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Gastrointestinal
PASS program drill notes
| Question | Answer |
|---|---|
| What disease has a corkscrew x-ray? | Esophageal spasm |
| What disease has an apple core x-ray? | Cancer |
| What disease has a stacked coin x-ray? | Intussusception |
| What disease has a thumbprint x-ray? | Toxic Megacolon |
| What disease has an abrupt cutoff x-ray? | Volvulus |
| What disease has a barium clumping x-ray? | Celiac sprue |
| What disease has a bird's beak x-ray? | Achalasia |
| What disease has a string sign x-ray? | Pyloric stenosis |
| What diseases have solid dysphagia? | Schatzki's rings, stricture, and cancer |
| What disease has solid and liquid dysphagia? | Esophageal spasm, scleroderma, achalasia |
| What is Barrett's esophagus? | Metaplasia, ↑Adenocarcinoma risk |
| What are Esophageal Varices? | Vomit blood everywhere, portal HTN |
| What is Mallory-Weiss? | Tear LES mucosa, chronic vomiters |
| What is Boerhaave's? | Tear all layers of esophagus, left-sided pneumonia/effusion |
| What is Achalasia? | Lost LES Auerbach's, bird's beak, Chaga's, choked on solids |
| What is Hirschsprung's? | Lost rectum Auerbach's, no meconium passage |
| What is Zenker's diverticulum? | Cough undigested food from above UES, halitosis |
| What is a Traction diverticulum? | Eat big bolus => gets stuck above LES |
| What is Plummer-Vinson syndrome? | Esophageal webs, spoon nails, Fe-deficiency anemia |
| What are Schatzki rings? | Esophageal webs in lower esophagus |
| What is a TE fistula? | Choke with each feeding. Cough with each feeding |
| What is Esophageal atresia with TE fistula? | Vomit with 1st feeding, huge gastric bubble |
| What is Duodenal atresia? | Bilous vomiting with 1st feed, double bubble, Down's syndrome |
| What is Pyloric Stenosis? | Projectile vomiting (3-4 wk. old), RUQ olive mass |
| How does Choanale atresia present? | Turns blue with feeding |
| How is Tetralogy of Fallot presentation different? | Turns blue with crying |
| What makes Scleroderma unique? | ↓LES pressure |
| What makes Esophageal spasms unique? | ↑ peristalsis |
| What makes Achalasia unique? | ↓Peristalsis and ↑LES pressure |
| What disease has RUQ olive mass? | Pyloric Stenosis |
| What disease has an RLQ sausage mass? | Intussusception |
| What is a Bezoar? | Mass hair or vegetables ==> antrum obstruction |
| What is Gastritis type A? | Upper GI bleed, anti-parietal cell Ab |
| What is Gastritis type B? | Upper GI bleed, spicy foods, H. pylori infection |
| What is a Duodenal ulcer? | Too much acid --> pain after meal/at night, type O blood, H. pylori, pain relieved by eating |
| Which type of GI ulcer pain is relieved by eating? | Duodenal ulcer |
| What is a Gastric ulcer? | Broken mucus layer: pain during meal, NSAIDs, type A blood |
| Which type of GI ulcer is most likely associated with losing weight? | Gastric ulcer |
| What is a Sliding hiatal hernia? | Fundus slides from esophageal hiatus to thorax ==> sucks acid into thorax |
| What is Rolling hiatal hernia? | Fundus sticks thought hole in diaphragm, strangulates bowel "rolls" |
| What is Menetrier's disease? | Protein-losing, thick stomach rugal folds |
| What defines constipation? | < 3 BM per week |
| What defines diarrhea? | > 200g per day |
| What is Osmotic diarrhea? | Watery |
| What is Secretory diarrhea? | Laxative use |
| What is inflammatory diarrhea? | Blood, pus |
| What is Celiac Sprue? | Jejunum, wheat allergy, villous atrophy, anti-gliadin Ab |
| What is the antibody associated with Celiac Sprue? | Anti-gliadin antibody |
| What is Tropical Sprue? | Ileum celiac sprue |
| What is Mesenteric Ischemia? | Pain out of proportion during physical exam |
| What bugs cause bloody diarrhea? | "CASES" Campylobacter Amoeba (E. histolytica) Shigella E. coli (EHEC) Salmonella |
| What is the difference b/w 1 Biliary Cirrhosis and 1 Sclerosing Cholangitis? | PBC ==> anti-mitochondrial Ab, bile ducts destroyed, xanthelasma PSC ==> p-ANCA Ab, bile duct inflammation, beading, onion skinning, associated with UC |
| What is Ascending Cholangitis? | Common duct stone gets infected |
| What are signs of alcoholic cirrhosis? | Spider angioma, palmar erythema, Dupyutren's contractions |
