GI & Hepatic Disorders Review

A comprehensive set of question-and-answer flashcards covering gastrointestinal and hepatic disorders, their clinical features, causes, and treatments.

What causes GERD?

Decreased tone or dysfunction of the lower esophageal sphincter (LES).

What are common GERD triggers?

Alcohol, chocolate, coffee, fatty foods, nicotine, obesity, pregnancy, and certain medications.

What is the pathophysiology of GERD?

Chronic acid exposure damages the esophageal lining, leading to erosion, ulcers, and Barrett's esophagus (cancer risk).

What are typical GERD symptoms?

Heartburn, epigastric pain, regurgitation, dysphagia, cough, asthma, and pneumonia.

How is GERD treated?

Lifestyle changes, proton-pump inhibitors (PPIs), H2 blockers, antacids, and surgery (fundoplication).

What is a hiatal hernia?

Protrusion of the stomach through the diaphragm; may be sliding or paraesophageal type.

What are hiatal hernia symptoms and treatment?

Belching, chest pain, GERD-like symptoms; managed similarly to GERD.

What is irritable bowel syndrome (IBS)?

A functional GI disorder characterized by abdominal pain and changes in bowel habits.

What are common IBS symptoms?

Abdominal pain, bloating, altered bowel habits (constipation and/or diarrhea), anxiety, and depression.

How is IBS treated?

Dietary modifications, stress reduction, fiber supplements, antidiarrheals, and antispasmodics.

What is nonalcoholic fatty liver disease (NAFLD)?

Accumulation of fat in the liver in the absence of significant alcohol use.

What is nonalcoholic steatohepatitis (NASH)?

Fatty liver with inflammation that can progress to fibrosis and cirrhosis.

What is alcoholic liver disease?

Liver injury from chronic alcohol use, ranging from fatty liver to cirrhosis.

What are signs of alcoholic hepatitis?

Right upper-quadrant pain, jaundice, fever, and hepatomegaly.

What are alcohol withdrawal symptoms?

Tremors, agitation, seizures, and delirium tremens.

How is alcohol withdrawal treated?

Supportive care, benzodiazepines, intravenous fluids, and vitamin supplementation.

What is peptic ulcer disease (PUD)?

Ulceration of the stomach or duodenum, commonly due to H. pylori infection or NSAID use.

What are classic PUD symptoms?

Burning epigastric pain that is worse on an empty stomach.

How is PUD treated?

PPIs, antibiotics for H. pylori, and avoidance of NSAIDs.

What is Crohn's disease?

Transmural inflammation with skip lesions that can affect any part of the GI tract.

What is ulcerative colitis?

Continuous mucosal inflammation limited to the colon and rectum.

How is inflammatory bowel disease (IBD) managed?

5-aminosalicylic acid (5-ASA) drugs, corticosteroids, immunomodulators, and biologic agents.

What is appendicitis?

Inflammation of the appendix, usually due to luminal obstruction.

What are appendicitis symptoms?

Periumbilical pain migrating to the right lower quadrant, rebound tenderness, and fever.

What is pancreatitis?

Inflammation of the pancreas, which can be acute or chronic.

What are common causes of pancreatitis?

Gallstones, alcohol use, abdominal trauma, and hyperlipidemia.

What are typical pancreatitis symptoms?

Severe epigastric pain radiating to the back, nausea, and vomiting.

How is acute pancreatitis treated?

NPO status, aggressive intravenous fluids, and pain control.

What is hepatitis?

Inflammation of the liver caused by viruses, alcohol, or drugs.

How is hepatitis A transmitted and prevented?

Fecal-oral route; vaccination provides prevention.

How are hepatitis B and C transmitted?

Blood exposure and sexual contact; vaccine available for B but not for C.

What is cirrhosis?

End-stage liver disease characterized by fibrosis and loss of normal liver architecture.

What are common complications of cirrhosis?

Portal hypertension, ascites, hepatic encephalopathy, and variceal bleeding.

What is hepatic encephalopathy?

CNS dysfunction due to liver failure causing ammonia accumulation.

What are signs of hepatic encephalopathy?

Confusion and asterixis (flapping tremor).

What are characteristic skin signs of liver failure?

Jaundice, spider angiomas, and palmar erythema.

What is diverticulosis?

Asymptomatic outpouchings of the colonic wall.

What is diverticulitis?

Inflammation or infection of diverticula causing left lower-quadrant pain and fever.

How is diverticulitis treated?

NPO status, antibiotics, and intravenous fluids.

What are current colorectal cancer screening guidelines?

Colonoscopy every 10 years starting at age 45–50 in average-risk individuals.

What is small bowel obstruction (SBO)?

Mechanical blockage of the small intestine causing distension and vomiting.

How is an SBO managed?

NPO status, nasogastric tube decompression, IV fluids, and possible surgery.

