PANCE Flashcards Gastroenterology GI

154 cards

Flashcard to help study for the PANCE/PANRE- Gastroenterology, including buzz words


 
  
Created Aug 30, 2012
by
pancestudy

 

 
Table View
 
Download
 
Print

Flashcard Set Preview

  Side A   Side B
1
Fat, forty, female, fertile w/ RUQ pain
 
Cholelithiasis or Cholecystitis
2
Fever, RUQ pain, radiation to back
 
Cholecystitis
3
Elevated Alkaline phosphatase, urinary bilirubin
 
Cholecystitis
4
F, RUQ pain, Jaundice, gallstones & dilated common duct on US
 
Ascending cholangitis (Charcot’s triad)
5
Hx IBD, progressive RUQ pain, wt loss, F, jaundice & pruritis.  Elevated bilrubin...
 
Primary sclerosing cholangitis (diffuse intra- and extrahepatic duct sclerosing and dilatation)
6
Elevated AST, ALT, indirect bilirubin
 
hepatitis
7
Isolated elevated indirect bilirubin
 
Gilbert’s syndrome
8
Elevated indirect bilirubin w/ defective glucuronyl transferase
 
Crigler-Najjar Dz
9
Photosensitivity, abd pain w/ neurologic dysfunction, erythema or skin fragility
 
porphyria
10
H.pylori gastritis
 
2antibiotics & PPI
11
Chronic cough, bitter taste in mouth or throat, dyspepsia
 
GERD
12
Multiple or constant GI ulcer pain despite medications
 
Zollinger-Ellison Syndrome
13
Peri-umbilical or flank ecchymosis
 
Acute pancreatitis (Cullen & Grey Turner’s Sign)        
14
N/V, epigastric abdominal pain, worse supine, caused by alcohol ingestion, or following fatty...
 
Acute pancreatitis 
15
Abdominal distension, bloating, intermittent, colicky pain, high-pitched rushes & tinkles
 
SBO
16
Air fluid levels on upright abd plain film
 
SBO
17
Air under diaphragm, rigid board-like abdomen
 
Perforated viscus, perforated ulcer
18
>60yo F, LLQ pain
 
Diverticulitis.  IV Abx, fluids, NPO.
19
Elderly, Hx atherosclerosis.  Dull crampy periumbilical pain post-prandial
 
Mesenteric ischemia
20
Neonate w/ projectile vomiting.  Olive sized mass.
 
Pyloric stenosis
21
Choking, cyanosis, respiratory distress, increased secretions in 1st hours of life
 
Tracheoesophageal fistula
22
Painless rectal bleeding in pediatrics
 
Meckel’s diverticulum
23
Alcoholic with massive hemoptysis
 
Esophageal varicies (Tx w/ octreotide)
24
Female with recurrent abdominal pain, alternating diarrhea, constipation.  Pain relieved...
 
IBS.  TCA’s (nortriptyline) good if diarrhea predominant symptom
25
Bloody Diarrhea
 
Ulcerative colitis
26
Supraclavicular LAD (L > R)
 
Virchow’s node – metastatic abdominal cancer
27
Hard periumbilical nodule
 
Sister mary Joseph nodule = indicates metastatic gastric and pancreatic cancers
28
PUD, Pernicious anemia (Type A Gastritis), H. pylori
 
Gastric Ca
29
Apple core lesion
 
Colon Cancer
30
Elderly with positive hemmocult.  
 
Colon Cancer – get colonoscopy
31
CEA
 
Colon Carcinoma
32
Family history of young age colon cancer, multiple polyps found on colonoscopy
 
Familial adenomatous polyposis (Gardner’s syndrome)
33
AFP
 
Hepatocellular carcinoma, testicular seminoma (germ cell tumor)
34
CA 19-9
 
Pancreatic Ca
35
CA-125
 
Ovarian Carcinoma
36
Chemotherapy induced N&V 
 
Treat with Ondansetron (Zofran) (5-HT3 blockers) 
37
Traveler’s Diarrhea
 
E. coli is cause.  Hydration & Cipro to treat
38
Greasy, foul smelling, floating stools.  Pear-shaped flagellated protozoan w/ 2 “eyes”. ...
 
Giardia
39
Afebrile, watery or loose stool.  No blood or mucus
 
Viral Gastroenteritis
40
Abdominal pain, diarrhea after picnic/party.  Eaten ham, cream, custards, mayonnaise
 
Staphylococcus aureus infectious diarrhea
41
Acute bacterial diarrhea w/ prodrome of HA, F, then crampy abd pain & diarrhea
 
Campylobacter jejuni – most common cause of acute bacterial diarrhea
42
Painless rectal bleeding.  Bulging perianal mass w/ straining
 
Internal hemorrhoids
43
Pediatric with perianal pruritis esp. at PM.  Positive cellophane tape test
 
Pruritis ani – Pinworms (enterobiasis).  Tx is Mebendazole
44
Weight loss, recurrent greasy stools (steatorrhea) mixed with diarrhea after certain foods
 
Celiac Sprue
45
Anti-endomysial antibodies
 
Celiac Sprue
46
Beriberi
 
Thiamine; Alcoholics, Neuro Sx
47
Pellagra
 
Niacin (4D’s dermatitis, diarrhea, dementia, death), bright red tongue
48
Scurvy
 
Vit C (easy bleeding, bruising, hair & tooth loss, joint pain & swelling)
49
Rickets
 
Vit D (Osteomalacia)
50
Night blindness
 
Vit A deficiency
51
Magenta tongue
 
Riboflavin deficiency (B2)
52
s/p gastric bypass surgery or gastric surgery.  N, abd cramping, dizziness after eating....
 
