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Midterm - random Qs Flashcards

1
Q

What mechanical dysphasia is usually asymptomatic unless circumferential. And if they are circumferential they cause intermittent dysphasia to solids

A

Webs

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2
Q

What is Plummer-Vinson syndrome?

A

Proximal esophageal webs PLUS iron-def anemia

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3
Q

What is the diverticulum called that is located in hypopharyngeal region?

A

Zenker’s diverticulum

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4
Q

Triad of Zenker’s diverticulum sx

A

Dysphagia
Halitosis
Aspiration

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5
Q

GERD Pathophysiology

A

Inappropriate LES relaxation

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6
Q

Things that make you higher risk for GERD

A 
Abdominal obesity
Pregnancy
Gastric distinction (over-indulgence)
Delayed gastric emptying e.g. diabetes
Smoking
Hiatal hernia
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7
Q

GERD #1 and #2 Sx

A

Heartburn
Acid regurgitation

And these Sx are good enough for initial Dx and treatment. If there are alarm Sx as well, then need to do more.

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8
Q

Globus hystericus is what?

A

AKA globus sensation

Perfection of lump or fullness in throat (but there is nothing)

Often occurs in setting of anxiety or obsessive-compulsive disorders but can be due to GERD as well

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9
Q

DDX duodenal ulcers vs gastric ulcers (age, acid levels)

A

Gastric: OLDER >60 yo with normal-to-low acid levels. P worse with eating.

Duodenal: YOUNGER 30-55 yo with normal-to-high acid levels. P relieved by eating.

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10
Q

Common risk factors PUD (peptic ulcer disease)?

A

H.pylori and NSAIDS

Also: smoking tobacco, chronic alcohol use, COPD, CAD, CKD

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11
Q

Is Tylenol (acetaminophen) a risk factor for PUD?

A

No. It’s not an NSAID

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12
Q

Most common PUD complication

A

Bleeding. Hematemesis or melena

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13
Q

What is Zollinger-Ellison Syndrome?

A

PUD due to endocrine tumor that produces too much gastrin which causes gastric acid hypersecretion

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14
Q

chronic alcohol abuse labs?

A

2:1 AST:ALT (Scotch before Lunch)

Macrocytic anemia MCV >91 um^3

GGT > 35 U

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15
Q

Etiology of hepatocellular liver disease

A 
NAFLD
Alcoholic hepatitis
Viral hepatitis
AI disease
Dru-induced
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16
Q

Etiologies of obstructive liver disease

A

Gallstone disorders
Sclerosis get cholangitis
Pancreatitis
Pancreatic cancer

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17
Q

Liver specific signs of liver disease

A

Jaundice, dark ruin, light/clay-colored stool, pruritis

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18
Q

What are 3 ways to get jaundice?

A

Intrahepatic cholestasis
Post-hepatic cholestasis
Non-hepatic jaundice either Gilbert’s syndrome or hemolytic jaundice due to disorders of RBC breakdown

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19
Q

When do spider angiomata cause concern for liver disease?

A

When they are in the arms, face, upper torso.

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20
Q

Excoriations

A

Chronic scratching due to pruritis

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21
Q

More advanced liver disease signs:

A 
Mm wasting
Weight loss
Ascities
Edema
Caput Medusa
Bruising
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22
Q

Overt hepatic failure

A

Hepatic encephalopathy

Asterixis (hand tremor when wrist extended)

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23
Q

1 cause of acute liver failure

A

Drugs

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24
Q

1 drug that causes acute liver failure

A

Acetaminophen (APAP)