| What is Hepatorenal syndrome? | Pts with liver disease build up liver toxins that cause renal failure |
| What is Cholangitis? | Inflammation of bile duct => Charcot's triad, Reynold's pentad |
| What is Cholecystitis? | Inflammation of gallbladder ==> Murphy's sign (+) |
| (+) Murphy sign | Cholecystitis |
| What is Cholelithiasis? | Formation of gallstones ==> RUQ colic |
| What is Cholestasis? | Obstruction of bile duct ==> pruritis, ↑alkaline phosphatase, jaundice |
| What is Conjugated bilirubin? | Water soluble; "direct" |
| What is Unconjugated bilirubin? | Fat soluble; "indirect" |
| What is the most common type of gallstone? | Cholesterol (can't see on x-ray) |
| What type of gallstone can be seen on x-ray? | Ca-bilirubinate |
| What is Xanthoma? | Cholesterol buildup (elbow or Achilles) |
| What is Xanthelasma? | Triglyceride buildup (under eye) |
| What does high cholesterol cause? | Atherosclerosis |
| What does high triglycerides cause? | Pancreatitis |
| What is Type 1 Hyperlipidemia? | Bad liver LL (CM) |
| What is type 2a Hyperlipidemia? | Bad LDL or B-100 receptors; trapped in ER (LDL only) |
| What is type 2b Hyperlipidemia? | Less LDL/VLDL receptors (LDL/VLDL) |
| What is type 3 Hyperlipidemia? | Bad Apo E (IDL/VLDL) |
| What is type 4 Hyperlipidemia? | Bad Adipose LL (VLDL only) |
| What is type 5 Hyperlipidemia? | Bad C2 (VLDL/CM) because C2 stimulates LL |
| What is Crigler-Najjar? | Unconjugated bilirubin, usually in infants |
| What is Gilbert's syndrome? | Glucoronyl transferase is saturated ==> stress unconjugated bilirubin |
| What is Rotor's? | Bad bilirubin excretion => conjugated bilirubin |
| What is Dubin-Johnson? | Bad bilirubin excretion => Black liver |
| What is Cullen's sign? | Bleed around umbilicus ==> hemorrhagic pancreatitis |
| What is Turner's sign? | Bleed into flank ==> hemorrhagic pancreatitis |
| What test is used for following pancreatitis? | - Amylase --> sensitive, breaks down carbs |
| What does Ranson's criteria tell you? | Poor prognosis for pancreatitis patients |
| What is Ranson's criteria at presentation? | "WAGLA" WBC > 16 K/Ul (infection) Age >55 (usually multiple illness) Glucose > 150 mg/dL (islet cells are fried) LDH: > 350 IU/L (cell death) AST: >250 IU/L (cell death) |
| What is Ranson's criteria at 48 hours? | "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 <60 mm Hg (fluid/protein leak --> ARDS) Base deficit > 4mEq/L (diarrhea => pancreatic enzymes are dead) |
| What is Carcinoid syndrome? | Diarrhea, flushing, wheezing |
| Which NT is associated with Carcinoid syndrome? | Serotonin |
| What produces Currant Jelly sputum? | Klebsiella |
| What produces Currant Jelly stool? | Intussusception |
| What is Gardener's syndrome? | Familial polyposis with bone tumors |
| What is Turcot's syndrome? | Familial polyposis with brain tumors |
| What is Familial polyposis? | 100% risk of colon cancer, APC defect ==> annual colonoscopy at 5 y/o |
| What is Peutz-Jegher syndrome? | Hyperpigmented mucosa ==> dark gums,/vagina with hyperplastic polyps |
| What is Chron's disease? | IBD with cobblestones, melena, creeping fat, fistulas |
| What is Ulcerative Colitis? | IBD with pseudopolyps, hematochezia, lead pipe colon, toxic megacolon |
| Which biliary condition is often associated with UC? | Primary Sclerosing Cholangitis |
| What is Intussusception? | Currant jelly stool, staked coin appearance on enema, symptoms come and go |
| How does Diverticulosis present? | Bleeds |
| How does Diverticulitis present? | Hurts |
| Hoes dos Spastic Colon present? | Intermittent severe cramps |
| How does IBS present? | Alternating diarrhea/constipation |
| How do External Hemorrhoids present? | Pain |
| How do Internal Hemorrhoids present? | No pain |
| What is Pseudomembranous colitis? | Overgrowth of C. difficile due to normal flora being killed off, usually by Clindamycin use |
| What is Whipple's disease? | T. whippleii destroys GI tract, then spread causing malabsorption |
| What color is an upper GI bleed? | Black |
| What color is a lower GI bleed? | Red |
| What adds color to stool? | Bilirubin |
| What is the default color of stool? | Clay-colored |
| What is the default color of urine? | Tea-colored |
Created by:
rakomi
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