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PP GI Flashcards

0
Q

What disease has an apple core x-Ray?

A

Cancer

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1
Q

What disease has a corkscrew x-Ray?

A

Esophageal spasm

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2
Q

What disease has a stacked coin x-Ray?

A

Intussusception

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3
Q

What disease has a thumbprint x-Ray?

A

Toxic megacolon

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4
Q

What disease has an abrupt cutoff x-Ray?

A

Volvulus

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5
Q

What disease has a barium clumping x-Ray?

A

Celiac sprue

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6
Q

What disease has a birds beak x-Ray?

A

Achalasia

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7
Q

What disease has a string sing on contrast x-Ray?

A

Cron’s

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8
Q

What disease have solid dysphagia?

A

Schatzki rings
Strictures
Cancer

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9
Q

What disease have solid and liquid dysphagia?

A

Esophaeal spasm
Scleroderma
Achalasia

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10
Q

What is Barrett’s esophagus?

A

Metaplasia ( squamous to columnar epithelia)
Increase Adeno CA
Goblet cells seen in the distal esophagus

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11
Q

What are Esophageal Varices?

A

Vomit blood everywhere

Portal HTN

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12
Q

What is Mallory-Weiss?

A

Tear LES mucosa
Chronic vomiters
Hematemesis with retching

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13
Q

What is Boerhaave’s?

A

Tear all layers of esophagus

Left side pneumo/ pain/ effusion

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14
Q

What is Achalasia?

A

Los LES Auerbach’s
Birds beak
Chaga’s
Choke on solids

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15
Q

What is Hirschsprung’s?

A

Lost rectum Auerbach’s

No meconium passage

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16
Q

What is Zenker’s diverticulum?

A

False diveticulum
Esophaeal diverticula located immediately above the UES
Cough undigested food from above UES
Halitosis

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17
Q

What is Traction diverticulum?

A

Esophaeal diverticula located near the midpoint of the esophagus
Eat big bolus => get stuck above LES

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18
Q

What is Plummer-Vinson syndrome?

A 
Esophageal webs
Spoon nails
Fe-deficiency anemia
Glossitis 
Dysphagia
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19
Q

What are Schatzki rings?

A

Esophageal webs in lower esophagus

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20
Q

What is a TE fistula?

A

Choke w/ each feeding

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21
Q

What is Duodenal atresia?

A

Bilious vomiting w/ 1st feed
Double bubble
Downs

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22
Q

What is an Esophageal atresia w/ TE fistula?

A

Vomiting w/1st feeding

Huge gastric bubble

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23
Q

What is Pyloric stenosis?

