Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
100 Cards in this Set
- Front
- Back
Most common location where volvulus occurs:
|
* Sigmoid colon
|
|
What is the Charcot triad and what is it indicative of?
|
* Charcot triad = fever, jaundice, and RUQ pain
* Indicative of cholangitis (infection of biliary tree proximal to an obstruction) |
|
What is the window period of hepatitis B?
|
* Period where HBsAg nor HBsAb is found
|
|
Viral family to which Hepatitis B belongs:
|
* Hepadnavirus -- dsDNA virus
|
|
Parasite that can cause megacolon, megaesophagus, and cardiac failure:
|
* Trypanosoma cruzi (Chagas disease)
|
|
A pt with high levels of gastrin will probably have high levels of:
|
* Secretin
|
|
Pt's with pancreatic calcifications due to pancreatitis are at risk of developing what secondary disease:
|
* Diabetes-- due to islet cell destruction
|
|
Type of hernia where the gastroesophogeal junction is above the esophageal hiatus of the diaphragm:
|
* Sliding hiatal hernia
|
|
Progesterone derivative drug that is good at stimulating the appetite
|
* Megestrol
|
|
Most frequent cause of intrassusception in kids:
|
* Hyperplasia of peyers patches
|
|
How do adults usually get intrassusception?
|
* Tumors or polyps caught in peristaltic action
|
|
What causes malrotation?
|
* Failure of the cecum to descend to its normal position in the RLQ
|
|
The use of these drugs can lead to melanosis coli:
|
* Anthracene laxative abuse-- accumulation of brown black pigment in macrophages in the lamina propria
|
|
Most commonly infarcted areas in the colon due to hypovolemia/hypotension:
|
* Watershed areas such as the splenic flexure and mid-rectum
|
|
In what GI layer does a "mural" infarction occur?
|
* Muscluaris propria
|
|
Acquired dilitation (telangiectasia) of the thin walled veins of the superficial lamina propria in the cecum:
|
* Angiodysplasia
|
|
What are internal and external hemorrhoids covered with?
|
* Internal = rectal epithelium
* External = anal squamos epithelium |
|
Most common clinical characterisitcs of tropical sprue:
|
* Steatorrhea and folate-deficiency anemia
|
|
These immunoglobins (in the intestinal mucosa) are increased in Celiac disease:
|
* IgA and IgM
|
|
Characteristic finding in the lamina propria of the small bowel of a patient with Whipple disease:
|
* presence of macrophages filled with PAS-positive, diastase-resistant granules
|
|
Disorder associated with ulcerative colitis, its characterized by alternating strictures and dilation with "beading" on ERCP. It is inflammation and fibrosis of bile ducts:
|
* Primary sclerosing cholangitis
|
|
A patient with "tinkling" bowel sounds probably has:
|
* Bowel obstruction-- don't give these pt's prokinetics such as metaclopromide
|
|
A kid with hypoglycemia, coma, elevated liver enzymes, and elevated ammonia levels probably has ingested:
|
* Aspirin-- Reye's sydnrome
|
|
A 1 wk old infant who develops GI bleeding, GI perforation, abdominal distress, and sepsis probably has:
|
* Necrotizing enterocolitis
|
|
Tumors from the penis, vagina, and anal canal all drain where?
|
* Medial side of the horizontal chain of the superficial inguinal lymph nodes
|
|
The type of E. coli that produces travelers diarrhea:
|
* ETEC (enterotoxigenic E. coli) increases cAMP resulting in a secretory, self limiting diarrhea
|
|
What clinical lab test is used to confirm candidiasis?
|
* Germ tube test
|
|
What would predispose a patient to a highly vascular tumor of the liver?
|
* Exposure to vinyl-chloride-- an angiosarcoma
|
|
Organism that can cause a life-threatening watery diarrhea in a patient who eats raw oysters:
|
* Vibrio vulnificus
|
|
In acute cholecystitis, where is the occlusion?
|
* In the cystic duct
|
|
Organism that can cause pigmented gallstones:
|
* Clonorchis sinesis (Oriental liver fluke)
|
|
A fungating esophageal mass with glands that extend into the muscular layer and have large, hyperchromatic nuclei is probably:
|
* Esophageal adenocarcinoma (major risk factor is GERD)
|
|
Pancreatic adenocarcinoma has a bleak survival rate which is similar to what other GI adenocarcinoma:
|
* Similar to esophageal adenocarcinoma
|
|
When treating a kid for diarrhea and you give Pedia-lyte, what is the purpose of the glucose?
