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287 Cards in this Set
- Front
- Back
|
male
smoking & alcohol scaly plaques what would you see histologically? |
keratin pearls
(squamous cell carcinoma of oral cavity) |
|
|
55 yo woman, parotid cancer
what type of cells? treatment? |
epithelial
connective complete resection (high recurrence rate) - pleomorphic adenoma of salivary gland |
|
|
malignant adenoma of salivary gland
where could it be located? |
submandibular or minor salivary glands
|
|
|
cystic
lymphoid stroma facial tumor acini form cells what sex? |
males
(Warthin's tumor) |
|
|
what is the most common malignant tumor of the salivary gland?
|
mucoepidermal tumor
|
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|
black/asian smoker/drinker
insidious dysphagia where is the lesion? treatment? |
middle 3rd of esophagus
surg. excision (squamous cell carcinoma of esophagus) |
|
|
Barrett's esophagus
lower 3rd of esophagus weight loss prognosis? |
dismal
(adenocarcinoma) |
|
|
ZES
hiatal hernia obesity scleroderma what do you see histologically? |
reactive epithelial changes
- enlarged nuclei - basal cell hyperplasia - papillae elongation - ^cell turnover (GERD) |
|
|
burning wave after meals
what cells would you see histologically? |
eosinophils
|
|
|
red velvet esophagus
what's the cutoff for classification? |
3.5 cm (short vs. long - higher cancer risk)
(Barret's esophagus) |
|
|
>15 eosinophils
|
Eosinphilic esophagitis
|
|
|
young male
dysphagia |
Eosinophilic esophagitis
|
|
|
Eosinophilic esophagitis
tx? |
dilation
|
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|
Barrett's esophagus
treatment? 1) high-grade dysplasia 2) low grade |
1. ablation
2. follow up |
|
|
erosions, ulcers in throat
60 yo old cause? |
pill esophagitis (doxycycline)
|
|
|
malnourished child
white-yellow plaque what would you expect to see histology? |
pseudohyphae/yeast
candida esophagitis |
|
|
adult
viral inclusion creating a halo in cell cause? |
Herpes (HSV1)
|
|
|
Ground glass appearance
|
Herpes Virus
Hep B |
|
|
Child
Chest pain Painful swallowing multiple grouped vesicles |
HSV2
|
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|
esophagitis that affects endothelial cells
|
CMV
|
|
|
esophagitiis
fever (systemic) |
CMV
|
|
|
esophagitis
single distal ulcer |
CMV
|
|
|
esophagitis
immunosuppresed Diff Dx? |
Candida
Herpes CMV |
|
|
Alcoholic
severe vomitting cause? |
painful mucosal lacerations
Inadequate relaxation of LES during vomitting Mallory Weiss |
|
|
transmural tear of distal esophagus
cause? |
extreme retching
Boerhaave Syndrome |
|
|
Alcoholic
cough up blood excessive bleeding ascites cause of bleeding? |
esophageal varices from cirrhosis/portal HTN
(bottom 1/3 of esophagus) |
|
|
signet ring cells
|
Diffuse Gastric carcinoma
|
|
|
pseudomembranes and pus adherent to inflammed mucosa
|
acute gastritis
|
|
|
degenerative epithelium
neutrophils mononuclear lymphocytes |
chronic gastritis
|
|
|
ragged epithelium in stomach
|
chronic gastritis
|
|
|
pit abscesses
|
chronic gastritis
|
|
|
neutrophils limited to antrum/cardia
|
chronic gastritis
|
|
|
lymphoid follicle - stomach
|
chronic gastritis
|
|
|
recent vomiting
hemorrhagic lesions multiple antral ulcers/erosions |
acute gastritis
|
|
|
complications of chronic gastritis?
|
PUD
gastric carcinoma |
|
|
no atrophy of glands
increased acid production assoc w/ gastric caricnoma? location? |
none
antrum (Western, non-atrophic antral gastritis) |
|
|
atrophy of glands
predisposes to gastric carcinoma potential cause? |
suboptimal living conditions
Multifocal atrophic gastritis (Eastern) |
|
|
atrophic changes in both antrum and corpus mucosa
what glands are inflamed? |
multifoca atrophic gastritis (Eastern)
oxyntic |
|
|
ratio of ulcers in stomach to duodenum?
