GI Diagnosis Flashcards
(82 cards)
1
Q
Type of diarrhea that ↓ with fasting, <1 L vol and has > 50 osmotic gap
A
Osmotic
2
Q
Type of diarrhea that persists with fasting, >1 L vol daily and may have small osmotic gap
A
Secretory
3
Q
Type of diarrhea that hass >6 x daily bowel mvts
Stool with mucus and blood
Volume <1 L daily
A
Exudative
4
Q
Strawberry gallbladder
A
Cholesterolosis
5
Q
RF for Cholelithiasis
A
fat, fertile, female, forties
6
Q
MC etiology of Cholelithiasis
A
cholesterol
7
Q
MC location of Acute Cholecystitis
A
Cystic duct/neck obstruction
8
Q
Hallmark of Chronic Cholecystitis
A
Rokitansky-Aschoff sinuses
9
Q
MC gallbladder carcinoma
and MC location
A
MC Adenocarcinoma
fundus or body > neck
10
Q
What causes pancreatic pseudocysts?
A
massive liquefactive necrosis
11
Q
MC location of pancreatic neoplasms
A
head of pancreas
12
Q
What diagnostic test should you do for ductal adenocarcinoma?
A
Endoscopic retrograde cholangiopancreatography
(ERCP) with aspiration cytolog
13
Q
What diabetes is insulin dependent?
A
Type 1 DM
14
Q
Absolute deficiency of insulin due to autoimmune destruction of islets
A
Type 1 Diabetes
15
Q
Relative insulin deficiency and insulin resistance both seen in most cases; after many years, insulin deficiency becomes severe
A
Type 2 Diabetes
16
Q
Dysphagia
Ring of mucosal tissue in the distal esophagus which can cause narrowing and dysphagia
A
Schatzki’s Ring
17
Q
Dysphagia
fullness, gurgling, coughing, aspiration, regurgitation of food, obstructive sx
A
Zenker’s Diverticula
18
Q
Dysphagia
↑ LES resting pressire & inability to relax
Absence of peristalsis in body of esophagous
Dilated esophagous (caused chest pain)
Narrowed distal esophagous (bird’s beak)
A
Achalasia
19
Q
What is MC cause of esophageal infection?
A
candidias
20
Q
What is MC cause of gastroduodenal injury in U.S.?
A
NSAIDs
21
Q
What is the mechanism of NSAID damage?
A
Inhibit prostaglandins through reversible inhibition of both COX-1 (PG are GI protective) and COX-2 (PG mediate pain, inflam and fever) enzymes
22
Q
Epigastric abd pain worse in AM
Fatigue, black stool
Anorexia, melana, hematemesis, weight loss
A
Peptic Ulcer Disease
23
Q
Bloating N/V Early satiety Epigastric pain Regurgitation of undigested food Weight loss
A
Gastroparesis
24
Q
Major cause of infant morbidity and mortality
Fever, Vomiting, Diarrhea, Dehydration
A
Rotavirus
25
People in close quarters – cruise ship
Vomiting, abdominal cramps, diarrhea, low-grade fever
Food, water, swimming pools, shellfish (heat- resistant)
Norovirus
26
Diarrhea, headache, nausea
| Children < 3 years immunosuppressed adults
Astrovirus
27
Signs of wet beriberi
```
peripheral vasodilatation
high‐output heart failure
dyspnea
tachycardia
cardiomegaly
pulmonary edema
peripheral edema
warm extremities
mimicking cellulitis
```
28
Signs of dry beriberi
polyneuropathy- affecting leg, footdrop, wristdrop, areflexia
CNS- Wernicke encephalopathy, Korsakoff (or combo)
29
Signs of Wernicke encephalopathy
nystagmus, ophthalmoplegia, truncal ataxia, confusion
30
Signs of Korsakoff syndrome
mnesia and psychiatric manifestations
31
Esophageal ca etiology
Squamous cell carcinoma (Eastern Europe and Asia)
| Adenocarcinoma (western Europe)
32
SB ca etiology
adenoCa
33
Pancreas Cancer etiology
adenoCa
34
Anal Pain
"I'm passing razor blades"
Anal Itching
Outlet Bleeding
Anal Fissure
35
```
Very painful
Feels like hard pea sticking out
Constant Pain Protrusion
Bleeding
Tender Mass Protrusion
```
Secondary Findings: skin necrosis, prolapsed Internal, hemorrhoids
Thrombosed External Hemorrhoid
36
```
Constant Pain
Pressure
Subacute Onset
Fever
Malaise
Visable bulge on buttock
```
