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Flashcards in GI Deck (64):
1

What is the best lab test for chronic pancreatitis?

Low fecal elastase

2

Tumor marker for hepatocellular carcinoma?

AFP

3

What are the two lymph node findings associated with gastric cancer (location and name)?

-Left supraclavicular=Virchow's
-Periumbilical=Sister Mary Joseph

4

Treatment for Ulcerative colitis?

5-ASA (Mesalamine for small bowel disease and Sulfasalazine for large bowel disease)

exacerbations=steroids

5

Bug associated with diarrhea and pseudo-appendicitis?

Yersinia

6

Marker for Primary Biliary Cholangitis? Who gets it?

-Anti-mitochondrial antibodies
-Bitches get it
(pBc=Bitches, ladies also carry the mitochondria, which helps with remembering the antibodies...you're welcome)

7

What is the treatment for PBC?

Ursodeoxycholic acid

8

What marker is associated with PSC? What does imaging show?

-pANCA.
-beads on a string

(p=penis, beads=balls, men get this more)

9

What disease is associated with PSC?

Ulcerative colitis

10

What patient population is more likely to get fulminant hepatic failure if they have hepatitis E?

Preggos

11

What types of viral hepatitis increase your risk of hepatocellular carcinoma?

Hep B and C

12

What meds are used for outpatient treatment of diverticulitis?

-Cipro and flagyl
-Bactrim and flagyl
-amoxicillin-clavulonate

13

Treatment for hepatic encephalopathy?

Lactulose and Rifaximin (kills bacteria that produce ammonia)

14

When are alcoholic cirrhosis patients eligible for liver transplant?

-abstinence from booze for 6 months

15

What is Budd-Chiari Syndrome? Symptoms? What is the most sensitive and specific test to diagnose it?

-thrombosis and occlusion of the hepatic vein or supra hepatic portion of the IVC
-Symptoms: ascites, jaundice, hepatomegaly +/- RUQ pain
-Hepatic venography is the most sensitive and specific (Ultrasound is the best initial test)

16

What SAAG score indicates portal HTN?

SAAG >= 1.1

17

Treatment of SBP?

-Cefotaxime or third generation cephalosporin x 5 days.
-Albumin =helps prevent hepatorenal

18

Lab test for suspected hemochromatosis (bronze diabetes)? Tx?

-Ferritin and Transferrin
-Tx: phlebotomy

19

Lab test for Wilson's? What foods should these people avoid?

-Low ceruloplasmin
-high copper food: shellfish, organ meats, chocolate, nuts, mushrooms

20

Markers associated with autoimmune hepatitis?

-Anti-smooth muscle Ab, Liver kidney microsomal (LKM) antibodies

21

Risk for hepatic adenoma?

OCP

22

Ranson criteria?

GA LAW, C HOBBS
Glucose
AST
LDH
Age
WBC

Ca2+
Hematocrit
Oxygen
BUN
Base deficit
Sequestration of fluid

23

What is the treatment for Entamoeba histolytica?

Metronidazole or paromomycin

24

What is the treatment for Giardia lamblia?

Metronidazole

25

What is the treatment for Trichinella spiralis

Albendazole or mebendazole

26

What is the treatment for Cryptosporidium parvum?

Nitazoxanide

27

What tests are used to evaluate for celiac disease?

-anti-tissue transglutaminase Ab
-Anti-gliadin Ab
-Anti-endomysial Ab

-EGD with duodenal biopsy--> blunting of villi and hypertrophic crypts

28

What is the triad associated with Plummer-vinson syndrome?

Esophageal webs, dysphagia, and iron deficiency anemia

29

"Corkscrew" on Barium Swallow? Tx?

Diffuse Esophageal Spasm
-Tx: CCB and nitrates or TCA

30

What is Barrett's esophagus?

Metaplasia of the columnar cells of the distal esophagus

31

Pt with bad breath and regurgitating food that was eaten several days ago?

Zener's Diverticulum (right above the UES)

32

Treatment of H. pylori?

