
Primary Sclerosing cholangitis (pANCA, ANA)
Pseudopolyps
@ Rectum
Toxic Megacolon

Tx: 5ASA, Steroids

37

Crohns keywords

Anti-Saccharomyces-Cervisiae Abs (ASCA)
Cobblestone
Fistulas
Non-caseating granulomas
Perianal fissures
Skip lesions
Transmural
Watery diarrhea
Nephrolithiasis (IBD causes impaired fat absorption)

Tx: 5ASA, Corticosteroids, Infliximab IV (TNFa Ab), No NSAIDS.

38

Primary Sclerosing Cholangitis (PSC) keywords

HLA-DR52A
pANCA
Males with Ulcerative Colitis
Cholangiocarcinoma risk
Onion Skinning

Tx: Ursodiol, ERCP, Liver transplant

39

Most common type of colonic polyps?

Adenomatous. Have malignant potential.

40

Primary Biliary Cirrhosis (PBC) --> cholestasis

S&S

Dx

Tx

middle age woman
pruritus, skin hyperpigmentation,
hepatomegaly, fatigue, xanthelasma, steatorrhea
Increased ALKPHOS

+ Anti-mitochondrial Ab (AMA)

Tx: Ursodeoxycholic Acid

41

Esophageal Varices Ppx?

Propranolol, Nadolol (non-selective BBs)