PE: Erythema, induration, swelling, drainage
Perianal abscess
37
```
Asymptomatic
Biliary colic (pain)
Cholecystitis (inflammation/infection)
Choledocholithiasis
Cholangitis (life threatening obstruction when stone gets impacted or impacts bile duct)
RUQ Pain, crescendo/decrescendo
```
Cholelithiasis
38
Constant and severe RUQ pain
Radiation to shoulder
Fever, N/V
Cholecystitis
39
Charcot's triad: Fever, RUQ pain, jaundice
Reynolds Pentad: above +sepsis, mental status change
Ascending Cholangitis
40
Asymptomatic
Abnormal LAE’s
Cholangitis
Complications:
Stones
Strictures Due to inflammation
and fibrosis
Cholangiocarcinoma (screen with MRI every year for this)
Higher risk of colon cancer in patients with UC
Primary Sclerosing Cholangitis (PSC)
41
Eriology of Cholelithiasis
```
MC cholesterol
Black pigment (darker and harder)
Brown pigment (bacteria-brown and softer)
```
42
Diagnostic test of choice for ascenginf cholangitis
Endoscopy (ERCP)
43
Test for PSC
Cholangiogram
MRCP -minimally invasive and prevents introduction of bacteria to bild duct
44
Eriology of GB ca
Adenocarcinomas
45
```
N/V/D
Abd. Pain
Fever, Chills, HA
~ 4 hr after ingetsion
Summer months
```
Ham and other pork products, poultry, baked goods, salads)
Staphylococcal Food Poisoning
46
Sudden onset of nausea and vomiting Incubation period 1-6 hours
Abdominal cramps, watery diarrhea, nausea Incubation period 10-12 hours
Freid rice
Bacillus cereus Food Posioning
47
Canned food
| Lassitude, progressive weakness and vertigo
Clostridium botulinum Food Posioning
48
14h to 5 days
Abrupt onset of profuse watery diarrhea with flecks of mucus (“rice water stool”) *HM
Mild to severe/life-threatening dehydration Fever in <5%
Vibrio cholerae
49
Incubation: 1-3 days
Watery diarrhea, abdominal cramps, low-grade fever
frutit, uncooked veggies
Enterotoxigenic E. coli (ETEC)
50
Fever, Vomiting, Diarrhea, Dehydration
| infant
Rotavirus
51
Vomiting, abdominal cramps, diarrhea, low-grade fever
Food, water, swimming pools, shellfish (heat- resistant)
Cruise
Norovirus
52
Asymptomatic in most children
```
Acute
1-4 week incubation
Loose, foul-smelling stools Steatorrhea: fat malabsorption
Cramping, bloating, nausea
Anorexia, malaise, weight loss
No blood in stools
```
Chronic → growth impairment
Bever
Giardia duodenalis
53
Loose stools to massive watery or grossly bloody diarrhea
Severe abdominal cramping relieved by defecation
Bacteremia, meningitis, abscesses
Gastroenteritis less common
poultry
Campylobacter
54
Prodrome: abdominal cramps & mild fever
Non-bloody diarrhea within hours, progressing to bloody diarrhea within 1-2 days
grounf beef
STEC: Shiga toxin producing E. coli
55
Incubation: 6-48 hours
Fever, abdominal cramping, nausea, vomiting, & chills
Diarrhea watery, less commonly frankly bloody
eggs
Nontyphoidal Salmonella (NTS) Enterocolitis
56
Asymptomatic colonization Amoebic dysentery
Amoebic colitis
Liver abscess
tropical areas w/ poor sanitation
Amoebiasis
57
Chills, sweats, headache, malaise Cough, sore throat
Fever
Psychosis & confusion
Pain, constipation, N/V/D
“rose spots” – faint salmon-colored maculopapular rash on truck
Hepatosplenomegaly
Typhoid Fever
58
```
Abd pain radiating to back
N/V
Agitation
Abd distension
Guarding
```
Cullen, grey turner
Pseudocyst- only drain if causing sx
Alcoholic
Acute Pancreatitis
59
Weight loss, abd pain radiaitng to back
Loose, foul smelling stools (steatorrhea), diabetes
alcoholic
Chronic Pancreatitis
60
Amylase and lipase nrml or mildly elevated
Abx plain film- shows calcifications in pancreatic ducts
CT, MRI or EUS establishes dx
Honeycomb, ductal dilation
Chronic Pancreatitis
61
Incubation period ~ 30 d
