Gastrointestinal

Front 1

Inflammation of tongue; assoc. w/ vit B2 or B12 deficiency

Back 1

glossitis

Front 2

drying and scaling of lips with fissuring at corners; assoc w/ vit B2 deficiency

Back 2

cheilosis

Front 3

atrophy of papillae & mucosa, exposing underlying vasculature; assoc w advanced vit B12 def

Back 3

smooth beefy red tongue

Front 4

What is strawberry tongue assoc. with?

Back 4

Scarlet fever

Front 5

Koplik's spots are the first sign of what?

Back 5

measles

Front 6

diverticula that occur above upper esophageal sphincter?

Back 6

Zenker's

Front 7

diverticula that occur at midpoint of esophagus?

Back 7

Traction

Front 8

diverticula that occur above the lower esophageal sphincter

Back 8

Epiphrenic

Front 9

Which type of gastritis is associated with chronic irritation due to H. pylori ?

Back 9

Chronic Type B

Front 10

Which type of gastritis affects the fundus and is an autoimmune problem with antibodies against parietal cells and intrinsic factor?

Back 10

Chronic Type A

Front 11

What disorders (3) are usually associated with Chronic Type A gastritis?

Back 11

Hashimoto's Disease
Addison's Disease
Vitiligo

Front 12

Autoimmune destruction of the adrenal gland such that it loses its ability to produce aldosterone; results in hyperK+, hypoNa+, Increased ACTH, POMC, and MSH

Back 12

Addison's Disease

Front 13

Which type of gastritis results in pernicious anemia (d/t loss of IF) and achlorhydria (d/t parietal cell loss)

Back 13

chronic type A gastritis

Front 14

What is the most common colonic polyp?

Back 14

Hyperplastic polyps

Front 15

This type of polyp os most common in those in their 50s and 60s and is d/t decreased epithelial cell turnover

Back 15

Hyperplastic polyps

Front 16

Do hyperplastic polyps have risk for malignant transformation?

Back 16

little to no risk

Front 17

These type of polyps can occur sporadically or in associateion with Peutz-Jeghers Syndrome

Back 17

Hamartomatous polyps

Front 18

These polyps are NEOPLASTIC and also known as adenomas

Back 18

Adenomatous polyps

Front 19

what are the 3 subtypes of adenomatous polyps?

Back 19

tubular adenoma
villous adenoma
tubulovillous adenoma

Front 20

Inherited AD hamartomatous polyp disorder + spotted melanin hyperpigmentation of lips, palms, and soles

Back 20

Peutz-Jeghers Syndrome

Front 21

Is the risk for colon cancer in someone with Peutz-Jeghers Syndrome greater than the general population and is it d/t the polyps?

Back 21

It is greater than that of the general population but is not d/t the polyps

Front 22

FAP is d/t the loss of what tumor suppressor gene?

Back 22

APC

Front 23

What is the chance of colon cancer once polyps develop with FAP?

Back 23

almost 100% chance

Front 24

An inherited AD disorder with a CARPET of adenomatous polyps in the colon

Back 24

FAP

Front 25

Classic FAP + benign mandible and skull tumors

Back 25

Gardners syndrome

Front 26

classic FAP + malignant brain tumors

Back 26

Turcot's syndrome

Front 27

Disorder d/t defective DNA mismatch repair genes also known as Lynch Syndrome?

Back 27

Hereditary Nonpolyposis Colorectal Cancer Syndrome (HNPCC)

Front 28

HNPCC has an increased risk for colon cancer as well as what? (especially 2)

Back 28

endometrium and ovary

but also stomach, liver, brain, prostate, skin, biliary ducts, sm. intestine

Front 29

What are the 2 molecular mechanisms responsible for colon cancer?

Back 29

1) APC/Beta-catenin pathway
2) k-RAS (oncogene) is mutated and p53 tumor suppressor gene) is activated

Front 30

These 4 risk factors predispose one to colon cancer?

Back 30

1) excessive dietary caloric intake
2) high refined carbohydrate diet
3) intake of red meat
4) reduced consumption of dietary fiber

Front 31

LEFT or RIGHT colonic cancers cause a change in bowel habits?

