PP GI Flashcards
1
Q
What disease has a corkscrew x-ray?
A
Esophageal spasm
2
Q
What disease has an apple core x- ray?
A
Cancer
3
Q
What disease has a stacked coin x- ray?
A
Intussusception
4
Q
What disease has a thumbprint x-ray?
A
Toxic megacolon
5
Q
What disease has an abrupt cutoff x- ray?
A
Volvulus
6
Q
What disease has a barium clumping x- ray?
A
Celiac sprue
7
Q
What disease has a bird’s beak x-ray?
A
Achalasia
8
Q
What disease has a string sign x-ray?
A
Pyloric stenosis
9
Q
What diseases have solid dysphagia?
A
Schatzki’s rings, stricture, cancer
10
Q
What diseases have solid and liquid dysphagia?
A
Esophageal spasm, scleroderma, achalasia
11
Q
What is Barrett’s Esophagus?
A
Metaplasia, ↑AdenoCA risk
12
Q
What are Esophageal Varices?
A
Vomit blood everywhere, portal HTN
13
Q
What is Mallory-Weiss?
A
Tear LES (bld) mucosa with chronic vomiters
predispose: alcohol, Bolimia nervosa
14
Q
What is Boerhaave’s?
A
Tear all layers of esophagus, left- sided pneumo/pain/effusion
15
Q
What is Achalasia?
A
Lost LES Auerbach’s, bird’s beak, Chaga’s, choke on solids
16
Q
What is Hirschprung’s?
A
Lost rectum Auerbach’s, no meconium passage
17
Q
What is a Zenker’s diverticulum?
A
Cough undigested food from above UES, halitosis
18
Q
What is a Traction diverticulum?
A
Eat big bolus => gets stuck above LES
19
Q
What is Plummer-Vinson syndrome?
A
Esophageal webs, spoon nails, Fe- deficiency anemia
20
Q
What are Schatzki rings?
A
Esophageal webs in lower esophagus
21
Q
What is a TE fistula?
A
Choke w/ each feeding; cough w/ each feeding
22
Q
What is an Esophageal atresia w/ TE fistula?
A
Vomit w/ 1st feeding, huge gastric bubble
23
Q
What is Duodenal atresia?
A
Bilious vomiting w/1 feed, double bubble,
Down’s
24
Q
What is Pyloric stenosis?
A
Projectile vomiting (3-4 wk old), RUQ olive mass
25
How does Choanale atresia present?
| Conginital narrowing back of the nasal cavity
Turns blue with feeding
26
How is the Tetrology of Fallot presentation different?
Turns blue with crying
| raise pulmonary vascular resistance: decre RV preload---R to L shunt
27
What makes Scleroderma unique?
↓LES pressure
28
What makes Esophageal spasms unique?
↑Peristalsis
29
What makes Achalasia unique?
↓Peristalsis and ↑LES pressure
30
What disease has a RUQ olive mass?
Pyloric stenosis
31
What disease has a RLQ sausage mass?
Intussusception
32
What is a Bezoar?
Mass of hair or vegetables =>
antrum obstruction
33
What is Gastritis type A?
Upper GI bleed, anti-parietal cell Ab
B12 def
34
What is Gastritis type B?
Upper GI bleed, spicy foods, H. pylori
35
# Gastric ulcer
lesser curvature may cause bleeding from the
left gastric artery.
36
# Duodenal ulcer
posterior wall may cause bleeding from the
gastroduodenal artery
37
What is a Duodenal ulcer?
| complication
Too much acid: pain after meal/ at night, type O blood, H. pylori, pain relieved by eating
| GI Bleed and perforation
38
What is a Gastric ulcer?
Broken mucus layer: pain during
meal, NSAIDs, type A blood
39
What is a Sliding hiatal hernia?
Fundus slides from esophageal hiatus to thorax => sucks acid into thorax
40
What is a Rolling hiatal hernia?
