GI Correlation Flashcards by erin flaherty

what are acholic stools?

white clay colored stools, which result from the absence of secretion of bile into the GI tract

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what is Cullen sign?

ecchymosis around the umbilicus secondary to hemorrhage

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what is dyspepsia?

postprandial epigastric discomfort

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what is dysphagia?

difficulty in swallowing

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what is hematemesis?

vomiting blood

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what is hematochezia?

passage of bright red blood or maroon stools

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what is melena?

dark colored stool consistent with broken down hemosiderin in bowel; tarry

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what is pneumobilia?

abnormal presence of gas in the biliary system/bile ducts

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what is pneumomediastinum?

abnormal presence of air or gas in the mediastinum

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what is a pneumoperitoneum?

abnormal presence of air or gas in the peritoneal cavity

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what is odynophagia?

painful swallowing

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if someone comes in with RUQ what should you think?

gallbladder issues

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if someone comes in with epigastric pain what should you think?

pancreatitis or PUD/GERD

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if someone comes in LUQ pain what should you think?

gastritis or PUD

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if someone comes in with RLQ pain what should you think?

appendicitis

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if someone comes in with LLQ pain what should you think?

diverticulitis

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if someone comes in with peri-umbilical pain what should you think?

small or large bowel obstruction or appendicitis

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what is visceral pain secondary to?

distention or stretching

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what is parietal pain secondary to?

inflammation in the parietal peritoneum

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how is oropharyngeal dysphagia characterized and what is the most likely category of causation?

trouble initiating swallowing and neurologically caused

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what questions are important to ask if someone comes in with esophageal dysphagia?

solids liquids, or both; progressive or not; constant or intermittent

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what are the categories of causation for esophageal dysphagia?

mechanical or motility

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what is in a CBC?

blood cell count

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what is a CBC with Diff?

a blood count with the percentage and absolute differential counts (Baso, Eos, Mono)

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what does a basic metabolic panel show?

your electrolytes

what does a comprehensive metabolic panel show?

your electrolytes + liver function tests

what would you order if you were checking for pancreatitis?

lipase and amylase

what would you order to assess the liver?

AST/ ALT, GGT, fractionate bilirubin, and PT/INR

what does an acute abdominal series consist of?

a single view chest x-ray and a flat and upright x-ray of the abdomen

what is an acute abdominal series good for?

great to check quickly for free air (pneumoperitoneum) bowel obstruction and/or constipation

what is the barium swallow x-ray used for?

to differentiate between mechanical lesions and motility disorders

barium study is more sensitive for detecting subtle esophageal narrowing due to what?

rings, achalasia, and proximal esophageal lesions

what is the study of choice when a patient has persistent heartburn, dysphagia, odynophagia, or structural abnormalities detected on barium study?

EGD

what is the use of an EGD?

it is diagnostic and therapeutic

what is an ultrasound good for?

imaging fluid filled structures like the gallbladder, bladder, kidneys, aorta and vessels, and the heart

what is an US limited by?

air and fat

what is an ERCP used for?

if you have a patient with gallbladder disease who has elevated liver function tests--> they may have a stone in the common duct

what is the main difference between an ERCP and an MRCP?

an ERCP is both diagnostic and therapeutic while an MRCP is only diagnostic

what is a HIDA scan?

test specific for the gallbladder; measures the functional ability of the gallbladder

if you perform a HIDA scan on a patient and their gallbladder ejection fraction is less than 38%, what do they have?

biliary dyskinesia

what scan gives you the most information about abdominal pathology?

CT scan

how is diagnosis of GERD made?

based on clinical symptoms alone or an upper endoscopy

what are peptic ulcers?

defects in the gastric or duodenal mucosa that extend through the muscularis mucosa

what are two major risk factors for developing peptic ulcers?

H. pylori infection and NSAIDs

what is the most common cause of an UGI bleed?

peptic ulcers

how would you diagnose PUD?

EGD and check for H. pylori infection

what is the treatment for PUD?

proton pump inhibitor and eradicate H. pylori

H. pylori is associated with many types of GI pathology including:

PUD, chronic gastritis, gastric adenocarcinoma, gastric mucosa associated lymphoid tissue (MALT) lymphoma, and duodenal ulcers

what are two ways you can test for H. pylori?

urea breath test and fecal antigen test

how would you get a false negative fecal or urea breath test?

if the patient doesn't stop their proton pump inhibitor medication 14 days prior to the test

what is melena secondary to 90% of the time?

UGIB

what is hematochezia due to?

lower GI bleed

how is an UGIB defined?

any GI bleed originating proximal to the ligament of Treitz

what organs are involved in an UGIB?

the esophagus, stomach, the duodenum

how is a LGIB defined?

any GI bleed originating distal to the ligament of Treitz

what organs are involved in an LGIB?

jejunum, ileum, colon, and rectum

what are esophageal and gastric varices?

dilated submucosal veins resulting from portal hypertension

what are esophageal and gastric varices most often a result of?

alcoholic liver disease

what is cholelithiasis?

gallstones

what is cholecystitis?

inflammation of the gallbladder usually secondary to stone/obstruction in the neck of the gallbladder or cystic duct- LFTs are normal

what is choledocholithiasis?

when there is a stone stuck in the common bile duct (neither the liver nor the gallbladder can drain bile, LFTs are elevated

what is ascending cholangitis?

the biliary tree gets inflamed and infected; air in the biliary tree

what is gallstone pancreatitis?

when a gallstone gets stuck in the pancreatic duct- elevated LFTs and pancreatic enzymes (lipase and amylase)

how is a dysfunctional gallbladder diagnosed?

with a HIDA scan

what are the risk factors for pancreatitis?

gallstones and alcohol abuse

where does the appendicitis pain become localized?

McBurney's point

what is diverticulosis?

small pouches called diverticula in the colon

what is diverticulitis?

infection or inflammation of the diverticula

what would the barium swallow test look like on a patient with achalasia?

like a bird's beak in the distal esophagus

what is Chagas disease?

esophageal dysfunction indistinguishable from primary idiopathic achalasia

when should Chagas disease be considered?

in patients from endemic regions like mexico, central and south america

what is chagas disease caused by?

a parasite= trypanosoma cruzi