|
1:4
|
|
|
ulcer near lesser curvature near incisura angularis
cause? |
H. pylori
|
|
|
ulcer on greater curvature toward fundus
cause? |
NSAIDs
|
|
|
gastric ulcers due to which bacterial gene products?
|
VacA, CagA by H. pylori
|
|
|
what 3 ways does H. pylori causes gastric ulcers?
|
1. inflammation
2. increase acid secretion 3. impairs duodenal bicarb secretion |
|
|
causes of acute gastric ulcer?
|
recent trauma/surgery
CNS (Cushing) stress (sepsis/shock) |
|
|
pernicious anemia
|
autoimmune gastritis
|
|
|
Ab to parietal cell and Intrinsic factor
|
autoimmune gastritis
|
|
|
old pt
Fe deficiency hypergastrinemia |
autoimmune gastritis
|
|
|
what part of stomach is destroyed in autommune gastritis?
complication? |
oxyntic glands = achlorhydria
pernicious anemia |
|
|
what is the cause of autoimmune gastritis?
|
cross reactivity of H. pylori Ab to self antigens
|
|
|
thin mucosa
proliferated ECL cells from what? |
hypergastrinemia in autoimmune gastritis
|
|
|
cancer in stomach
type? |
adenocarcinoma
|
|
|
ulcerative
preceded by gastric atrophy where is the lesion located? |
distal stomach
intestinal type adenocarcinoma |
|
|
stomach cancer
young pt histology? |
diffuse gastric carcinoma
|
|
|
monotonous sheets of neoplastic cells
|
diffuse gastric carcinoma
|
|
|
fullness
vomiting weight loss dysphagia melena |
advanced gastric carcinoma
|
|
|
2 ways that H. pylori leads to gastric carcinoma
|
atrophic gastritis
intestinal metaplasia |
|
|
blood type A is a risk factor for what?
|
gastric carcinoma
|
|
|
smoked, salted, preserved meat is a risk factor for what?
|
gastric carcinoma
|
|
|
how do gastric carcinomas spread?
|
direct
lymphatic hematogenous |
|
|
HLA-DQ mutation
demographic of pt? |
bimodal
whites in infancy and 20-30 |
|
|
bimodal disease
|
celiac sprue
UC Crohn's Campylobacter |
|
|
dermatitis herpetiformis
|
celiac sprue
|
|
|
indigestion
small RBC's |
celiac sprue
(macrocytic anemia) |
|
|
In a Free Speech Essay question, what do you do if the speech the statute is regulating is Content Specific (regulates the message)?
|
In a Free Speech Essay question, what do you do if the speech the statute is regulating is Content Specific (regulates the message)?
Ask if the Speech being regulated is Protected or Unprotected. If [1] Protected – Apply strict scrutiny – i.e., the statute is unconstitutional unless the government can show the law is necessary to a compelling interest; [2] Unprotected – Unprotected includes Clear and Present Danger; Defamation; Obscenity; Child Porn; Fighting Words; Fraudulent Commercial Speech |
|
|
two potential problems w/ negative serotype testing in celiac sprue?
