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GI II > Week 1 (Exam 1) > Flashcards

Week 1 (Exam 1) Flashcards

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1
Q

What are Signet Ring Cells and Lintis Plastica indicative of?

A

Gastric Adenocarcinoma

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2
Q

How can you get an Acquired Esophageal Web?

A

Eosinophilic Esophigitis

Plummer Vinson Syndrome

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3
Q

What are the major anti-DA drugs?

A

Phenothiazines (Chlorpromazine, Perphenazine, Prochlorperazine) and metoclopramide

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4
Q

What secretory products would tell you that a carcinoid tumor in the gut is aggressive?

A

Serotonin, Substance P, Polypeptide YY

This is in the ilium and jejunum

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5
Q

What drug is exclusively given to patients on permanent NSAID treatment?

A

Misoprostol

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6
Q

What key histological finding would you look for to identify Candida?

A

Pseudohyphae

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7
Q

What do GIST tumors arise from?

A

Cajal cells (Kit mutation)

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8
Q

What are the different clinical features between duodenal and gastric ulcers?

A

Duodenal: Gnawing 1-3 hours after eating, relieved by food
Gastric: Worse within 30 minutes of eating, food doesn’t help. DO ENDOSCOPY

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9
Q

How is PUD diagnosed?

A

Urea Breath Test (stop PPI for 14 days first)

Fecal Antigen Test

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10
Q

What do -petant drugs block?

A

Substance P aka Neurokinin 1

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11
Q

What part of the stomach is most commonly affected by H Pylori?

A

antum

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12
Q

If a patient has Clarithromycin resistance, what should you substitute it with?

A

Amoxicillin

Tetracycline

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13
Q

What do you add to the triple therapy if a patient’s H Pylori isn’t responding to it?

A

Bismuth

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14
Q

What other effects do anti-histamine drugs have on the body?

A

Anti-cholinergic to the CNS

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15
Q

What is the initial therapy for nausea and vomiting associated with pregnancy?

A

Doxylamine (with some B6)

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16
Q

What fungus is associated with 45 degree angle branching?

A

Aspergillus

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17
Q

What part of a patients history would clue you in that they have an esophageal stricture?

A

Their acid reflux improves as the stricture progresses

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18
Q

How is Gastroparesis diagnosed?

A

Gastric Scintigraphy

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19
Q

Osler Weber Rendu Disease

A

Vascular Dysplasia leading to bleeding

Severe Epistaxis

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20
Q

What proteins are responsible for squamous differentiation?

A

P63 and NOTCH1

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21
Q

What are the two pharmaceutically administered cannabanoids?

A

Dronabinol (one metabolite)

Nabilone (many metabolites)

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22
Q

What do -setron drugs block?

A

5HT3 receptors at the Vagal N

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23
Q

How do you treat a patient with red wale markings on endoscopy?

A

Variceal Banding
Give Non-Selective Beta blockers and maybe ligation to prevent more.
This is Esophageal Varices

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24
Q

What are the drugs found in Prevpac?

