Term
| Presence of stones in salivary glands or ducts |
|
Definition
|
|
Term
| The three major salivary glands |
|
Definition
parotid
submandibular
sublingual |
|
|
Term
Dehydration, diuretics, smoking, gout, anti-cholinergics, trauma
Risk factors for which disorder? |
|
Definition
|
|
Term
Management of sialolithiasis when stones <2mm
|
|
Definition
Hydration
Moist heat
massage the gland
Sialogogues
d/c anticholinergics |
|
|
Term
| Chronic inflammatory disorder characterized by diminished salivary and lacrimal gland function |
|
Definition
|
|
Term
| How is Sjogren's (mouth form) managed? |
|
Definition
Stimulation of salivary flow
Oral hygiene
Muscarinic agonists like pilocarpine and cevilimine |
|
|
Term
| Of the disorders of the GI, which creates a higher risk of cavities? (dental carries) |
|
Definition
|
|
Term
| Most common form of oral cancer |
|
Definition
|
|
Term
| Two classifications of dysphagia and where do patients 'point' in each one |
|
Definition
Oropharyngeal -point to cervical region
and
Esophageal - point to suprasternal notch or sternum |
|
|
Term
|
Definition
|
|
Term
|
Definition
Neurons that control the muscles that relax the esophageal walls are degenerated due to an inflammatory process.
This results in uninhibited tone of the lower esophageal sphincter |
|
|
Term
|
Definition
Smooth muscle relaxants like nitrites and calcium channel blockers
Botox
Surgical dilation of LES |
|
|
Term
| Which GI disorder is associated with increased risk of esophageal cancer? |
|
Definition
|
|
Term
| A condition that develops when reflux of the stomach contents causes troublesome symptoms/complications |
|
Definition
GERD
Gastroesophageal Reflux Disease |
|
|
Term
| 4 Clinical manifestations of GERD |
|
Definition
Heart burn
Chest pain
dysphagia
Regurgitation |
|
|
Term
| Name some lifestyle modifications that may help with the symptoms of GERD |
|
Definition
head of bed elevation
avoid fatty foods, chocolate, peppermints and excessive alcohol
Avoid supine position after meals
not smoking
weight loss
|
|
|
Term
| 2 Most common types of esophageal cancers |
|
Definition
Squamous cell carcinoma
Adenocarcinoma |
|
|
Term
| Risks of Esophageal squamous cell carcinoma |
|
Definition
smoking/alcohol
underlying esophageal dz like achalasia
genetics
high temp food and beverage
Iran & Asia |
|
|
Term
| Risks for Adenocarcinoma of the esophagus |
|
Definition
Barrett's metaplasia, caused by GERD
Smoking
alcohol
obesity
|
|
|
Term
Generally dysphagia associated with solid foods is due to a mechanical obstruction.
What may be the cause when dysphagia is associated with both solids and liquids? |
|
Definition
| A motor disorder such as achalasia etc. |
|
|
Term
| Defects in the GI mucosa that extend through muscularis mucosae. |
|
Definition
|
|
Term
| Two locations for peptic ulcers |
|
Definition
|
|
Term
| Peptic Ulcer Dz is associated with which 2 main factors? |
|
Definition
NSAIDs
H. Pylori infection |
|
|
Term
Dyspepsia is a manifestation of peptic ulcer dz and there are 2 types
Which is associated with epigastric burning, gnawing pain that occurs for a few weeks then goes away periodically |
|
Definition
|
|
Term
Dyspepsia is a manifestation of peptic ulcer dz and there are 2 types
Which type is associated with worsened epigastric pain following eating, early satiety, fatty food intolerance and N&V? |
|
Definition
|
|
Term
| Tx of Peptic Ulcer Dz when caused by H.Pylori |
|
Definition
Proton Pump inhibitor
+
Antibiotic |
|
|
Term
| For NSAID induced Peptic Ulcer disease, which antisecretory therapy is better, PPIs or H2 blockers? |
|
Definition
| Ulcers heal faster with PPIs |
|
|
Term
In the case of NSAID-induced Peptic ulcer disease, the NSAID is usually withdrawn.
