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126 Cards in this Set
- Front
- Back
What causes a corkscrew x-ray?
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esophageal spasm
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What causes an apple core x-ray?
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cancer
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What causes a stacked coin x-ray?
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intussusception
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What causes an abrupt cutoff in an x-ray?
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volvulus
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What causes a bird's beak on x-ray?
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achalasia
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What causes a string sign on x-ray?
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pyloric stenosis
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What are causes of solid dysphagia?
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Schatzki's rings
strictures cancer |
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What are Schatzki's rings?
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lower esophageal webs
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What are causes of liquid dysphagia?
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scleroderma
achalasia esophageal spasm |
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What is Barrett's esophagus?
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metaplasia
increased risk of adenocarcinoma |
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What are esophageal varices?
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due to portal hypertension
vomit blood when they rupture |
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What is Mallory-Weiss?
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chronic vomiters
tear at LES mucosa |
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What is Boerhaave's esophagus?
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transmural (all layers) rupture of the esophagus
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What is achalasia?
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increased LES pressure
decreased peristalsis lost LES Auerbach's plexus bird's beak on x-ray |
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What is Hirschsprung's?
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congenital lack of Auerbach's in the rectum
newborn won't pass meconium |
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What is a Zenker diverticulum?
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above UES
cough undigested food halitosis |
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What is a traction diverticulum?
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below the UES
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What is Plummer-Vinson syndrome?
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esophageal webs (UES)
spoon nails iron deficiency anemia |
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What is a TE fistula (H-type)?
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choke with each feeding
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What is esophageal atresia with a TE fistula (C-type)?
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vomit with first feeding
huge gastric bubble |
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What is duodenal atresia?
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bilious vomiting with first feeding
double bubble Down's syndrome |
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What is pyloric stenosis?
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non-bilious projectile vomiting (3-4 wk old)
RUQ olive sign |
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What is choanal atresia?
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turns blue with feeding
"smurf on a nipple" |
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What makes scleroderma unique?
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decreased LES pressure
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What makes esophageal spasms unique?
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increased peristalsis
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What makes achalasia unique?
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decreased peristalsis and increased LES pressure
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What disease has a RUQ olive mass?
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pyloric stenosis
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What disease has a RLQ sausage mass?
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intussusception
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What is a bezoar?
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mass of undigestable material
antrum obstruction |
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What is Type A gastritis?
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autoimmune
anti-parietal cell Ab atrophic/achlorhydria adenocarcinoma risk increased |
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What is Type B gastritis?
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H. pylori
spicy foods |
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What is a duodenal ulcer?
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loss of barrier
pain after meal and during the night relieved by eating (weight gain) assoc with H. pylori and type O blood |
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What is a gastric ulcer?
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loss of barrier
pain during meals associated with NSAID's and type A blood |
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What is a sliding hiatal hernia?
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fundus slides through esophageal hiatus into thorax
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What is a rolling hiatal hernia?
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bowel protrudes through a defect in the diaphragm
strangulates bowel |
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What is Menetrier's disease?
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lose protein through rugal folds (generalized edema)
thick rugal folds |
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What defines constipation?
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< 3 BM per week
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What defines diarrhea?
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> 200g per day
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What is osmotic diarrhea?
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watery
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What can cause secretory diarrhea?
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laxative use
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What is inflammatory diarrhea?
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blood and pus
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What is celiac sprue?
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jejunum
wheat allergy villous atrophy anti-gluten/gliadin Ab |
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Where is tropical sprue?
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distal ileum
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What is mesenteric ischemia?
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pain out of proportion to exam
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What are the bugs that cause bloody diarrhea?
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CASES
C: campylobacter A: amoeba (E. histolytica) S: shigella E: E. coli S: salmonella |
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What is cholangitis?
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inflammation of the bile duct
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What is Charcot's triad?
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jaundice
fever RUQ pain |
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What is Reynold's pentad?
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jaundice
fever RUQ pain hypotension change in mental status |
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What is ascending cholangitis?
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common bile duct infection due to stone
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What is primary sclerosing cholangitis?
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p-ANCA
bile duct inflammation beading associated with ulcerative colitis |
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What is primary biliary cirrhosis?
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anti-mitochondrial Ab...
bile ductules destroyed.. xanthelasma |
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What is cholestasis?
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obstruction of bile duct
pruritis increased ALP jaundice |
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What is cholecystitis?
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inflammation of the gall bladder
Murphy's sign |
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What is cholelithiasis?
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formation of gallstones
RUQ pain |
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What is choledocholithiasis?
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gallstone obstructs bile duct
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What is the most common gall stone?
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cholesterol (invisible on x-ray)
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What is conjugated bilirubin?
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water soluble
direct |
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What is unconjugated bilirubin?
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fat soluble
indirect |
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What are signs of alcoholic cirrhosis?
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spider angioma
palmar erythema gynecomastia |
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What is hepatorenal syndrome?
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build-up of liver toxins causing renal failure
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What is a xanthoma?
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cholesterol buildup (elbow, Achilles)
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What does high cholesterol cause?
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atherosclerosis
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What is a xanthelasma?
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triglyceride buildup under eye
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What do high triglycerides cause?
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pancreatitis
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What is type 1 hyperlipidemia?
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bad liver LPL
high chylomicrons |
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What is type 2a hyperlipidemia?
