Stuff I should know
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Barrett's esophagitis is caused by what? | GERD
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| Barrett's esophagitis predisposes to what malignancy? Most common location? | Adenocarcinoma; distal 1/3
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| Ranitidine- brand name, pharm class, use | Zantac, H2 blocker, GERD
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| Zantac- generic name, pharm class, use | Ranitidine, H2 blocker, GERD
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| Famotidine- brand name, pharm class, use | Pepcid, H2 blocker, GERD
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| Pepcid- generic name, pharm class, use | Famotidine, H2 blocker, GERD
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| TUMS- pharm class, use | Antacid, Acid reflux/GERD
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| Alka Seltzer- pharm class, use | Antacid, Acid reflux/GERD
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| Mylanta- pharm class, use | Antacid, Acid reflux/GERD
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| Maalox- pharm class, use | Antacid, Acid Reflux/GERD
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| Nexium- pharm class, use | Esomeprazole, PPI, for moderate-severe GERD
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| Aciphex- pharm class, use | Rabeprazole, PPI, for moderate-severe GERD
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| Prilosec- generic name, pharm class, use | Omeprazole, PPI, for moderate-severe GERD
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| Omeprazole- brand name, pharm class, use | Prilosec, PPI, for moderate-severe GERD
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| Prevacid- pharm class, use | Lansoprazole, PPI, for moderate-severe GERD
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| Protonix- pharm class, use | Pantoprazole, PPI, for moderate-severe GERD
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| Mechanism of action for H2 blockers in GERD | Decrease production of stomach acid
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| Mechanism of action for PPIs in GERD | Inhibit the H+/K+ ATPase = inhibits acid secretion
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| Common causes of infectious esophagitis (3) | Candida, CMV, Herpes simplex
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| Symptoms of infectious esophagitis | odynophagia/dysphagia in immunocompromised pt
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| Lab test for infectious esophagitis (immunocompromised pt + odynophagia/dysphagia) | Endoscopy + cytology/culture
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| Cranial nerves involved in swallowing | V, VII, IX, X, XI, XII
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| Cause: dysphagia with liquids and solids | Neurogenic- injury/disease of brainstem or cranial nerves involved in swallowing (V, VII, IX, X, XI, XII)
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| Cause: regurgitation of undigested food and liquid several hours after eating | Zenker's Diverticulum
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| Zenker's Diverticulum- description and symptoms | outpouching of posterior hypopharynx causing regurgitation of undigested food and liquid several hours after eating
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| Cause: Slow progression of solid food dysphagia | Esophageal stenosis
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| Cause: Slow progressive dysphagia with episodic regurgitation and chest pain | Achalasia
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| Achalasia- description and symptoms | Decreased peristalsis + increased lower esophageal sphincter tone = slow progressive dysphagia with episodic regurgitation and chest pain.
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| Cause: dysphagia + intermittent chest pain that may or may not be associated with eating. | Esophageal spasm
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| Dysphagia lab test | Barium swallow/pharyngoscopy/esophagoscopy
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| Most common types of esophageal malignancy (2) | Squamous cell and adenocarcinoma
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| Most common location of esophageal adenocarcinoma? | Distal 1/3 of esophagus
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| Most common location of esophageal squamous cell carcinoma? | Proximal 2/3 of esophagus
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| Cause: rapid progression of dysphagia for solid food? | Esophageal malignancy
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| Most likely diagnosis: vomiting + hematemesis | Mallory Weiss tear
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| Esophageal varices- description and most common location | Dilation of veins of esophagus, commonly at distal end
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| Esophageal varices- cause | Portal hypertension/cirrhosis
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| Budd Chiari Syndrome- complications | Portal vein thrombosis -> esophageal varices
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| Bleeding Esophageal varices- treatment | Hemodynamic support- high volume fluid replacement + vasopressors + endoscopic therapy + pharm vasoconstriction
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| Common causes of gastritis/duodenitis (4)? | Autoimmune/pernicious anemia, H.pylori, NSAIDS, alcohol
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| Treatment for H. pylori | PPI + Amoxicillin (or metronidazole) + Clarithromycin x 14 days
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| Most likely diagnosis for nausea + feeling of excessive fullness after meals? | Delayed gastric emptying
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| Treatment for delayed gastric emptying (pharm category + 2 examples)? | Prokinetics: cisapride, metoclopramide
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| Cisapride- pharm class, use | Prokinetic, for delayed gastric emptying
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| Metoclopramide- pharm class, use | Prokinetic, for delayed gastric emptying
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| Most common location for PUD? | Duodenal>gastric
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| Most likely diagnosis for burning/gnawing abdominal pain radiating to back that improves with food? | Duodenal ulcer
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| Most likely diagnosis for burning/gnawing abdominal pain radiating to back that worsens with food? | Gastric ulcer
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| Zollinger Ellison Syndrome- description | Gastrin secreting tumor; gastrin stimulates H+ secretion and growth of gastric mucosa. Cause PUD.
