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Flashcards in GI Deck (99)
1

Cleft lip/palate

Failure of facial prominences to fuse

2

Painful ulcer with gray base surrounded by erythema in mouth

Aphthous ulcer

3

Multiple bouts of oral ulcers, genital ulcers and difficulty seeing

Behcet syndrome
- Immune complex vasculitis

4

White, rough patch on side of tongue

Oral hairy leukoplakia
- EBV

5

anti-endomysial

Celiac sprue

6

anti-transglutaminase

Celiac sprue

7

Intrapeithelial CD8, crypt hyperplasia, villous atrophy/flattening

Celiac sprue

8

Liver tumor with central scar

Focal nodular hyperplasia

9

Abdominal pain, jaundice, pruritis, weight loss

Cholangiocarcinoma

10

Cholangiocarcinoma risk factors

PSC, Clonorchis, cirrhosis, choledochal cysts

11

anti-mitochondrial

PBC

12

anti-topoisomerase

systemic sclerosis

13

Xanthoma/hypercholesterlemia, pruritis, icterus, jaundice, HSM, elevated IgM, alk phos, GGT, 40 y/o woman

PBC
- Auto-immune granulomatous

14

Mumps complications

Sterility if post-puberty
Asceptic meningitis
Pancreas

15

Salivary gland inflammations

Stone from SA

16

Tumor of cartilage and epithelium in partoid. Mobile, painless

Pleomorphic adenoma
-HIGH rate of recurrence

17

#1 salivary tumor

Pleomorphic adenoma

18

Hx of salivary tumor with sudden onset facial paralysis

Pleomorphic adenoma --> carcinoma

19

Cystic salivary tumor with lymphoid tissue

Warthin

20

#1 malignant salivary tumor

Mucoepidermoid
- Parotid & CN VII

21

Plummer-Vinson Syndrome

Iron deficiency anemia
Esophageal web
Atrophic glossitis/beef red tongue

22

Painful hematemesis with crackling noise in skin

Mallory-Weiss
- alcohol or bulemia

23

Boerhave syndrome

Esophageal rupture from mallory-weis --> subcutaneous emphysema (crakckling)

24

#1 cause of death in cirrhosis

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