What is done in the case where the NSAID cannot be discontinued? |
|
Definition
NSAIDS
+ PPI or Misoprostol (prostaglandin) |
|
|
Term
Anatomical location of Upper GI bleed
(proximal to what?) |
|
Definition
| Proximal to ligament of Treitz |
|
|
Term
Anatomical location of Lower GI bleed
|
|
Definition
| Distal to Ligament of Treitz |
|
|
Term
| 2 symptoms associated with upper GI bleed |
|
Definition
|
|
Term
| Symptoms associated with lower GI bleed |
|
Definition
|
|
Term
| 2 Main symptoms of gastric cancer |
|
Definition
weight loss (due to insufficient calories)
Persistent abdominal pain |
|
|
Term
| There are 3 steps in normal nutrient processing, which goes wrong in cirrhosis? |
|
Definition
| luminal and brush border processing |
|
|
Term
| There are 3 steps in normal nutrient processing, which goes wrong in pernicious anemia |
|
Definition
| Luminal and brush border processing |
|
|
Term
| There are 3 steps in normal nutrient processing, which goes wrong in Vitamin B12 deficiency |
|
Definition
| Luminal and brush border processing |
|
|
Term
| There are 3 steps in normal nutrient processing, which goes wrong in Celiac disease |
|
Definition
| Absorption in intestinal mucosa |
|
|
Term
| There are 3 steps in normal nutrient processing, which goes wrong in atrophic gastritis |
|
Definition
| Luminal and brush border processing |
|
|
Term
| There are 3 steps in normal nutrient processing, which goes wrong in lactase deficiency |
|
Definition
| Absorption into the intestinal mucosa |
|
|
Term
| Celiac disease is an immune disorder in genetically predisposed individuals. Which aspects of the immune response are involved? |
|
Definition
IgA antibodies to gliadin and to endomysium (tissue transglutaminase)
T cell response to gliadin |
|
|
Term
| 3 key features of Celiac disease |
|
Definition
Villous atrophy
Symptoms of malabsorption
resolution of symptoms upon withdrawal of gluten in diet |
|
|
Term
| Celiac disease is closely associated with which other disorder due to genetics |
|
Definition
|
|
Term
| Name a nutritional deficiency that can be found in pts with celiac disease |
|
Definition
| Vitamin D deficiency which causes hyperparathyroidism which can cause bone loss |
|
|
Term
| Common cause of Vit B12 deficiency |
|
Definition
|
|
Term
| How is pernicious anemia treated? |
|
Definition
|
|
Term
| Absorptive results of resection of jejunum |
|
Definition
| since it is the primary digestive/absorptive site for most nutrients there is temporary reduction in absorption of most nutrients |
|
|
Term
| Absorptive results of ileum resection |
|
Definition
fluid/electrolyte loss
vit B12 deficiency
impaired fat and fat-soluble vitamin absorption (due to loss of bile)
However, can adapt well |
|
|
Term
| Results of colon resection |
|
Definition
Reduced water, electrolyte and short chain fatty acid
absorption
but intestinal adaptation is stimulated |
|
|
Term
| Severity of diarrhea is defined by its duration, what are the timelines of the acute/persistent/chronic classifications |
|
Definition
Acute </= 14days
Persistent=15+ days
Chronic= 30+ days |
|
|
Term
| Common causes of acute diarrhea |
|
Definition
Bacteria/viruses
(self-limiting) |
|
|
Term
|
Definition
Secretory
Osmotic
Motility related
Inflammatory |
|
|
Term
| Cholera toxin causes which type of diarrhea |
|
Definition
|
|
Term
| Celiac dz causes which type of diarrhea |
|
Definition
|
|
Term
| Laxatives cause which type of diarrhea |
|
Definition
|
|
Term
| Diabetic neuropathy to the vagal nerve causes which type of diarrhea |
|
