Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IM EOR > GI/Nutrition -- 12% of EOR > Flashcards

GI/Nutrition -- 12% of EOR Flashcards

1
Q

What antibody is associated with ulcerative colitis?

A

P-ANCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What antibody is associated with Crohn’s disease?

A

ASCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the cancer marker used to monitor hepatocellular cancer?

A

AFP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the cancer marker used to monitor pancreatic cancer?

A

C19-9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does Hep B surface antigen (HBsAg) presence indicate?

A

Current infection with Hep B, either acute or chronic; transmissible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does Hep B surface antibody (HBsAb/anti-HBs) presence indicate?

A

Hep B immunity; either prior infection or vaccination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does Hep B core antibody (HBcAb/anti-HBc) presence indicate?

A

History of Hep B infection or current infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Interpret Hep B results:
+ POSITIVE HBsAg
- NEGATIVE HBsAb
+ POSITIVE HBcAb

A

Current Hep B infection

If asymptomatic:
- Acute or chronic?
- Antibodies have not yet been produced in sufficient enough numbers to provide immunity
- Test IgM core antibody– this gets produced before HBsAb
+ if positive, acute, asymptomatic infection
- if negative, chronic infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Interpret Hep B results:
- NEGATIVE HBsAg
+ POSITIVE HBsAb
- NEGATIVE HBcAb

A

Has been vaccinated against Hep B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Interpret Hep B results:
- NEGATIVE HBsAg
+ POSITIVE HBsAb
+ POSITIVE HBcAb

A

Immunity via prior Hep B infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the marker of acute Hep B viral replication?

A

E antigen – when positive, high risk of transmission

Progress from E+ to E- is milestone in HBV treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the marker for acute Hep A infection?

A

Anti-HAV IgM (Hep A antibody IgM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Flu-like symptoms, clay stools, dark urine, and LFTs in the thousands are symptoms associated with what condition?

A

Acute hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the diagnostic criteria for acute pancreatitis?

A

2/3 must be present:

  • Epigastric pain
  • Lipase 3x UNL
  • Imaging w/ evidence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What imaging modality is best for diagnosing acute pancreatitis?

A

CT with contrast is best

US can be done

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Epigastric pain with significantly elevated lipase and ALT (3x UNL) is indicative of what condition?

A

Gallstone pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe cut-off sign

A

Seen on abdominal XR, paucity of air in colon distal to splenic flexure 2/2 functional spasm of descending colon due to pancreatic inflammation.

Indicative of severe, acute pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe sentinel loop as an abdominal XR finding

A

Localized ileus of a segment of the small intestine. May indicate acute pancreatitis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the treatment for acute pancreatitis?

A

NPO (can use NJ tube)
IVF (aggressive, decrease BUN)
Pain management (hydromorphone, fentanyl)

NO routine/prophylactic use of antibiotics BUT if there is concern for necrotizing pancreatitis or there is concurrent extrapancreatic infection, use imipenem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How do chronic and acute pancreatitis differ in presentation?

A

Acute presents with elevated lipase

Chronic presents with steatorrhea, weight loss, fat-soluble vitamin deficiency (incld B12)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What imaging is used to diagnose chronic pancreatitis?

A

CT with contrast
May seen calcifications of pancreas on US
Consider ERCP if obstructive jaundice is present; may identify gallstones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the treatment for chronic pancreatitis?

A

LSMs
PPIs
Oral pancreatic enzyme replacements (lipase, amylase, protease)
Analgesics

Surgery in refractory cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What syndromes are associated with pancreatic cancer?

A 
MEN1:
3 P's: 
- Primary hyperparathyroidism
- Pituitary adenomas
- Pancreatic/GI endocrine tumors [zolinger-ellison, insulinoma, non-fxning])

Neurofibromatosis 1:

  • Cafe au lait macules, inguinal/axillary freckling
  • Iris hamartomas
  • Neurofibromas
  • Possible osseous lesions (young)

von Hippel-Linau:
- Lots of tumors: retinal, cerebellum, clear cell renal, pheochromocytomas, epididymis, pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

A patient with pancreatic cx and a pheochromocytoma should be worked up for what condition?

