GI Flashcards
(99 cards)
1
Q
Cleft lip/palate
A
Failure of facial prominences to fuse
2
Q
Painful ulcer with gray base surrounded by erythema in mouth
A
Aphthous ulcer
3
Q
Multiple bouts of oral ulcers, genital ulcers and difficulty seeing
A
Behcet syndrome
- Immune complex vasculitis
4
Q
White, rough patch on side of tongue
A
Oral hairy leukoplakia
- EBV
5
Q
anti-endomysial
A
Celiac sprue
6
Q
anti-transglutaminase
A
Celiac sprue
7
Q
Intrapeithelial CD8, crypt hyperplasia, villous atrophy/flattening
A
Celiac sprue
8
Q
Liver tumor with central scar
A
Focal nodular hyperplasia
9
Q
Abdominal pain, jaundice, pruritis, weight loss
A
Cholangiocarcinoma
10
Q
Cholangiocarcinoma risk factors
A
PSC, Clonorchis, cirrhosis, choledochal cysts
11
Q
anti-mitochondrial
A
PBC
12
Q
anti-topoisomerase
A
systemic sclerosis
13
Q
Xanthoma/hypercholesterlemia, pruritis, icterus, jaundice, HSM, elevated IgM, alk phos, GGT, 40 y/o woman
A
PBC
- Auto-immune granulomatous
14
Q
Mumps complications
A
Sterility if post-puberty
Asceptic meningitis
Pancreas
15
Q
Salivary gland inflammations
A
Stone from SA
16
Q
Tumor of cartilage and epithelium in partoid. Mobile, painless
A
Pleomorphic adenoma
-HIGH rate of recurrence
17
Q
1 salivary tumor
A
Pleomorphic adenoma
18
Q
Hx of salivary tumor with sudden onset facial paralysis
A
Pleomorphic adenoma –> carcinoma
19
Q
Cystic salivary tumor with lymphoid tissue
A
Warthin
20
Q
1 malignant salivary tumor
A
Mucoepidermoid
- Parotid & CN VII
21
Q
Plummer-Vinson Syndrome
A
Iron deficiency anemia
Esophageal web
Atrophic glossitis/beef red tongue
22
Q
Painful hematemesis with crackling noise in skin
A
Mallory-Weiss
- alcohol or bulemia
23
Q
Boerhave syndrome
A
Esophageal rupture from mallory-weis –> subcutaneous emphysema (crakckling)
24
Q
1 cause of death in cirrhosis
A
Rupture of esophageal varices
25
Painless hematemesis, portal HTN
Rupture of esophageal varices
26
Progressive dysphagia, bad breath, high LES pressure
Achalasia
- loss of myenteric plexus = can't relax
- T. cruzi
- --> SCC
27
Adult onset asthma
GERD
28
Risk factors for GERD
```
Alcohol
Obesity
Fat rich diet
Caffeine
Hiatal hernia
Tobacco
```
29
Type of epithelium in Barrett's
Metaplasia from stratified squamous --> Non-ciliated columnar w/ goblet cells
30
Risk factors for SCC of esophagus
```
Upper 2/3
#1 worldwide
Alcohol
HOT TEA - Iran, China
Achalasia
Webs
Lye/injury
```
31
Projectile non-bilious vomiting, visible peristalsis, small palpable mass in abdomen
Pyloric stenosis
32
CuRling ulcer
BuRn --> hypovolemia --> inc acid
33
Cushing ulcer
Inc ICP -->inc vagus --> inc acid
34
Atrophy of gastric mucosa, achlorhydria, megaloblastic anemia
Auto-immune gastritis
- Fundus & Body
- Abs --> parietal cells or intrinsic factor
- INC ADENOCARCINOMA
- Damage by T-cells (Type IV HS)
35
Complications of H. pylori gastritis
Intestinal type adenocarcinoma
| B- cell MALT
36
Epigastric pain improves w/ meals
Duodenal ulcer
- posterior --> gastroduodenal a. rupture or pancreatitis
- hypertrophy of Brunner glands
- NEVER malignant
37
Epigastric pain worsens w/ meals
Gastric ulcer
| - LESSER curvature
38
Intestinal type gastric carcinoma
```
Ulcer
H.pylori
Nitrosamines
Sister-Mary Joseph nodule
Lesser curvature
Type A blood
```
39
Signet ring cells (nucleus on edge d/t mucous), early satiety, thickening of stomach wall
Diffuse type gastric carcinoma
| - No H. pylori or nitrosamines
40
Cancer assoc w/ B/L ovarian tumors
Diffuse gastric type
41
Acute onset of diffuse seborrheic keratoses
Lesar-Trelat sign = gastric carcinoma
42
Assoc with duodenal atresia
Down syndrome
| Double bubble sign
43
Most common congenital GI anomaly
Meckels
44
Volvulus in elderly
Sigmoid
45
Volvulus in younger ppl
Cecum
46
Kid w/ currant jelly stools
Intussusception
```
Kids = lymphoid hyperplasia from rotavirus
Adults = tumor
```
47
Causes of SI ischemia
Transmural
- SMA thrombosis, embolism - A-fib, poluarteritis
- SMV - polycythemia vera, Lupus
Mucosal = hypotension
48
HLA DQ6, 8
Celiac sprue
49
Chronic diarrhea w/ small vesicles on skin
Celiac sprue
- dermatitis herpetiformis
- IgA in dermal papillae
- IgA deficiency
- DUODENUM
50
Refractory celiac disease can lead to?