Dumping syndrome
53
crampy abdominal pain, increased high pitched bowel sounds, gas only in the small intestine
 
Small bowel obstruction
54
gas with obstipation and failure to pass flatus
 
Paralytic ileus 
55
hypocalcemia in ESRD
 
deficiency of vitamin D
56
somatostatin receptor scintography
 
ze study of choice
57
Two top causes of hypercalcemia
 
Primary hyperparathyroidism and malignancy account for 90% of all cases of hypercalcemia....
58
 soft tissue thickening of the pericolic fat, diverticula, and thickening of the bowel...
 
CT findings consistent with diverticulitis
59
haustral markings
 
haustral markings= LARGE BOWEL. 
60
cause of LBO
 
cancer, diverticulum, volvulus
61
causes of SBO
 
adhesions, hernia
62
Rx indicated for prevention of NSAID ulcers
 
omeprazole
63
Trx systemic htn/ascites
 
start sprinolactone. if refractory can do paracentesis or tips
64
 the best visualization of an esopahgeal web or ring.
 
barium esophagram
65
Barium studies contraindication
 
patients with a possible perforation
66
acute performation 
 
perform hartmann procedure, if scheduled colectomy and primary anastomosis is considered.
67
PUD imaging
 
upper endoscopy
68
absence of ganglion cells in the colon and typically presents early in life with failure...
 
Hirschsprung disease
69
pyloric stenosis imaging
 
upper GI with barium
70
 inner tube or coffee bean on imaging
 
volvulus
71
The treatment of choice for diarrhea caused by Giardia 
 
metronidazole 250 to 750 mg po three times per day. 
72
cholera DOC
 
doxycycline or tetracycline
73
drug  used to treat Campylobacter.  
 
Erythromycin
74
drug used to treat cholera and shigellosis.
 
Quinolones
75
at what size do cecal obstructions  require surgery
 
>12cm require surgical intervention
76
d/c what drug prior to  fecal and urea breath testing.
 
no PPI 1-2 weeks prior to fecal and urea breath testing.
77
 increased serum ammonia
 
asterixis; consider hepatic encephalopathy- give lactulose
78
autoimmune heptatitis
 
corticosteroids
79
Celiac diet (abstain from eating)
 
BROW: Barley Rye Oats Wheat
80
lead pipe colon, thumbprinting, loss of haustral markings
 
ulcerative colitis
81
Double bubble on Xray 
 
 represents duodenal atresia (related to Down Syndrome)
82
 most common complication associated with acute pancreatitis.
 
Pancreatic pseudocysts suspected for a patient who has continued abdominal pain, the development...
83
alendronate (fosamax), which is known to cause what ADR
 
 esophagitis
84
hypochloremic alkalosis with potassium depletion.
 
 pyloric stenosis
85
 hallmark of peptic ulcer disease 
 
Dyspepsia (epigastric pain)
86
variceal hemorrhage prophylaxis
 
Beta blocker
87
 affects women typically between ages 40 and 60. It is often discovered incidentally when...
 
Primary biliary cirrhosis
88
Calcification of the gall bladder, frequently referred to as a porcelain gall bladder, and...
 
 gall bladder cancer 
89
A significantly elevated PT/INR as well as bilirubin > 10 mg/dl 
 
 indicators of severe alcoholic hepatitis and increased mortality requiring hospitalization
90
hematemesis with severe retrosternal tearing pain
 
boerhaave's syndrome- get esophogram and emergent surgical consult
91
esophagram with "birds beak"
 
achalasia- tx botox, myotomy
92
smooth circumferential structure in the distal esophagus
 
schatzki ring- get esophagram
93
dysphagia with regurgitation of food especially in the am; older patients
 
zenker's diverticulum; get barium esophagram, surgery in severe cases
94
esophageal web may develop from what deficiency?
 
iron deficiency  (plummer vinson syndrome)
95
when to take PPIs
 
take 30 minutes before meals
96
complication of GERD
 
barrett's esophagus (which has an increased risk adenocarcinoma); tx long term PPI
97
serum gastrin level >150
 
consider ZES
98
ulcer disease- weight loss versus weight gain
 
GUS- weight loss DUS- weight gain
99
two main causes indirect unconjugated bilirubinemia
 
hemolysis, inherited (gilbert, crigler)
100
biliary colic, n/v, jaundice, ELEVATED LFTs
 
choledolithiasis
101
fever, RUQ pain, jaundice
 
charcot's triad
102
risk of pancreatitis with what procedure
 
ERCP
103
women (40-50) with fatigue, jaundice, pruritis, hepatomegaly, elevated alk phos, AMA +
 
