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SurgeryGI
GI
188
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6th Grade
08/21/2009

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Term
Where is a mallory weiss tear located?
Definition
gastroesophageal junction
Term
Predisposing factor for mallory weiss tear?
Definition
alcoholism
Term
Alcoholic pt after binge drinking-first vomit food and gastric contents followed by forceful retching and bloody vomitus, dx?
Definition
Mallory Weiss Tear
Term
What is the diagnostic test of choice for Mallory Weiss Tear?
Definition
EGD
Term
Tx for Mallory Weiss tear?
Definition
endoscopic hemostatic therapy
Term
When is surgery indicated for mallory weiss tear?
Definition
when endosopic managment fails
Term
Most common type of esophageal cancer?
Definition
SCC - seen with alcohol and tobacco use
Term
Which esophageal cancer is seen in patients with chronic reflux?
Definition
Adenocarcinoma
Term
Dysphagia, weight loss, hoarseness, tracheoesophageal fistula, recurrent aspiration and possible symptoms of metastatic ds, dx?
Definition
Esophageal Carcinoma
Term
Which test is diagnostic for esophageal carcinoma?
Definition
endoscopic biopsy
Term
Apple core lesion on barium swallow is indicative of what?
Definition
esophageal carcinoma
Term
Most common malignant tumor of esophagus in African American males?
Definition
squamous cell
Term
Most common symptom of an esophageal stricture?
Definition
dysphasia
Term
Diagnostic study for stricture?
Definition
Endoscopy with biopsy to differentiate peptic stricture
Term
Presenting symptoms for stricture?
Definition
dysphagia of solids or liquids, heartburn
Term
Tx for esophageal stricture?
Definition
dilation and PPI
Term
Most common symptom associated with esophageal varices?
Definition
bleeding
Term
Main predisposing factor to esophageal varices?
Definition
Portal HTN
Term
Main complication of esophageal varices?
Definition
blood loss leading to hypovolemia leading to shock
Term
Emergent tx for varies?
Definition
emergent endoscopy and hemostasis, as well as FFP or platelets
Term
Most common type of gastric carcinoma?
Definition
adenocarcinoma
Term
most common symptoms of gastric carcinoma?
Definition
weight loss, anemia, anorexia, GI upset
Term
tx for gastric carcinoma?
Definition
surgery and chemo
Term
mucosal tear at the gastroesophageal junction is known as what?
Definition
mallory-weiss tear
Term
In addition to discontinuation of drinking alcohol, what else is reccomended for treatment of alcoholic cirrosis?
Definition
fold acid and supportive measures for iron and electrolyte defiency
Term
endoscopy should be preformed if patient doesn't respond to PPI within how long?
Definition
1 month
Term
After curative colorectal cancer surgery, how often should one have subsequent exams?
Definition
3 yrs
Term
Incubation period for hepatitis B is what?
Definition
3-180 days
Term
Diagnostic study of choice for cholelithiasis?
Definition
ultrasound of abdomen
Term
faint blue abdominal discoloration indicative of retroperitoneal bleeding, dx?
Definition
Cullen sign
Term
Gnawing, dull, aching, or hunger-like epigastric pain is consistent with what disease?
Definition
PUD
Term
Two most common causes of PUD?
Definition
NSAIDs and h pylori
Term
Most common cause of LBO in adults?
Definition
colon cancer
Term
Most common type of gallstone in the US is what?
Definition
cholesterol - mixed
Term
Which population has the highest incidence of gallstones in the country?
Definition
native americans before 60 YO
Term
What is the best description of pathology of acute cholecystitis?
Definition
sustained obstruction of the cystic duct with inflammation
Term
Patient presents with midepigastric pain, weight loss, jaundice, on examination he is icteric. On palpation of abdomen you find a distended non-tended gallbladder, dx?
Definition
pancreatic carcinoma
Term
What are findings on an abdominal ultrasound consistent with choledocolithiasis?
Definition
dilated hepatic ducts
Term
Which organ is most commonly injured as a result of blunt abdominal trauma?
Definition
spleen
Term
73 YO jaundiced female is noted to have a posthepatic obstruction on ultrasound, what is the best test to evaluate?
Definition
CT
Term
What is charcots triad and what does it refer to?
Definition
fever, RUQ, jaundice - ascending cholangitis
Term
What is the treatment of choice for symptomatic cholelithiasis?
Definition
laprascopic cholecystectomy
Term
Pt presents with severe epigastric pain radiating to the back, pain has been present for 8 hours, N/V, WBC of 14, and serum amylase of 500, dx?