CA
| T-cell Lymphoma
51
Site of celiac disease
DUODENUM
52
Site of tropical sprue
Jejunum & ileum --> vit B12 & folate deficiency
Responds to antibiotics
53
Steatorrhea w/ PAS + MO in lamina propria of SI
MO loaded with T. whippelii
Can also cause arthritis, involve valves, LN, CNS
54
B-48
Chylomicrons
55
B-100
LDL, VLDL
56
Tumor + for chromogranin
Carcinoid
57
Only small bowel cancer
Carcinoid
58
5-HIAA in urine
Carcinoid
59
What must you have to order to have carcinoid syndrome (bronchospasm, diarrhea, flushing, R sided valve disease)?
Mets --> liver
No L-sided heart disease b/c LUNG HAS MAO
60
Most common cause of acute abdomen
Appendicitis
Kids = lymphoid hyperplasia
Adults = fecalith
61
30 y/o women w/ recurrent bouts of diarrhea and abdominal pain
IBD
62
Hallmarks of UC
CRYPT ABSCESSES w/ neutrophils
PSC, p-ANCA
63
Hallmarks of CD
Transmural
NON-bloody diarrhea
GRANULOMAS
Cobblestone, creeping fat, strictures
calcium stones, fistulas
Ankylosing spondylitis, erythema nodosum, uveitis
64
Dx of hirschsprungs
Rectal suction bx
65
Hematochezia, LLQ pain, constipation, older ppl
Diverticula
66
Hematochezia, RLQ pain, constipation, older ppl
Angiodysplasia
| - cecum
67
Pneumaturia, UTIs with fecaluria
Fistula from sigmoid diverticula
68
Post-prandial pain, weight loss, pain and bloody diarrhea
Ischemic colitis
| - atherosclerosis of SMA @ SPLENIC FLEXURE
69
abdominal pain with bloating, flatulence, change in bowel habits that improves with defecation
IBD
70
Most common polyp
serrated, benign, L colon
71
Adenoma-Carcinoma sequence
APC --> KRAS --> p53
72
Adenomatous polyps
benign --> malignant
| ASPIRIN IMPEDES PROGRESSION
73
High risk polyps for progression
>2cm
Sessile/Flat
Villous = villain
74
Gardner syndrome
Fibromatosis & Osteomas (skull)
75
Turcot syndrome
FAP + medulloblastoma or glial tumors
76
Kid with polyp protruding from anus
Juvenile, hamartomatous polyp, solitary
Polyposis = multiple --> carcinoma
77
Multiple GI hamartomas, hyperpigmentation on lips, oral mucosa, genitals
Peutz-Jeghers sydrome
INC RISK for colorectal, breast, GYN cancer
78
Napkin ring lesion, dec stool caliber, LLQ pain
Colorectal carcinoma
| - adenomacarcinoma sequence
79
Raised lesion, iron deficiency anemia, vague pain
Colorectal carcinoma
| - Microsatellite instability = DNA mismatch --> instability in repeating non-coding DNA
80
Kid in car accident w/ pain radiating into back, N/V, elevated lipase
Acute pancreatitis
81
Inc urine, amylase:cr, inc amylase and lipase, DEC Ca
Acute pancreatitis
82
Chain of lakes, pain radiating into the back, steatorrhea, fat sol vitamin deficiencies, excess neutral fats in stool
Chronic pancreatitis
- etOH or CF
- Amylase and lipas NOT helpful
- Inc risk for DM-II, carcinoma
83
Thin elderly male presents with new onset diabetes, pain worse lying down, better bending forward, pale stools, palpable GB, CA 19-9, migratory thrombophlebitis
Pancreatic carcinoma
| - smoking and chronic pancreatitis
84
Risk factors for cholesterol gallstones
```
Radiolucent
Women, 40, OCPs - high estrogen
Cholestyramine binds bile acids
Clofibrate inc HMG-CoA reductase
Native American
CD
Cirrhosis
```
85
Pigmented gallstones
Radioopaque
| Extravascular hemolysis - infection from ascaris, clonorchis
86
Rokitansky-Aschoff sinus
Herniation of GB mucosa --> mucular wall
87
Porcelain GB
chronic cholecystitis
- dystrophic calcification
--> carcinoma in elderly woman
88
Bands of fibrosis and regenerative nodules , ascites, anemia, hemorrhoids
Cirrhosis
| - TGF-beta from STELLATE CELLS
89
Asterixis, gynecomastia, spider angiomas, palmar erythema, jaundice
Cirrhosis
| - both PT and PTT inc but follow PT
90
Mallory bodies
Swelling of hepatocytes
| DEGENERATED INTERMEDIATE FILAMENTS
91
Inc ferritin, dec TIBC, inc serum iron, inc % sat
Hemochromatosis
- HFE gene
- testicular atrophy
- Prussian blue stain (vs. lipofuscin)
92
ATP7B gene
Wilson disease
93
Behavioral changes, chorea, dementia, discolored iris
Wilson disease
- -> HCC
- Tx = D-penicillamine
94
Periductal onion skinning, string of pearls, p-ANCA, UC
PSC
95
Only flu-like illness you use aspirin
Kawasaki
96
Intraperitoneal bleeding during pregnancy
Rupture of hepatic adenoma
| - OCPs
97
Risks for HCC
HBV, HCV
storing grains - Aflatoxin from Aspergillus
Cirrhosis
High AFP
98
Nodular free edge of liver
Mets to liver
| - LUNG, BREAST, colon, pancreas
99
3 most common causes of small bowel obstruction
ABCs - adhesions, bulges/hernia, cancer
