Biliary Tract
Describe Boas sign in Acute Cholecystitis
Referred pain just inferior to the right scapula in acute cholecystitis due to phrenic nerve irritation
Common cause of lower GI bleed
Diverticulosis
Findings on colonoscopy in patients with Chron's disease
Skip lesions and cobblestones, through the entire GI tract
What type of colonic polyp is most likely to become cancerous?
Villous adenoma
Diagnostic test for pt with odynophagia and weight loss
Endoscopy as these are alarm symptoms
Describe Charcot's Triad in Acute Cholangitis
Fever, RUQ abd pain and Jaundice
Most common area of the large intestine to be affected by diverticulitis
Sigmoid colon
Most common area of the GI tract for Chron's disease
Terminal Ileum
Tumor marker for the diagnosis of Colon Cancer
CEA (not very specific or sensitive)
Dysphagia to solids and liquids, lower esophageal sphincter narrowing, absence of peristalsis distally on a barium Esophagram?
Achalasia
What are the components of Reynold's Pentad?
Fever, RUQ pain, jaundice, altered mental status and hypotension
Pt with systemic toxicity (fever, tachycardia, hypotension) and colonic dilation on abdominal radiograph that is >6cm
Toxic Megacolon
What type of Peptic Ulcer generally improves with the ingestion of food?
Duodenal Ulcers
3 components of Plummer Vinson Syndrome
1. Dysphagia
2. Esophageal webs
3. Iron Deficiency anemia
Pain and difficulty with swallowing for several months with stacked, corrugated rings in the esophagus in a child with a history of asthma.
Eosinophilic esophagitis
Gallstone seen in bacterial and parasitic infections
Brown Stones (from a biliary fluke)
Bloody diarrhea, LLQ abdominal pain, loss of haustral markings on barium enema, what is the first line treatment?
Topical 5-aminosalicyclic acid
What is triple and quadruple therapy for H.Pylori positive patients?
Triple: Clarithromycin, Amoxicillin, PPI (Metronidazole if PCN allergic)
Quad: Tetracycline, Metronidazole, Bismuth, PPI
What medications are used as primary prophylaxis in prevention of a rebleed in a patient with esophageal varices?
Non-selective beta blockers (Nadolol and Propranolol)
Esophageal Neoplasm in a patient with excessive alcohol use, mass in the proximal esophagus and no history of GERD
Squamous cell carcinoma
Transient episodes of jaundice during times of stress, labs show isolated elevated indirect bilirubin, what is the diagnosis?
Gilbert's Syndrome
Pt with hyperlipidemia, hypertension and previous MI, has dull abdominal pain that increases after meals. Has lost 15 lbs in 3 months. What diagnostic imaging should be ordered?
CT Angiography (mesenteric ischemia)
Multiple severe, refractory ulcers, not responsive to PPI treatment
Zollinger-Ellison Syndrome
Pruritic papules and vesicles on their forearms and knees with a history of Celiac disease
Dermatitis Herpetiformis
Halitosis, dysphagia and occasional regurgitation of undigested food. Diagnosis and diagnostic test?
Zenker's Diverticulum
Barium Esophagram