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bad LDL or B-100 receptors
high LDL most common in general population |
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What is type 2b hyperlipidemia?
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fewer LDL/VLDL receptors
high LDL and VLDL |
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What is type 3 hyperlipidemia?
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bad ApoE
high IDL and VLDL |
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What is type 4 hyperlipidemia?
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bad adipose LPL
high VLDL |
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What is type 5 hyperlipidemia?
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bad C2
high VLDL and chylomicrons associated with diabetes mellitus |
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What do chylomicrons do?
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take triglycerides from GI to liver and endothelium
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What does VLDL do?
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takes triglycerides from liver to adipose
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What does IDL do?
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take triglycerides from adipose to tissue
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What does LDL do?
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only one to carry cholesterol
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What are the breakdown products of VLDL?
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IDL and LDL
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What is Crigler-Najjar Type I?
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unconjugated bilirubin buildup in infants
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What is Gilber's syndrome?
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stress leads to increased unconjugated bilirubin
increased load saturates glucuronyl transferase (deficiency in UDP glucuronyl transferase) |
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What is Rotor's?
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bad bilirubin storage leads to increased conjugated bilirubin
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What is Dubin Johnson?
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bad bilirubin excretion leads to increased conjugated bilirubin black liver
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What is Cullen's sign?
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hemorrhagic pancreatitis
bleeding around umbilicus |
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What is Turner's sign?
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hemorrhagic pancreatitis
bleeding into flank |
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What are the tests for pancreatitis?
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amylase (sensitive) - breaks down carbohydrates
lipase (specific) - breaks down triglycerides |
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What does Ranson's Criteria tell you?
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prognosis of pancreatitis
|
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What is carcinoid syndrome?
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flushing
wheezing diarrhea |
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How is carcinoid syndrome diagnosed?
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5-HIAA in the urine
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What is the most common primary location for a carcinoid tumor?
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appendix
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What is the most common metastatic origin for a carcinoid tumor?
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small bowel
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What are the most common metastatic sites for a carcinoid tumor?
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lung and heart
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What is the most common location for a benign carcinoid tumor?
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appendix
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What does currant jelly sputum tell you?
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Klebsiella
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What does currant jelly stool tell you?
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intussusception
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What is familial polyposis?
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100% risk of colon cancer
APC defect begin annual colonscopy at 5 yo |
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What is Gardener's syndrome?
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familial polyposis with bone tumors
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What is Turbot's syndrome?
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familial polyposis with brain tumors
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What is Peutz-Jegher syndrome?
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hyperpigmented mucosa
|
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What is Crohn's disease?
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IBD with
cobblestones melena creeping fat fistulas |
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What is Ulcerative Colitis?
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IBD with
pseudopolyps hematochezia lead pipe colon toxic megacolon |
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What is intussusception?
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currant jelly stool
stacked coin enema |
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How does diverticulosis present?
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bleeds
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How does diverticulosis present?
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bleeds
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How does diverticulitis present?
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LLQ pain
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How does spastic colon present?
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intermittent severe cramps
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How does IBS present?
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alternating diarrhea/constipation with a hx of stress
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How do external hemorrhoids present?
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pain on defecation
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How do internal hemorrhoids present?
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no pain
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What is pseudomembranous colitis?
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overgrowth of C. difficile due to normal flora being killed off
usually by clindamycin use |
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What is Whipple's disease?
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T. whippelii destroys GI tract and then spreads causing malabsorption and arthralgias
PAS + |
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What color is an upper GI bleed?
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black
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What color is a lower GI bleed?
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red
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What adds color to stool?
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stercobilinogen being oxidized to stercobilin
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What gives urine its yellow color?
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urobilinogen being oxidized to urobilin
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What is the default color of stool?
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clay-colored
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What is the default color of urine?
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tea-colored
|
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EXTRAS START HERE
What are the risk factors for primary liver cancer? |
Hep B and C
aflatoxin vinyl chloride alcohol carbon tetrachloride anyline dyes smoking hemochromatosis benzene schistosomiasis |
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What are the risk factors for esophageal and gastric carcinoma?
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smoking
alcohol nitrates japanese |
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What causes gastroenteritis within 8 hours of eating?
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pre-formed toxin
S. aureus (potato salad) C. perfringens (holiday turkey/ham) B. cereus (fried rice) |
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What bacteria are associated with colon cancer?
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C. malanogosepticus
S. bovis |
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What are the hepatitis B labs during the window period?
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HBeAb +
HBcAb + |
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What are the hepatitis B labs for an acute recent infection?
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HBcAg +
HBsAg + HBcAb + |
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What are the hepatitis B labs within 2 weeks of immunization?
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HBsAg +
|
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What are the hepatitis B labs greater than 2 weeks after immunization?
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HBsAg +
|
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What are the hepatitis B labs of somebody with a previous infection who is now immune?
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HBcAb +
HBsAb + |
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What are the hepatitis B labs of a chronic carrier?
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HBsAg + for > 6 months
HBsAb +/- |
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What is the only renally excreted statin?
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preavastatin
|
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What statins need liver enzymes check every 3 months?
|
atorvastatin
lovastatin simvastatin |
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What is the MOA of statins?
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inhibit HMG-CoA reductase
most active around 8 pm must take every night for max efficacy |