Excreted in stool 1-2 wks before onset
Flu like sx, fatigue, loss of appetite, nausea
Dark urine, pale feces, scleral icterus, jaundice, tender & enlarged liver
raw shellfish
Hepatitis A
62
Incubation period 15‐45 days
Infection usually subclinical (esp in children and YA)
Undercooked pork or wild game
Hepatitis E
63
1‐4months
Malaise, rash, fever, arthralgia/arthritis
Anorexia, nausea/vomiting, abdominal pain
May have jaundice and tender liver on exam
extrahepatic: Polyarteritis nodosa, glomerulonephritis
IDU, YA male
Hepatitis B Virus
64
blood transmitted
| concurrent with Hep B
Hepatitis D
65
Clinically indistinguishable from other hepatitis causes
Asymptomatic or mild constitutional sx
HIV co-infection → ↑progression to fibrosis, blunted immune recovery, ↑ morbidity and mortality
Slow progression to liver dz
IDU, sexual
Hepatitis C
66
Pain, diarrhea or obstipation, fever
| LLQ pain MC (bc in sigmoid colon)
Diverticulitis
67
MC cause of hematochezia
Painless, profuse bleeding
Diverticular Hemorrhage
68
acute-onset, continued pain; nausea, vomiting; bloody diarrhea
Pain out of proportion to exam
Acute Mesenteric Ischemia
69
Weight loss, chronic diarrhea, bleeding or anemia, recent abx
Recurrent abdominal pain or discomfort
at least 3 days/mo in the last 3 months
+ at least two of the following:
Pain improves w/ defecation
Onset associated w/ a change in bowel habits
Onset associated w/ a change in stool form
Irritable Bowel Syndrome
70
RLQ pain
| Low fever, nausea, anorexia
Appendicitis
71
Occult or overt bleeding, anemia, abdominal pain, change in bowel habits
NSAID in high conc
NSAID Colopathy
72
Anorexia, muscle cramps, paresthesias, irritability
Advanced deficiency may cause:
“wet beriberi”‐ cardiovascular syndrome
“dry beriberi”‐peripheral and the central nervous
systems (wernicke encephalopathy, Korsakoff syndrome)
B1
| Thiamine Deficiency
73
cheilosis, angular stomatitis, glossitis, seborrheic dermatitis, weakness, corneal vascularization, anemia
B2
| Riboflavin deficiency
74
Anorexia, weakness, irritability, mouth soreness, glossitis, stomatitis, and weight loss
Advanced deficiency: triad of the three D’s (pellegra): dermatitis, diarrhea, and dementia
B3
| Niacin defieiency
75
Mouth soreness, glossitis, cheilosis, weakness, and irritability, peripheral neuropathy, a pellagra‐like syndrome, anemia, and seizures
B6
| Pyridoxine defieiency
76
Loss of appetite and weight loss , weakness,
sore tongue, headache, heart palpitations.
Can slow growth rat.
Greater risk to give birth to low birth weight
preamuture infants, neural tube defects
B9
| Folate deficiency
77
```
Macrocytic anemia (pernicious anemia), glossitis,
peripheral neuropathy, weakness, hyperreflexia, ataxia, loss of proprioception, poor coordination, and affective behavioral changes
```
Neurologic defects
B12 deficiency
78
Scurvy: hemorrhagic skin lesions, abnormal osteoid and dentin formation
Fatigue, depression, & CT defects, (gingivitis, petechiae, rash) internal bleeding, impaired wound healing
Impaited bone growth in children
Vitamin C
| Ascorbic Acid defieincy
79
Night blindness, dryness of the conjunctiva, Bitot’s spots (white patches on the conjunctiva), ulceration and necrosis of the cornea (keratomalacia), perforation, endophthalmitis, hyperkeratosis
vit A deficiency
80
Important for calcium homeostasis and metabolism → bone growth and immune system
vit D deficinecy
81
Mild hemolytic anemia
Neurological deficits (areflexia, gait disturbances, decreased vibration and proprioception, and ophthalmoplegia)
Vit E deficiency
82
Easy bruisability and mucosal bleeding (especially epistaxis, GI hemorrhage, menorrhagia, and hematuria)
vit K deficiency
