GI Flashcards
(115 cards)
1
Q
What is the term for difficulty swallowing?
A
Dysphagia
2
Q
Birds beak esophagus on barium swallow should make you think of what diagnosis?
A
Achalasia
3
Q
What is the most common location for an anal fissure?
A
Posterior midline
4
Q
Crohn’s is found where in the GI tract?
A
Esophagus to anus
5
Q
What does HBsAG indicate?
A
Active Hep B infection
6
Q
How do you treat Achalasia?
A
Loosen up the muscle, botox, dilation, or surgery
7
Q
A corkscrew appearance on barium study should make you think of what diagnosis?
A
Esophageal spasms
8
Q
Epigastric abdominal pain which radiates to the back should make you think of what diagnosis?
A
Pancreatitis
9
Q
In order to contract Hep D what must you already have?
A
Hep B
10
Q
LLQ pain and tenderness should make you think of what diagnosis?
A
Diverticulitis
11
Q
What ist he treatment for Mallory-Weiss tears?
A
Watching and waiting, these will typically resolve in 48 hours
12
Q
Thumbprint sign on abdominal film should make you think of what diagnosis?
A
Intestinal ischemia
13
Q
What will the bowel sounds be early on in a small bowel obstruction? Later on?
A
Early they are HYPERactive, late they are HYPOactive
14
Q
A patient has had GERD for years. Over the past year he has noticed an increase in difficulty swallowing his food. This should make you think of which diagnosis?
A
Esophageal strictures
15
Q
What are two treatments you should consider for esophageal strictures?
A
Dilation of the esophagus and long term PPIs
16
Q
What are two common predisposing factors for esophageal varices?
A
Portal HTN and cirrhosis often caused by alcoholism
17
Q
What is a common symptom that goes along with chest pain for GERD patients?
A
Dry cough
18
Q
What medication is most commonly used for long term treatment of GERD?
A
PPIs - omeprazole, lansoprazole, pantoprazole
19
Q
What is the imaging modality of choice for pancreatitis?
A
CT
20
Q
What is the best test to check for H. pylori?
A
Urea breath test
21
Q
Is PUD more common in the duodenum or stomach?
A
Duodenum
22
Q
What is the most common location for a pancreatic tumor?
A
75% occur in the head of the pancreas
23
Q
With a gastric ulcer are the patients symptoms exacerbated or relieved with food?
A
Exacerbated
24
Q
Fasting gastrin will be above what level with gastronome?
A
150pg/mL
25
Projectile vomiting should make you think of what diagnosis?
Pyloric stenosis
26
Most gallstones are made of what substance?
Cholesterol
27
What is the name of the sign when a patient shows inhibited respiration with pressure over the RUQ? What diagnosis does it suggest?
Murphy's sign, cholecystitis
28
What is the *most specific* test for acute cholecystitis?
HIDA
29
What is the gold standard for diagnosis and treatment of bile duct stones?
ERCP
30
What is Charcot's triad?
RUQ pain, fever, jaundice
31
What is Reynold's pentad and what does it mean?
Charcot's triad + hypotension + altered mental status. It indicates high risk of sepsis.
32
What is the main risk factor for esophagitis?
Immunocompromised patient
33
An endoscopy for presumed esophagitis shows multiple shallow ulcers. What diagnosis should you be thinking of?
Herpes simplex virus
34
List two common offending agents for pill induced esophagitis?
NSAIDs, KCL, iron, antibiotics
35
A thirty year old African American woman presents with dysphagia. You notice she also has thickened skin. A barium swallow demonstrates the absence of peristalsis. What diagnosis should you be thinking of?
Scleroderma
36
What is the most common cause of PUD?
H. pylori (FYI this is Michelle's favorite bacteria everyone get her an H. pylori for her bday)
37
What is the most specific diagnostic test for PUD?
Endoscopy
38
What is the only curative therapy for gastric adenocarcinoma?
Surgical resection
39
A patient presents complaining of right upper quadrant pain 20 min after meals. What diagnosis should you be thinking of?
Cholecystitis
40
What does ERCP stand for?
Endoscopic retrograde cholangiopancreatography.... Say that 20 times fast
41
What is the most common cause of acute bacterial cholangitis?
Choledocholithiasis
42
Onion ring fibrosis from a bile duct biopsy should make you think of what diagnosis?
Primary sclerosing cholangitis
43
What 2 viral hepatitis infections are self limiting?
A and E
44
Pica is often related to what type of anemia?
Iron deficiency anemia
45
What does Anti-HBc indicate?
Previous or on-going hepatitis B infection
46
What does Anti-HBs indicate?
Recovery from infection or immunization to Hep B
47
What is the recommended treatment for Hep C infections?
Pegylated interferon alpha-2a
48
What medication used in hep b infections helps prevent the need for liver transplant?
Lamivudine
49
There are vaccines for which two versions of hepatitis?
Hep A and Hep B
50
Will a patient with achalasia have dysphagia to liquids, solids, or both?
Both
51
If you have heartburn that does not improve with medication what diagnosis should you be thinking about?
Gastrinoma
52
What are the two 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?
Cholelethiasis and ETOH
56
Describe cullens sign
Umbilical ecchymosis often related to pancreatitis
57
What are the 5 points of Ranson's criteria on admission?
