Gastroenterology SMLE Review Notes

Vocabulary-style flashcards based on Gastroenterology SMLE review notes covering esophageal, gastric, hepatic, and intestinal disorders.

Dysphagia

Difficulty in swallowing, which can be caused by oropharyngeal neurological issues or esophageal lumen obstruction and motility disorders.

Odynophagia

Pain during the act of swallowing.

Heartburn

A condition where stomach contents are forced back up into the esophagus.

Plummer-Vinson syndrome

A syndrome characterized by the triad of dysphagia, iron deficiency anemia (IDA), and an esophageal web.

Diffuse esophageal spasm

A motility disorder presenting with chest pain relieved by Nitroglycerine or cold milk, showing a corkscrew appearance on barium swallow.

Achalasia

An esophageal motility disorder characterized by dysphagia to solids and liquids, regurgitation of undigested food, and a bird beak appearance on barium swallow.

Barrett’s esophagus

A pre-malignant condition where the normal squamous lining of the lower esophagus is replaced by columnar mucosa, potentially containing intestinal metaplasia.

H. pylori Non-invasive tests

Diagnostic methods including Serology, Urea breath test, and Fecal antigen test.

H. pylori Triple therapy

A treatment regimen consisting of a PPI, Clarithromycin, and either Amoxicillin or metronidazole for $14$ days.

Bismuth quadruple therapy

A treatment regimen for H. pylori consisting of bismuth, Tetracycline, Metronidazole, and a PPI for $14$ days.

Restrictive transfusion strategy

The practice of transfusing blood in UGIB only if $Hb < 7$ (unless the patient has cardiac comorbidities where the target is higher).

ALT/LDH ratio

A ratio used to differentiate AST/ALT elevations $> 1000$; a ratio $> 1.5$ suggests viral hepatitis, while $< 1.5$ suggests drug-induced injury or liver ischemia.

Wilson disease

A disorder of abnormal copper accumulation in the brain and liver, presenting with liver cirrhosis and neurological symptoms; treated with Penicillamine.

Hereditary Hemochromatosis

A primary iron overload disorder screened via fasting serum transferrin saturation and confirmed by genetic testing.

Non-alcoholic fatty liver disease (NAFLD)

Liver fat accumulation associated with obesity, insulin resistance, and type $2$ DM; treated with weight loss and Vitamin E (for non-diabetics).

Primary biliary cholangitis (PBC)

A female-predominant disease involving pruritis, high ALP, and positive anti-mitochondrial antibody (AMA).

Primary sclerosing cholangitis (PSC)

A male-predominant disease associated with ulcerative colitis, characterized by pruritis, high ALP, and a string of beads appearance on MRCP.

Serum Ascitic albumin gradient (SAAG)

Calculated as Serum Albumin - Ascitic Albumin; a value $> 1.1$ indicates causes like cirrhosis or cardiac ascites.

Spontaneous Bacterial Peritonitis (SBP)

An infection of ascitic fluid confirmed by a granulocyte count $> 250$, treated with IV Cefotaxime or Ceftriaxone.

Child-Pugh Classification

A scoring system for liver cirrhosis: Class A (well compensated, score $5$ to $6$), Class B (significant compromise, score $7$ to $9$), and Class C (decompensated, score $10$ to $15$).

Celiac disease

An immune-mediated reaction to gluten (wheat, rye, barley) resulting in flat mucosa, villous atrophy, and crypt hyperplasia on jejunal biopsy.

Dermatitis herpetiformis

An itchy, blistering skin rash that is a commonly associated diagnosis with celiac disease.

Crohn disease

An inflammatory bowel disease characterized by transmural involvement, skip lesions, and non-caseating granulomas, commonly affecting the terminal ileum.

Ulcerative colitis

An inflammatory bowel disease characterized by continuous distribution starting in the rectum, affecting the mucosa and submucosa, and presenting with bloody diarrhea.

Rome 4 criteria

Diagnostic criteria for IBS requiring recurrent abdominal pain at least $1$ day per week in the last $3$ months related to defecation or change in stool frequency/form.