Definition
acute Pancreatitis
Term
What criteria is used to triage patients with acute pancreatitis?
Definition
ranson's criteria
Term
Most common complication associated with chronic pancreatitis?
Definition
pancreatic pseudocyst
Term
What exam finding is associated with Couvoisier's sign?
Definition
Palpable, non-tender gallbladder
Term
What is an appropriate screening test for hepatocellular carcinoma in patients with cirrosis?
Definition
alpha-fetoprotein
Term
Initial tx of choice for patients with portal hypertension?
Definition
diuretics and sodium restriction
Term
What is the most important factor in determining overall survival rates with patients with breast cancer?
Definition
axillary lymph node status
Term
Chronic intestinal ischemia is most likely to have abdominal pain that is associted with what?
Definition
fear of eating
Term
22 YO obese white female is seen with c/o breast mass in UOQ of left breast, lesion is smooth firm, and freely movable, dx?
Definition
Fibroadenoma
Term
What is the most common type of hernia?
Definition
indirect inguinal hernia
Term
most appropriate screening tool for AAA?
Definition
abdominal x-ray
Term
Most common site of an arterial occlusion due to embolic disease?
Definition
femoral
Term
Patient presetns with acute onset of severe abdominal pain radiating to the back, prior history of knawing epigastric pain which was previously relieved by antacids, with rebound and guarding
Definition
PUD
Term
What will be seen on radiograph for PUD?
Definition
pneumoperitoneum, free air
Term
What is most sensitive and specidic diagnostic finding of acute appendicitis?
Definition
CT scan
Term
What is the primary benefit from using mesh repairs for inguinal hernias?
Definition
reduced risk of recurrence
Term
Most common symptom of crohn's disease?
Definition
abdominal pain, diarrhea, weight loss
Term
progressive dysphagia and regurgitation of undigested food, patient has tried drinking large amounds of fluids with meals in an attempt to wash down food, most likely diagnosis?
Definition
achalasia
Term
bird beak deformity is indicative of what?
Definition
achalasia
Term
first priority in relieving SBO?
Definition
correction of fluid and electrolyte abdominalites
Term
MCC of massive lower GI bleeding?
Definition
diverticular disease
Term
Most common fistula that develops as a consequence of colonic diverticular disease?
Definition
colovesicular
Term
What is the most important risk factor in the development of colon cancer?
Definition
age
Term
Colorectal carcinoma is most commonly spread through which mechanisms?
Definition
regional lymphatics
Term
What is classic finding on radiograph associated with sigmoid colon cancer?
Definition
apple core lesion
Term
As part of post op surveillance in pts tx for colorectal cancer, which blood test should be employed for 2-3 months?
Definition
CEA
Term
first line tx for Chron's disease?
Definition
sulfasalazine
Term
Pt presents with large air filled kidney shaped mass in the LUQ, finding is most compatible with what?
Definition
cecal volvulus
Term
Radiographic findings most compatible with large bowel obstruction include what?
Definition
distended proximal colon with air fluid levels
Term
What type of hemmoroid will require manual manipulation for reduction?
Definition
third degree
Term
Tearing pain associated with defecation, BRBPR on toilet paper, dx?
Definition
Anal fissure
Term
Important risk factor in the development of gastric carcinoma?
Definition
helicobacter pylori infection
Term
first test for diagnosis of Zollinger-Ellison syndrome?
Definition
serum gastrin level
Term
Midepigastric pain that is relieved by eating food, dx?
Definition
duodenal
Term
Most common cause of colon cancer and most common location?
Definition
Adenocarcinoma and rectum
Term
test of choice for colon cancer?
Definition
colonoscopy
Term
What type of surgical procedure can be utilized with a persistent anal fissure?
Definition
lateral internal sphincterectomy
Term
Most common location of a perirectal abscess?
Definition
perianal
Term
Tx for anorectal abscess?
Definition
drainage ASAP
Term
Most common cause of anal fistula?
Definition
crypt infection
Term
diagnosis of pilonidal cyst?
Definition
clinical
Term
tx for pilonidal cyst
Definition
cleansing, draining, possible surgery to remove the cyst
Term
How long does a duodenal ulcer typically take to heal?
Definition
4-6 weeks
Term
What is diagnostic test of choice for colon cancer?
Definition
colonoscopy
Term
test of choice for diverticulitis during acute attack?
Definition
Abdominal/Pelvic CT
Term
Presenting symptoms of diverticulitis?