A

von Hippel Lindau - genetic testing, loss of function variant of VHL gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Palpable gallbladder in a jaundiced patient is suspicious for what condition?

A

Classically pancreatic malignancy

Not specific, though, may also occur with other causes of biliary obstruction (chronic pancreatitis, common hepatic duct obstruction if proximal to cystic duct, choledocolithiasis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are common s/sx of pancreatic cancer?

A

Usually asymptomatic

  • Unintentional weight loss
  • Jaundice
  • Epigastric or mid-back pain
  • Courvosier sign
  • Non-specific anorexia, n/v/d, steatorrhea, dark urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the MC location of anal fissures?

A

Posterior midline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the screening parameters for colon cancer?

A

Average risk: start at 45, q10 years if normal until 75 YO

1st degree relative older than 65 at dx: start at 40, q10 years if normal until 75

1st degree relative younger than 65 at dx: start at 40, q5 years if normal until 75 OR 10 years before relative’s age at diagnosis (q5 years)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

How do the presentations of R vs L-sided colon cancer differ?

A

R (proximal) generally presents with chronic, occult bleeding leading to anemia

L (distal) more commonly presents with bowel obstruction and pencil-thin stools

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the cancer marker used to monitor progression of colorectal cancer?

A

CEA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Buzzword: apple core lesion

A

Seen on barium enema: suggestive of colorectal cancer, follow with colonoscopy + biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the MC site of esophageal cancer?

A

Upper 1/3 of esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the MC type of esophageal cancer?

A

Squamous cell is most common

Barrett’s/GERD is associated with adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Describe the pathological process involved in Barrett’s esophagus

A

Pathological transition of squamous to columnar epithelial tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How is hepatic cancer progression monitored?

A

AFP

US q/6-12 months for high risk patients

36
Q

What are the conditions for transplant in a patient with hepatic cancer?

A

1 tumor <5 cm or

Fewer than 3 tumors, all <3cm, limited to liver only

37
Q

What are 7 RF for gastric cancer?

A 
H pylori = biggest RF
Men >40 YO
Salted/cured/smoked foods
Pernicious anemia
Chronic atrophic gastritis
Smoking
EtOH
38
Q

What is the MC type of gastric cancer?

A

Adenocarcinoma

39
Q

What is the treatment for acute cholangitis?

A

Antibiotics + biliary drainage within 34-48 hours

Elective cholecystectomy after resolution of cholangitis

40
Q

What antibiotics are used in the treatment of acute cholangitis?

A
  • Ertapenem alone
  • Pip-tazo alone
  • Metro +
      • cephalophorin or
      • cipro or
      • levofloxicin
41
Q

What are the symptoms associated with cholangitis?

A

Charcot’s/Reynaud’s triad/pentad:

  • Fever
  • Jaundice
  • RUQ pain
  • AMS
  • Hypotension/sepsis
42
Q

A patient presents with fever, jaundice, RUQ pain, and hypotension with elevated WBCs, alk phos, and LFTs on labs. How is the suspected condition definitively diagnosed?

A

ERCP is gold standard for diagnosing cholangitis

43
Q

Describe Boas sign

A

Ass’d with cholecystitis

Pain radiating to shoulder/subscapular area 2/2 phrenic nerve irritation

44
Q

Patient presents with episodic epigastric pain worsened by meals and pain with palpation of the RUQ. How is the suspected condition diagnosed?

A

US is used to diagnose gallstones

If negative or unclear, proceed to HIDA

*HIDA (cholescintigraphy) is gold standard for diagnosing cholecystitis

45
Q

How is cholecystitis medically (non-op) managed?