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| Most common locations of gastrinomas in Zollinger Ellison Syndrome? | Pancreas and duodenum
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| How to distinguish Zollinger-Ellison Syndrome from PUD? | ZES may be refractory to treatment
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| Zollinger Ellison Syndrome labs (2) | Fasting gastrin level, secretin test
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| Zollinger Ellison Syndrome treatment | PPIs, surgical resection of gastrinoma when possible
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| What is Virchow's node? | Left Supraclavicular lymphadenopathy
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| Symptoms of Gastric adenocarcinoma? | Dyspepsia unresponsive to therapy, weight loss, anemia, occult GI bleeding, age >40.
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| Most common site for extra nodal non-Hodgkin's lymphoma? | Stomach
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| Diarrhea definition | 3+ liquid/semisolid stools daily x2-3 consecutive days
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| Infectious causes of watery diarrhea (6)? | Norovirus, Rotavirus, Cryptosporidia, Cyclospora, Vibrio, Clostridium perfringens toxin
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| Organisms responsible for diarrhea from undercooked poultry (2)? | Salmonella, Campylobacter
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| Infectious causes of bloody diarrhea (3)? | E.coli, Shigella, Campylobacter
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| Inflammatory diarrhea symptoms | bloody diarrhea + fever
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| Secretory diarrhea causes | Pancreatic insufficiency, bacterial toxins, laxatives
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| Definition of normal bowel function | Range of 3 stools/day to 3 stools/week.
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| Definition of constipation | Decrease in stool volume, increase in stool firmness, and straining
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| Causes of constipation | ignoring urge, decreased motility of colon (age, emotion, low bulk diet), obstruction (tumor, sprain), nerve injury, narcotics
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| Constipation conservative management | Increase fiber (20-40g/day), increase fluid intake, exercise
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| Cause of small bowel obstruction (2) | Adhesions or hernia
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| Most likely cause of large bowel obstruction | Neoplasm. Others: strictures, hernias, volvulus, intussusception, fecal impaction
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| Definition of volvulus | Twisting of bowel on itself
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| Common site of volvulus | Sigmoid or cecal area
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| Physical exam finding of volvulus | Tympany
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| Pt presents complaining of cramping abdominal pain, distention, nausea, vomiting, and obstipation. You suspect a volvulus. What imaging study should you do? | Abdominal plain film- will show colonic distension
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| Treatment for volvulus | Endoscopic decompression
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| Screening tests for Celiac disease | IgA antiendomysial and antitissue transglutaminase antibodies
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| Confirmation test for Celiac disease | Small bowel biopsy
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| Areas affected by Crohn's Disease | The entire GI tract, except the rectum which is frequently spared(Small and large bowels, mouth, esophagus, stomach).