Definition
LLQ pain, change in bowel habits (diarrhea)
Term
birds beak on sigmoidoscopy typically indicates what?
Definition
volvulus
Term
Which type of inflam bowel disease is mouth to anus?
Definition
crohn's disease
Term
hallmark of UC?
Definition
bloody diarrhea
Term
Major complication from Crohn's disease?
Definition
fistula
Term
Major complication for UC?
Definition
toxic megacolon
Term
Most common site of anal fissure?
Definition
posterior midline
Term
Contraindication for hemmoroidectomy?
Definition
Crohn's disease
Term
Best study for polyps?
Definition
colonoscopy
Term
Most common location for polyps?
Definition
rectosigmoid
Term
Most common type of thyroid carcinoma?
Definition
Papillary Thyroid Carcinoma
Term
Which is the most common type of thyroid cancer?
Definition
papillary thyroid carcinoma
Term
Major risk factor for papillary thyroid carcinoma?
Definition
radiation to the head and neck
Term
What is the tumor marker for papillary thyroid carcinoma?
Definition
thyroglobulin
Term
Orphan Annie Nuclei are characteristic of which type of neoplastic dz?
Definition
Papillary Thyroid Carcinoma
Term
What antithyroid drug is used in tx of multinodular goiter?
Definition
PTU
Term
most common cause of hyperparathyroidism?
Definition
adenoma
Term
three syndromes associated with MEN?
Definition
pheochromocytoma, thyroid medullary carcinoma, hyperparathyroidism
Term
which medication should be used in the inital tx of hyperparathyroidism?
Definition
furosemide
Term
what is initial test on eval of cushings syndrome?
Definition
dexamethosone supression
Term
cushing syndrome is due to what?
Definition
excess cortisol
Term
three causes of excess cortisol?
Definition
pituitary ACTH hypersecretion, ectopic ACTH secreting tumor, adrenal tumor secreting cortisol
Term
classic triad of pheochromocytoma?
Definition
palpitations, headache, episodic diaphoresis
Term
most common site for pheochromocytoma?
Definition
adrenal
Term
primary hyperaldosteronism due to high aldosterone production, dx?
Definition
Conn Syndrome
Term
most common sources of conns syndrome?
Definition
adrenal adenoma or adrenal hyperplasia
Term
four main symptoms/signs of conn syndrome?
Definition
hypertension, headache, polyuria
Term
test of choice from esopageal varices??
Definition
EGD
Term
most common cause of esophageal varices?
Definition
portal hypertension
Term
acute medical tx for esophageal varices?
Definition
nitroglycerin
Term
tx for esophageal varices?
Definition
band ligation, endoscope, liver transplant
Term
which type of esophageal cancer is associated with barret's esophagus?
Definition
adenocarcinoma
Term
what is the most common type of esophageal cancer?
Definition
squamous cell carcinoma
Term
most common type of gastric carcinoma?
Definition
adenocarcinoma
Term
procedure of choice for diagnosis of upper PUD?
Definition
EGD
Term
which labs/diagnostics should be ordered when suspicious of a PUD?
Definition
FOBT, and CBC, EGD, maybe KUB and CT scan
Term
What is the DOC for pain with acute cholecystitis?
Definition
demerol
Term
most common cause of acalculous cholecystitis?
Definition
biliary stasis
Term
main tx for acute cholecystitis?
Definition
IVF, IV abx, pain control, and cholecystectomy
Term
what will be seen on US with acute cholecystitis?
Definition
pericholecystic fluid, thickened gallbladder wall, distended gallbladder, stones present
Term
management for choledocholithiasis?
Definition
ECRP, common bile duct exploration
Term
main complication of ERCP?
Definition
pancreatitis
Term
most common cause of ascending cholangitis?
Definition
choledocolithiasis
Term
most common cause of cirrosis?
Definition
chronic hep c, and alcohol
Term
tumor marker for HCC?
Definition
alpha fetal protein
Term
what is diagnostic for HCC?
Definition
biopsy
Term
what is the best imaging for HCC?
Definition
Helical CT scan with contrast
Term
two most common causes of pancreatitis?
Definition
gallstones, and alcoholism
Term
patient presents with severe midepigastric pain, N/V, radiating to the back, relieved with sitting forward, dx?
Definition
acute pancreatitis
Term
What might be seen on CT with pancreatitis?
Definition
inflammation, gallstones, edema, masses, pseudocysts
Term
three major complications associated with acute pancreatitis?
Definition
pseudocyst, abscess, ascites
Term
periumbilical ecchymosis?
Definition
cullen sign
Term
flank eccymosis is called what sign?
