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