Leukoplakia? Acyclovir 2. In a patient with tonsilar exudate is is more commonly bacterial or viral? Viral 70% Bacterial 30% 3. Lower lip malignancy = Upper lip malignancy = Lower lip = squamous cell carcinoma Upper lip = basal cell carcinoma 4. First location on body that shows hyperpigmentation due to Addison's? Buccal mucosa 5. Diagnosis for lack of peristalsis in upper 1/3 of esophagus? Myesthenia Gravis 6. Why would the mother of a newborn with TEF have an over sized stomach? Polyhydramnios 7. Patient presents with halatosis and food coming out of their nose - diagnosis? Zenker's diverticulum 8. Acquired achalaia and Hirschprung in an adult - what is the diagnosis? Chagas disease 9. Most common cause of hematochezia? Diverticulosis 10. When would a patient present with Haman's crunch? Borhavve syndrome 11. Why are Upper GI bleeds black? Presence of Hematin in stool 12. What is the most common cause of malabsorption? Celiac 13. HIV patient presents with Whipple lie symptoms what is the diagnosis? Mycobacterium Avium (MAI) 14. Mechanism of Invasive diarrhea? Bacteria invades the enterocytes 15. Mechanism of secretory diarrhea? Bacteria toxin increases cellular cAMP or cGMP 16. Most common cause of osmotic diarrhea? Lactase deficiency 17. Volume of stool for Secretory diarrhea High 18. Volume of stool for osmotic diarrhea High 19. Volume of stool for invasive diarrhea Low 20. Is osmotic diarrhea cause a hyper, iso, of hypotonic water loss? Hypotonic 21. pH of stool in lactase deficiency Low 22. Substance you must give with water to re-hydrate patient with secretory diarrhea? Glucose 23. Most common cause of invasive diarrhea? Campylobacter 24. Diagnosis if diarrhea is described as "partially acid fast" Cryptosporidium 25. Suspected C. Diff infection-how do you confirm diagnosis? Stool antigen 26. Imaging of small bowel obstruction shows what? Step ladder appearance - air, fluid, air, fluid 27. What is colicy pain a sign of? Obstruction 28. Describe colicky pain Pain with completely pain free intervals 29. What is obstipation? No stool, no gas 30. Most common cause of intestinal obstruction? Adhesion 31. Does the small bowel or large bowel more commonly obstruct? Small bowel 32. Difference between pain in small bowel ischemia and colon ischemia? Small bowel= diffuse pain Colon= Very localized pain 33. Most common location of angiodysplasia? Cecum 34. Diverticulum and polyps look very similar on gross exam, how can you tell the difference? Polyp - Into the lumen of bowel Diverticulum - Out of the wall of the bowel 35. Most common location of fistula formation in diverticulosis? Bladder 36. Only disease to produce right lower quadrant colicky pain? Crohn's 37. Histology from a colon polyp shows strawberry on a stick appearance- diagnosis? Tubular addenoma 38. How will the stool appear of someone with a Villous adenoma? Covered in mucous 39. True or false- All carcinoid tumors are malignant? True 40. Colon cancer causing a iron deficiency is on what side? Right side Goljan Audio Study online at quizlet.com/_m82bs 41. Is AST or ALT a specific liver enzyme? ALT 42. Organelle that contains GGT? Smooth ER 43. In addition to AFP what marker will be elevated in heptocellular carcinoma? Alpha-1 antitrypsin 44. Give in order from most to least common the types of Viral hepatitis? A,B,C,D,E 45. Is there nutmeg liver in Portal hypertension No 46. Is there nutmeg liver in Budd-Chiari Yes 47. Cell that stores Vitamin A Ito cells 48. Which cell starts lying down fibrous tissue in cirrhosis? Ito cell 49. Will a patient with primary biliary cirrhosis present with jaundice? Not until very late in the disease 50. Two drugs that cause benign intrahepatic cholestsis? Oral contraceptives and anabolic steroids 51. In what age group are iron supplements contraindicated? Elderly 52. Is free copper and total copper increased or decreased in Wilson's Free copper= Increase Total copper= Decrease 53. What is Dupatron's contracture Contracture of the fingers due to fibrous tissue forming around the tendons due to increased estrogen in cirrhosis 54. Causal organism of sporadic peritonitis in a child? Strep pneumo 55. Causal organism of sporadic peritonitis in adults? E. Coli 56. First imaging study to order in any pathology of the pancreas? CT 57. First imaging study to order in gallbladder