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25
What is max safe total daily dose of Acetaminophen (APAP) for adults Max safe SINGLE dose for adults?
Daily dose: 4000 mg Single dose: 1000 mg
26
What 2 elevated labs suggest obstructive liver disease?
Alkaline phosphatase and GGT (gamma-glutamyl transferase)
27
Risk factors for nonalcoholic fatty liver disease
Overweight/obese BMI >25 | Insulin resistance/diabetes A1C >5.7
28
What is NASH
Non-Alcoholic SteatoHeptatits 2nd stage of NAFLD
29
How do you Dx NAFLD?
1 - increase liver fat >5% 2 - absence of unhealthy alcohol consumption 3 - exclude other possible causes of liver fat accumulation
30
NAFLD-related cirrhosis is 3-4X [more/less] common than cirrhosis caused by hep C
MORE
31
Dyspepsia vs gastritis
Dyspepsia describes upper GI sx Gastritis is inflammatory pathology of gastric mucosa
32
What patient pop is likely to get gastroparesis?
Poorly controlled diabetes melitus due to autonomic neuropathy Could also be caused by meds.
33
The sx of gastroparesis are the sx of dyspepsia. So how do you diagnose gastroparesis?
EGD to r/o other causes Confirm with radionuclide gastric emptying study
34
Risk factors for gallstones
Obesity Sudden weight loss Oral contraceptive use and estrogen Pregnancy
35
What is biliary colic and how many pts get it?
1/3 get these sx: - abrupt onset - steady ache/fullness - severe pain: may radiate to right scap/shoulder - precipitated by eating fatty food - subsides w/in few hours NO FEVER
36
Timeline for acute cholecystitis
Biliary colic >5 hours and progressively getting worse
37
Timeline for cholelithiasis
Biliary colic <2 hours
38
What is ERCP?
Endoscopic retrograde cholangio-pancreatography Combines fluoroscopic imaging and endoscopy. It can remove obstructing stones in the CBD
39
Complications of choledocholithiasis if you don’t get stones out in time:
Cholangitis Acute gallstone pancreatitis
40
What is cholangitis?
Inflammation of bile duct (acute or chronic)
41
Acute cholangitis
Ascending cholangitis Charcot’s triad
42
What is Charcot’s triad and what disease is it associated with?
Biliary pain Jaundice Spiking fever = leukocytosis Acute cholangitis
43
If dx of acute cholangitis is missed, what can happen?
Infection can continue and cause systemic toxicity aka Reynold’s Pentad: 1-3: Charcot’s Triad 4. Hypotension 5. Altered mental status (shock)
44
Define cholelithiasis
Stones in gallbladder
45
Define cholecysitis
Inflammation of gallbladder
46
Define choledocholithiasis
Stones in CBD
47
Define cholangitis
Inflammation of bile ducts ascending into liver
48
Define cholecystectomy
Surgical removal of gallbladder
49
Define calculous
Related to presence of gallstones
50
Define acalculous
Absence of gallstones
51
Define ERCP
Endoscopic retrograde cholangiopancreatography
52
Define MRCP
Magnetic resonance cholangiopancreatography
53
How are hepatitis viruses transmitted?
``` A: Fecal-oral, contaminated food B: blood, sex C: blood-IV drug use D: dependent on B E: ```
54
Which hepatitis virus does NOT carry the risk of becoming chronic infection
A
55
Likelihood of chronic infection with HBV is grated in which age group?
Younger Only 2-10% of people who contract HBV older than 35 yo develop chronic disease
56
Complications of HBV
Progression to cirrhosis | Increased risk of hepatocellular carcinoma
57
Which kind of viral hepatitis has NO immunizations?
HCV
58
Patients for which kind of chronic hep need regular screening for hepatocellular carcinoma?
B and C Every 6-12 months
59
#1 cause of acute pancreatitis #2 cause
``` #1 Gallstones #2 Alcohol abuse ```
60
Dx acute pancreatitis?
Refer to ED for blood work and imaging Labs: lipase, amylase Imaging: Abdominal CT scan
61
What are the lab findings that confirm pancreatitis?
3x normal serum lipase and amylase
62
Cullen’s sign
Bruising around belly button area
63
Grey Turner’s sign
Bruising around flank area
64
Classic presentation of acute pancreatitis?
Sudden, severe P epigastric region of abdomen that radiates to back Steady P, “boring” quality
65
Most common abdomen finding for pancreatitis?
Upper abdominal tenderness Often WITHOUT guarding, rigidity or rebound tenderness because pancreas is retroperitoneal (cushioned)
66
Is acute pancreatitis reversible or irreversible?
Reversible Chronic is irreversible
67
#1 cause of chronic pancreatitis?
Alcohol abuse Strong association with smoking
68
Steatorrhea is seen in what disease?
Chronic pancreatitis
69
Are amylase and lipase levels elevated with chronic pancreatitis?
Usually NOT strikingly elevated
70
Tx chronic pancreatitis
1 - pancreatic enzymes 2 - control pain with Tylenol and NSAIDs 3 - avoid exacerbating factors: alcohol, tobacco, eat smaller meals 4 - monitor/treat blood sugar levels if elevated
71
Cachexia
Wasting syndrome

GI (11 decks)

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