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| Characteristic finding of Crohn's Disease | Skip lesions
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| Common presenting complaints of Crohn's Disease | Abdominal cramps, diarrhea in patient <40, blood in stool, low-grade fever, anemia, polyarthralgia, fatigue
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| Laboratory test in Crohn's Disease | Colonoscopy
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| Treatment for acute Crohn's attacks | Oral corticosteroids
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| Maintenance therapy for Crohn's Disease | Mesalamine- a bowel-specific anti-inflammatory (aminosalicylate)
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| Characteristic findings of Ulcerative Colitis | Continuous disease (no skip lesions) starting distally at rectum and progresses proximally
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| Common symptoms of Ulcerative Colitis | Bloody, pus-filled diarrhea and tenesmus
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| Tests to avoid with Ulcerative Colitis and why | Colonoscopy + barium enema -> risk of perforation and toxic megacolon
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| Test for Ulcerative Colitis | Sigmoidoscopy/Colonoscopy
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| Treatment for Ulcerative Colitis | Topical or oral (Mesalamine) aminosalicylates (anti-inflammatory) and corticosteroids. Total proctocolectomy is curative.
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| Characteristic S&S of IBS | Constipation, Diarrhea, or alternating Constipation and Diarrhea, dyspepsia, pain worse with food intake and relieved by defecating, most common in women.
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| Lab findings of IBS | Normal
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| IBS treatment | Avoid triggers, high fiber diet, bulking agents, symptomatic
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| Definition of Intussusception | Invagination of a proximal segment of bowel into the portion just distal to it.
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| Characteristic of patient most likely to get intussusception | Child following viral infection
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| Common cause of intussusception in adults | Neoplasm
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| Clinical features of intussusception | Colicky pain, mucus and blood in stool (currant jelly), sausage-like mass
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| Currant jelly stool/mucus + blood in stool is indicative of what condition? | Intussusception
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| Lab test for intussusception | Barium/air enema + hospitalization
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| Description of diverticulosis | Large outpouching of mucosa in colon
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| How to prevent diverticulitis in diverticulosis? | High fiber diet and avoid constipating foods
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| Diverticulitis S&S | LLQ pain, +/- fever, altered BMs, nausea, vomiting
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| Lab tests in diverticulitis | Fecal occult blood, plain film radiography
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| Diverticulitis treatment | low residue diet, broad spectrum antibiotics, +/- hospitalization for IV abx, bowel rest and analgesics
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| Can a pt with diverticulitis eat nuts, seeds, popcorn, etc? | Yes
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| Cause of ischemic bowel disease | Cardiovascular/collagen vascular disease
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| Most common site of intestinal infarction (AMI- acute mesenteric ischemia) | Small bowel
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| Most likely diagnosis for abdominal pain occurring 10-30 minutes after eating, relieved somewhat by squatting or lying down. | Chronic mesenteric ischemia/ ischemic bowel
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| Most likely diagnosis for sudden onset of severe abdominal pain, out of proportion to exam findings... may develop involuntary guarding, rebound, and heme positive stool | Acute mesenteric ischemia/ ischemic bowel
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| Diagnostic test for ischemic bowel | Colonoscopy
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| Description of Hirschsprung's Disease | Congenital aganglionosis of the colon
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| Description of toxic megacolon | Extreme dilatation and immobility of the colon... an emergency
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| Causes of toxic megacolon in adults | Ulcerative colitis, Crohn's, pseudomembranous colitis, infection (amebiasis, Shigella, Campylobacter, C.diff)
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| Cause of toxic megacolon in children | Hirschsprung's disease
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| Symptoms of toxic megacolon | Fever, prostration, severe cramps, abdominal distension, rigid abdomen, rebound tenderness
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| Diagnostic test for toxic megacolon | Plain film radiography
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| Treatment for toxic megacolon | Decompression of colon
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| Symptoms if colonic polyps (if any... usually asymptomatic) | Constipation, flatulence, rectal bleeding
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| When should screening start for a pt with a history of familial polyposis and how often should they be screened? | Start at age 10-12 q1-2 years
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| Clinical features of colon cancer | Slow growing; abdominal pain, long-term change in bowel habits, occult bleeding, intestinal obstruction