Fundus sticks through hole in diaphragm, strangulates bowel "rolls
41
What is Menetrier's disease?
Protein-losing, thick stomach rugal folds
42
What defines Constipation?
< 3 BM per week
43
What defines Diarrhea?
>200g per day
44
What is Osmotic diarrhea?
Watery
| stops with intravenous nutrition
45
What is Secretory diarrhea?
active secretion of water
| Hi cAMP
46
# endocrine
secretory diarrhea
Hyperthyroidism
Addison disease
Diabetes mellitus
47
# bacteria
secretory diarrhea
Cholera (“rice water” diarrhea)
Enterotoxigenic E. coli (traveler's diarrhea)
C. perfringens
C. difficile (associated with antibiotic and PPI use)
Protozoa: e.g., giardiasis, cryptosporidiosis
Viruses: e.g., norovirus, rotavirus, adenovirus
48
# neuroendocrine
secretory diarrhea
Carcinoid syndrome
Gastrinoma
49
What is Inflammatory diarrhea?
Blood, pus, leukocyte
| damage to instinal mucosa, electrolyte disruption
50
# infectious cause
inflamatory diarrhea
Shigellosis (bacillary dysentery)
Nontyphoidal: salmonellosis
Enteroinvasive Escherichia coli,
E. coli (O157:H7)
Campylobacteriosis
Yersiniosis
Amebiasis (amebic dysentery caused by Entamoeba histolytica)
Clostridioides difficile (rarely bloody)
51
Ulcerative colitis, Crohn disease
Colorectal cancer
| associated with what diarrhea
inflamatory diarrhea
| blood and pus
52
What is Celiac sprue?
Jejunum, wheat allergy, villous atrophy, anti-gliadal Ab
| change diet
53
What is Tropical sprue?
Ileum celiac sprue
54
1° Biliary Cirrhosis
| findings
anti-mitochondrial Ab,
bile ductules destroyed,
xanthelasma
55
1° Sclerosing Cholangitis?
| findings
p-ANCA Ab,
bile duct inflammation,
beading,
onion skinning,
Associated w/ UC
56
What is Mesenteric ischemia?
Pain out of proportion to exam
57
What bugs cause bloody diarrhea?
"CASES"
Campylobacter
Amoeba (E. histolytica)
Shigella
E. coli
Salmonella
58
What is the difference b/w 1° Biliary Cirrhosis and 1° Sclerosing Cholangitis?
1° Biliary Cirrhosis: anti-mitochondrial Ab, bile ductules destroyed, xanthelasma
1° Sclerosing Cholangitis: p-ANCA Ab, bile duct inflammation, beading, onion skinning, associated w/ UC
59
What is Ascending Cholangitis?
Common duct stone gets infected
60
What are the signs of alcoholic cirrhosis?
Spider angioma, palmar erythema, Dupuytren's contractions,
61
What is Hepatorenal Syndrome?
Pts w/ liver disease build up liver toxins that cause renal failure
62
What is Cholangitis?
Inflammation of bile duct => Charcot's triad, Reynold's pentad
63
What is Cholecystitis?
Inflammation of gallbladder => Murphy's sign
64
What is Cholelithiasis?
Formation of gallstones => RUQ colic
65
What is Choledocholithiasis?
Gallstone obstructs bile duct
66
What is Cholestasis?
Obstruction of bile duct => pruritis, ↑alkaline phosphatase, jaundice
67
What is Conjugated bilirubin?
Water soluble "direct"
68
What is Unconjugated bilirubin?
Fat soluble "indirect"
69
What is the most common
type of gallstone?
Cholesterol (can't see on x-ray)
70
What type of gallstones can be seen on x- ray?
Ca-bilirubinate
71
What is a Xanthoma?
Cholesterol buildup (elbow or Achilles)
72
What is a Xanthelesma?
Triglyceride buildup (under eye)
73
What does high cholesterol cause?
