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Flashcards in Integrative GI Deck (60)
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1
Q

old alcoholic man, worsening midepigastric pain radiating to the back

N/V, steatorrhea
no rebound, similar sx in past

dx is ___
finding on imaging

A

chronic panc

pancreatic calcifications

2
Q

woman w severe epigastric pain radiating to back

no alcohol/drugs

inc lipase/amylase

test to determine etiology

or ____

A

RUQ ultrasound

TG measurement

3
Q

old man, recurrent severe RUQ pain, N/V, jaundice

Fever, elevated alk phos, WBC

mechanism of findings ___
dx is ___

A

obstructed CBD

acute cholangitis

4
Q

woman w RUQ pain, esp when eating greeasy food

labs normal

dx is ____
secretion of __ is causing sx

A

biliary colic

CCK

5
Q

elderly man, LLQ pain and fever, no temp

dx is _____
mechanism __ of protrusions in ___

A

diverticulitis

inflammation, colonic wall

6
Q

elderly man, epigastric pain radiating to the back, wl, jaundice

inc amylase/lipase, ALP

mass in pancreas
screen w elevated ___

A

CA 19-9

7
Q

young woman, vomiting bright red blood

history of freq vomiting, has since become more forceful

dx is ____

A

mallory weis syndrome

8
Q

MA woman, epigastric pain
hx of previous gastric/duodenal ulcers

H pylori is negative
more ulcers found

dx is ___
excessive secretion of __

A

ZE syndrome

gastrin

9
Q

severe pain OoP to exam, older person w CAD

dx is ___

A

mesenteric ischemia

10
Q

young woman, sudden lower ab pain

could be ___

w dyspareuia, chronic discharge dx is ___

A

ectopic pregnancy

PID

11
Q

paroxsymal, severe pain, cannot sit still, hematuria

dx is __

A

nephrolithiasis

12
Q

old person, debilitated, ab distension, massive colon on xray

dx is ____

A

sigmoid volvulus

13
Q

1-2 yr old pt, intermittent jelly-like stools

dx is ___

A

intussusception

14
Q

old man, flatulence/ab cramping

watery stools after trip to another country

resolved w loperamide/bismuth

dx is ___
caused by ___

A

travelers diarrhea

ETEC

15
Q

young woman, multiyear history of constipation/bloating/loose stools w mucus

no inflammatory findings

dx is ____

A

irritable bowel syndrome

16
Q

young man, vomiting after eating tuna salad

stomach cramping/loose watery stool

cause of sx ____

A

staph aureus

17
Q

shellfish exposure, travel w low K

microorganism is ___

classically described as __

A

Vibrio species

rice water stools

18
Q

HIV, chronic watery diarrhea

C
G
I
C
C
A
crypto
giardia
isospora
cyclospora
CMV
19
Q

chronic steatorrhea
duodenal biopsy w villous atrphy

dx is ____

look for ab to ___

A

celiac disease

TTG

20
Q

outdoor exposure w high eosinophils and diarrhea

dx is ___

A

stronglyoides

21
Q

watery diarrhea, facial flushing

dx is ____
look for high ____

A

carcinoid syndrome

5 HIAA

22
Q

young male, yellow eyes post illness

labs normal

dx is ____
deficient in ____

A

gilbert syndrome

glucuronyltransferase

23
Q

young boy, jaundice, dark urine, gray stools

hepatomegaly, inc direct bilirubin

mechanism is ___

A

obstructed biliary system

24
Q

mild jaundice, inc LDH, reticulocytes, peripheral smear shows schistocytes

dx is ____

A

hemolytic anemia

25
Q

MA woman, pruritis, very high alk phos

dx is ___
antibodies present __

A

PBC

antimitochondrial

26
Q

liver dz, altered mental status, young person

dx is ___
low ___

A

wilsons disease

ceruloplasmin

27
Q

diabetes, CHF, liver dz, skin/teste findings

dx is ____
mutation in _)___

A

hemochromatosis

HFE gene

28
Q

MA woman, jaundice, high transaminases

dx is _____

antibodies present

A

autoimmune hepatitis

ASMA, ALKMA

29
Q

man w jaundice, dark urine

history of UC
elevated alk phos, bilirubin