Back 31

LEFT

Front 32

Anyone >50 yo with iron-deficiency anemia must be worked up to rule out what?

Back 32

colon carcinoma

Front 33

What is the most common place for diverticulum formation?

Back 33

sigmoid colon

Front 34

What are the 2 types of diverticular disease?

Back 34

diverticulosis
diverticulitis

Front 35

Diverticular disease yielding a (+) hemoccult stool and often gross bleeding but painless

Back 35

Diverticulosis

Front 36

Diverticular disease with LLQ pain, fever, elevated neutrophils, often diarrhea- but hemoccult (-) ?

Back 36

Diverticulitis

Front 37

How is the DX of diverticulitis made and what is the TX?

Back 37

DX: CT scan
TX: ciprofloxacin and metronidazole

Front 38

IBD characterized by "skip lesions" transmural, granulomas, crypt abscesses, (+) string sign and more pain w/ less bleeding

Back 38

Crohn's disease

Front 39

IBD characterized by continuous lesions, pseudopolyps, lead pipe colon, more bleeding and less pain?

Back 39

Ulcerative colitis

Front 40

Which IBD has a high risk of colon CA and toxic megacolon?

Back 40

Ulcerative colitis

Front 41

In this one case non-smokers have a stronger propensity for developing what?

Back 41

Ulcerative colitis

Front 42

What is the most common universal symptom of malabsorption?

Back 42

steatorrhea +/- diarrhea

Front 43

What are the Labs (4) for suspected malabsorption?

Back 43

Sudan II stain of stool, stool fat analysis, D-xylose absorption test, and Schilling test

Front 44

In this disorder a biopsy shows flat villi in the duodenum and some patients develop dermatitis herpetiformis

Back 44

Celiac Sprue

Front 45

People with Celiac Sprue are at an increased risk for the development of what?

Back 45

MALT lymphoma

Front 46

Celiac Sprue labs show anti-gliadin; what are other names for this?

Back 46

anti-gluten, anti-endomysial Ab, anti-reticulum

Front 47

This disease affects any organ, shows PAS (+) macs in mucosa on biopsy and is due to Tropheryma whippelii

Back 47

Whipple's Disease

Front 48

What is important about treatment of Whipple's disease with antibiotic therapy?

Back 48

any antibiotic therapy has to be administered for at least 4-6 months, but preferably 1 year

Front 49

Most common biliary stone in the US?

Back 49

Cholesterol

Front 50

How must cholelithiasis be treated in those with porcelain gallbladder or Native American's? and why?

Back 50

Surgically;
increase gallbladder CA risk

Front 51

Patient with fever, RUQ pain, Murphy's sign and N/V, elevated neutophils & alk phos. What may be the cause?

Back 51

Cholecystitis

Front 52

Patient with RUQ pain, jaundice, clay-colored stool, tea-colored urin, elevated alk phos and conjugated bilirubin; what may be the cause?

Back 52

choledocholithiasis

Front 53

complication of choledocholithiasis with elevated alk phos, conj bilirubin, PLUS elevated neutrophils?

Back 53

Ascending cholangitis

Front 54

What comprises Charcot's triad?

Back 54

RUQ pain + jaundice + fever

Front 55

when one part of the bowel "telescopes" into neighboring bowel?

Back 55

INTUSSUSCEPTION

Front 56

What part of the bowel is usually involved in intussusception?

Back 56

terminal ileum

Front 57

What age group is at highest risk for intussusception?

Back 57

5-10 month old children

Front 58

With what infection is the most significant risk of intussusception?

Back 58

adenovirus infection

Front 59

Currant-jelly stool, RUQ palpable sausage-shaped mass with a vacant LRQ is indicative of what?

Back 59

Intussusception

Front 60

During fetal development if the duodenum and colon malrotate around mesentery what is this called?

Back 60

midgut volvulus

Front 61

What are the risk factors for necrotizing enterocolitis? (3)

Back 61

maternal use of NSAIDs, prematurity, and comorbid disease at birth

Front 62

Hirschprung's disease is d/t a lack of development of what?

Back 62

Auerbah's and Meissner's plexuses

Front 63

Vomiting, obstipation, chronic abdominal pain, and no peristalis in neonates is indicative of what disease?

Back 63

Hirschprung's Disease