A 
Projectile vomiting (3-4 wk old)
RUQ olive mass
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24
How does Choanal atresia present?
Turns blue with feeding
25
How is the Tetrology of Fallot presentation different?
Turns blue with crying
26
What makes Scleroderma unique?
Decrease LES pressure
27
What makes Esophageal spasms unique?
Increase peristalsis
28
What make Achalasia unique?
Decrease peristalsis | Increase LES pressure
29
What disease has a RUQ olive mass?
Pyloric stenosis
30
What disease has a RLQ sausage mass?
Intussusception
31
What is a Bezoar?
Mass of hair or vegetables => Antrum obstruction
32
What is Gastritis Type A?
Upper GI bleed | Anti-parietal cell Ab
33
What is Gastritis Type B?
Upper GI bleed Spicy food H. pylori
34
What is a Duodenal ulcer?
Too much acid: pain after meal/ at night Type O blood H pylori Pain relieved by eating
35
What is a Gastric ulcer?
Broken mucus layer: pain during meal NSAIDS Type A blood
36
What is a Sliding hiatal hernia?
Funds slides from esophageal hiatus to thorax => stuck acid into thorax
37
What is a Rolling hiatal hernia?
Fundus sticks through hole in diaphragm | Strangulates bowel "rolls through a hoe"
38
What is Ménétrie's disease?
Protein losing | Thick stomach rugal folds
39
What defines Costipation?
< 3 BM per week
40
What defines Diarrhea ?
> 200g per day
41
What is Osmotic diarrhea?
Watery
42
What is Secretory diarrhea?
Laxative use
43
What is inflammatory diarrhea ?
Blood, pus
44
What is Celiac sprue?
Wheat allergy Villous atrophy Anti-gliadal Ab Associated with DQ2 and DQ8 and dermatitis herpetiforme
45
What is Tropical sprue?
Ileum celiac sprue
46
What is ischemic colitis?
Pain out of proportion to exam due to reduction of intestinal blood flow
47
What bugs cause bloody diarrhea?
"CASES" - Campylobacter - Ameoba ( E. histolytica) - Shigella - E. coli - Salmonella
48
What is the difference b/w 1st Biliary Cirrhosis and 1st Sclerosing Cholangitis?
``` 1st Biliary Cirrhosis - female ( 49) - Anti-mitochondrial Ab - Bile ductules destroyed - Xanthelasma 1st Sclerosing Cholangitis - men (around 40) - p-ANCA AB - Bile duct inflammation - Beading - Onion skinning - Associated w/ UC and cholangiocarcinoma ```
49
What is Ascending Cholangitis?
Common duct stone gets infected
50
What are the sings of alcoholic cirrhosis?
Spider angioma Palmar erythema Dupuytrens contractions Gynecomastia
51
What is Hepatorenal syndrome?
Pts w / liver disease build up liver toxins that causes renal failure
52
What is cholangitis?
Inflammation of bile duct => charcots triad, Reynolds pentad
53
What is cholecystitis?
Inflammation of the gall bladder => Murphy's sing
54
What is cholelithiasis?
Formation of gallstones => RUQ colic
55
What is Choledocholithiasis?
Gallstone obstruct bile duct
56
What is Cholestasis?
Obstruction of bile duct => pruritus, increase alkaline phosphatase, jaundice
57
What is Conjugated bilirubin?
Water soluble "direct"
58
What is Unconjugated bilirubin?
Fat soluble "indirect"
59
What is the most common type of gallstone?
Cholesterol "can't see on x-ray"
60
What type of gallstone can be seen on x-ray?
Ca-bilirubinate
61
What is xanthomas?
Cholesterol buildup ( elbow or Achilles )
62
What is a Xanthelasma?
Triglyceride buildup (under eye)
63
What does high cholesterol cause?
Atherosclesosis
64
What do high triglycerides cause?
Pancreatitis
65
What is Crigler-Najjar?
Absent UDP-glucuronyl transferase Unconjugated bilirubin Usually in infants
66
What is Gilbert's syndrome?
Mildly decrease UDP-glucuronyl transferase or decrease bilirubin uptake Asymptomatic
67
What is Rotors?
Bad bilirubin excretion => like Dubin-Johnson but without the black liver
68
What is Dubin-Johnson?
Bad bilirubin excretion => black liver | Conjugated hiperbilirubinemia
69
What is Cullen's Sign?
Bleed around umbilicus => hemorrhagic pancreatitis
70
What is Turners sign?
Bleed into flank => hemorrhagic pancreatitis
71
What tests are used for fallowing pancreatitis?
Amylase- sensitive, break down carbs | Lipase- specific, breaks down TGs
72
What does Ranson's criteria tell you?
Poor prognosis for pancreatitis pts
73
What is Carcinoid syndrome?
``` Due to production of 5-HT Bronchospasm Flushing Diarrhea Right side heart disease/ murmur ```
74
What produces Current Jelly sputum?
Klebsiella
75
What produces Currant Jelly stool?
Intussusception
76
What is Gardeners syndrome?
Familial polyposis w/ bone tumors
77
What is Turcot's syndrome?
Familial polyposis w/ brain tumor
78
What is Familial polyposis?
100% risk of colon cancer | APC defect => annual colonoscopy at 5y/o
79
What is Peutz Jegher syndrome?
Hyperpigmentated mucosa => dark gums / vagina
80
What is Crohn's disease?
IBD w/ cobblestone Melena Creeping fat Fistulas
81
What is Ulcerative colitis?
IBD w/ pseudopolyps Hematochezia Lead pipe colon Toxic megacolon
82
What is Intussusception?
Currant jelly stool Stacked coin enema Six come and go
83
How does diverticulosis present?
Often asymptomatic
84
How does diverticulitis present?
LLQ pain
85
How does Spastic Colon present?
Intermittent severe cramps
86
How does IBS present?
Alternating diarrhea / constipation
87
Hoe do External Hemorrhoids present?
Pain
88
How do Internal hemorrhoids present?
No pain
89
What is Pseudomembranous Colitis?
Overgrowth of C. Difficile, due to normal flora being killed off usually by Clindamycin use
90
What is Whipple's disease?
T. Whippleii destroy GI tract, then spread causing malabsorption Arthralgia
91
What color is an upper GI bleed?
Black
92
What color is a lower GI bleed?
Red
93
What adds color to stool?
Bilirubin
94
What is the default color of stool?
Clay-colored
95
What is the default color of urine?
Tea-colored
96
What is an Epiphrenic diverticulum?
Esophaeal diverticula located immediately above the LES
97
Which are the Retroperitoneal structures?
``` SAD PUCKER Suprarenal ( adrenal) Aorta and IVC Duodenum ( 2-4th part) Pancreas ( not the tail) Ureters Colon ( descending and ascending) Kidney Esophagus Rectum ```
98
Bile?
Rate limiting enzyme: cholesterol 7 alpha hydroxylase Functions: - digestion and absorption of lipids and fat-soluble vit - cholesterol excretion - antimicrobial activity
99
What is Whipple's disease?
Infection with Tropheryma whippleii PAS-positive foamy Can cause: cardiac symptoms, athralgias and neurologyc symptoms Older men
100
What is Abetalipoproteinemia?
Decrease synthesis of apolipoprotein B that result in inability to generate Chylomichron Fat accumulation in enterocytes Present in early childhood with malabsorption and Neurologic manifestations
101
What is Meckel' diverticulum?
``` True diverticulum Present with the Rule of five 2's: - 2 inches long - 2 feet from the ileocecal valave - 2% of population - first 2 years of life - 2 type of epithelia ( gastric/pancreatic) ```
102
What is Wilson's disease?
Inadequate hepatic copper excretion and failure of copper to enter circulation as Ceruloplasmin Characteristics: - decrease Ceruloplasmin - corneal deposits ( Kayser-Fleischer ring) - hemolytic anemia - basal ganglia degeneration ( parkinsonian symptoms) - dementia, dyskinesia, dysarthria Tx: penicillamine

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