Definition
|
|
Term
| Hyperthyroidism causes which type of diarrhea |
|
Definition
|
|
Term
| Acute diarrhea can be caused by both bacteria and viruses, which tends to be more severe? |
|
Definition
|
|
Term
| In terms of acute gastroenteritis, which toxin do you suspect when symptoms occur with 6 hours |
|
Definition
Staphylococcus aureus
Bacillus cereus |
|
|
Term
| In terms of acute gastroenteritis, which toxin do you suspect when symptoms occur after more than 16 hours |
|
Definition
| Viral or bacterial infection, eg. enterohemorrhagic E. coli |
|
|
Term
| In terms of acute gastroenteritis, which toxin do you suspect when symptoms start as diarrhea and progress to fever/headache/stiffness/muscle aches |
|
Definition
|
|
Term
| Management of Acute Gastroenteritis |
|
Definition
HYDRATION
Some sort of oral rehydration solution that contains:
sodium chloride, trisodium citrate, potassium chloride, glucose |
|
|
Term
| What is thought to be the primary cause of appendicitis? |
|
Definition
|
|
Term
|
Definition
Abdominal pain that starts out in the periumbillical region then migrates to right lower quadrant.
Fever
Anorexia
Nausea & Vomiting |
|
|
Term
| Definition of constipation |
|
Definition
<3 BM per week
but it does depend on what is normal for the pt |
|
|
Term
| Management of constipation |
|
Definition
Exercise
Increased fluid intake
Regular BM pattern
Diet/fiber
Laxatives |
|
|
Term
| 3 types of laxatives and an example of each |
|
Definition
Bulk-forming-Metamucil
Osmotic- MiraLAX
Stimulant-Senna |
|
|
Term
| Chronic abdominal pain and altered bowel habits in the absence of any organic cause |
|
Definition
|
|
Term
| What is the most commonly diagnosed GI condition? |
|
Definition
|
|
Term
| Specify the characteristics of abdominal pain associated with Irritable Bowel Syndrome |
|
Definition
Not Progressive
Does not awaken from sleep
does Not prevent sleep
not associated with weight loss/malnutrition/anorexia |
|
|
Term
| The 2 major forms of inflammatory bowel disease and the different areas they affect |
|
Definition
1. Crohn's disease-any part of GI tract from mouth to anus
2. Ulcerative colitis-affects the colon |
|
|
Term
Ulcerative Colitis vs. Crohn's Dz
In which is hematochezia more common? |
|
Definition
|
|
Term
Ulcerative Colitis vs. Crohn's Dz
In which is mucus/pus in stool more common? |
|
Definition
|
|
Term
Ulcerative Colitis vs. Crohn's Dz
Which is associated with small bowel involvement? |
|
Definition
|
|
Term
Ulcerative Colitis vs. Crohn's Dz
Which is associated with fistulas/perianal dz? |
|
Definition
|
|
Term
Ulcerative Colitis vs. Crohn's Dz
Which is associated with Transmural mucosal inflammation? |
|
Definition
|
|
Term
Ulcerative Colitis vs. Crohn's Dz
Which ALWAYS has rectum involvement? |
|
Definition
|
|
Term
Ulcerative Colitis vs. Crohn's Dz
Which has continuous lesions? |
|
Definition
|
|
Term
| 4 Pharmacologic approaches used to treat Inflammatory Bowel Disease |
|
Definition
Aminosalicylates
Corticosteroids
Immuno modulators
Experimental drugs |
|
|
Term
| 4 Drug types to treat the symptoms of Inflammatory Bowel diseases |
|
Definition
Anti-diarrheals
bile acid-binding agents
Antispasmodics
Acid suppressants |
|
|
Term
| Most common symptoms of diverticulitis |
|
Definition
|
|
Term
| Management of uncomplicated diverticulitis |
|
Definition
Bowel rest (clear fluids only)
Antibiotics |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Abdominal pain
abnormal bowel movements
hematochezia/melena
weakenss
anemia
weight loss |
|
|
Term
| Leading cancers in children |