Primary biliary cirrhosis; treat with bile acid sequestrant, cure is transplant
104
Gold standard dx biliary cirrhosis
 
liver biopsy
105
womean 30-50 with fatigue, anorexia, arthralgias, +ANA, +ASMA
 
Autoimmune hepatitis, get liver biopsy
106
fatigue, jaundice, pruritis, pain; associated with ulcerative colitis
 
primary sclerosing cholangitis
107
nontender palpable gall bladder with hx weight loss
 
klatskin tumor/cholangiocarcionoma
108
rx causes acute pancreatitis
 
azothioprine, pentamide, valproate, thiazides
109
Ranson Criteria
 
At admission: "GA LAW" (Glucose 200, Age>55, LDH >350, AST>250, WBCcount>16)
*...
110
most common cause chronic pancreatitis
 
alcohol abuse
-other causes CF, hyperparathyroidism, hx acute panc.
111
imaging of choice chronic pancreatitis
 
CT- look for calcifications
112
most common location pancreatic cancer
 
head
113
increased % transferrin sat
 
hemochromatosis (autosomal recessive)
114
low serum ceruloplasmin, increased urine copper
 
wilson's disease, treat with penicillamine
115
icterus, jaundince, malaise with ALT>AST (20x)
 
Viral hepatitis
116
chronic hep B carriers are at risk for what?
 
HCC
117
most common blood bourne infection
 
hepatitis C
118
leading cause of chronic liver failure
 
hepatitis C
119
diagnosis of hepatitis C
 
screen with EIA, if positive use RIBA to confirm
120
hepatitis C treatment
 
interferon plus ribavirin
121
factor that impact hep C trx
 
genotype, race (AA males less likely to respond)
122
most common cause cirrhosis
 
alcoholic hepatitis
123
non alcoholic versus alcoholic liver disease
 
if AST/ALT >2.0 think ALCOHOL
124
most common metastatic cancer
 
hepatocellular cancer
125
most common location crohn's disease
 
terminal ileum
126
spares the rectum
 
crohn's disease
127
skip lesions
 
crohn's disease
128
colicky RLQ pain, diarrhea, low grade fever, weight loss
 
crohn's disease
129
string sign
 
crohn's disease
130
cobblestoning
 
crohn's disease
131
what is malabsorbed with  crohn's disease
 
vitamin B12 and Fat
132
most common complication  crohn's disease
 
fistula
133
medical management  crohn's disease
 
mesalamine, sulfasalazine; azathioprine; biologics (Humira)
134
>50 y/o with hx atherosclerotic disease sudden severe abdominal pain; post prandial
 
mesenteric ischemia
135
celiac sprue diet (CAN EAT)
 
CRAP (corn, rice, arrowroot, potatoes)
136
dematologic manifestation celiac sprue
 
dermatitis herpetiformis (pruritic papulovesicles over extensor surfaces and trunk/neck)
137
mucosal biopsy: villous atrophy, blunting of villi duodenum
 
findings with celiac sprue
138
crypt abscess
 
ulcerative colitis
139
complications ulcerative colitis
 
toxic megacolon, performation, cancer
140
treatment ulcerative colitis
 
aminosalicylate, cortiocsteroids, immunosupperives, tnf
COLECTOMY IS CURATIVE
141
most common cause lower GI bleed >50 y/o
 
diverticulitis
142
acute painless large volume maroon or bright red blood in pt >50y/o
 
diverticulosis
143
treatment diverticulitis
 
often self resolving, elderly give metronidazole and cipro x 10-14 days
if multiple attacks...
144
DRE: exquisite tenderness posterior midline position; anal skin tag
 
anal fissure
145
dilation of vascular bed above dentate line
 
internal hemorrhoids
146
dilation of vascular bed below dentate line
 
external hemorrhoids
147
intermittent dysphagia for solids and liquids, especially cold
 
diffuse esophageal spasm; treat with PPI
148
dysphagia to solids first, liquids later
 
esophageal cancer
149
affects the lower 2/3 of the esophagus
 
adenocarcinoma
150
foul smelling breath with oral regurgitation and coughing during meals, aspiration pneumonia
 
zenker diverticulum; tx surgical repair and myotomy
151
bloating, cramping, abdominal discomfort, diarrhea after gastrectomy
 
dumping syndrome
early: overdistention from excess carbslate: hypoglycemia
152
sudden skin flushing, wheezing, diarrhea, plaque like fibrinous deposits on the heart
 
carcinoid syndrome; treat with octeotride
153
recurrent crampy abdominal pain 3 day/month for the past 3 months associated with improvement...
 
IBS
154
what GI problem has high association with Hashimoto thyroiditis
 
celiac disease


Upgrade and get a lot more done!
Upgrade    Cancel