Atherosclerosis
74
What does high triglycerides cause?
Pancreatitis
75
What is Type 1 Hyperlipidemia?
Bad Liver LL (CM)
| Lipoprotein lipase, hi chilomicron
76
What is Type 2a Hyperlipidemia?
Bad LDL or B-100 receptors: trapped
in ER (LDL only)
77
What is Type 2b Hyperlipidemia?
Less LDL/VLDL receptors (LDL/VLDL)
78
What is Type 3 Hyperlipidemia?
Bad Apo E (IDL/VLDL)
79
What is Type 4 Hyperlipidemia?
Bad Adipose LL (VLDL only)
80
What is Type 5 Hyperlipidemia?
Bad C2 (VLDL/CM) b/c C2 stimulates LL
81
What is Crigler-Najjar?
Unconjugated bilirubin, usually in infants
82
What is Gilbert's syndrome?
Glucoronyl transferase is saturated
=> stress
unconjugated bilirubin
83
What is Rotor's?
Bad bilirubin storage => conjugated bilirubin
84
What is Dubin-Johnson?
Bad bilirubin excretion => black liver
85
What is Cullen's sign?
Bleed around umbilicus =>
hemorrhagic pancreatitis
86
What is Turner's sign?
Bleed into flank => hemorrhagic pancreatitis
87
What tests are used for following pancreatitis?
Amylase – sensitive, breaks down
carbs
88
What does Ranson's criteria tell you?
Poor prognosis for pancreatitis pts
89
What is Ranson's criteria at presentation?
"WAGLA"
WBC: >16K/μL (infection)
Age: >55 (usually multiple illnesses)
Glucose: >200 mg/dL (islet cells are fried)
LDH: >350 IU/L (cell death)
AST: >250 IU/L (cell death)
90
What is Ranson's criteria at 48hr?
"BuCH was a SOB"
BUN: ↑ >5mg/dL (↓renal blood flow)
Ca: <8 mg/dL (saponification)
Hct: drops >10% (bleed into pancreas)
Sequester >6 L fluid => 3rd spacing
pO2: <60mm Hg (fluid/protein leak → ARDS)
Base deficit >4mEq/L (diarrhea => pancreatic enzymes are dead)
91
What is Carcinoid syndrome?
Diarrhea, flushing, wheezing
92
What produces Currant Jelly sputum?
Klebsiella
93
What produces Currant Jelly stool?
Intussuception
94
What is Gardener's syndrome?
Familial polyposis w/ bone tumors
95
What is Turcot's syndrome?
Familial polyposis w/ brain tumors
96
What is Familial polyposis?
100% risk of colon cancer, APC defect => annual colonoscopy at 5y/o
97
What is Peutz-Jegher syndrome?
Hyperpigmented mucosa => dark gums/vagina w/hyperplastic polyps
98
What is Crohn's disease?
IBD w/ cobblestones, melena, creeping fat, fistulas
99
What is Ulcerative colitis?
IBD w/ pseudopolyps, hematochezia, lead pipe colon, toxic megacolon
100
What is Intussuception?
Currant jelly stool, stacked coin appearance on enema, sx come and go
101
How does Diverticulosis present?
Bleeds
102
How does Diverticulitis present?
Hurts
103
How does Spastic Colon present?
Intermittent severe cramps
104
How does IBS present?
Alternating diarrhea/constipation
105
How do External Hemorrhoids present?
Pain
106
How do Internal Hemorrhoids present?
No pain
107
What is Pseudomembranous Colitis?
Overgrowth of C. difficile due to normal flora being killed off, usually by Clindamycin use
108
What is Whipple's disease?
T. whippleii destroy GI tract, then spread causing malabsorption,
109
What color is an upper GI bleed?
Black
110
What color is a lower GI bleed?
Red
111
What adds color to stool?
Bilirubin
112
What is the default color of stool?
Clay-colored