Definition
grey-turner sign
Term
main cause of chronic pancreatitis?
Definition
repeated acute pancreatitis, from alcohol typically
Term
test of choice for chronic pancreatitis?
Definition
endoscopic U/S
Term
chain of lakes refers to which disease and diagnostic test?
Definition
ERCP for chronic pancreatitis
Term
classic triad for chronic pancreatitis?
Definition
diabetes, steatorrhea, pancreatic calcifications
Term
Most common type of Pancreatic Carcinoma?
Definition
Adenocarcinoma (90%)
Term
Palpable gall bladder and jaundice, with no hx of biliary colic should be suspicious for what disease?
Definition
pancreatic cancer
Term
primary diagnostic tool of pancreatic carcinoma?
Definition
ERCP
Term
what is the tumor marker for pancreatic carcinoma?
Definition
CA 19-9
Term
What is the most common type of cervical cancer?
Definition
squamous cell
Term
What symptoms are typical of acute diverticulitis?
Definition
LLQ pain and rebound tenderness
Term
Which antibiotic should be used in the setting of acute appendicitis?
Definition
cefoxitin
Term
Most common cause of ischemic bowel disease?
Definition
arterial embolism
Term
major symptoms associated with ischemic bowel disease?
Definition
abdominal pain, hematochezia, melena, diarrhea
Term
best imaging for ischemic bowel disease?
Definition
1) colonoscopy, 2) CT scan
Term
tx for ischemic bowel disease?
Definition
resuscitation and supportive measures (IV fluids and O2, pain control, NG tube)
Term
which two antibiotics should be used in the tx of acute diverticulitis?
Definition
cipro, and flagyl
Term
most common location of colon cancer?
Definition
Rectum
Term
best two tests for DUB?
Definition
endometrial biopsy and pelvic U/S
Term
which tumor marker is elevated in Ovarian cancer?
Definition
CA-125
Term
U/S showing string of pearls is characteristic of what disease?
Definition
Polycystic Ovarian Syndrome
Term
Medical management for PCOS?
Definition
spironolactone, metformin, Clomiphene
Term
Most common risk factor for cervical cancer?
Definition
HPV
Term
Most common symptoms of cervical cancer?
Definition
post coital bleeding, cervical ulceration, leukorrhea
Term
Most common type of vulvar carcinoma?
Definition
squamous cell carcinoma
Term
post menopausal vaginal bleeding might be suspicious for what type of disorder?
Definition
vaginal squamous cell carcinoma
Term
post menopausal vaginal bleeding might be suspicious for what type of disorder?
Definition
vaginal squamous cell carcinoma
Term
best screening test for AAA?
Definition
ultrasound
Term
patient presents with "tearing" back pain, hypotension, and hemodynamic instability, dx?
Definition
aortic dissection
Term
most common cause of aortic dissection? (2)
Definition
HTN, marfans
Term
What is the gold standard test for aortic dissection?
Definition
aortography
Term
acute tx for aortic dissection?
Definition
control blood pressure
Term
What is the gold standard test for diagnosis of PVD?
Definition
arteriogram
Term
Patients with ulcers on toes or top of foot are typically due to which type of vascular disease?
Definition
arterial
Term
Most common symptom of PAD?
Definition
claudication ischemic pain when walking
Term
Patient presents with hair loss on foot, ulcers, pulselessness, and cool to the touch, dx?
Definition
Peripheral Arterial Disease
Term
Tx for claudication?
Definition
Pentoxifylene (Trental)
Term
Most common location of PAD?
Definition
superficial femoral and popliteal
Term
Imaging of choice for DVT?
Definition
compression ultrasound
Term
Patient with achy legs, worse with standing, relieved with elevation, dx?
Definition
Venous insuffiency
Term
What is becks triad, and what does it relate to?
Definition
hypotention, JVD, muffled heart sounds
Term
most common type of bladder carcinoma?
Definition
transitional cell carcinoma
Term
classic presentation of bladder cancer?
Definition
painless hematuria
Term
gold standard for diagnosis of bladder cancer?
Definition
cystoscopy with biopsy
Term
Most common method of biopsy for prostate cancer?
Definition
transrectal biopsy
Term
most common type of testicular carcinoma?
Definition
germ cell
Term
main tumor markers for recurrence of testicular cancer?
Definition
BHCG, and alpha fetoprotein
Term
what should be the initial study for possible testicular carcinoma?
Definition
Scrotal U/S
Term
what is the most helpful screening test for prostate cancer?
Definition
PSA
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