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| When should screening begin for colon cancer and how often? | Start at age 50 q5-10 years
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| Anorectal abscess is a result of what? | Infection
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| Why does an anorectal fistula form? | As a complication of chronic abscess
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| S&S of anorectal abscess | Painful swelling at anus and painful defecation, localized tenderness, erythema, swelling, and fluctuance... fever in deeper abscesses
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| S&S of anal fissure | Severe tearing pain on defecation, hematochezia, bright red blood on toilet paper
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| Anal fissure treatment | Bulking agents, increased fluid, sitz bath for acute pain, topical nitroglycerin
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| Rating category of hemorrhoid that is visible perianally | External hemorrhoid
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| Rating category of hemorrhoid that is confined to anal canal and may bleed with defecation | Stage I hemorrhoid
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| Rating category of hemorrhoid that protrudes from anal opening and reduces spontaneously. Bleeding and mucoid discharge may occur. | Stage II hemorrhoid
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| Rating category of hemorrhoid that requires manual reduction after BM.Pt may have pain and discomfort | Stage III hemorrhoid
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| Rating category of hemorrhoid that is chronically protruding and risks strangulation | Stage IV hemorrhoid
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| Treatment of Stage IV hemorrhoid | Surgery- injection, rubber band ligation, sclerotherapy
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| Treatment of Stage III hemorrhoid and initial Stage IV hemorrhoid | Suppositories with anesthetic and astringent
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| Treatment of Stage I and II hemorrhoids | High fiber diet, increased fluids, bulk laxatives
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| Most common cause of appendicitis? | Fecalith
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| McBurney's point | 1/3 distance from anterior superior iliac spine to umbilicus, where pain localizes in appendicitis
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| Psoas sign-describe | Patient is supine and attempts to raise R leg against resistance- causes pain in appendicitis
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| Obturator sign- describe | Patient is supine and attempts to flex and internally rotate the R hip with the knee bent- causes pain in appendicitis
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| Lab findings in appendicitis | Leukocytosis (10,000-20,000 cells/mL), CT to confirm
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| Most common causes of pancreatitis (2)? | Cholelithiasis, alcohol abuse
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| Causes of pancreatitis other than cholelithiasis and alcohol abuse (6)? | Scorpion sting, hyperlipidemia, trauma, drugs, hypercalcemia, penetrating PUD
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| S&S of pancreatitis? | Epigastric pain radiating to back, lessens when leans forward or in fetal position, nausea and vomiting
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| What is the most sensitive and specific test for pancreatitis? | Lipase
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| Labs for pancreatitis? | Lipase, amylase, CBC- WBC, liver enzymes (Increased if biliary obstruction)
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| Ranson's criteria used to predict prognosis of what condition? | Pancreatitis
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| What 8 factors does Ranson's criteria use for prognosis of pancreatitis? | WBC count, blood glucose, lactate dehydrogenase, AST, arterial PO2, Base deficit, Calcium, BUN
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| Treatment for acute pancreatitis? | NPO, maintain fluids, parenteral nutrition, Meperidine for pain, +/- abx
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| Most common cause of chronic pancreatitis? | Alcohol abuse
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| Classic triad of chronic pancreatitis- what is it and how often does it occur? | Pancreatic calcification, steatorrhea, DM. Occurs in 20% of patients.
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| Diagnostic study for chronic pancreatitis? | Abdominal plain film radiography- shows calcification
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| Treatment for chronic pancreatitis? | D/C alcohol, low fat diet, surgical removal of part of pancreas for pain control
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| Describe Courvoisier's sign | Palpable gallbladder- may indicate pancreatic cancer
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| What are the S&S of pancreatic cancer? | Andominal pain +/- radiation, jaundice, Courvoisier's sign
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| Treatment for pancreatic cancer? | Whipple's procedure (surgical resection)
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| Diagnostic study for pancreatic cancer? | CT and angiography
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| Describe Murphy's sign. | Palpate liver/gallbladder during inhalation and pt stops breathing
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| Should an asymptomatic patient with choledocholithiasis be treated? | No
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| Complications of choledocholithiasis (3)? | Cholecystitis, pancreatitis, acute cholangitis
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| Labs for choledocholithiasis? | Liver tests: AST, ALT, serum bilirubin, alkaline phosphatase, GGT. TRANSABDOMINAL ULTRASOUND.
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| Cause of acute cholecystitis? | Obstruction of bile duct- stone
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| S&S of acute cholecystitis? | Colicky epigastric or RUQ pain after a high fat meal, may radiate to R shoulder/subscapula, nausea, vomiting, low grade fever
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| Labs of acute cholecystitis? | HIDA scan, ^ serum and urine bilirubin, ^WBC
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| Treatment of acute cholecystitis? | Surgery
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| Common infectious causes of acute cholangitis (4)? | E.coli, Enterococcus, Klebsiella, Enterobacter
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| Most common cause of acute cholangitis? | Choledocholithiasis
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| What are the features of Charcot's Triad and what condition are the typically positive in? | RUQ tenderness, jaundice, fever... present in acute cholangitis
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| What are the features of Reynold's Pentad? | Charcot's Triad (RUQ pain, jaundice, fever) + altered mental status + hypotension... indicates sepsis in acute cholangitis. Disease can become rapidly fatal
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| Labs in acute cholangitis | ERCP is optimal, RUQ ultrasound is good initial test. ^WBC, ^bilirubin, ^transaminase
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| Treatment for acute cholangitis? | ABX (Fluoroquinolone+Ampicillin+Gentamycin +/- Metronidazole, ERCP + stent placement
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| Most common features of primary sclerosing cholangitis (2)? | Jaundice + pruritis
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| S&S of primary sclerosing cholangitis? | Jaundice, pruritis, fatigue, malaise, weight loss, hepatomegaly/splenomegaly
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| Conservative treatment for primary sclerosing cholangitis | Ursodiol (a bile acid that decreases liver enzymes) + endoscopic management of stricture
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| Definitive management of primary sclerosing cholangitis? | Liver transplant
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| What is the most common cause of hepatitis? | Viral
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| What is the second most common cause of hepatitis? | Alcohol
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| Which viral strains cause chronic hepatitis? | B,C,D
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| What is Wilson's Disease? | Inherited disorder resulting in accumulation of copper in the tissues, especially liver and brain.
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| What is a unique clinical presentation of Wilson's Disease? | Kayser-Fleischer rings- yellow/brown rings around edge of iris from copper deposition
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| Gold standard for diagnosis Wilson's Disease? | Liver biopsy
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| Treatment for Wilson's Disease? | Pencillamine- chelates the copper
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| What are 2 inherited disorders that can cause hepatitis? | Wilson's Disease and Alpha-1 antitrypsin deficiency
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| Which Hepatitis viral strains are transmitted by fecal-oral route? | A and E
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| Describe the Rule of 20's for Hepatitis | 20% of those infected will clear virus, 20% who develop chronic disease will develop cirrhosis in 20 years, 20% will develop hepatocellular CA
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| Hepatitis D is seen only in conjunction with which other viral hepatitis? | Hepatitis B
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| Hepatitis B and C are frequently coinfected with what other STD? | HIV
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| S&S of Hepatitis? | Fatigue, malaise, anorexia, nausea, tea colored urine, and abdominal discomfort, scleral icterus, jaundice
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| Lab interpretation: Anti-HAV | Active disease
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| Lab interpretation: HAV IgG | Resolved Hepatitis A
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| Lab interpretation: HBsAg | Ongoing Hepatitis B infection
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| Lab interpretation: anti-HBs | Hepatitis B immunity by past infection or vaccination
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| Lab interpretation: anti-HBc | Acute hepatitis; it is present between HBsAg and anti-HBs
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| Lab interpretation: HBeAg | Highly contagious active infection
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| Lab interpretation: anti-HBe | Active infection, lower viral titer = not as contagious
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| Treatment of acute hepatitis | Supportive
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| Treatment of chronic hepatitis B | Tenofovir + Emtricitabine/Lamivudine for HepB + Efavirenz for HIV.
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| Pt's with Hepatitis B should also be treated for what infection? | HIV, regardless of CD4 count
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| Patients with Hepatitis C should be vaccinated against what other forms of Hepatitis? | A and B
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| Vaccines are available for what forms of hepatitis? | A and B
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| Causes of toxic hepatitis (4)? | Alcohol, acetaminophen, isoniazid, phenytoin (among others)
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| What drug can be used for acetaminophen toxicity? | Acetylcysteine
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| What is the most common cause of cirrhosis? | Alcohol
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| Late stage S&S of cirrhosis? | Ascites, pleural effusions, peripheral edema, ecchymoses, esophageal varices, hepatic encephalopathy signs: asterixis, tremor, dysarthria, delirium, coma eventually
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| Labs in cirrhosis | Minimally abnormal until late dz. Mild^ in AST and alk phos, decreased albumin. U/S, CT or MRI
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| Cirrhosis treatment | D/C alcohol, if ascites: salt restriction and bed rest vs. spironolactone. Liver transplant.
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| Benign or malignant: hepatic cavernous hemangioma | Benign
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| Benign or malignant: hepatocellular adenoma | Benign
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| Benign or malignant: infantile hepatic hemangioendothelioma | Benign
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| Common site of metastasis for breast and lung cancer? | Liver
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| Labs for hepatocellular carcinoma | ^alpha fetoprotein, CT/MRI/hepatic angiography
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| Treatment for hepatic carcinoma | Surgical resection if confined to one lobe, liver transplant in some
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| Umbilical hernia often occurs when? | Birth
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| Treatment of umbilical hernia? | Surgery if indicated but most resolve on own
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| Describe a hiatal hernia | Protrusion of stomach through diaphragm...causes GERD
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| Treatment of hiatal hernia? | Acid reduction vs. surgery
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| Incisional hernias often occur with what type of incision? | Vertical
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| What are the 3 types of inguinal hernias? | Direct, Indirect, and Femoral
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| Describe an indirect inguinal hernia | Passage of intestine through internal inguinal ring down inguinal canal; may pass into scrotum
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| What is the most common type of inguinal hernia? | Indirect
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| Which type of inguinal hernia commonly passes into the scrotum? | Indirect
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| Describe a direct inguinal hernia | Passage of intestine through external inguinal ring at Hesselbach's triangle
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| What is the least common type of inguinal hernia? | Femoral
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| Describe femoral hernia | Passage of intestine through femoral ring
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| Describe ventral hernias | Weakening of anterior abdominal wall via incision or umbilical allows passage of intestine
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| Hernia treatment | Surgery
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| Most likely diagnosis for newborn with excessive saliva, choking/coughing with feeding | Esophageal atresia
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| Diagnostic "test" for esophageal atresia | Inability to pass nasogastric tube
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| Treatment for esophageal atresia | Surgery + NPO to prevent aspiration
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| Most likely diagnosis for newborn with new onset respiratory distress and bowel sounds heard in chest | Diaphragmatic hernia
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| Describe diaphragmatic hernia | Hernia through the diaphragm in newborns compresses a lung, causing respiratory distress and bowel sounds able to be heard in the chest
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| Treatment for diaphragmatic hernia | Immediate intubation an ventilation, suction stomach via NG tube, surgery
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| Most likely diagnosis in an infant 4-6 weeks old who projectile vomits after feedings, but always seems hungry. Mom complains of weight loss and baby is dehydrated | Pyloric stenosis
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| Physical exam finding in infant with pyloric stenosis? | Olive-shaped mass to right of umbilicus
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| Diagnostic test for pyloric stenosis | U/S; "string sign"
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| Most common site of bowel atresia? | Ileum
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| Most likely diagnosis for infant presenting with signs of bowel obstruction within first few days of life? | Bowel atresia
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| Describe Hirschsprung's Disease | Congenital megacolon caused by absence of bowel innervation (by Meissner's and Auerbach's autonomic plexuses)
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| S&S of Hirschsprung's Disease | Constipation/obstipation, vomiting, failure to thrive in infant
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| Hirschsprung's Disease treatment | Surgical resection of affected bowel
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| Night blindness warrants suspicion of what vitamin deficiency? | Vitamin A
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| Rickets warrants suspicion of what vitamin deficiency? | Vitamin D
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| Bleeding warrants suspicion of what vitamin deficiency? | Vitamin K
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| Beri Beri (nerve tingling, poor coordination, edema, weakness, and cardiac dysfunction) warrants suspicion of what vitamin deficiency? | Thiamin
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| Oral inflammation + eye disorders warrants suspicion of what vitamin deficiency? | Riboflavin
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| "Flushing" warrants suspicion of what vitamin deficiency? | Niacin
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| Tingling + Fatigue + Headache warrants suspicion of what vitamin deficiency? | Pantothenic Acid
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| Headache + Anemia + Seizures + Flaky skin + sore tongue warrants suspicion of what vitamin deficiency? | B6
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| Megaloblastic anemia + sore tongue + diarrhea + mental disorders warrants suspicion of what vitamin deficiency? | Folate
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| Megaloblastic anemia + poor nerve function warrants suspicion of what vitamin deficiency? | B12
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| Scurvy (poor wound healing, petechiae, bleeding gums) warrants suspicion of what vitamin deficiency? | Vitamin C
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| Functions of Vitamin A (4)? | Vision, epithelial cell maturity, resistance to infection, antioxidant
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| Toxicity of what vitamin can inhibit the function of Vitamin K? | Vitamin E
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| Functions of Vitmain D (2)? | Calcium regulation, cell differentiation
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| Functions of Vitamin E (3)? | Slow cell aging, vascular wall integrity, antioxidant
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| Function of Vitamin K (1)? | Clotting
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| Functions of Thiamin (2)? | Carbohydrate metabolism, nerve function
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|
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| Function of Riboflavin (1)? | Energy
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|
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| Functions of Niacin (2)? | Energy, fat metabolism
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|
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| Functions of Pantothenic Acid (2)? | Energy, fat metabolism
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|
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| Functions of Vitamin B6 (3)? | Protein metabolism, neurotransmitter synthesis, hemoglobin
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|
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| Function of Folate (1)? | DNA synthesis
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|
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| Functions of Vitamin B12 (2)? | Folate metabolism, nerve function
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|
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| Folate needs what other vitamin for its metabolism? | Vitamin B12
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|
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| Functions of Vitamin C (3)? | Collagen synthesis, hormone function, neurotransmitter synthesis
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| Describe Phenylketonuria | Autosomal recessive disorder resulting in inability to metabolize the protein phenylalanine, which, when accumulated, results in mental retardation and movement disorders
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| Most likely diagnosis for middle-aged woman presenting with cholestatic liver enzyme levels. She does not take any meds, does not drink alcohol, and does not complain of abdominal pain. No previous biliary tract surgeries. | Primary biliary cirrhosis
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| Risk Factor for non-healing duodenal ulcer? a)age >50 b)high fat diet c)cigarette smoking d)chronic stress e)alcohol use | C) cigarette smoking
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|
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| Before treating a Hepatitis C patient with interferon, you must first ensure they do not have this type of disease, as interferon is contraindicated with it. | Autoimmune diseases
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| Describe the S&S of primary biliary cirrhosis | Common in women between ages 40-60, often found incidentally with elevated alkaline phosphatase level as it is often asymptomatic.
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|
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| Patients with HIV may be affected by chronic diarrhea caused by what organism? (Pt's found to have this organism with chronic diarrhea should always be checked for HIV) | Cryptosporidium
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|
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| Which strain of hepatitis is most likely to become chronic hepatitis? | Hepatitis C
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|
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| Should a pregnant woman with Hepatitis C be concerned about transmitting the virus to her baby? | No, risk of transmission is low
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|
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| What is the most common malignant tumor of the esophagus in the African American male population? | Squamous cell carcinoma
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|
||||
| In Western society, diverticulosis most often occurs in what part of the colon? | Sigmoid
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|
||||
| Routine colonoscopy on a patient with no other risk factors should be performed how often as of age 50? | Every 10 years
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|
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| Treatment for Giardia lamblia? | Metronidazole
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|
||||
| Describe Markle sign/Jar sign | Patient is asked to stand on toes, then drop quickly to heels. Pain location upon hitting the floor should be noted, and indicates peritoneal irritation
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|
||||
| Blumberg sign is also known as what? | Rebound tenderness
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|
||||
| Pellagra consists of what triad? | Dermatitis, Diarrhea, and Dementia
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|
||||
| Pellagra is caused by deficiency of what vitamin? | Niacin
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|
||||
| Most common causes (2) of niacin deficiency in the US? | Alcoholism or malabsorption
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|
||||
| Describe signs and significance of Cullen sign | A faint blue coloration (superficial edema and bruising) around the umbilicus, indicates retroperitoneal bleeding
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|
||||
| Dermatitis herpetiformis, a pruritis paplovesicular rash on extensor surfaces of arms and legs, trunk and neck is likely to have what GI condition? | Celiac Disease
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|
||||
| Describe the S&S of Whipple Disease | Seronegative arthritis, fever, lymphadenopathy, weight loss, malabsorption, and diarrhea occurring in 4th-6th decades of life.
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|
||||
| Treatment for antibiotic-associated colitis | Oral metronidazole> IV Vancomycin
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|
||||
| B12 requires what for adequate absorption from the stomach? | Intrinsic factor
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|
||||
| Best initial diagnostic test for suspected perforated peptic ulcer | Upright/Decubitus abdominal plain film
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|
||||
| Most common cause of traveler's diarrhea in adults (3) | E.coli, Shigella, and C.jejuni
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|
||||
| Most common cause of acute gastroenteritis in children | Rotavirus
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|
||||
| Initial treatment for mild-moderate ulcerative pancolitis | 5-ASA products (sulfasalazine or mesalamine)
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|
||||
| Describe Meckel's diverticulum | Congenital outpouching of distal ileum that often presents by age 2 with painless rectal bleeding or symptoms similar to appendicitis (epigastric/umbilical pain)
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|
||||
| An ICU patient with sepsis who is being mechanically ventilated due to respiratory failure is at increased risk of what GI complication? | Stress ulcer
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|
||||
| A diet high in nitrates significantly increases risk for cancer of which organ? | Stomach
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|
||||
| Lab test to confirm diagnosis of Giardia lamblia | Stool sample for ova and parasites
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|
||||
| Lab test for hepatic encephalopathy-induced mental status changes (confusion/lethargy) | Serum ammonia
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|
||||
| Describe Gilbert syndrome | Hereditary; reduced activity of the enzyme glucuronyltransferase (conjugates bilirubin), therefore causing high levels of unconjugated bilirubin in the bloodstream. Sx: jaundice, fatigue and other vague symptoms
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|
||||
| Describe conjugated vs. unconjugated bilirubin | Bilirubin comes from heme of old RBCs broken down by the spleen. It is transported to liver bound to albumin, where it is conjugated with glucuronic acid by glucuronyltransferase, making it H20 soluble and secreted in bile
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|
||||
| Cause of conjugated/direct bilirubinemia? | Impaired bilirubin excretion from liver due to hepatocellular disease (hepatitis, cholelithiasis, sclerosing cholangitis, cancer)
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|
||||
| Most common hernia in men? | Femoral
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|
||||
| Most common population to exhibit obturator hernias? | Elderly women
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|
||||
| Where will direct and indirect hernias be palpated? | Above the inguinal ligament
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|
||||
| Where will femoral hernias be palpated? | Below the inguinal ligament
🗑
|
||||
| Most cases of thiamine deficiency in the US are caused by what condition? | Alcoholism
🗑
|
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