pathology? Ultrasound 58. Imaging shows C-sign on barium study of the abdomen- diagnosis? Pancreatic carcinoma in the head of the pancreas 59. True of false acute pancreatitis stop peristalsis in duodenum close to pancreas? True- this is localized ileus 60. Most common metabolic bone disease in annorexia? Osteoporosis 61. Acid/Base disturbance in a bulemic? Met. Alkalosis 62. Most common complication of obesity? Hypertension 63. Why does a child with Kwashikor have red hair? Copper deficiency 64. Excess Vit._____results in cerebral edema and hepatotoxicity? Vit. A 65. Breast milk lacks what 2 vitamins? D, K 66. What is the effect on p450 of phenytoin, alcohol, barbituates, and rifampin? Induce p450 67. What is the effect on Vit. D with increased p450 activity? Vit. D deficiency 68. How does Vit. E help prevent athrosclerosis? neutralizes oxidized LDL 69. Hemolytic anemia and neurological symptoms what is the diagnosis? Vit. E deficiency 70. What is the result in Vit. E toxicity? Bleeding due to lack of factors II, VII, IX, X, C,S 71. How does Vit. E decrease coagulation factors? Decreases the synthesis of coagulation factors, (does not inhibit epoxide reductase) 72. Most common cause of Vit. K deficiency? Antibiotics 73. How do you treat rat poison overdose? Vit. K injection (rat poison is essentially Warfarin) 74. What type of collagen is weak in Vit. C deficiency? Type 1 75. What type of kidney stone forms in Vit. C toxicity? Uric acid stones 76. What vitamin must you always give to patient in ER before giving glucose? B1 77. Co-factor for glutathione reductase B2 78. What is function of chromium? Glucose tolerence factor, allows insulin to do job 79. Chromium deficiency? Hyperglycemia and glucosuria refractory to insulin ,Peripheral neuropathy ,Encephalopathy, Hyperlipidemia 80. Copper deficiency? Hypochromic, microcytic anemia Neutropenia Osteopenia Depigmentation of skin & hair Skeletal abnormalities Neurologic abnormalities 81. Copper excess? Acute (rare): nausea, vomiting, diarrhea, epigastric abdominal pain, coma, oliguria, acute renal failure, hepatic necrosis, vascular collapse, and death Chronic: accumulates in liver (hepatic necrosis & cirrhosis), kidneys (renal failure), brain (neurologic disorders), & corneas 82. Fluoride deficiency? Contributes to dental caries 83. Fluoride excess? Acute, high dose (5-10 g)- death Chronic (years of 20-80 mg/day) - mottling of teeth, calcification of tendons & ligaments, exostoses, & increased 84. Iodine dificiency? Newborns - spontaneous abortions, stillbirths, congenital abnormalities, hypothyroidism, dwarfism, deafness & severe mental retardation (cretinism), increased perinatal and infant mortality, Adults - thyroid goiter & hypothyroidism, impaired mentation 85. Iodine excess? Chronic ingestion of large quantities can lead to hypothyroidism with goiter or hyperthyroidism 86. Iron deficiency? Most common nutrient deficiency in U.S. Microcytic, hypochromic anemia (causing tachycardia, fatigue, pallor, and altered mental and motor development) Glossitis Impaired temperature regulation in the cold Decreased resistance to infection 87. Iron excess? Cirrhosis Diabetes mellitus Hyperpigmentation (gray tinge) of the skin Other Fatigue Testicular atrophy & sterility Arthropathy Cardiac arrhythmias Hypothyroidism 88. Manganese deficiency? dermatitis and hypocholesterolemia 89. Manganese excess? Neurotoxicity 90. Molybdenum deficiency? amino acid intolerance, irritability, visual field defects, coma 91. Molybdenum excess? Excess of 10 to 15 g/day can cause gout-like syndrome with elevated serum molybdenum, uric acid, and xanthine oxidase 92. Selenium deficiency? muscular discomfort or weakness Cardiomyopathy 93. Selenium excess? Garlic smell to breath (from production of dimethylselenide in body and release from the lungs) Nausea and vomiting Abdominal pain Loss of hair & nails Tenderness & loss of fingernails Diarrhea 94. Zinc deficiency? Alopecia Skin rash of face, groins, hands, & feet Growth retardation Delayed sexual development Impaired wound healing & immune function Diarrhea Blunting of taste and smell 95. Zinc excess? Epigastric abdominal pain Nausea & vomiting Diarrhea Chronic (>20 mg/day orally) Decreased serum copper levels (hypocupremia) Microcytosis & neutropenia Reduced HDL cholesterol Impaired immune