-PPI, amoxicillin, clarithromycin

33

What is a Cushing ulcer associated with?

Increased intracranial pressure -> increased gastric acid secretion

34

How can you determine if a GI bleed is upper or lower?

NG lavage

35

Medication for GI bleed if varices are suspected?

Octreotide (decrease splanchnic blood flow)

36

Most common causes of SBO?

-Adhesions
-Bulge (incarcerated hernia)
-Cancer

37

Old man with abdominal pain, diarrhea, weight loss, arthralgia and neurological problems....diagnosis?

Whipple disease (Tropheryma whipplei)

38

Intestinal biopsy showing lamina propria filled with fat droplets and PAS + foamy macrophages? Tx?

Whipple disease
-IV ceftriaxone then oral Bactrim for 12 months

39

What is the D-Xylose test used for?

To test for passive absorption of carbohydrates.
-Will be NORMAL in pancreatic insufficiency (does not need pancreatic enzymes to absorb).
-Will be abnormal in celiac disease

40

How do you calculate a stool osmotic gap? What value is osmotic diarrhea? Secretory?

-Osmotic gap= 290 - 2(Na+stool + K+stool)
->125--> osmotic diarrhea
- secretory diarrhea

41

Cause of a caucasian with foul-smelling diarrhea and iron deficiency anemia?

Celiac disease

42

Recent immigrant from the Dominican Republic with foul-smelling chronic diarrhea with macrocytic anemia?

Tropical Sprue

43

Chronic diarrhea + arthralgia + ataxia

Whipple Disease

44

What skin finding is associated with Celiac?

Dermatitis herpetiformis

45

Chronic diarrhea with a positive stool sudan stain and a normal D-xylose test. Cause?

Pancreatic insufficiency

46

Most common food borne bacterial GI infection?

Salmonella

47

"bacterial dysentery"? Treatment?

-Shigella
-FQ, bactrim

48

When should you do further studies for acute diarrhea? What is the workup?

Severe diarrhea: hypovolemia, bloody stools, fever, >6 stools/day, duration >1 week, severe abdominal pain, older age, immunocompromised.
-workup: fecal leukocytes, stool culture, +/- ova and parasites if immunocompromised, +/- giardia and E. histolytic if associated with surface water, c. diff toxin

49

Rice water diarrhea

vibrio cholera. Agressive rehydration!!

50

What parasitic infection can cause liver abscesses?

Entamoeba histolytica. Tx: metronidazole

51

Rome Criteria for IBS?

-recurrent abd pain for 3+ days/month/3months and 2 of the following:
-Relief with defecation
-onset associated with change in frequency of stool
-onset associated with change of form of stool

52

What serum lab findings can distinguish Crohn's from UC?

Crohns=ASCA +
UC= pANCA +

53

What unique image can you see on a plain film of a patient with ovules?

Double bubble

54

How can a gallstone obstruct the normal propulsive ability of the bowel?

-can pass through a biliary-enteric fistula and become impacted in the ileum

55

Carcinoid syndrome symptoms?

"Be FDR"
-bronchospasm
-flushing
-diarrhea
-right sided valvular disease

56

Outpatient treatment of diverticulitis?

-NPO
-FQ + metronidazole

57

APC gene mutation?

Lynch syndrome (hereditary non-polyposis colon cancer)

58

What is the best initial lab test in a suspected ZES? Then what?

-gastrin level --> if >1000 then do a secretin stimulation test

59

Migratory thrombophlebitis (Trousseaus sign)?

can be a complication of pancreatic adenocarcinoma

60

What is necrolytic migratory erythema associated with?

Glucagonoma

61

What meds can stop insulin production in an insulinoma

Diazoxide and octreotide

62

Best test for acute cholangitis?

ERCP

63

"porcelain gall bladder" (with calcifications) seen on US?

Gallbladder cancer

64

What patients are at risk for acalculous cholecystitis?

-Critically ill patients
-TPN