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100 Cards in this Set
- Front
- Back
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Most likely cause of a lower GI bleed in a patient >40 years of age?
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Diverticulosis
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Diagnostic modality used when ultrasound is equivocal for cholecystitis.
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HIDA scan
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Risk factors for cholelithiasis
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Female, fat, fertile, forty, flatulent
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Inspiratory arrest during palpation of the RUQ.
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Murphy's sign, seen in cholecystitis
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The most common cause of SBO in patients with no history of abdominal surgery.
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Hernia
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The most common cause of SBO in a patient with a history of abdominal surgery.
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Adhesions
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Most common organism that causes diarrhea.
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Campylobacter
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Organism that causes diarrhea in a patient that has recently taken antibiotics.
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Clostridium difficile
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Organism that causes diarrhea in a patient that has gone camping.
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Giardia
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Organism that causes diarrhea in a patient that has traveler's diarrhea.
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ETEC
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Organism that causes diarrhea in a patient at a church picnic eating potato salad (mayonnaise).
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Staphylococcus aureus
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Organism that causes diarrhea in a patient that was eating under cooked hamburgers.
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E. coli 0157:H7
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Organism that causes diarrhea in a patient that was eating fried rice.
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Bacillus cereus
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Organism that causes diarrhea in a patient that was eating poultry or eggs.
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Salmonella
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Organism that causes diarrhea in a patient that was eating raw seafood.
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Vibrio, HAV
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Organism that causes diarrhea in a patient with AIDS
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Isospora, Cryptosporidium, Mycobacterium avium complex (MAC)
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Organism that causes diarrhea in a patient with pseudoappendicitis.
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Yersinia
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A 25 year old Jewish man presents with pain and watery diarrhea after meals. Exam shows fistulas between and skin and nodular lesions on his tibias.
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Crohn's disease
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Inflammatory disease of the colon with increase risk of colon cancer.
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Ulcerative colitis (greater risk than Crohn's)
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Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, primary sclerosing cholangitis
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Irritable bowel disease (IBD)
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Medical treatment for IBD
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5-ASA agents (sulfasalazine) and steroids during acute exacerbations.
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Superficial tear in the esophageal mucosa of an alcoholic.
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Mallory-Weiss syndrome
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Full thickness esophageal rupture in a patient that was vomiting.
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Boerhaave syndrome
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RUQ pain, jaundice, and fever
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Charcot's triad
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RUQ pain, jaundice, and fever, shock, and change in mental status
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Reynold's pentad
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How do you treat hepatic encephalopathy?
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decrease protein intake, lactulose, rifaximin
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First step in the management of a patient with an acute GI bleed.
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ABC's
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A 4 year old child presents with oliguria, petechiae, and jaundice following and illness with blood diarrhea. Most likely dx and cause?
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Hemolytic-uremic syndrome (HUS) due to E. coli 0157:H7
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Classic causes of drug induced hepatitis.
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TB meds (Rifampin, INH, pyrazinamide), acetaminophen, and tetracycline
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A 40 year old obese woman with elevated alkaline phosphatase, elevated bilirubin, pruritis, dark urine, and clay-colored stools.
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Biliary tract obstruction
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Which hernia has the greatest risk for incarceration- indirect, direct, or femoral?
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Femoral
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"shaggy" mucosa
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Candida
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Treatment for oral candidiasis in a non AIDS patient
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Oral Nystatin or cotrimazole
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Treatment for candida esophagitis in an AIDS patient.
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IV or oral flucanazole
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Treament for herpes esophagitis.
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IV or oral acyclovir
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What is required for a definitive diagnosis of possible esophagitis?
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biopsy
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Drug induced esophagitis. (mneumonic is PAINT)
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1. Potassium chloride
2. Alendronate 3. Iron 4. NSAIDS 5. Tetracycline |
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A narrowing of the lower part of the esophagus that can cause difficulty swallowing.
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Schatzki ring
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exists between the longitudinal and circular layers of muscularis externa in the gastrointestinal tract and provides motor innervation to both layers
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Auerbach's plexus
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Txt for a patient with a "birds-beak" deformity at the LES.
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1. Nifedipine before meals
2. botulism injection or pneumatic dilation |
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Dx of a "cork screw" appearance of esophagus on barium swallow.
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Diffuse esophageal spasm
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What type of esophageal neoplasm is expected in a smoker with history achalasia?
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Squamous cell Carcinoma
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What type of esophageal neoplasm is expected in an obese patient witha history of Barrett's esophagus and GERD?
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Adenocarcinoma
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Female patient with cervical esophageal webs, glossitis, and iron deficiency anemia.
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Plummer-Vinson syndrome
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A diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle.
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Zenker's diverticulum
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Considered to be a premalignant condition because it is associated with an increased risk of esophageal cancer (more specifically, adenocarcinoma).
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Barrett's esophagus
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Anemia that is a late complication to autoimmune gastritis.
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Pernicious
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Most common cause of peptic ulcer disease.
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1. H. pylori
2. NSAIDS |
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The triad of gastric acid hypersecretion, severe peptic ulceration, and Gastrinoma.
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Zollinger-Ellison syndrome
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Dx in a male patient with projectile nonbilious vomiting and "string sign".
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Pyloric stenosis
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Which blood group is considered a etioligical factor to gastric neoplasms?
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A
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Lymph node enlargement in the left supraclavicular region suggesting Neoplasm.
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Virchow's node
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Periumbilical node enlargement suggesting neoplasm.
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Saint Mary Joseph node
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Triple therapy for H. pylori.
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1. PPI BID
2. Amoxicillin, 1g BID 3. Flagyl 500mg BID |
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Most common cause of chronic gastritis.