CT shows dilated peripheral ___
mild dilatin of __
normal ____

dx is _____

A

intrahepatic duct
hepatic duct
bile duct

PSC

30
Q

transmural inflammation, skip lesions, fistulas, noncaseating granulomas

dx is ____

A

chrons disease

31
Q

bloody diarrhea, toxic megacolon

dx is ____

A

UC

32
Q

extraintestinal manifestations common in S/U/A

risk of ___

A

sclerozing cholangitis, uveitis, arthritis

colon cacer

33
Q

tender nodules on shins is ____

necrotic skin ulcers w purple/red borders is __

A

erythema nodosum

pyoderma gangrenosum

34
Q

woman w difficulty swallowing food/liquid

hx of GERD

ct shows bird beak

dx is ___
dec ability of ___ to ____

A

achalasia

LES, relax

35
Q

hx of GERD, upper endoscopy shows intestinal metaplasia

dx is ____
risk of ____

A

Barrets Esophagus

adenocarcinoma

36
Q

hernia protrudes through external inguinal ring, does not enter inguinal canal

medial to inferior epigastric artery

type of hernia

A

direct inguinal hernia

37
Q

young boy, severe RLQ pain, anorexia/fever

rebound/guarding

resists active extension of hip

dx is ___
inflammation over ___

A

AA

psoas major muscle

38
Q

old man, vomiting bright red blood

exam shoes jaundice, spider angiomas, ascites, splenomegaly

dx is ___
anastamoses for bleedign

A

cirrhosis

left gastric vein and azygous vein

39
Q

old woman, vomiting bright red blood

taking lots of NSAIDs, EGD shows bleeding ulcer on posterior duodenum

vessel source is ____

A

gastroduodenal artery

40
Q

100+ polyps at young age, assc w osteomas, dental findings, lipomas/skin findings, retinal pigment hypertrophy

dx is _____

A

Gardner syndrome

41
Q

PJS assc w O/B/U/P tumors

A

ovary, breast, uterus, pancreas

42
Q

small/large intestine and stomach w hamartomas, congenital abnormalities

dx is ____

A

juvenile polyposis

43
Q

acetominophen OD tx w __

restores ___ as precursor, binds ____

A

N acetylcysteine

glutathione, NAPQI

44
Q

OCP, develops ascitees

concerned for ___ which is obstructed ____

may lead to ____

A

Budd chiari syndrome, hepatic vein

hepatic adenoma

45
Q

SE of MTX

A

hepatic fibrosis

46
Q

Metoclopromide for N/gastroparesis/neuro sx

SE include ___

ie smacking lips, protruded tongue, tics/troticollis

A

tardive dyskinesia

47
Q

autoimmune hepatitis can be caused by __ and ____

A

nitrofurantoin/minocycline

48
Q

infant, fails to pass meconium

enema shows narrow rectosigmoid jxn, dilated above

dx is ____
failed ____

A

hirschprung dz

NCC migration

49
Q

Down syndrome, ab distension/vomiting

xray shows ___
dx is ____

A

double bubble

duodenal atresia

50
Q

young boy, painless lower GI bleeding w out diarrhea

dx is ___

A

meckels diverticulum

51
Q

infant, jaundice/hepatomegaly, E coli sepsis

low glucose, reducing substances in urine

dx is ___

A

galactosemia

52
Q

young infant, postprandial vomiting, alkalosis/ low Cl

dx is ____

A

pyloric stenosis

53
Q

hernia in inguinal canal, lateral to the inferior epigastric artery

dx is ___
presistent ___

A

indirect inguinal hernia

processus vaginalis

54
Q

diarrhea, dementia, rash

dx is ___
deficient in ___

A

pellagra

Niacin/B3

55
Q

night blindness
deficient in ___

excess retinol is ___

A

Vitamin A

teratogenic

56
Q

PN may be caused by

__, __, ___ deficiencies

A

VB1 (thiamine_
VB6 (pyridoxine)
VB12

57
Q

macrocytic anemia caused by

__ deficiency, normally in __

__ deficiency w neuro sx
found in __
can be low by __ dz

A

folate, vegetables

VB12, animal products
terminal ileum

58
Q

swollen gums, poor wound healing, bruising

deficient in ___
dx is ___

A

VC

scurvy

59
Q

neonatal hemorrhage, deficient in ____

A

VK

60
Q

rickets in breast fed infant

deficient in ____

A

Vitamin D