|
possibly IgA deficient
possible Giardia infection |
|
|
malabsorption from eating a donut
tests needed to confirm? |
1. duodenal biopsy
2. positive response to gluten-free diet 3. anti-endomysium and anti-gliadin |
|
|
jungle
villous flattening Tx? complication if you don't? |
B12 and folate
antibiotics megablastic anemia Tropical sprue |
|
|
villus flattening
crypt hyperplasia lymphocytes in epithelial cells |
celiac sprue
|
|
|
scalloped duodenal folds on endoscopy
|
celiac sprue
|
|
|
PAS+ macrophage invasion
tx? |
trimethoprim-sulfamethoxazole
Whipple's |
|
|
middle aged man
weight loss diarrhea painful joints pericarditis neurologic symptoms defect? |
HLA-B27
Whipple's |
|
|
Diarrhea Stool osmotic gap <50
causes? how are they different? |
rotavirus/norwalk (damage epithelium)
v. cholera, e.coli (don't damage epithelium_ - toxin mediated, just hypersecrete (secretory diarrhea) |
|
|
diarrhea not stopped by fasting
|
secretory
inflammatory |
|
|
Describe fraudulent commercial speech as an unprotected speech
|
Describe fraudulent commercial speech as an unprotected speech
Generally commercial speech is protected by may be restricted as to false or deceptive advertising or illegal products; a lawful, narrowly tailored regulation will be valid if it directly advances a substantial government interest and there is a reasonable “fit” between the means used and the legislation’s end; attorney may advertise, provided it is not misleading; in-person solicitation is not protected. |
|
|
stool osmotic gap >50
causes? |
sorbitol, mannitol, lactulose
osmotic diarrhea |
|
|
inflam diarrhea
- bacterial cause |
shigella
salmonella campylobacter e.coli |
|
|
inflam diarrhea
- viruses |
coronavirus
|
|
|
inflam diarrhea
- protozoa |
crypto, e. histolytica
|
|
|
diarrhea
motility causes? |
IBS
neuroendocrine tumor too fast |
|
|
constipation
motility cause? |
bacterial overgrowth
neuropathy scleroderma blind loop syndrome too slow |
|
|
pseudomembranous colitis
avoid what medication? |
anti-diarrheal
C. dificile |
|
|
punctate necrosis
erupting volcano caused by what? |
clindamycin
|
|
|
watery diarrhea, becomes exudative
yellow-white exudate plaques in colon test to confirm? tx? |
C. dificile toxin in stool
metronidazole/vancomycin (IV) |
|
|
colon
patch mucosal reddening/ulceration fibrosis young pt cause? cause? |
cocaine-induced ischemic colitis
|
|
|
colon
patch mucosal reddening/ulceration fibrosis old pt cause? |
ischemic colitis from vascular compromise
|
|
|
segmental infarction in colon
cause? |
obstruction of large vessel (celiac, SMA, IMA)
|
|
|
focal lesion in colon
cause? |
hypoperfusion
|
|
|
ischemic colitis
what is the most likely location? |
splenic flexture
|
|
|
dilated caps
hemorrhage superficial epithelial necrosis volcano lesion |
ischemic colitis
|
|
|
previous radiation
sudden bleeding and abdominal pain HTN |
ischemic colitis
|
|
|
elderly woman
dense lymphocytic infiltrate thick sub-epi collagen no gland destruction what kind of diarrhea? |
watery
lymphocytic colitis |
|
|
elderly white female
inflammation in mucosa rectum |
UC
|
|
|
granular and friable mucosa - pseudopolyp
type of stool? histology? infiltrate? |
bloody diarrhea
- arch. disarray - lymphocytes and plasma cells in lamina propria UC |
|
|
fulinant course w/ toxic megacolon
|
UC
C. dificle |
|
|
urgency
weight loss arthritis ankylosing spondylitis |
UC
|
|
|
erythema nodosum (legs)
pyoderma gangrenosum related to what bile/liver condition? |
primary sclerosing cholangitis
UC |
|
|
UC treatment?
|
topical (sulfasalazine)
systemic (prednisone) colectomy (HGD) |
|
|
Rich old white woman
ileocecal lesion what types of gross structures would you see? tx? |
fistula, stricture
infliximab Crohn's |
|
|
fissures
granuloma |
Crohn's
|
|
|
changed bowel habits
bleeding location? detection timeline? prognosis? |
right colon
late good CRC |
|
|
changed bowel habits
obstruction location? detection timeline? prognosis? |
left colon
early bad CRC |
|
|
how to determine metastases of CRC?
|
CT
|
|
|
lesions in lymph nodes, then liver
what lab is elevated? |
CEA
|
|
|
mature goblet cells
no dysplasia |
hyperplastic polyps
|
|
|
worst histology prognosis for adenoma?
|
villous
|
|
|
2 histologies of adenoma?
|
tuberculated
villous |
|
|
adenoma-carcinoma sequence mutations?
|
APC
B-catenin p53 p16 K-RAS SMAD2 telomerase microsatellite |
|
|
yellow tumor from endocrine cells?