A

Amoxacillin
Clarithromycin
Lansoprazole

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25
What is the prototypical PPI CYP450 inhibitor?
Omeprazole
26
A Patient has thickened gastric folds and chronic protein loss. What is this person at greater risk of?
Gastric Adenocarcinoma (this is Menetrier disease)
27
What is the major side effect of Bismuth Compounds?
Dark, Tarry Stool
28
Where is the source of an Upper GI Bleed?
Proximal to the Ligament of Treitz (D-J Junction)
29
What adverse effect would you worry about if giving a patient a -setron drug?
QT prolongation (torsade de pointe)
30
How would you define Nutcracker Esophagus?
Swallowing is too powerful
31
Cimetidine is a Histamine Antagonist used to treat ulcers. What are the major side effects?
Anti-Testosterone: Gyno (m) Galactorrhea (w) | Neutropenia, Thrombocytopenia
32
What would you give for vertigo?
Meclizine or Cyclizine
33
How does Scopolamine work to treat motion sickness?
72 hour patch of M1 blockade
34
What is the Achalasia Triad?
Incomplete LES relaxation Increased LES tone Aperistalsis of the esophagus
35
What drugs are found in Helidac?
Bismuth Metronidazole Tetracycline +PPI Omeprazole (not in pack)
36
What does Emphysema sound like?
Hamman’s Sign: Crunching, rasping sound with heartbeat during systole and in the left lateral decubitus position.
37
What symptoms would you expect to present in a Zenker Diverticulum?
Oropharyngeal Dysphagia | Halitosis, Regurgitation, Protrusion in neck
38
What is the risk of giving Metoclopramide to a patient with Gastroparesis?
Tardive Dyskinesia
39
What are the Histamine Receptor Antagonists?
``` Diphenhydramine Dimenhydrinate Hydroxyzine Promethazine Meclizine and Cyclizine ```
40
How would you differentiate the inflammatory infiltrate of H. Pylori vs Auto-immune Gastritis?
Autoimmune has increased lymphocytes and Macrophages, H. Pylori has neutrophils and plasma cells
41
What PPI would you recommend for a pregnant patient?
Pantoprazole or Lansoprazole
42
What would you give for pregnancy-induced NV?
B6 w/w/o histamine blocker or 5HT blocker +DA antagonist +Steroid or another DA antagonist
43
How would you characterize a tumor caused by a PLAG1 mutation?
Pleomorphic / mixed: Well Demarcated Histological heterogeneity
44
What do HPV strains E6 and E7 act on, respectively?
E6: P53 and TERT (increased telomerase) E7: P21 and RB-E2F
45
Blood supply to the trachea is divided into thirds. What arteries supply the upper, middle, and lower thirds, respectively?
Upper: Inferior Thyroid A Middle: Thoracic Aorta (branches) Lower: Left Gastric A
46
What is the prototypical CYP450 inhibitor?
Cimetidine
47
What two Serotonin antagonists would you give for a delayed onset?
Palonosetron | Granisetron
48
Peutz-Jeghers Syndrome
Multiple GI Hamartomatous Polyps | Mucal Macules and Hyperpigmentation
49
Zollinger Ellison Syndrome
Make too much Gastrin
50
How does Oropharyngeal Dysphagea present?
Difficulty Initiating Swallowing | Food stuck at Suprasternal Notch
51
What key step must be undertaken in the development of diffuse gastric cancer?
Loss of E-Cadherin
52
What are the possible side effects of Substance P blockers?
CYP450 interactions | CNS and GI
53
What is the Misoprostol MOA?
Prostaglandin E1 analog (increases mucous and bicarb for cytoprotection)
54
What would you give for Diabetic Gastroparesis?
Metoclopramide
55
What are the two sets of risk factors for Pyloric Stenosis?
Turner and Edward Syndrome | Erythromycin and Azithromycin during pregnancy
56
When esophageal perforation is spontaneous, its called Boerhaave’s. Where does this occur?
Trans mural rupture at the Gastroesophageal Junction
57
An infant has food impaction and feeding intolerance, as well as rashes on their chest, joint extremities, and scalp. What is the likely dx?
Eosinophilic Esophagitis
58
How do you diagnose an upper GI bleed?
EGD
59
What two tumors are indicative of GI metastasis?
Virchow: just above the clavicle Krukenberg: ovarian
60
How would you prevent perforating a suspected Zenkers Diverticulum during a diagnostic exam?
Video Esophagography or barium swallow is done BEFORE EGD
61
What disease has Corkscrew and Rosary Bead Esophagus on barium swallow?
Diffuse Esophageal Spasm
62
What is the core of H Pylori treatment?
Triple therapy for 10-14 days: Clarithromycin +Amoxicillin / Metronidazole +PPI
63
What is most likely suspected with impaction of large, poorly chewed food bolus?
Schatzki Ring (steakhouse syndrome)
64
What are the -prazole drugs?
PPIs
65
What does H Pylori use to cause ulcer?
Can-A Positive Toxin
66
What do you do about really persistent H Pylori, lasting beyond 14 days?
Consider PPI therapy | Switch to non-Metronidazole Quadruple Therapy
67
What neurokinin-1 blocker can you give prophylactically for post-op nausea and vomiting?
Aprepetant ONLY
68
What are the -tidine drugs?
H2 receptor antagonists (anti-ulcer)
69
How is Acute Paralytic Ilius diagnosed?
Plain abdominal radiography or CT | Gas and fluid dissension in large and small bowels
70
What would you diagnose when you see histological findings on Balloon Cells, Hyperkeratosis, and Acanthosis?
Hairy Leukoplakia
71
Netupetant and FosNetupetant are only found in combo with which other drug?
Palonosetron
72
What tumor suppressor is OVER-expressed in HPV?
P16 (encoded by CDKN2A)
73
What is the likely diagnosis of palatine mass that isn’t a torus?
Adenoid Cystic Carcinoma: | Pain is common from growth along nerves
74
Where are you most likely to find a Warthin tumor?
A Smoking Man’s Parotid
75
What disease is characterized by Pernicious Anemia, adenocarcinoma, carcinoid tumor, and atrophy?
Auto-immune gastritis
76
What disease is characterized by PUD, adenocarcinoma, and MALToma?
H. Pylori Gastritis
77
What are the only indications for Histamine blockers Meclizine and Cyclizine?
Motion Sickness and Vertigo
78
Lymphoepithelial lesions are diagnostic of what?
MALToma
79
Where does a Zenker Diverticulum occur?
Between the cricopharyngeus muscle and the inferior pharyngeal constrictor muscle
80
How does an SBO present physically?
Decreased or absent or high pitched bowel sounds | NV (possibly feculent)
81
Meckel Diverticulum comes from a congenital abnormality of what structure?
Vitelline Duct
82
What are the downstream effects of increased Wnt signaling?
Loss of APC tumor supressor Gain of b-Catenin expression Causes Intestinal Type Gastric Cancer
83
What are the major effects of Metoclopramide?
``` Anti cholinergic (drowsiness, urinary retention, etc) Increased GI motility ```
84
A patient has spoon nails, esophageal webs, angular chelitis and glossitis. What is this?
Plummer-Vinson | Comes with Fe-Deficient Anemia
85
What is the translocation associated with MALTomas?
11;18
86
What are the three parts of a high-emetogenic regimen for chemo-induced N/V?
1. NK antagonist 2. 5HT antagonist 3. Corticosteroid (maybe add Olanzapine to block D2, or cannabinoid)
87
What about Sucralfate makes it a relative contraindication for patients with renal disease?
It contains some aluminum
88
How does Type A gastritis come about?
Loss of rural folds Antibodies to Parietal Cells Anti Intrinsic Factor Abs
89
A patient has a dull, gnawing chest pain and coffee ground emesis. What do you think this is?
PUD
90
What infection can cause Achalasia?
Chagas Disease (T Cruzi from Reduviid Bug)
91
What set of symptoms occurs in disease associated with Sjogrens?
Keratoconjunctivitis: Blurred vision Burning, itching, secretions in conjunctiva

GI II (4 decks)

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