|
Definition
Leukemia
Brain tumors
Lymphoma |
|
|
Term
| Two major categories of hyperbilirubinemia |
|
Definition
Elevation of Unconjugated bilirubin
Elevation of both conjugated and unconjugated bilirubin |
|
|
Term
| Which type of bilirubin will be elevated with hemolysis? |
|
Definition
| Overproduction of bilirubin with hemolysis causes elevated unconjugated |
|
|
Term
| Which type of bilirubin will be elevated with impaired bilirubin uptake by the liver? |
|
Definition
|
|
Term
| Which type of bilirubin will be elevated with physiologic jaundice of the newborn |
|
Definition
|
|
Term
| Which type of bilirubin will be elevated with hepatocellular disease? |
|
Definition
| Both unconjugated and conjugated |
|
|
Term
| Which type of bilirubin will be elevated with biliary obstruction? |
|
Definition
| both conjugated and unconjugated |
|
|
Term
| Where in the body does unconjugated bilirubin become conjugated? |
|
Definition
|
|
Term
| Autosomal recessive defect in cellular copper transport |
|
Definition
|
|
Term
| Predominant neurological features of Wilson's dz |
|
Definition
|
|
Term
| Predominant hepatic features of Wilson's disease |
|
Definition
Chronic hepatitis
Asymptomatic liver function abnormalities |
|
|
Term
| Predominant ocular feature of Wilson's disease |
|
Definition
| Kayser-fleischer rings-most common with neuro presentations |
|
|
Term
| Why does Wilson's disease result in cirrhosis |
|
Definition
| impaired biliary excretion of copper results in the accumulation of copper in the liver, which damages it progressively, leading to cirrhosis. |
|
|
Term
| How is Wilson's dz managed? |
|
Definition
Two phases of therapy
-removal of copper
-prevention of re-accumulation via potent chelators |
|
|
Term
| What compound may be helpful in Wilson's dz due to its interference with absorption of copper |
|
Definition
|
|
Term
| Of the 3 Hep viruses, which is generally self-limiting and acute? |
|
Definition
|
|
Term
|
Definition
Abdominal pain/distention
Breast development
Dark urine
pale stools
fatigue
fever
itching
jaundice
weight loss |
|
|
Term
| What will be found upon physical examination in hepatitis? |
|
Definition
Enlarged and tender
Fluid in abdomen
Jaundice |
|
|
Term
| How does Hepatitis A cause injury to the liver? |
|
Definition
| the virus replicates in hepatocytes and T cells then kill the hepatocytes |
|
|
Term
| Hep A or B, which is more likely to present with jaundice? |
|
Definition
|
|
Term
Interpretation of Hepatitis Blood Test Results
Antibodies against core antigen and surface antigen, but no surface antigens |
|
Definition
| Immune due to natural infection |
|
|
Term
Interpretation of Hepatitis Blood Test Results
No surface antigen
no antibodies to core antigens
antibodies to surface antigens |
|
Definition
| immune due to vaccination |
|
|
Term
Interpretation of Hepatitis Blood Test Results
-Presence of surface antigens
-presence of antibodies to core antigens
-presence of IgM antibodies to core antigens
-no antibodies to surface antigen |
|
Definition
|
|
Term
Interpretation of Hepatitis Blood Test Results
Presence of surface antigen
presence of antibodies to core antigen
no IgM
no antibodies to surface antigen |
|
Definition
|
|
Term
| T/F Majority of Hep C patients progress to chronic infection |
|
Definition
|
|
Term
| What is the most common cause of chronic liver disease? |
|
Definition
|
|
Term
| Tx for 2 types of Hepatits is mainly supportive, however the remaining Hepatitis virus is generally treated with antiviral therapy and other testing. Which one is it? |