where does it make up 50%? |
Carcinoid
SI |
|
|
what do u need for carcinoid syndrome?
|
production of 5-HT
hepatic dysfunction |
|
|
tumor that resolves w/ antibiotics?
|
maltoma (H. pylori)
|
|
|
where are most stomach polyps located?
|
fundus
|
|
|
shoulder pain referred from where?
|
diaphragm
|
|
|
infarction in proximal 2/3 of transverse artery
which artery was compromised? |
superior mesenteric
|
|
|
you think a female pt w/ abdominal pain needs surgery, what is the next step?
|
pregnancy test
|
|
|
sharp, acute, localized pain
|
perforation
|
|
|
intermittent, crampy, poorly localized pain
|
obstruction
|
|
|
abdominal pain reasons for surgery
|
appendicitis
peritonitis acute pancreatitis diverticulitis mesenteric ischemia |
|
|
constant, localized pain
|
infection/stasis
|
|
|
pain out of proportion
|
mesenteric ischemia
|
|
|
LUQ pain
|
pancreas
PUD |
|
|
positive murphy's sign?
|
cholecystitis
|
|
|
charcot's triad?
can lead to? |
RUQ, jaundice, fever
Reynald's pentad: + HTN, mental status changes |
|
|
genital pain referred from?
|
renal colic
|
|
|
LLQ constant, localized pain
tx? |
antibiotics
diverticulitis |
|
|
most common causes for
small bowel obstruction large bowel obstruction |
adhesions (prior surgery)
colon cancer |
|
|
acute pancreatitis
tx? |
conservative management
|
|
|
asymptomatic gallstones?
|
conservative management
|
|
|
cause of diverticulitis?
|
low fiber = low residue stool = sigmoid has to push hard = high pressure
|
|
|
LLQ pain
fever leukocytosis inflammation |
diverticulitis
|
|
|
when treat hemorrhoids?
|
when prolapse
|
|
|
posterior mid-line tear
pain during pooping |
anal fissure
|
|
|
classic triad of anal fissure:
|
exposed fiber tears
sentinel skin tags hypertrophied of internal sphincter |
|
|
what cannot be palpated during DRE?
|
internal hemorrhoids
|
|
|
picnic
short explosive gastroenteritis stop suddenly pathogen? |
staph
|
|
|
both diarrhea and vomiting
high fever |
viral
|
|
|
traveled in northern mexico
drank ice water how proceed? |
treat for giardia, don't bother testing
|
|
|
traveled in mexico
paucity of pus in stool dysentery |
entamoeba
|
|
|
seems like appendicitis
terminal ileum sickest pathogen? |
salmonella
typhoid fever |
|
|
immunocompromised
bowel infections at risk for? |
c. dificile
crypto MAC |
|
|
how to treat travelers diarrhea?
|
don't unless systemic, could just be change in e.coli
|
|
|
which e.coli causes travelers diarrhea?
|
ETEC
EAEC |
|
|
1 nuclei in cyst
central karyosome ingested RBC |
entamoeba
|
|
|
prodrug
duration of wise |
short term
omeprazole |
|
|
NSAID ulcers
how to counteract and a contraindication? |
misoprostol
pregnant women |
|
|
what do you take for maintenance dose against H. pylori
|
ranitidine
|
|
|
increase gastric motility
cholinesterase inhibitor agonist? |
neostigmine
bethanecol |
|
|
one issue for metoclopramide?
|
not for long term use
|
|
|
approaches to treat GERD
|
reduce pressure (^ gastric emptying)
reduce acid |
|
|
how do treat paralytic ileus?
|
neostigmine
|
|
|
where do you find the cell responsible for hepatocyte regeneration?
|
oval cell in canal of Hering
|
|
|
which aminotransferase is more specific for liver
|
ALT
|
|
|
elevated GGT
diff dx? |
cholestasis
alcohol |
|
|
hereditary
elevated measured direct hyperbilirubinema causes? |
dublin-johnson syndrome
rotor syndrome |
|
|
hereditary
elevated indurect hyperbilirubinemia causes? |
crigker-najjar
gilbert syndrome reduced UDP-glucuronly transferase activity |
|
|
microscopic changes in cirrhosis besides fibrosis?
|
loss microvilli
lose exchange convert sinusoids to vacular channels form intrahepatic shunts |
|
|
cirrhosis
causes |
alcohol
hep B & C drugs bilitary tract dz cardiac |
|
|
cirrhosis complications
|
liver failure
portal HTN HCC |
|
|
acute fatty liver
causes? |
pregnancy
reye syndrome |
|
|
mother gave her kid aspirin to treat viral illness
kid developed cerebral edema w/ encephalopathy and microvesicular fatty liver |
reye syndrome
|
|
|
can cause hemorrhoids
|
portal HTN
|
|
|
caput medusae (umbilical)
|
portal HTN
|
|
|
other than hep, viruses that cause hepatitis
|
EBV
CMV herpes yellow fever rubella |
|
|
elevated CEA
no history of cirrhosis cause? |
vertical transmission of Hep B
|
|
|
lymphoid follicles
steatosis which virus |
hep C
|
|
|
pregnant mom presents w/ acute liver failure
|
hep E
|
|
|
diff b/w grade and stage
|
grade - inflammation
stage - fibrosis |
|
|
feathery necrosis
|
cholestasis
|
|
|
HBs, elevated Total HBc
|
chronic infection
|
|
|
HBs +
elevated Total HBc + HBc IgM + Hbs Ab |
acute infection (early)
|
|
|
HBs -
Total HBc Ab + IgM HBc Ab + HBs Ab +/- |
<6 months
|
|
|
Hbs -
Total HBc Ab + IgM HBc Ab - HBs Ab + |
past infection
|
|
|
Hbs -
Total HBc Ab - IgM HBc Ab - HBs Ab + |
vaccinated
|
|
|
all negative
|
at risk
|
|
|
Hbe +
|
ongoing infection (bad)
|
|
|
Hep B
% subclinical % acute |
subclinical: 65%
acute: 25% |
|
|
Hep C
% chronic % stable % cirrhosis % acute infection w/ recovery |
chronic - 85%
stable - 80% cirrhosis - 20% acute infection w/ recovery - 15% |
|
|
vaccination for Hep B prevents...
|
Hep B
Hep D |
|
|
Fecal-oral hepatitis
unique feature? |
A, E
no lipid coat (doesn't get emulsified by bile and can pass on) |
|
|
Parenteral hepatitis
which one sexual and veritical? |
Hep B, C, D
|
|
|
esosinophilic bodies made of intermediate filaments
condition? |
steatohepatitis
(mallory bodies) |
|
|
what type of cells do you see in alcoholic steatohepatitis?
|
neutrophils
|
|
|
pt took NSAIDS and now acute liver failure
treatment? |
give N-acytlcysteine
|
|
|
how does metabolic syndrome cause NAFLD
|
1. mobilizes fat from adipocytes
2. impaired oxidation/high oxidative stress 3. decreased VLDL syn 4. fat = ^ TNF & inflammatory damage |
|
|
female
rheumatoid arthritis coagulopathy plasma cells condition |
autoimmune hepatitis
|
|
|
infiltrate around portal tract
plasma cell |
autoimmune hepatitis
|
|
|
anti-SM
|
autoimmune hepatitis
|
|
|
gross appearance: chocolately brown
test? |
prussian blue
(hemachromatosis) |
|
|
labs in hemachromatosis
|
^ transferrin saturation
^ hepatic iron index (>20,000) |
|
|
hemachromatosis: significant risk for...
|
HCC (200x)
|
|
|
pt w/ history of transfusions and B-thalassemia
|
hemachromatosis
|
|
|
AR
|
alpha-1-antitrypsin deficiency
Wilson's dz |
|
|
mutation in wilson's
|
Cu-transporting ATPase
|
|
|
defect in AAT
|
Z protein
|
|
|
PAS stain: eosinophilic globular material in hepatocyte cytoplasm
|
AAT
|
|
|
test for Wilson's
|
decreased ceruloplasmin
increased liver copper increased urine copper Kayser-Fleischer rings in eyes |
|
|
steatosis
hepatitis cirrhosis nuclear glycogenation of hepatocytes mallory bodies |
wilson disease
|
|
|
abdominal pain
normal liver tests |
focal nodular hyperplasia
hepatic adenoma |
|
|
lesion
collagenous stroma vascular channels |
hemangioma
|
|
|
lesion
stellate fibrous scar separating nodules |
focal nodular hyperplasia
|
|
|
localized proliferation of hepatocytes
isolated arteries |
hepatic adenoma
|
|
|
hormonal use in women
|
hepatitic adenoma
|
|
|
single small lesion w/ proliferation of small ductules
|
bile duct adenoma
|
|
|
multiple small, dilated bile ducts in expanded portal tract
|
bile duct hamarthoma
|
|
|
cirrhotic pt
low grade dysplasia nodule |
macroregenerative nodules
|
|
|
causes of HCC
diag? |
hep B & C
cirrhosis aflotoxin AFP |
|
|
mutation that goes from hepatic adenoma to HCC
|
B-catenin
|
|
|
elevated AFP
young pt |
fibrolamellar variant of HCC
|
|
|
conditions assoc w/ cholangiocarcinoma
|
liver fluke
thorotrast PSC fibrocystic dz of bile duct |
|
|
hepatitis
necrosis bile duct injury ductopenia |
GVHD
|
|
|
endothelialitis
hyperacute (Ab-mediated) rejection ductopenia |
HVGD
|
|
|
endothelial injury and central vein occlusion
cause? |
BM chemo
(Sinusoidal Obstruction Syndrome) |
|
|
regenerative parenchymal nodules throughout liver, compress each other, atrophied parenchyma in between
|
Nodular regenerative hyperplasia
|
|
|
pylophlebitis
hypercoag state splenic vein thrombosis propagation |
portal vein obstruction (intra hepatic)
|
|
|
cirrhosis
cancer sickle cell, DIC sclerosis |
portal vein obstruction (extra-hepatic)
|
|
|
rate of hepatic infarcts?
histology? |
rare (dual blood supply)
bland coag necrosis |
|
|
swollen liver
glisson capsule ascites centrolibular fibrosis |
budd-chiari
|
|
|
elevated indirect bilirubin
elevated liver enzymes excessive bleeding periportal HTN |
HELLP
pregnant |
|
|
secondary biliary obstruction
|
biliary atresia
cholelithiasis biliary stricture/masses |
|
|
female
variceal bleeding pruritis late jaundice schogren scleroderma |
primary biliary cirrhosis
|
|
|
florid duct lesion
ductopenia |
primary biliary cirrhosis
|
|
|
male
rheumatoid arthritis UC pancreatitis retroperitoneal fibrosis |
PSC
|
|
|
concentric fibrosis histology
|
PSC
|
|
|
1 month old
fever yellow elevated AP causes? |
sepsis
hepatitis BILIARY ATRESIA paucity of bile ducts |
|
|
causes of adenocarcinoma of gallbladder and cholangiocarcinoma?
|
gallstone
fibrocystic dz of bile duct biliary tract infection IBD PSC thorotrast |
|
|
50 yo native american woman w/ 3 kids
|
cholelithiasis
|
|
|
conditions assoc w/ estrogen
|
gallstones
hepatic adenoma |
|
|
Japan
RUQ colic pain cause? |
chronic hemolytic anemia
Crohn ileac resection CF, pancreatic insufficiency (pigment stone) |
|
|
abscesses in liver
cause? |
acute cholangitis
|
|
|
anti-liver/kidney microsomal Ab?
