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Challenge Bowl > GI (Pearls of Wisdom) > Flashcards

GI (Pearls of Wisdom) Flashcards

1
Q

A patient presents with chronic, progressive dysphagia of SOLIDS & LIQUIDS. A barium study shows a dilated esophagus with a distal “BIRD BEAK” appearance. What is the likely dx?

A

Achalasia

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2
Q

What study is the gold standard for diagnosing achalasia?

A

Esophageal manometry

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3
Q

MC sx of esophageal dz:

A

heartburn

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4
Q

What is the single, best dx study for evaluating a pt w/ GERD?

A

EGD

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5
Q

Barrett esophagitis is assoc. w/ which type of cancer?

A

Esophageal adenocarcinoma

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6
Q

What is the most predominant type of cancer of the PROXIMAL esophagus?

A

squamous cell carcinoma

  • distal = adenocarcinoma
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7
Q

MC benign esophageal neoplasm:

A

Leiomyoma

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8
Q

MCC of infectious esophagitis:

A

Candida albicans

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9
Q

MC viral cause of infectious esophagitis:

A

HSV

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10
Q

A diverticular outpouching usually located posteriorly in the hypopharynx

A

Zenker’s diverticulum

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11
Q

Repeated violent bouts of vomiting that results in a tear involving the submucosa and mucosa, typically in the right posterolateral wall of the gastroesophageal jxn

A

Mallory-Weiss tear

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12
Q

Repeat violent bouts of vomiting that results in a full-thickness tear, usu in the unsupported L posterolateral wall of the distal esophagus

A

Boerhaave syndrome

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13
Q

air in the mediastinum following an esophageal perforation

A

Hamman sign

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14
Q

MC type of gastric carcinoma?

A

Adenocarcinoma

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15
Q

gastric carcinoma that has metastasized to the ovary

A

Krukenberg tumor

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16
Q

Stomach cancer is assoc. w/ the enlargement of what LNs?

A

Supraclavicular nodes (Virchow’s node)

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17
Q

After the fluid and blood resuscitation of a bleeding ulcer, what is the most useful diagnostic test?

A

upper endoscopy

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18
Q

Name 2 endocrine problems that can cause PUD:

A
  1. Zollinger-Ellison syndrome

2. hyperparathyroidism

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19
Q

A 48-yo female diabetic pt presents with a multimonth h/o chronic nausea, early satiety, & postprandial bloating. What is the most likely dx?

A

Diabetic gastroparesis

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20
Q

What is the diagnostic TOC to evaluate a pt suspected to have gallstones?

A

Abdominal US

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21
Q

What is the diagnostic TOC to evaluate a pt suspected to have gallstones?

A

Abdominal US

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22
Q

A 54-yo man, 2 days postop for a R knee replacement, presents with RUQ abd pain, nausea, & low-grade fevers. His US fails to reveal any gallstones or other obvious GB abnormality. What is the probable dx?

A

Acalculous cholecystitis

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23
Q

Name the sign: pain on inspiration w/ palpation of the RUQ

A

Murphy sign

- seen in cholecystitis

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24
Q

Name the sign: pain on inspiration w/ palpation of the RUQ

A

Murphy sign

- seen in cholecystitis

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25
Q

An 11 yo child w/ sickle cell anemia presents w/ fever, RUQ abdominal pain, and jaundice. What is the most likely dx?

A

ascending cholangitis

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26
Q

Charcot’s triad

A
  1. Fever
  2. RUQ abd pain
  3. jaundice
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27
Q

Gallstones w/in the GB sac

A

Cholelithiasis

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28
Q

Inflammation of the common bile duct, often caused by infxn or choledocholithiasis

A

Cholangitis

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29
Q

Inflammation of the GB

A

Cholecystitis

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30
Q

Gallstones that have migrated from the GB sac into the common bile duct

A

Choledocholithiasis

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31
Q

What is the most likely dx for a pt who presents with epigastric pain that radiates to the back & is partially relieved by sitting up?

A

Pancreatitis

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32
Q

What are the major causes of acute pancreatitis?