A

NPO
Fluid resus
Ceftriaxone + metronidazole

Elective cholecystectomy at later date when resolved

46
Q

Patient presents with episodic epigastric pain worsened by meals and pain with palpation of the RUQ. What is the MC etiologic agent of the suspected condition?

A

E coli is MC etiologic agent of cholecystitis

47
Q

What liver enzyme is more elevated in EtOH-related liver disease?

A

AST:ALT >1

48
Q

Other than ALT/AST, what labs are abnormal in decompensated liver disease?

A 
Elevated alk phos, less than 3x normal limit
Elevated bilirubin
Decreased albumin
Decreased Na+
Elevated PT/INR
May also see anemia, thrombocytopenia
49
Q

What is the treatment for decompensated liver disease?

A

Lactulose + rifaximin for encephalopathy
Diuretics for ascites
Cholestyramine for pruritis
US q/6 mo to monitor for cancer (heightened risk)

Transplant is definitive treatment

50
Q

What is the MC cause of cirrhosis?

A

Chronic hep C

Other causes:

  • EtOH
  • other chronic hepatitis viruses
  • NAFLD
  • Hemochromatosis
  • PSC
  • Drug toxicity
51
Q

How is diverticular disease diagnosed?

A

CT for diverticuLITIS

Colonoscopy for diverticuLOSIS

52
Q

Under what (6) conditions might a patient be hospitalized for diverticulitis?

A
  • Presence of complications:
    • abscess
    • fistula
    • perforation
    • obstruction
  • Fever >102.5
  • Sepsis
  • Immunosuppression
  • Increased age
  • Unable to tolerate PO intake
53
Q

What is the treatment for uncomplicated diverticulitis?

A

Metronidazole + cipro (or levofloxacin)

+ clear liquid diet

54
Q

What is the treatment for complicated diverticulitis?

A

Consider CT-guided percutaneous drainage if abscess >3cm exists

Surgical repair if diverticulitis is refractory, recurrent, or complicated by perforation or stricture formation

55
Q

What is the MC area for diverticulosis/itis to occur and why?

A

Sigmoid colon 2/2 increased pressure

56
Q

What syndrome is associated with formation of esophageal strictures?

A

Plummer-Vinson syndrome

  • Dysphagia
  • Webs/strictures
  • Iron deficiency anemia

(2ndry glossitis, angular chelitis, nailbed changes; splenomegaly may also occur)

57
Q

How are esophageal strictures diagnosed?

A

Barium esophagram (swallow study)

58
Q

Describe Schatzki rings

A

Esophageal strictures associated with hiatal hernia; cause constriction at the squamocolumnal junction

59
Q

What is the difference between an esophageal web and an esophageal ring?

A

Ring: concentric 2-5mm diaphragm of tissue that protrudes into esophageal lumen. Usually in distal esophagus.

Web: thin (<2 mm) eccentric membrane that protrudes into the esophageal lumen. Covered in squamous epithelium.

60
Q

What is the MC cause of upper GI bleeding?

A

PUD
Esophageal varices
Erosive esophagitis

61
Q

Pt presents with ascites and vascular lesions with central arteriole, which can be seen pulsating when compressed with a glass slide. What is the pathogenesis of these lesions?

A

Believed to be response to estrogen metabolism –> testosterone in men; occurs in cirrhosis (as well as pregnancy)

62
Q

Important consideration when dealing with esophagitis in a patient with HIV

A

Require prophylaxis with fluconazole prior to endoscopy

63
Q

What is the gold standard for diagnosis of GERD?

A

24 hr ambulatory pH monitoring

Generally there is a trial of PPI and then endoscopy before proceeding to manometry, then pH monitoring

64
Q

What are some medications that should be avoided with GERD?

A 
B-agonists
Alpha blockers
Nitrates
CCBs
Anticholinergics
Theophyline
65
Q

How are hemorrhoids graded?

A

1: bleed only, no prolapse
2: prolapse but reduce spontaneously
3: prolapse needing manual reduction
4: permanently prolapsed

66
Q

How are hemorrhoids treated?