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NSAIDS
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The only genome in Hepatitis that is DNA.
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Hep B
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Sexually spread Hepatitis
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Hep B then D
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Which screening test is needed for Hep A?
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Anti-HAV immunoglobulin M
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Which screening test is needed for Hep B?
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HBsAg
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Which screening test is needed for Hep C?
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Anti-HCV
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Which screening test is needed for Hep D?
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Anti-HDV
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Which screening test is needed for Autoimmune hepatitis?
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ANA
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Which screening test is needed for Wilson's disease?
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Ceruloplasmin
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Tx for chronic Hep C.
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inteferon-alpha and ribavirin
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Total bilirubin of 40, LFTs normal, no response to phenobarbial, and kernicterus in an infant.
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Crigler-Najjar syndrome Type 1
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Total bilirubin of 12, LFTs normal, 75% reduction of bilirubin with phenobarbital therapy, patient develops kernicterus with fasting.
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Crigler-Najjar syndrome Type 2
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Total bilirubin of 3, phenobarbital reduces bilirubin to normal. Most common hereditary cause of hyperbilirubin.
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Gilbert syndrome
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Large ecchymoses on the flanks
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Grey Turner's sign
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Periumbilical ecchymosis
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Cullen's sign
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GA LAW
1. Glucose > 200 2. Age > 55 3. Lactate >350 4. AST > 250 5. WBC > 16,000 |
Ranson's criteria at admission
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C HOBBS
1. Calcium < 8 mg/dL 2. HCT decreased by 10%4. 3. PaO2 < 60 mmHg 4. BUN increased 5 mg/dL 5. Base deficit > 4 mEq/L 6. Sequestered fluid > 6 L |
Ranson's criteria after 48 hours
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What are the etiologies of acute pancreatitis? (I GET SMASHED)
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1. Ideopathic
2. Gallstones 3. EtOH 4. Trauma 5.Steroids 6. Mumps 7. Autoimmune dz (SLE) 8. Snake/scorpion bites/stings 9. Hypercalcemia/lipidemia 10. ERCP 11. drugs(NSAIDs,sulfas,diuretics) |
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Where and what kind of neoplasm usually occurs in the pancreas?
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1. Head
2. Adenocarcinomas |
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Palpable, nontender gallbladder. What is the sign?
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Courvoisier's sign
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What is the sign for Migratory thrombophlebitis?
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Trousseau's sign of malignancy
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Resecting the pancreas from tumors in the head is called what procedure?
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Whipple procedure
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A vestigial remnant of the omphalomesenteric duct (also called the vitelline duct or yolk stalk), and is the most frequent malformation of the gastrointestinal tract.
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Meckel's diverticulum
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What type of immunoglobulin deficiency is comonly seen in patients with celiac disease?
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IgA deficiency
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What is the tx for celiac disease?
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gluten-free diet
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What type of vitamin toxicity is seen in a patient with hepatocellualr necrosis and intracranial hypertension?
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vitamin A
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What type of vitamin defieciency is seen in a patient with glossitis, macrocytic megaloblastic anemia, and optic neuropathy?
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Vitamin B12 (cobalmin)
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What type of vitamin defieciency is seen in a patient with night blindness and dry skin?
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Vitamin A
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What type of vitamin defieciency is seen in a patient with convulsions and hyperirritablilty?
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Vitamin B6 (pyridoxine)
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What type of vitamin deficiency is seen in a patient with angular somatitis, cheliosis, and corneal vascularization?
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Vitamin B2 (riboflavin)
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What type of vitamin deficiency is seen in a patient with pellagra?
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vitamin B3 (niacin)
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A patient presents c/o dementia, diarrhea, and dermatitis, what must be ruled out?
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Vitamin B3 deficiency (niacin). Pellagra.
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What type of vitamin defieciency is seen in a patient with scurvy?
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Vitamin C
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A patient presents c/o swollen gums, bruising, anemia, and poor wound healing, what must be ruled out?
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Scurvy
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What is the most common vitamin deficiency in the United States?
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Folic Acid
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What type of vitamin defieciency is seen in a patient with spinocerebellar ataxia, myopathies, and anemia?
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Vitamin E (tocapherol)
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What type of vitamin deficiency is seen in a teenage patient that has consumed raw eggs for body building and now presents with dermatitis and enteritis?
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Biotin
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A patient with selenium deficiency may present with what pathology?
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keshan disease (cardiomyopathy)
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Which vitamins are fat soluble?
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vitamins A,D,E, and K
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55 y/o male presents c/o pain in the MCP joints. Pt states he drinks 4 or 5 beers daily and has noticed darkening of his skin. Hypogonadism and cardiomegaly also present. Labs reveal serum iron @ 250 mcg/dl. What is his most probable dx?
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Hemachromatosis
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An autoimmune disease that presents with pruritis, jaundice, + antimitochondrial antibodies, and elevated alkaline phosphatase in a middle aged woman.
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Primary biliary cirrhosis
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Green to brown deposits of copper in Descemet's membrane. What is the possible dx and name of the eye pathology?
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1. Wilson's disease
2. Kayser-Fleischer rings |
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Second leading cause of cancer in the U.S. is...
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Colon (rectal) cancer
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A patient presents c/o cutaneous flushing, diarrhea, abdominal cramps, wheezing, and right sided cardiac valvular lesions. High levels of seratonin metabolite 5-HIAA are in his urine. What is his mot likely dx? Tx?
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1. Carcinoid syndrome
2. octreotide and tumor debulking |
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Name of a gastric adenocarcinoma that metastisizes to the ovary.
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Krukenberg tumor
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Which chromosome is the marker for Gardner's syndrome? What is the tx?
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1. chromosome 5q21
2. No cure known |