A

Alcoholism

gallstone dz

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33
Q

Name 2 metabolic causes of acute pancreatitis

A
  1. hypertriglyceridemia

2. hypercalcemia

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34
Q

MCC of chronic pancreatitis in Western society:

A

chronic alcohol abuse

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35
Q

What are the laboratory abnormalities assoc. w/ pancreatitis?

A
  • leukocytosis
  • hyperglycemia
  • elevated amylase
  • elevated lipase
  • hepatic enzyme elevation
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36
Q

What are some abdominal XR findings assoc. w/ acute pancreatitis?

A
  • sentinel loop

- calcification of the pancreas

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37
Q

What are some abdominal XR findings assoc. w/ acute pancreatitis?

A
  • sentinel loop

- calcification of the pancreas

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38
Q

Name the sign: Periumbilical ecchymosis indicative of pancreatitis, severe upper GI bleeding, or ruptured ectopic pregnancy

A

Cullen sign

39
Q

Name the sign: A palpable, distended GB in the RUQ of pts w/ jaundice. It is usu the result of a malignant bile duct.

A

Courvoisier sign

40
Q

Where is the MC site of pancreatic cancer?

A

the pancreatic duct system found in the HEAD OF THE PANCREAS

41
Q

What is the tumor marker that can assist in diagnosing pancreatic cancer?

A

CA 19-9

42
Q

What are the 2 MCCs of ascites?

A
  1. Chronic liver dz

2. Peritoneal carcinomatosis

43
Q

How are hepatitis viruses transmitted?

A
  • A & E = fecal, oral route

- B, C, D = blood borne

44
Q

A dz of IRON OVERLOAD in the liver & other organs w/ the most likely defect occurring in a regulatory mechanism for iron absorption in the small intestine. Name the condition.

A

Hemachromatosis

45
Q

A dz of IRON OVERLOAD in the liver & other organs w/ the most likely defect occurring in a regulatory mechanism for iron absorption in the small intestine. Name the condition.

A

Hemachromatosis

46
Q

What is the MC screening test for hemochromatosis?

A

Serum ferritin

47
Q

A 52-yo pt presents w/ tremor, ataxia, dementia, cirrhosis, and GRAY-GREEN rings around the edge of the cornea. What is the dx?

A

Wilson dz

48
Q

What is looked at to accurately diagnose Wilson dz?

A

Diminished serum ceruloplasmin levels

49
Q

MC vascular tumors of the liver:

A

hemangiomas

50
Q

MCC of jaundice in pregnancy

A

Viral hepatitis

51
Q

MC liver disorder related to pregnancy

A

Intrahepatic cholestasis

52
Q

A 43-yo pt presents w/ a 6-wk h/o frequent, malodorous diarrhea that leaves an oily sheen to the surface of the toilet water. You suspect a malabsorption disorder. What is the best study to screen for fat malaborption?

A

A microscopic stool examination using Sudan stain

53
Q

A 43-yo pt presents w/ a 6-wk h/o frequent, malodorous diarrhea that leaves an oily sheen to the surface of the toilet water. You suspect a malabsorption disorder. What is the best study to screen for fat malaborption?

A

A microscopic stool examination using Sudan stain

54
Q

What is the best test to differentiate malabsorption caused by small bowel vs pancreatic etiology?

A

d-Xylose test

55
Q

What is the most sensitive & specific serum marker for celiac dz?

A

Tissue transglutaminase (tTG)

56
Q

Name the dz assoc. w/ the following sx:

  • Wt. loss
  • diarrhea
  • Arthralgias
  • Cardiac involvement
A

Whipple dz

57
Q

What GI dz is MCly assoc. w/ Dermatitis Herpetiformis?

A

Celiac dz

58
Q

What GI dz is MCly assoc. w/ Dermatitis Herpetiformis?

A

Celiac dz

59
Q

MC cancer arising in the colon:

A

adenocarcinoma

60
Q

What is the gold standard for identifying colorectal cancer?

A

Colonoscopy

61
Q

A benign disorder of pigmentation that develops w/in the walls of the colon

A

Melanosis coli

62
Q

What laxatives are MCly assoc. w/ melanosis coli?

A

Anthraquinones

aloe and senna

63
Q

A 72-yo female pt presents w/ a 2-day h/o progressively worsening LLQ abdominal pain assoc. w/ constipation & chills. What is the most likely dx?

A

Diverticulitis

64
Q

MC tumor of the appendix:

A

carcinoid tumor

65
Q

What Abs are commonly assoc. w/ C. diff colitis?

A

Clindamycin, ampicillin, & 3rd gen. cephalosporins

66
Q

What Abs are commonly assoc. w/ C. diff colitis?

A

Clindamycin, ampicillin, & 3rd gen. cephalosporins

67
Q

What is the 1st line tx of C. diff colitis?

A

Metronidazole (Flagyl)

68
Q

What is the most likely source of acute hematemesis in a 43-yo male pt w/ a h/o cirrhosis?

A

Esophageal varices

69
Q

MCC of hematochezia or lower GI bleeding in adults

A

Internal hemorrhoids

70
Q

MCC of lower GI bleeding in children:

A

Meckel diverticulum

71
Q

MCC of lower GI bleeding in children:

A

Meckel diverticulum

72
Q

An 82-yo male pt presents w/ an acute onset of crampy LLQ abdominal pain w/ the urge to defecate & expulsion of bloody diarrhea. Assoc. sxs include: nausea, fever, & tachycardia. Plain film abdominal XRs reveal “thumbprinting” changes.

A

Ischemic colitis

73
Q

An 82-yo male pt presents w/ an acute onset of crampy LLQ abdominal pain w/ the urge to defecate & expulsion of bloody diarrhea. Assoc. sxs include: nausea, fever, & tachycardia. Plain film abdominal XRs reveal “thumbprinting” changes. Dx?

A

Ischemic colitis

74
Q

An 82-yo male pt presents w/ an acute onset of crampy LLQ abdominal pain w/ the urge to defecate & expulsion of bloody diarrhea. Assoc. sxs include: nausea, fever, & tachycardia. Plain film abdominal XRs reveal “thumbprinting” changes. Dx?

A

Ischemic colitis

75
Q

An umbilical metastasis manifesting as periumbilical LAD from an internal malignancy.

A

Sister Mary Joseph node

76
Q

What is a common cause of acute abdominal pain in illicit drug users?

A

Acute mesenteric ischemia

77
Q

What is a common cause of acute abdominal pain in illicit drug users?

A

Acute mesenteric ischemia

78
Q

MCC of gastroenteritis in U.S.:

A

viruses

79
Q

MCC of childhood diarrhea

A

Rotavirus

80
Q

MCC of childhood diarrhea

A

Rotavirus

81
Q

MC bacterial source to infectious diarrhea in the U.S.

A

Campylobacter jejuni

82
Q

MC parasitic diarrhea infxn in the U.S.:

A

Giardia lamblia

83
Q

MC parasitic diarrhea infxn in the world?

A

Amebiasis

Entamoeba histolytica

84
Q

MC parasitic diarrhea infxn in the world?

A

Amebiasis

Entamoeba histolytica

85
Q

Pellagra is caused primarily by a deficiency of what nutrient?

A

Niacin

86
Q

What are the 3 Ds of pellagra?

A

Dermatitis
Dementia
Diarrhea

87
Q

Rickets is assoc. w/ a deficiency of what vitamin?

A

Vitamin D

88
Q

Rickets is assoc. w/ a deficiency of what vitamin?

A

Vitamin D

89
Q

A 38-yo male pt presents w/ anorexia, lethargy, arthralgias, & swollen gums. What vitamin deficiency may be present?

A

Vitamin C (scurvy)

90
Q

Deficiencies in either of these 2 micronutrients may cause paresthesias, tetany, seizures, or arrhythmia:

A

Calcium or magnesium

91
Q

Deficiencies in either of these 2 micronutrients may cause paresthesias, tetany, seizures, or arrhythmia:

A

Calcium or magnesium

92
Q

Night blindness may be assoc. w/ what vitamin deficiency?

A

Vitamin A

93
Q

What is the MC digestive complaint in the U.S.?

A

Constipation

Challenge Bowl (9 decks)

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