What is large bowel obstruction (LBO)?

Blockage of the large intestine, often due to cancer or volvulus.

What are typical LBO symptoms?

Gradual abdominal distension, constipation, and less frequent vomiting.

What is a volvulus?

Twisting of the intestine leading to obstruction and potential ischemia.

What is intussusception?

Telescoping of one bowel segment into another, most common in children.

What is celiac disease?

Autoimmune response to gluten resulting in small-intestinal villous atrophy.

What are common celiac disease symptoms?

Chronic diarrhea, bloating, and malabsorption.

How is celiac disease diagnosed?

Positive tissue transglutaminase (tTG) antibodies and confirmatory intestinal biopsy.

What is the treatment for celiac disease?

Strict lifelong gluten-free diet.

What are hemorrhoids?

Swollen veins in the rectum or anus that can cause pain or rectal bleeding.

What is an anal fissure?

A tear in the anal mucosa causing severe pain and bright red bleeding with defecation.

What is an anal fistula?

An abnormal tract between the anal canal and perianal skin.

What is anal cancer?

Malignancy often related to HPV infection, presenting with bleeding and pain.

What is hepatocellular carcinoma (HCC)?

Primary liver cancer associated with chronic hepatitis B, hepatitis C, or cirrhosis.

How is hepatocellular carcinoma treated?

Surgical resection, liver transplantation, or local ablative therapies.

What is gallstone disease?

Formation of cholesterol stones in the gallbladder causing right upper-quadrant pain.

What is cholecystitis?

Inflammation of the gallbladder, usually due to gallstones obstructing the cystic duct.

What are signs of cholecystitis?

Murphy's sign, right upper-quadrant pain, and fever.

What is cholangitis?

Bacterial infection of the biliary ducts secondary to obstruction.

What is Charcot's triad for cholangitis?

Right upper-quadrant pain, jaundice, and fever.

What is primary sclerosing cholangitis (PSC)?

Autoimmune-mediated fibrosis of intra- and extrahepatic bile ducts, often associated with ulcerative colitis.

What is cholangiocarcinoma?

Aggressive, rare cancer of the bile ducts.

What is pancreatic cancer?

Highly aggressive tumor of the pancreas that often presents with painless jaundice.

Malignant Melanoma

• most deadly skin cancer

• Tx: excision, immunotherapy.

• use: ABCDE

Basal cell carcinoma

• pearly papule with telangiectasias

• Tx: excision, rarely metastasizes

Squamous cell carcinoma

• red scaly patch, lips/ears = aggressive

• Tx: excision

Sx of cirrhosis

jaundice, ascites, variceal bleeding, encephalopathy, spider angiomas, gynecomastia wasting.

Tx of cirrhosis

avoid hepatotoxins, manage complications, and get liver transplants

Sx of diverticulitis

LLQ pain, fever, tachycardia, nausea, occult blood

Ulcerative Colitis

Patho:

Affects mucosa & submucosa only

Crypt abscesses, goblet cell loss,

pseudopolyps from granulationtissue

Severe cases → toxic megacolon,

dilation, infarction, perforation

Longstanding UC ↑ colon cancer

risk (especially with early onset)

Symptoms (relapsing/remitting):

Bloody diarrhea (often >20/day),

colicky pain, urgency, tenesmus,

weight loss, anemia, dehydration.

Dx:

Colonoscopy + biopsy (shows

continuous inflammation,

pseudopolyps)

Tx:

Topical 5-ASA (enema/suppository)

first-line

Oral 5-ASA for maintenance

Corticosteroids for flares

Immunomodulators/biologics if

refractory

Complications:

Toxic megacolon, colon cancer,

venous thromboembolism,

osteoporosis (from steroids)

Sx and Tx of Crohn’s Disease

Sx: Abdominal distention, sharp cramping pain, nausea, vomiting,

dehydration, and electrolyte loss.

Tx: NG tube for decompression IV fluids for hydration

Pain meds, antiemetics, antibiotics

Most partial: medical management

Complete: often needs surgery

Barrett's esophagus

(squamous to columnar cell change in esophagus)

→ ↑ cancer risk

Causes: Perforated ulcer, appendicitis, bowel obstruction, ischemic bowel,

gallbladder rupture, or liver injury.

Types:Primary: No perforation

Secondary: From perforation, trauma,

or nearby infection

Sx (Classic Triad):Abdominal pain

worsened by movement/cough, Abdominal rigidity, Rebound tenderness

Tachycardia, tachypnea, clammy skin, oliguria, decreased bowel sounds,

hypotension, fever, shock

Tx:IV fluids, broad-spectrum IV antibiotics, NG tube decompression, peritoneal lavage, abscess drainage (surgical or percutaneous)

What is Peritonitis?

Inflammation of the peritoneum due to infection or leakage of Gl contents into the sterile abdomina