A

Conservative:

  • High fiber diet
  • Increased fluids
  • Warm Sitz baths
  • Topical rectal steroids
  • Lidocaine

Rubber band ligation is MC procedure if conservative tx fails

Hemorrhoidectomy for stage 4 external hemorrhoids

67
Q

Differentiate external vs internal hemorrhoids

A

Internal are proximal to the dentate line

External are distal to the dentate line

68
Q

What is the difference between type 1 and type 2 hiatal hernia?

A

Type 1: “Sliding”, MC. Gastroesophageal junction and part of the stomach slide together through the mediastinum >2cm

Type 2: “Rolling”: the stomach fundus rolls through with the GE junction remaining in anotomic position

69
Q

Differentiate Mallory-Weiss syndrome from Boerhaave syndrome

A

Mallory Weiss: tear(s) is longitudinal, mucosal, in the distal esophagus and/or proximal stomach

Boerhaave syndrome occurs when the esophagus is perforated, often 2/2 sudden increase in intraesophageal pressure. More likely to present with subcutaneous emphysema.

70
Q

How is PUD diagnosed?

A

Diagnosis per endoscopy + biopsy

71
Q

How is H pylori diagnosed?

A

Endo + biopsy:
- Rapid urease test + endo, biopsy

Monitor eradication via urea breath test, stool antigen test, or serologic antibody presence

72
Q

How is H pylori treated?

A

Triple therapy: CLAP:

  • Clarithromycin
  • Amoxicillin
  • PPI

Quad therapy: Treat My Belly Pain

  • Tetracycline
  • Metronidazole
  • Bismuth
  • PPI
73
Q

When is surgery indicated for PUD?

A

When ulcer is >3 cm

74
Q

What are some dermatologic manifestations of Crohn’s disease, and how are these manifestations treated?

A

Erythema nodosum: erythematous nodules, treat with elevation, rest, compression, NSAIDs, potassium iodide

Pyroderm gangrenosum: purulent ulcerations, ragged, violaceous borders. When limited, high potency topical steroids (clobetasol) or calcineurin inhibitors (tacrolimus)

75
Q

What supplementation is indicated in Crohn’s disease?

A

B12
Folic acid
Vitamin D

76
Q

How is Crohn’s disease diagnosed?

A

Upper GI series with small bowel follow-through - no contrast.

77
Q

RLQ pain, weight loss, non-bloody diarrhea, erythematous nodules on the skin, and diffuse msk pain is sus for what condition?

A

Crohn disease.

Usually non-bloody diarrhea, and lots of extraintestinal manifestations

78
Q

What are some buzzwords associated with Crohn disease?

A

Skip lesions on upper GI series

Cobblestone appearance on upper GI series

String sign on barium studies

ASCA+

79
Q

What is the MC location of involvement in Crohn disease?

A

Terminal ileum

80
Q

What layers of the intestinal wall are involved in IBD?

A

Crohn disease: transmural

UC: mucosal layers only

81
Q

How is Crohn disease treated?

A

5-ASA or steroids

In severe disease, TNF-inhibitors or biologics

82
Q

LLQ pain, tenesmus, bowel urgency, and bloody diarrhea is ass’d with what condition?

A

Ulcerative colitis

83
Q

How is ulcerative colitis diagnosed?

A

Flex sig – avoid colonoscopy or barium enema (can cause toxic megacolon)

84
Q

What are some buzzwords associated with ulcerative colitis?

A

Pseudopolyps on flex sig

Stovepipe sign on barium studies (loss of haustral markings in colon)

85
Q

How is UC treated?

A

Surgery is curative
Topical 5-ASA
Steroids

Fulminant/toxic megacolon: IV ASA, IV steroids, antibiotics

86
Q

How is IBS diagnosed?

A 
Rome Criteria:
2+ must be present:
- Pain related to defecation
- Ass'd change in stool frequency
- Ass'd change in stool form

Must be present at least 1 day per week for the past 3 months

IM EOR (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions