3 - Gi-Great Study Card

Front 1

1. Parotitis

Back 1

a. Inflammation of the parotid salivary gland
b. Etiology can be viral infxn like mumps from paramyxovirus OR bacterial infxns that block drainage
c. Often resolves spontaneously. Rarely reoccurs

Front 2

2. Pancreatitis

Back 2

a. Autodigestion of pancreas by pancreatic enzymes (extracellular damage → leaks digestive enzymes → trypsin → activated pancreatic proenzymes → autodigestion
b. Etiology: Gallstones, Ethanol, Trauma, steroids, mumps, autoimmune, scorpion sting, hypercalcemia/ hyperlipidemia, Drugs
c. S/sx: epigastric abdominal pain radiating to the back, anorexia, nausea
d. Labs: elevated amylase, lipase (more specific)
e. Can lead to DIC, ARDS, diffuse fat necrosis, pseudocyst formation

Front 3

3. Cholestasis

Back 3

a. Is any condition in which the flow of bile from the liver is slowed or blocked
b. Causes may be intrahepatic, extrahepatic, or medications.
c. Symptoms: clay colored or white stools, dark urine, inability to digest certain foods, itching, nausea/vomiting, RUQ pain, jaundice, persistent itching
d. Labs: elevated bilirubin and alkaline phosphatase

Front 4

4. Cirrhosis

Back 4

a. Cirrho ( greek) = tawny yellow
b. Diffuse fibrosis of liver, destroys normal architecture
c. Micronodular is < 3mm uniform size dt metabolic insult (e.g., alcohol, hemochromatosis, Wilson’s disease)
d. Macronodular is > 3mm varied size dt liver injury leading to hepatic necrosis (e.g., postinfectious or drug induced hepatitis. Increase risk of hepatocellular carcinoma
e. S/sx: scleral icterus, foul breath, spider nevi, gynecomastia, jaundice, testicular atrophy, liver “flap”, bleeding tendency, anemia, ankle edema

Front 5

5. Gilbert’s syndrome

Back 5

a. Hereditary hyperbilirubinemia
b. Mildly Dec UDP-glucoronyl transferase of Dec bilirubin uptake.
c. Asymptomatic can be assoc w/ stress situations → slight jaundice
d. Elevated unconjugated bilirubin without overt hemolysis.

Front 6

6. Hepatitis (non-infectious)

Back 6

a. Is inflammation of the liver due to noninfectious processes such as: chemicals like EtOH or medications, also genetic & metabolic disorders, autoimmune, and obesity
b. Sx: Jaundice, loss of appetite, fatigue, muscle & joint aches
c. Findings: Elevated Liver function tests ( AST, ALT,

Front 7

7. Portal hypertension

Back 7

a. Causes prehepatic, intrahepatic, posthepatic
b. Prehepatic causes: splenic shunting, portal vein thrombosis, tumor, pancreatitis
c. Intrahepatic causes: cirrhosis, sarcoidosis, idiopathic
d. Posthepatic causes: CHF, tricuspid stenosis, alcoholism
e. Complications are esophageal varices, peptic ulcer, splenomegaly, caput medusa, portal hypertensive gastropathy, hemorrhoids, ascites,

Front 8

8. Cholecystitis

Back 8

a. Inflammation of gallbladder
b. Usually dt gallstones, rarely from ischemia or infection
c. Elevated alkaline phosphatase if the bile duct becomes involved.

Front 9

9. Cholelithiasis

Back 9

a. Gallstones – form when solubilizing bile acids and lecithin are overwhelmed by ^ in cholesterol and /or bilirubin or gallbladder stasis
b. Risk factors: (4F’s) Female, Fat, Fertile, Forty
c. Cholesterol stones – MC, radiolucent w/ 10-20% opaque d/t calcification.
d. Pigment Stones – radiopaque – seen w/ chronic hemolysis → XS bilirubin in the bile → pigment stones

Front 10

10. Achlorhydia

Back 10

a. Production of gastric acid in the stomach is absent or low
b. Etiology: Autoimmune, excess anatacid use, Helicobacter pylori infxn, pernicious anemia, stomach ca,
c. S/Sx: GERD, diarrhea, stomach pains, decreased absorption of vitamins and nutrients
d. Treat underlying cause
e. Complications are unknown, but there have been reports of increased risk of gastric cancer

Front 11

11. Celiac disease

Back 11

a. Autoantibodies to gluten (gliadin) in wheat and other grains.
b. Primarily proximal small bowel – blunting of the villi and lymphocytes in the lamina propria.
c. Diagnose: Ab to gliadin, antitissue transglutaminase antibodies (tTGA) or anti-endomysium antibodies (EMA)
d. S/Sx: steatorrhea, malabsorption and vitamin deficiency. Assoc w/ dermatitis herpetiformis

Front 12

12. Enzyme deficiencies

Back 12

a. Protease deficiency – inability to digest proteins → Sx: XS Alkaline blood, edema, hypoglycemia, immune compromised
b. Amylase deficiency – inability to digest carbs and dead WBC → Sx: abcesses, derm probs,
c. Lipase deficiency – inability to digest fats → Sx: high cholesterol, diabetes, difficult losing weight, muscle spasms, meniere’s dz
d. Cellulase deficiency – inability to digest raw food → Sx: malabsorption
e. Sucrase deficiency – inability to digest sucrose → Sx: neuro sx- h/a, depression, severe mood swings, seizures,

Front 13

13. Lactase deficiency

Back 13

a. Inability to digest lactose
b. Sx: abdominal cramps and diarrhea

Front 14

14. Achalasia

Back 14

a. Failure of relaxation of the lower esophageal sphincter (LES) dt loss of myenteric plexus,
b. High LES opening pressure and uncoordinated peristalsis → progressive dysphagia
c. “bird’s beak” on barium swallow
d. Barium swallow shows dilated esophagus with an area of distal stenosis.
e. Assoc w/ increase risk esophageal carcinoma

Front 15

15. Adynamic ileus

Back 15

a. A condition that slows or prevents the passage of material through the intestines
b. Usually resolves without trx
c. Sx” cramping, abdominal pain, abdominal bloating, anorexia, and constipation
d. Etiology: drug side effect, anesthesia, abdominal surgery, hypokalemia, trauma, heart dz, kidney dz.

Front 16

16. Hiatal Hernia

Back 16

a. A condition in which part of the stomach sticks upward into the chest, through an opening in the diaphragm.
b. Cause is unknown, but risk factors are age, obesity, smoking
c. Sx: reflux – heart burn, chest pain, difficulty swallowing,

Front 17

17. Intussusception

Back 17

a. “telescoping” of 1 bowel segment into a distal segment.
b. Can compromise blood supply
c. Unusual in adults, more common in children

Front 18

18. Volvulus

Back 18

a. Twisting of portion of the bowel around its mesentery
b. Can lead to obstruction and infarction.
c. May occur at cecum & sigmoid colon, where there is redundant mesentery
d. Usually in elderly

Front 19

19. Megacolon

Back 19

a. Dilation of the colon that is NOT caused by mechanical obstruction
b. Often accompanied by paralysis of peristaltic movements of the bowel
c. Sx: constipation for a long duration, abdominal bloating, tenderness, tympany, pain, palpation of hard fecal masses
d. There are 3 etiologic types: Acute megacolon (infxn or Rx), Chronic megacolon (congenital, Rx, idiotpathic), and Toxic megacolon (ulcerative colitis & pseudomembransous colitis)
e. Worldwide MCC of acute megacolon is Chaga’s disease

Front 20

20. Aganglionic megacolon aka Hirschsprung’s disease

Back 20

a. A congenital disorder in which the nerve cells of the myenteric (Auerbach’s plexus) are absent.
b. It is rare disorder (1:5000) w/prevalence 4x in males
c. Autosomal dominant condition and develops in the early stages of pregnancy.

Front 21

21. Appendicitis

Back 21

a. All age groups
b. MC indication for emergent abdominal surgery in children
c. Initial difuse periumbilical pain → localized pain at McBurney’s point (1/2 distance from iliac crest to umbilicus) (RLQ near ileocecal jxn)
d. Nausea, fever may perforate → peritonitis

Front 22

22. Barrett’s esophagus

Back 22

a. The lining of the esophagus is damaged by stomach acid
b. Glandular metaplasia – replacement of nonkeratinized stratified squamous epithelium with intestinal columnar epithelium in the distal esophagus ( lower 1/3)
c. Due to chronic acid reflux (GERD)
d. Increases risk for adenocarcinoma

Front 23

23. Diverticular disease

Back 23

a. When diverticula (pouches) in the large intestine or colon become inflamed.
b. Most occur in the sigmoid colon and become more numerous with age.
c. Often benign & asymptomatic, abd pain after meals, hematochezia, N/V, fever, gas, bloating, constipation or diarrhea
d. Etiology is unknown: risk factors are low fiber diet, obesity, changes in intestinal pressure, aging, and physical abnormalities of colon wall, lack of physical activity
e. Diverticulosis – presence of many diverticula in intestinal wall. Very common in US b/c low fiber diets
f. Diverticulitis – one or more diverticula inflamed. Can be local or spread = peritonitis. Also can lead to large perforations.

Front 24

24. Enteritis aka food poisoning

Back 24

a. Inflammation of the small intestines usually resolves on its own
b. Etiology: MCC - bacteria or viruses, Crohn’s, NSAIDS, radiation
c. Can also involve stomach (gastritis) and large intestines (colitis)
d. Risk factors: recent travel, exposure to contaminated water
e. Sx: abdominal pain, diarrhea (acute & severe), loss of appetite, vomiting

Front 25

25. Esophageal ulcers

Back 25

a. Lesions in the lining of the lower esophagus
b. Sx: midsternal pain
c. MC assoc w/ GERD, also NSAID use, smoking, vomiting

Front 26

26. Gastric ulcers aka peptic ulcers

Back 26

a. Lesion in the lining of the stomach dt decreased mucosal protection against gastric acid.
b. Sx: pain is Greater w/ meals → weight loss
c. Older patients
d. Etiology: H. pylori infxn in 70% of cases, also NSAID use

Front 27

27. Duodenal ulcers

Back 27

a. Lesion in the lining of the proximal part of the duodenum dt increased gastric acid secretion or decreased mucosal protection
b. Sx: pain is Decreased w/ meals → weight gain
c. Tend to have clean “punched out” margins unlike raised/ irregular margins of carcinoma.
d. Complications: bleeding, penetration into pancreas, perforation, and obstruction.

Front 28

28. Esophagitis (non-infectious)

Back 28

a. Reflux esophagitis – caused by GERD through the LES
b. Eosinophilic esophagitis – caused by an allergic response often to food
c. Drug induced esophagitis – pills swallowed with little or no water comes in contact w/ lining of esophagus and causes irritation. Common culprits: NSAIDS, Abx ( tetracycline & doxycycline), KCl, Bisphosphonates

Front 29

29. Gastritis

Back 29

a. Acute gastritis aka erosive – disruption of the mucosal barrier -> inflammation. Etiology: stress, NSAIDS, Dec PGE2, EtOH, uremia, burns & brain injury
b. Chronic gastritis aka nonerosive – Type A = Autoimmune, Anemia (pernicious), Achlorhydia occurs in the fundus/ body of stomach
c. Chronic gastritis aka non erosive – Type B = MCC H. pylori affects the antrum of the stomach

Front 30

30. Gastroesophageal reflux disease (GERD)

Back 30

a. When the stomach contents leak backwards from the stomach into esophagus. Irritating the esophagus and causing heart burn.
b. Risk factors: EtOH, hiatal hernia, Obesity, Pregnancy, scleroderma, smoking
c. Sx: feeling food stuck behind the sternum, heartburn under sternum, nausea after eating, also can have coughing, regurgitation of food, difficulty swallowing, hiccups, or hoarseness, sore throat

Front 31

31. Crohn’s disease

Back 31

a. Disordered response to intestinal bacteria
b. Hallmarks-GIFTS: Granulomas, Ileum (terminal), Fistula, Transmural, Skip lesions
c. Also see rectal sparing & cobblestone
d. Sx: severe diarrhea, low grade fever. Bloody stools, weith loss, severe malabsoprtion, abd pain & distention, n/v
e. Familial tendencies, peaks ages 15-40yrs

Front 32

32. Ulcerative colitis

Back 32

a. Autoimmune
b. Hallmarks -C’s : Colon, Continuous, Crypt abcesses, carcinoma, “C”uperficial layers, “C”eudopoylps, colectomy