- RUQ pain for a few hours after fatty meal - N/V Whats the diagnosis? What do you see on US? How is this different than cholecystitis?

Cholelithiais - stones present on US - Stones seen in both cholelithiasis and cholecystitis, but in cholecystitis, there is inflammation and "pericholecystic" fluid on US. Pain will last more than 6+ hours.

- LLQ pain - fever - Leukocytosis Whats the dx? What might the pt have history of?

- DiverticulITIS - History of diverticulOSIS

McGuffin- Adult GI Disease- Leah Flashcards by Leah Stalnaker

RUQ pain lasting more than 6 hours; worse w/fatty meal
Pt stops mid-exhalation upon RUQ palpation
Pericholecystic fluid on U/S:

What is the diagnosis if:

stones are present on US
stones are NOT present on US

Stones: cholecystitis
No stones: acalculous cholecystitis
(Seen in trauma/burn patients)

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Difficulty swallowing/regurgitation of food before swallowing
birds beak appearance on barium swallow

What’s the diagnosis?
What might relieve the symptoms and what bug might be assc?

Achalasia
Might be relieved by nitroglycerin
(Confused with cardiac pathology)
Occasionally assc with Chagas Disease

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Anemia
Blood in stool
Collections of dilated vessels on colonoscopy

Diagnosis?
Age group?

Angiosysplasia; patients over 60

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Fever
RLQ pain
Worsening right sided pain with left sided palpation
Rebound tenderness
Psoas sign +

Diagnosis?

Appendicitis

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Hypoactive bowel sounds + some high pitched tinkling noises
Prior history of GI surgery
Obstipation

What’s the diagnosis?
What would you see on KUB?

Bowel Obstruction

See dilated bowel loops and air fluid levels on KUB

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Flushing
Diarrhea
Wheezing
Rt sided heart lesion

What’s the diagnosis?
What metabolite will be elevated?

Carcinoid tumor

High 5HIAA

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Severe Pain radiating to back or infrarenal pain
Hx of atherosclerosis

Diagnosis?
Possible outcome?

AAA –> death likely if ruptured

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Diarrhea, bloating, cramping,
Failure to thrive
papules, plaques, vesicles on skin

Whats the diagnosis?
What would you see on small bowel biopsy?

Celiacs- glialdin (gluten) antibodies

Destroyed villi on biopsy

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RUQ pain for a few hours after fatty meal
N/V

Whats the diagnosis?
What do you see on US?
How is this different than cholecystitis?

Cholelithiais

stones present on US
Stones seen in both cholelithiasis and cholecystitis, but in cholecystitis, there is inflammation and “pericholecystic” fluid on US. Pain will last more than 6+ hours.

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Painless rectal bleeding
history of low fiber diet
Old lady

Most likely diagnosis?
Colonoscopy findings?

-Diverticulosis, outpouchings of sigmoid colon

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LLQ pain
fever
Leukocytosis

Whats the dx? What might the pt have history of?

DiverticulITIS

- History of diverticulOSIS

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Type of esophageal cancer in the upper esophagus?

Lower?

Upper: squamous cell

- Lower: adenocarcinoma

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Risk factors (3) for esophageal cancer

tobacco
alcohol
Barrett’s

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Choking & coughing when eating
Halitosis
Regurgitating food eaten a while back

Whats the diagnosis?

Esophageal diverticulum

traps food, hence bad breath and late regurgitation

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Whats a Zenker’s diverticulum?

-False diverticulum between inferior pharyngeal constrictor and cricopharyngeus muslce

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Severe retrosternal chest pain
Crepitus on palpation of chest
hematemesis

Whats the diagnosis?
What will the patient have a history of?

-Esophageal rupture/ BoerHaave syndrome
(Mallory Weiss tear gone bad)
-Hx of alcoholism and retching

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chest pain esp when drinking cold liquid
corkscrew esophagus on barium swallow
relieved by nitroglycerin

Whats the diagnosis?

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-Esophageal spasm

Painless hematemesis
Hypotension
Anemia
History of alcoholism

Whats the diagnosis?

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esophageal varices 
(dilated submucosal veins in the lower 1/3 of the esophagus)

GERD
Dysphagia of SOLIDS only
Otherwise normal

Diagnosis?

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-Esophageal web

fibrovascular CT lesions

-Chest pain & odynophagia
Suggestive of?
Possible causes?

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-esophagitis
infectious: CMV/Candida/HSV/ VZV
chemical exposure
GERD

What do the lesions of the following look like?
Candida esophagitis
CMV esophagitis
HSV esophagitis

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Candida: nodular filling defect on barium swallow, pseudomembranes
CMV: linear ulcers
HSV: punched out ulcers

(+ intranuclear inclusions in both CMV HSV: he writes only CMV, Gusack writes both? Gusack more likely to ask.)

Abdominal pain
Acanthosis nigricans
Left supraclavicular and umbilical lymphadentopathy:

Diagnosis?

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Gastric cancer

Hx smoked foods, gastritis, anchlorhydria, H. pylori

Intractible vomiting
Early satiety
Weight Loss

Suggestive of?

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Gastric outlet obstruction, possibly secondary to cancer

Adult version pyloric stenosis

-Burning abdominal pain, worse with food

Suggestive of?

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-Gastritis

many possible etiologies: erosive, autoimmune, H. Pylori

- Burning chest pain - Night time cough - acid taste in mouth Suggestive of?

-GERD (loss of LES tone)

Liver disease in which AST is higher than ALT? | Disease in which they are both EXTREMELY high?

-AST is HIGHER than ALT in ALCOHOL INTOX. (Usually, ALT is higher- think alphabetical order, L before S) -will both be extremely high in shock liver

- String lesion on CT of bowel - Skip lesions sparing rectum on colonoscopy - Transmural inflammation Diagnosis?

Chrons

- Bloody diarrhea - Continuous lesions of rectum, colon +/- ileum - Mucosal and submucosal inflammation - Lead pipe appearance of bowel on CT Diagnosis?

Ulcerative colitis

- Anxious woman - frequent stool changes - abdominal pain Diagnosis?

-IBS

Causes of Mallory Weiss Tear?

-alcoholism, bulimia

SEVERE abdominal pain History of atherosclerosis/ a-fib Elevated lactate/ metabolic acidosis Diagnosis?

Mesenteric Ischemia

African American Male Pain radiating to back jaundice weight loss Diagnosis?

Pancreatic Cancer

LUQ pain History of gall stones/alcoholism Elevated lipase and amylase diagnosis?

Acute Pancreatitis

- Loss of fat in stool - Weight loss - Hyperglycemia/ polyuria Diagnosis?

-Chronic Pancreatitis

- Burning epigastric pain - N/V - Melena/ hematochezia diagnosis if worse with food? better with food?

Gastric ulcer- worse with food | Duodenal ulcer- better with food

- History of GERD - Sudden onset SEVERE epigastric pain - Guarding, rebound tenderness diagnosis?

Perforated ulcer

- tongue pain and burning - dysphagia - dry skin esp at lips and mouth angles diagnosis?

Plummer Vinson Syndrome | iron deficiency

Watery diarrhea and plaques on colon following abx use?

Pseudomembranous colitis

Abdominal pain, fever, chills, ascites Neutros on pericentesis Mental status changes, guarding & rebound Diagnosis?

Bacterial peritonitis

Weird movements Golden brown ring around cornea Low ceruloplasmin Dementia Diagnosis?

Wilsons Disease

McGuffin- Adult GI Disease- Leah Flashcards

(40 cards)