|
autoimmune hepatitis
|
|
|
pedunculated tumor
|
CRC
hemangioma |
|
|
desmoplastic fibrotic response
yellow retracted scar |
cholangiocarcinoma
|
|
|
thorotrast
|
HCC
cholangiocarcinoma angiosarcoma |
|
|
cholecystitis
most likely cause? |
gallstone
|
|
|
RUQ pain
inflammation HTN cause? |
ischemia
vasculitis post-surg post-mortem trauma sepsis acalculous cholecystitis (blood prob) |
|
|
acute pancreatitis
causes? |
ductal obstruction
acinar cell injury defective enzyme transport |
|
|
fat necrosis in pancreas
fibrinoid necrosis of blood vessels most likely cause? |
alcohol
gallstone |
|
|
hypocalcemia
multi organ failure electrolyte prob thrombosis (DIC) |
acute pancreatitis
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lesion
fibrous capsule fluid center condition? |
acute pancreatitis
pseudocyst |
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epigastric pain radiating to back
old HTN h/o of IV cocaine use cause? |
acute pancreatitis from ischemia and drug use
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epigastric pain
pt develops diabetes main cause? |
alcohol
chronic pancreatitis |
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diabetes
smoker lots of polyps |
pancreatic adenocarcinoma
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peutz-jegher pt
where is the lesion located? |
head of pancreas
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go to bed at night, wake up with regurgitated food on pillow
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achalasia
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trouble swallowing solids but not liquids
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obstruction - cancer
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trouble swallowing both liquids AND solids
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peristalsis problem
achalasia |
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odynophagia in an HIV patient
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candida esophagitis
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weakness in cricopharyngeal muscle halitosis
regurgitation through nose |
zenkers diverticulum
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missing ganglion cells in esophagus
spike at LES on pressure wave birds beak on barium swallow |
achalasia
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hirsprungs dz
chagas dz |
achalasia
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goblet cells in esophagus
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barrett's esophagus
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alcoholic
prominent veins in distal esophagus |
left gastric vein
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hematachezia
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diverticuLOSIS
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bulemic
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boerhaaves
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test for H. pylori
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urease test
H+ test |
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how useful is antibody serotype for diagnosing H. pylori
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can't diagnose recurrent infection (Ab doesn't go away)
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gastric ulcers and cancer
most likely region of the stomach |
stomach antrum and pylorus
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where in the stomach is H. pylori country?
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antrum and pylorus
lesser curvature |
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top cause of stomach cancer
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H. pylori
also MALT |
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duodenal polyp or ulcer
prognosis? |
usually benign
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H. pylori leading to PUD
where is the ulcer most likely to be? |
duodenum
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melena
why black |
upper GI bleed
acid acts on hematin |
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executive pt
lots of stress severe epigastric pain radiating to the left shoulder |
perforated ulcer
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50 yo woman
h/o weight loss signet rings (mucus filled) |
linitus plastica gastric adenocarcinoma
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what region of the world is gastric cancer really prevalent?
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Japan, smoked meats
BBQ in U.S. has same risk factors |
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nontender mass in left supraclavicular area (drains abdominal organs)
epigastric distress and weakness |
metastatic gastric adenoma
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folate and B12 level in bacterial overgrowth
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folate - normal (bacteria produce it)
B12 -low |
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malabsorption
blunt villi in SI foamy macrophage systemic what if HIV? |
whipples
MAC |
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alcoholic
malabsorption 2 reasons |
alcohol induced pancreatitis
cirrhosis induced bile salt deficiency |
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low volume diarrhea w/ blood
US |
campto jejuni
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AIDS diarrhea
acid fast |
cryptosporidium
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diarrhea up in the mountains
most common parasite |
Giardia
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giardia
tx? |
metronidazole
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entamoeba histolytica
tx? |
metronidazole
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pseudmembranous colitis
dx? |
toxin assay of stool
C. dificile |
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colicky pain (complete or absent)
no passed gas (ostipation) no bowel movement |
total obstruction of small bowel
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colicky pain
bloody stools 2 yo kid |
intussuception
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which bowel infarcts more?
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small bowel
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severe pain after meals
afraid to eat bloody stools lesion near splenic flexture |
ischemic colitis
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small bowel infarct vs. ischemic colitis
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Small bowel infarct - diffuse abdominal pain
ischemic colitis - hurts at splenic flexture |
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RLQ pain
hematochezia |
meckels diverticulum
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colicky pain
RLQ pain diarrhea young person |
Crohn's dz
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UC vs Crohns
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UC - bloody diarrhea
Crohns - fistulas |
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ileocecal region
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Crohn's
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rectum/colon
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UC
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what do you need to diagnose acute liver failure?
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prolonged PTT
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acute liver failure
centrilobular pattern cause? |
acetominophen
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when does prolonged PTT show up in drug vs. viral acute liver failure, respectively?
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drug - sooner
viral - later, parallel ^ in AST/ALT |
