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Flashcards in GI path Deck (17):
1

what condition produces periodic, simaltaneous, non-perisataltic contractions on esophogeal manomatry and a "cockscrew" appearance on barium swallow?

diffuse esophageal spasm

pts can present with liquid/solid dysphagia and chest pain due to inefficient propulsion of food into stomach

2

Elderly man presents with dysphagia and foul breath (halitosis) and food regurgitation. It's found that he has a mucosal outpouching through an area of muscle weakness located in the wall of the hypopharynx (killian triangle). What is the Dx?

Zenker's diverticulum

3

pt presents with progressive solid food dysphagia and unintentional weight loss. Hx reveals heavy alcohol use. What is the Dx?

esophogeal squamous cell carcinoma

4

Pt pt presents with progressive solid food dysphagia and unintentional weight loss. Hx reveals barretts, GERD, smoking and obesity. What is the Dx?

esophogeal adenocarcinoma

5

Pt. presents with esophageal smooth muscle atrophy and gut wall fibrosis in lower two thirds of the esophagus with dysphagia with acid reflux. Manometry shows absent peristaltic waves with decreased esophageal sphincter tone. Hx is significant for restrictive lung disease. What test would reveal the Dx?

test for Anti-Scl-70 (anti-topoisomerase 1) antibody

pt has diffuse scleroderma

6

what is the difference between primary billiary serosis and acute sclorosing cholangitis?

primary biliary sclerosis - autoimmune with + anti-mitochondiral antibody classically seen in middle-aged females

primary sclerosing cholangitis - 60% associated with positive pANCA, seen primarily in males over 40, associated with ulcerative colitis and cholangiocarcinoma, alternating beading and stricturing

7

what disease is associated with mucocutaneous pigmented lesions around the mouth/lips and oral buccal mucosa? Presents with multiple GI harmartomatous polyps and abdominal pain +/- bleeding due to intussesception or obstruction or malignant transformation.

Peutz-Jegers syndrome

serine/threonin kinase 11 mutation on chromasome 19

8

what are the associated HLA markers for celiacs disease?

HLA-DQ2 and HLA-DQ8

9

What is hte mallignancy risk for celiacs?

T-cell lymphoma

10

What are the associated demographics or conditions with celiacs?

european dissent

dermatitis herpetiformis

11

what are two cutaneous manifaestations of chron disease?

erythema nodosum and pyoderma gangrinosum

12

what is the cause of gilbert syndrome?

reduced bilirubin UDP glucoronosyltransferase activity

presents with unconjugated hyperbilirubinemia that is provoked by hemolysis fasting physical exertion, fever stress or fatigue

13

pt has atrophic glossitis and shuffling broad - based gate due to loss of prprioception from dosrolateral degeneration of the spinal cord. What is the cause?

pernicious anemia

14

2 year old with brisk, painless rectal bleeding - what is the cause?

THINK MECKEL DIVERTICULULM - failed obliteration of the vitelline duct (omphalomesteric duct)

normally regresses before 8th week of gestation

if not obliterated completely, HETEROTOPIC TISSUE persists in the ileum - can consist of gastric or pancreatic tissue in the midst of normal intestinal mucosa

15

2 year old with brisk, PAINFUL abdomain with palpable mass and rectal bleeding - what is the cause?

intussesception - probably associated with a meckel diverticulum which actas ass a lead point for bowel telescoping

16

infant presents with bilious emesis, abdominall pain and bloody stools. What was the cause?

gut malrotation with volvulus - bowl can rotatte around the SMA making it prone to v

17

kid presents with abdominal pain, lower growth percentile, diarrhea, rectal bleeding and elevated ESR. What is the Dx?

Chron's - transmurral inflammation

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