|
Definition
| Hep C requires more than just supportive tx, |
|
|
Term
| Tx for acetaminophen induced hepatitis |
|
Definition
|
|
Term
| Tx for Valproic acid induced hepatitis |
|
Definition
|
|
Term
| Key mechanism that leads to hepatic steatosis |
|
Definition
|
|
Term
| Late stage of progressive hepatic fibrosis characterized by distortion of the hepatic architecture and the formation of regenerative nodules |
|
Definition
| Cirrhosis, aka end-stage liver disease |
|
|
Term
| Cure for advanced cirrhosis |
|
Definition
| No cure, transplant is only option |
|
|
Term
| Goals in management of cirrhosis |
|
Definition
Slow progression
Prevent superimposed insults via vaccinations, avoid alcohol and acetaminophen
Prevent/treat complications
Arrange transplant |
|
|
Term
| Hepatocellular cancer commonly occurs in conjunction with which other disorder? |
|
Definition
|
|
Term
Term for:
Recurrent Right upper quadrant/epigastric pain that progresses for an hour; plateaus then slowly subsides |
|
Definition
|
|
Term
| Medical term for gallstones |
|
Definition
|
|
Term
| Most useful test for diagnosis of cholecystolith |
|
Definition
|
|
Term
| Inflammation of the gallbladder |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Differentiation between cholecystolith and cholecystitis |
|
Definition
| Both may have pain but the cystitis will have fever and WBC elevation |
|
|
Term
| key features of acute cholecystitis |
|
Definition
RUQ pain
Fever
Elevated WBC
usually related to gallstone disease |
|
|
Term
| Key features of acalculous cholecystitis |
|
Definition
same as acute but without the stones
-occurs in critically ill patients |
|
|
Term
| Chronic cholecystitis leads to: |
|
Definition
| Fibrosis and thickening of gallbladder wall |
|
|
Term
| Which form of cholecystitis is associated with high mortality and high morbitiy |
|
Definition
|
|
Term
| Management of cholecystitis |
|
Definition
Hospitalization
Supportive Care
Antibiotics
Cholecystectomy |
|
|
Term
| Why are antibiotics needs to treat cholecystitis |
|
Definition
| Bile stasis promotes secondary infection |
|
|
Term
T/F
Gallstones can affect the pancreas |
|
Definition
True
35% of pancreatitis is due to passage of gallstones |
|
|
Term
| Management of mild pancreatitis |
|
Definition
Supportive care including:
pain control
IV fluids
possibly antibiotics
Correction of electrolyte/metabolic imbalances |
|
|
Term
| Some possible etiologies of chronic pancreatitis |
|
Definition
Alcohol abuse
SLE
Genetics
autoimmune
Idiopathic |
|
|
Term
Symptoms of pancreatic cancer
|
|
Definition
dull ache in upper abdomen
profound weight loss
jaundice/pruritis/dark urine |
|
|
Term
Emergent severe abdominal pain
aka... |
|
Definition
|
|
Term
| 2 initial concerns addressed with acute abdomen |
|
Definition
-What is the cause
-Do they need surgery |
|
|
Term
Acute Abdomen
differential diagnosis in Infants |
|
Definition
Intussusception (invagination of intestine over itself)
Volvulus/malrotation (twisting/looping of intesting causes blockage)
pyloric stenosis (narrowing of the opening of the stomach into small intestine)
megacolon (abnormal dilation)
hernia |
|
|
Term
Acute Abdomen
Differential Diagnosis in Children |
|
Definition
Acute appendicitis
Mesenteric adenitis (inflammation of lymph nodes in abdomen)
diabetic ketoacidosis
hernia |
|
|
Term
Acute Abdomen
differential diagnosis in Adults |
|
Definition
PUD
gallbladder
ectopic pregnancy
pelvic inflammatory disease
mesenteric thrombosis/embolus
diverticulus
neoplasm |
|
|