|
* To aid sodium absorption via the intestinal glucose/sodium co-transport mechanism
|
|
Provide vascular circulation to the lower anal canal:
|
* Inferior rectal artery and vein
|
|
Typical labs in a young patient with Gilbert's disease:
|
* Elevated indirect bilirubin with a normal direct bilirubin (glucuronyl transferase deficiency)
|
|
A woman who is vomiting up bile could have this congenital anomlay:
|
* Annular pancreas which is compressing the duodenum (d/t failure of the ventral pancreas to migrate normally)
|
|
What does vaso-active peptide do?
|
* Stimulates GI fluid secretion and can cause a secretory diarrhea
|
|
Triad of symptoms often seen with hereditary hemochromatosis:
|
* Cirrhosis, diabetes, and skin bronzing
|
|
Where specifically does tylenol cause hepatic necrosis?
|
* Causes centrilobular necrosis around the terminal hepatic vein
|
|
Extraintestinal manifestations of ulcerative colitis
|
* Pyoderma gangrenosum and primary sclerosing cholangitis
|
|
Relatively specific lab finding in alcoholic cirrhosis:
|
* AST:ALT ration > 1.5
"your to-AST-ed in EtOH hepatitis" |
|
Common lab findings in viral hepatitis:
|
* ALT > AST
|
|
How does hepatocellular carcinoma (HCC) and renal cell carcinoma (RCC) typically spread?
|
* Hematogenous dissemination
|
|
Prostalandin E1 drug that is used to prevent NSAID induced ulcers:
|
* Misoprostol -- pregnant women should avoid this, as it can induce labor
|
|
How does gemfibrozil affect HDL, LDL and Trigs?
|
* slight decrease in LDL, slight increase in LDL, LARGE decrease in triglycerides-- best for high TRIG's
|
|
The most likely location of a cancer patient who has macrocytic anemia d/t B12 deficiency is where?
|
* The stomach, chronic atrophic gastritis (affects parietal cells) can lead to B12 deficiency and cancer
Cancer of the Ileum is uncommon |
|
Stress ulcers will often cause an increase in these 2 gastric products:
|
* Pepsin and gastric acid
|
|
What type of change occurs in Barret's esophagus?
|
* Non-keratinized squamos to NON-CILIATED columnar cells
|
|
Only GI hormone that is stimulated by fats, proteins, and carbs:
|
* Gastric inhibitory peptide (GIP)
|
|
Risk factors for gallstones:
|
* 5 "F's": Female, fat, forty, fertile, and flatulent-- Native Americans are also at a greater risk
|
|
Old patient with RLQ pain and fever probably has:
A young adult/kid with RLQ pain and fever probably has: |
* Think diverticulitis (acute appendicitis doesn't usually occur in the elderly
* Think acute appendicitis |
|
Features of achalasia:
|
* Failure of the LES to relax d/t loss of myenteric plexus-- dilated esophagus with distal stenosis ("Bird's beak on barium swallow)
|
|
Degradation of heme (such as in Sickle cell) will produce what type of gallstones:
|
* Calcium bilirubinate stones
|
|
1st test done on someone with suspected achalasia:
|
* Barium swallow-- although you would need to do an endoscopy to rule out cancer
|
|
A nearly complete blockage of blood flow in the hepatic veins or IVC is:
|
* Budd-Chiari syndrome
|
|
Levels of this protein are often elevated in hepatocellular carcinoma:
|
* Alpha-fetoprotein (AFP)
|
|
Tumor markers that are often elevated in pancreatic cancer are:
|
* CEA and CA 19-9
|
|
Extraintestinal manifestations of Crohns disease include:
|
* Migratory polyarthritis, uveitis, ankylosing spondylitis, erythema nodosum, and other immune disorders
|
|
Alcoholic hepatitis differs from viral hepatitis in that it has this finding in the liver:
|
* Mallory bodies (these aren't seen in viral hepatitis)
|
|
Barrett's esophagus can transform into what cancer:
|
* Esophageal ADENO-carcinoma
|
|
Extrapyramidal effects can be seen with this prokinetic:
|
* Metaclopromide
|
|
Complications of Crohns disease include:
|
* Strictures, fistulas, perianal disease, malabsorption, and nutritional depletion
|
|
Antidiarrheals (such as loperimide) are contraindicated in kids with diarrhea because:
|
* Can cause a toxic megacolon
|
|
What causes Cholestasis and what lab value is elevated?
|
* Cholestasis-- caused by DRUGS that interfere with bilirubin conjugation will have NORMAL AST/ALT but ELEVATED Alkaline Phosphate
|
|
What type of steatosis is caused by drugs (especially Aspirin in Reye's)?
|
* Microvesicular-- fat globules don't displace the nucleus
|
|
How is aspirin typically handled in the liver (what metabolic path)?