Older than 55, WBC greater than 16, glucose greater than 200, LDH greater than 350, AST greater than 150
58
What is the first step in treating GERD?
Lifestyle modification
59
Steatorrhea should make you think of what GI related diagnosis?
Pancreatitis
60
Describe Courvoisier's sign
Nontender, palpable gall bladder which may indicate pancreatic neoplasm
61
What tumor marker can be used to follow pancreatic cancer?
CA-19-9
62
Patient complains of periumbilical pain which has now
| moved over McBurney's point. What diagnosis should you be thinking of?
Appendicitis
63
Patient is supine and attempts to raise their right leg against resistance.. What test is this?
Psoas sign
64
What is the term for painful swallowing?
Odynophagia
65
The patient is supine and attempts to flex and internally rotate the hip
Obturator sign
66
What is the best imaging study for acute appendicitis?
CT
67
What disease is defined as an immunologic response to gluten?
Celiac disease
68
What two blood tests can be used to diagnose celiac's disease?
IgA endomysial antibody and Ig tTG antibody
69
How is celiac disease commonly diagnosed?
Endoscopic biopsy
70
How much fiber should you get in a day?
30 grams
71
What is the treatment for asymptomatic diverticulosis?
None
72
Is surgery curative for Crohn's disease or ulcerative colitis?
Ulcerative colitis
73
What causes Mallory-Weiss tears?
Forced vomiting or retching
74
A colonoscopy that shows cobblestone or skip lesions should make you think of what diagnosis?
Crohn's disease
75
What class of medication is first line to treat inflammatory bowel disease in the maintenance phase?
5-ASA products: Sulfasalazine, mesalamine
76
Currant jelly stool should make you think of what diagnosis?
Intussusception
77
Severe abdominal pain 30 min after a meal should make you think of what diagnosis?
Intestinal ischemia
78
What is the most common vessel blocked with intestinal ischemia?
Superior mesenteric artery
79
What is the most common cause of lower GI bleeds?
Diverticulosis
80
What ist he most common location of colorectal cancer?
Cecum about 38%
81
Colorectal cancer patients are almost all older than what age?
90% are over 50
82
An epigastric olive shaped mass should make you think of what diagnosis?
Pyloric stenosis
83
An elevated serum amylase and lipase should make you think of what diagnosis?
Pancreatitis
84
Under routine circumstances when should patients begin getting screening colonoscopies?
Age 50
85
What is the #1 cause of small bowel obstructions?
Postoperative adhesions
86
Air fluid levels on an abdominal x-ray should make you think of what diagnosis?
Bowel obstruction
87
Which is more likely to pass into the scrotum, a direct or indirect hernia?
Indirect
88
A string sign on barium swallow should make you think of what diagnosis?
Pyloric stenosis
89
What is the first line treatment of an anal fissure?
Fluid and fiber
90
What are two things that an anal fissure off midline might suggest?
Crohn's, syphilis, HIV, neoplasm
91
What medical treatment is given for gastronome?
PPI
92
What is the term for an abscess in the sacrococcygeal cleft?
Pilonidal disease
93
How do you treat H. pylori infections?
PPI + 2 Abx, commonly omeprazole and clarithormycin and amoxicillin or PPI + metronidazole + tetracycline
94
Painless bright red blood per rectum should make you think of what diagnosis?
Hemorrhoids
95
Which are painful, hemorrhoids above or below the dentate line?
Below, internal hemorrhoids are NOT pianful
96
A patient on sulfasalazine for an inflammatory bowel disease should be supplemented with which vitamin?
Folate
97
What is the most common anorectal problem affecting patients over 50?
Hemorrhoids
98
A gastrinoma is also known as what syndrome?
Zollinger-Ellison syndrome
99
Salivary amylase breaks down which macronutrient?
Carbohydrates
100
What ist he medical term for feeling like there is a lump in your throat?
Globus
101
Describe Grey-Turners sign.
Flank ecchymosis often related to pancreatitis
102
What are the first three steps of managing pancreatitis?
NPO, pain control, fluids
103
A patient presents with unproductive retching, acute localized epigastric distention and inability to pass an NG tube. What diagnosis should you be thinking of?
Gastric volvulus
104
What ist he most common cause of a folate deficiency?
Alcoholism
105
Should diverticulitis always be admitted?
No, mild cases can be treated as outpatients with rest and clear fluids
106
Which NSAID has the highest rate of peptic ulceration?
Naproxen
107
What is the diagnostic test of choice for Zenker's diverticulum?
Barium swallow
108
What is the leading cause of iron deficiency anemia?
Chronic GI bleed
109
At what age and how often should fecal occult blood test s be performed as a screening tool?
Beginning at age 50 and done every year thereafter
110
How often should patients with pernicious anemia have a screening endoscopy performed?
Every 5 years to look for signs of gastric carcinoma
111
Are one half of adult hernias direct or indirect inguinal hernias?
Indirect make up 50% of all adult hernias
112
Define pellagra?
Niacin (B3) deficiency
113
An endoscopy for presumed esophagitis shows several solitary deep ulcers. What diagnosis should you bet thinking of?
Cytomegalovirus
114
An abdominal exam with pain out of proportion to the exam should make you think of what diagnosis?
Intestinal ischemia
115
Does adenocarcinoma arise from the proximal or distal esophagus?
Distal
