GI Boards High-Yield Vocabulary Flashcards

High-yield board review flashcards covering key GI concepts in Esophagus, Liver, Pancreas, Small Bowel, IBD, Colon, Infections, Nutrition, and Pharmacology.

Achalasia (Manometric Definition)

Elevated integrated relaxation pressure (IRP) with absent normal peristalsis.

Achalasia Type I Pattern

Elevated IRP, 100% failed peristalsis, and no significant panesophageal pressurization.

Achalasia Type II Pattern

Elevated IRP, 100% failed peristalsis, with panesophageal pressurization in at least 20% of swallows.

Achalasia Type III Pattern

Elevated IRP with premature/spastic contractions in at least 20% of swallows and no normal peristalsis.

EGJ Outflow Obstruction

Requires excluding mechanical obstruction and secondary causes before LES-directed therapy; supportive testing includes timed barium esophagram and/or FLIP.

Zenker Diverticulum (Best Initial Study)

Barium esophagram/swallow study.

Functional Defecation Disorder

Characterized by inappropriate/paradoxical pelvic floor contraction or inadequate relaxation during attempted defecation, assessed with anorectal testing.

Dyssynergic Defecation (First-Line Treatment)

Pelvic-floor biofeedback therapy.

Ineffective Esophageal Motility (Peristaltic Reserve)

Intact peristaltic reserve predicts a lower likelihood of postoperative dysphagia after fundoplication compared to absent reserve.

Systemic Sclerosis (Esophageal Pattern)

Weak/absent distal peristalsis with hypotensive lower esophageal sphincter (LES), predisposing to reflux.

Buspirone (Gastric Function Effect)

Improves fundic accommodation and may reduce postprandial dyspeptic symptoms in selected patients.

Large Esophageal Varices Primary Prophylaxis

Nonselective beta blocker (including carvedilol in appropriate patients) OR endoscopic variceal ligation.

Acute Variceal Bleed Secondary Prophylaxis

Nonselective beta blocker plus serial endoscopic variceal ligation; consider TIPS for failure/rebleeding or selected high-risk cases.

Hepatic Encephalopathy (First-Line Therapy)

Lactulose titrated to clinical response; add rifaximin for recurrent episodes.

Cirrhosis HVPG Pattern

Increased wedged hepatic venous pressure with relatively normal free hepatic venous pressure, producing an elevated hepatic venous pressure gradient (HVPG).

Prehepatic Portal Hypertension (e.g., PVT) HVPG

Often normal HVPG because the pressure block is upstream of the hepatic sinusoids.

Posthepatic Congestion / Right-Heart Failure HVPG

Both free and wedged hepatic venous pressures can be elevated, with HVPG often remaining normal.

Primary Biliary Cholangitis (First-Line Treatment)

Ursodeoxycholic acid (UDCA).

Hereditary Hemochromatosis Treatment

Therapeutic phlebotomy when iron overload is present.

Hepcidin

Liver-produced hormone that decreases intestinal iron absorption and iron release from macrophages by causing ferroportin internalization/degradation.

Acute Fatty Liver of Pregnancy (AFLP) Fetal Defect

Associated with fetal defects in mitochondrial fatty-acid oxidation, classically long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD).

HELLP Syndrome

Acronym for Hemolysis, Elevated Liver enzymes, Low Platelets; definitive treatment is delivery with obstetric stabilization.

Wilson Disease Treatment

Copper chelation (e.g., trientine or D-penicillamine) and/or zinc to reduce copper absorption; fulminant cases require urgent liver transplantation evaluation.

Hepatocellular Carcinoma (HCC Imaging Hallmark)

Arterial phase hyperenhancement with portal/delayed washout on imaging in an at-risk patient.

Acute Cellular Rejection (Liver Transplant Histology)

Histologic triad of portal inflammation, bile duct injury/ductulitis, and venous endotheliitis.

Chronic Liver Allograft Rejection

Manifests as progressive cholestasis with ductopenia/vanishing bile ducts and vascular changes.

Biliary Anastomotic Stricture Post-Transplant

Managed endoscopically via ERCP with balloon dilation plus temporary stenting.

Fecal Elastase

Test used primarily to assess exocrine pancreatic insufficiency, not to diagnose chronic pancreatitis itself.

CFTR Function in Pancreatic Ducts

Promotes chloride/bicarbonate-rich fluid secretion; bicarbonate neutralizes gastric acid in the duodenum.

Pancreaticopleural Fistula

Characterized by a large recurrent pleural effusion with very high pleural-fluid amylase in a patient with pancreatic disease.

Charcot Triad

Fever, right-upper-quadrant pain, and jaundice.

Reynolds Pentad

Charcot triad (fever, RUQ pain, jaundice) plus hypotension and altered mental status.

Type III Choledochocele

Intraduodenal dilation of the distal common bile duct.

Type 1 Bile-Acid Diarrhea

Malabsorption secondary to ileal disease or resection causing impaired bile-acid reabsorption.

Fecal Alpha-1 Antitrypsin Clearance

Screening test for protein-losing enteropathy.

Collagenous Sprue

Histologically shows villous atrophy with a thickened subepithelial collagen band.

Teduglutide

A GLP-2 analog that promotes intestinal adaptation in selected short-bowel syndrome patients dependent on parenteral support.

Migrating Motor Complex (MMC)

Fasting motor activity that sweeps residual contents through the stomach and small bowel; disrupted by feeding.

Budesonide in Crohn Disease

Induction therapy for selected mild-to-moderate ileocecal disease; not appropriate for long-term maintenance.

Sulfasalazine Male Fertility Effect

Causes reversible oligospermia/reduced sperm function; switching to mesalamine resolves the issue.

Forrest III Peptic Ulcer

Clean-based ulcer with low rebleeding risk; endoscopic hemostatic therapy is not indicated.

Sigmoid Volvulus (Management)

Without ischemia/peritonitis: initial endoscopic detorsion/decompression followed by elective sigmoid colectomy. With ischemia/peritonitis: urgent surgery.

Acute Colonic Pseudo-Obstruction (Ogilvie)

Managed initially with conservative care; escalate to neostigmine or colonoscopic decompression if persistent or high risk.

Shiga Toxin-Producing E. coli (STEC) Complication

Hemolytic uremic syndrome (HUS), characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury.

Yersinia enterocolitica

Causes terminal ileitis/mesenteric adenitis mimicking appendicitis or Crohn disease; severe infection risk increases with iron overload.

Pellagra

Niacin deficiency syndrome characterized by dermatitis, diarrhea, and dementia (and death if untreated).

Zinc Deficiency Manifestations

Dermatitis, alopecia, dysgeusia, impaired wound healing, immune dysfunction, and hypogonadism/growth impairment.

Orlistat Mechanism

Inhibits gastric and pancreatic lipases to reduce dietary fat absorption.

Hereditary Diffuse Gastric Cancer Genes

Most commonly CDH1; CTNNA1 is another associated gene.

Pernicious Anemia

Autoimmune atrophic gastritis causing loss of parietal cells, reduced intrinsic factor, and B12 malabsorption; increases risk of gastric adenocarcinoma and type I gastric NETs.

Long-Term PPI Symptomatic Hypomagnesemia

Can present with weakness, cramps, tremor, seizures, or arrhythmias.

Eluxadoline Contraindications

Patients without a gallbladder, biliary obstruction/sphincter of Oddi disease, pancreatitis risk, severe liver disease, or significant alcohol use.