|
* Usually phase II (up to 3 grams) over this it is PHASE I which cause hepatic necrosis via toxic NAPQI
|
|
Budd-Chiari (thrombosis of major hepatic veins/IVC) which causes pain, ascites, hepatomegaly, etc, is most commonly caused by:
|
* Polycythemia Vera, hepatocellular carcinoma, or possible pregnancy
|
|
Veno-occlusive disease (collagen developing around the central hepatic veins) is most commonly associated with:
|
* Complications of bone marrow transplatation
|
|
Components of a hepatitis profile:
|
* HBsAg, Anti-HBs, Anti-HBc, Anti-HAV, Anti-HCV (HB surface, then ANTI-surface, core, A, and C)
|
|
Hep B marker that is there before symptoms appear:
|
* HBsAg
|
|
How would you know someone was immune to Hep A?
|
* They would have Anti-HAV IgG
|
|
What type of virus is Hep C?
|
* ssRNA
|
|
What would it mean if a pt had anti-HCV IgG?
|
* Their either infected or recovering-- this is NOT a protective antibody
|
|
Councilman bodies are a sign of:
|
* An acute hepatitis (apoptosis of hepatocytes)
|
|
Persistent inflammation and fibrosis is a sign of what in the liver?
|
* Sign of chronic hepatits progressing to post-necrotic cirrhosis
|
|
Pt with pigmented cirrhosis probably has:
|
* Hemochromatosis
|
|
What drugs can cause:
Acute hepatitis? Cholestasis? Fatty change? Fibrosis? |
* Acute Hep = Isoniazid, Tylenol
Cholestasis = Oral contraceptives, 'Roids Fatty change/Fibrosis = Amiodorone and Methotrexate |
|
Autoimmune disorder seen in women who have Anti-Mitochondrial Ab's, increased IgM, cirrhosis with portal HTN, hepatomegaly, and jaundice:
|
* Primary Biliary Cirrhosis-- (Granulomatous destruction of bile ducts in portal triads)
|
|
AD disorder characterized by PAS + red hepatic cytoplasmic granules:
|
* Alpha-Antitrypsin (increased risk for hepatocellular carcinoma)
|
|
A pt who has Kayser-Fleisher rings has a deficiency of what protein?
|
* Ceruloplasmin (copper-binding protein)
Wilson's disease is AR |
|
This complication of cirrhosis results in Asterixis d/t a defective urea cycle and false neurotransmitters (GABA):
|
* Hepatic encephalopathy
|
|
Most common malignancy of the bile ducts, clinical findings include jaundice and a Courvoisier's sign (palpable gallbladder):
|
* Cholangiocarcinoma -- most common cause is primary sclerosing pericholangitis
|
|
Cholelithiasisi (gallstones) is the most common cause of chronic cholecystitis which may lead to a porcelein gallbladder and then:
|
* Gallbladder adenocarcinoma
|
|
Acute cholecystitis is 90% of the time caused by:
|
* Stone in the cystic duct (could be d/t infection or severe volume depletion though)
|
|
Gold standard to identify cholelithiasis:
|
* Ultrasound
|
|
A pt with jaundice and a gallstone means the stone is most likely:
|
* In the common bile duct
|
|
Most common cause of gallstone in women:
|
* Gallstone obstructing the terminal part of the common bile duct where the bile activates pancreatic proenzymes
|
|
Gold standard for pancreatic imaging:
|
* CT scan
|
|
A pt with an abdominal mass and a persistent increase in serum amylase probably has:
|
* Pancreatic pseudocyst (persistent increased serum amylase)
|
|
Most common cause of pancreatic adenocarcinoma:
|
* Smoking
|
|
Genetic association with pancreatic adenocarcinoma:
|
* K-RAS, mutation of tumor suppressor genes (TP16 and TP53)
|
|
Gold standard tumor marker for pancreatic adenocarcinoma:
|
* CA19-9
|
|
How do patients with pancreatic adenocarcinoma present:
|
* Jaundice, light stools, and palpable gallbladder
|
|
This zone of the liver is most susceptible to ischemic (hypoperfusive) injury:
|
* Zone 3 (Pericentral vein zone) -- is where P450 metabolism occurs
|
|
Signs of cirrhosis:
|
* Portal HTN, ascites, and bridging fibrosis
|
|
A pt with a cystic lesion adjacent to the pancreas is most at risk of:
|
* Pt has a pancreatic pseudocysts-- biggest complication is rupture creating a GI HEMORRHAGE
|
|
A woman with itching, elevated conjugated bilirubin, increased Alk Phoshate, and granulomatous inflammation of the intrahepatic bile ducts has:
|
* Primary biliary cirrhosis -- she will have ANTI-MITOCHONDRIAL autoantibodies
|
|
A pt with type A chronic gastritis will have what blood finding?
|
* Increased macrocytes (macrocytic anemia d/t B12 deficiency)
|
|
Parasitic infection that can cause bowel obstruction in an adult:
|
* Ascaris lumbricoides
|