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Internal Medicine Medical (MD/DO) School Study Aid


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Intestinal Disorders
34 Picmonics to Learn | 1 hr 1 min

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Crohn's Disease Assessment
Diarrhea
5-6 per day
Cramping Abdominal Pain
Fever
Weight Loss
Malabsorption
Anemia
Complications
Obstruction
Fistulas
2 mins
Crohn's Disease Characteristics
Terminal Ileum and Colon
Rectal Sparing
Transmural Inflammation
Granulomas
Skip Lesions
Cobblestone Mucosa
Fissures
Fistulas
Perianal Disease
Creeping Fat
Lymphoid Aggregates
String Sign on Barium Swallow
2 mins
Crohn's Symptoms and Associations
Diarrhea
Malabsorption
Bile-Wasting
Pigment Gallstones
Oxalate Kidney Stones
Ankylosing Spondylitis
Erythema Nodosum
Uveitis
Migratory Polyarthritis
2 mins
Ulcerative Colitis Characteristics
Autoimmune
Mucosal and Submucosal Only
Rectal Involvement
Stepwise Lesions
Friable Pseudopolyp
Crypt Abscess
Loss of Haustra
Lead Pipe Appearance
Bloody Diarrhea
2 mins
Ulcerative Colitis Associations
Associations
Toxic Megacolon
Colorectal Carcinoma
Anterior Uveitis
Pyoderma Gangrenosum
Ankylosing Spondylitis
Primary Sclerosing Cholangitis
P-ANCA
1 min
Diverticulosis and Diverticulitis Assessment
Diverticulosis
Outpouching
Diverticulitis
Inflamed Diverticula
Assessment
Abdominal Pain
Abdominal Distention
Flatulence
Fever
Rectal Bleeding
Alternating Constipation and Diarrhea
Considerations
Peritonitis
1 min
Diverticulosis and Diverticulitis Interventions
Interventions
High Fiber Diet
Reduce Intra-abdominal Pressure
Stool Softeners
Exercise
Anticholinergics
Considerations
Antibiotics
Bowel Resection
1 min
Appendicitis
Mechanism and Characteristics
Fecolith leading to obstruction and infection
Most commonly affects teenagers
Presentation
Initial peri-umbilical visceral pain
Subsequent somatic right lower quadrant pain
Diagnosis
Rebound tenderness
Positive psoas sign
Pain at McBurney's point
Leukocytosis
Fever
Treatment
Appendectomy
1 min
Acute Appendicitis Treatment
Diagnosis
Diagnosis by Clinical Impression
Further Imaging Studies Not Required
Treatment
Immediate Appendectomy
NPO
IV Fluids
Antibiotics
Perforation
Tertiary Intention
Antibiotics Until Afebrile
1 min
Peptic Ulcer Disease Assessment
Mechanism/Cause
Helicobacter Pylori
Increased Stomach Acid
Assessment
Abdominal Pain
Heartburn (Pyrosis)
Melena
Weight Changes
GI Distress
Considerations
Most Commonly in Duodenum
Duodenal: Pain Relieved by Eating
Gastric: Pain Caused by Eating
2 mins
Peptic Ulcer Disease Interventions
Combination Drug Therapy
Two Antibiotics
Proton Pump Inhibitor (PPI)
Decrease Acid Secretion
Avoid NSAIDs
Diet and Lifestyle Changes
1 min
Hemochromatosis Signs and Symptoms
Signs and Symptoms
Micronodular Cirrhosis
Hepatocellular Carcinoma
Diabetes
Bronze Skin Coloring
CHF
Arthropathy
Testicular Atrophy
Impotence
1 min
Hemochromatosis Pathophysiology
Pathophysiology
Hemosiderin Deposition
Autosomal Recessive
HLA-A3
Secondary to Transfusion Therapy
Increase Iron
Increase Ferritin
Increased Transferrin Saturation
1 min
Wilson's Disease Pathophysiology
Autosomal Recessive
Mutation in ATP7B gene
Chromosome 13
Decrease in Ceruloplasmin
Inadequate copper excretion
Liver
Brain
Kidney
Cornea
Joints
Treat with Penicillamine
1 min
Wilson's Disease Symptoms
Cirrhosis
Hepatocellular Carcinoma
Basal Ganglia Degeneration
Dementia
Dyskinesia
Asterixis
Kayser-Fleischer Rings
Slit Lamp Exam
Hemolytic Anemia
1 min
Carcinoid Syndrome
Pathophysiology
Neuroendocrine Cells
Serotonin
Appendix
Diagnosis
Chromogranin A
Neuron Specific Enolase
Dense Core Bodies on EM
Signs and Symptoms
Symptoms When Metastasize to Liver
Flushing
Wheezing
Right Heart Murmur
Diarrhea
3 mins
Colorectal Cancer Assessment
3rd Most Common Cancer
Assessment
Change in Bowel Habits
Bowel Obstruction
Rectal Bleeding
Anemia
Weight Loss
Ascites
Considerations
Colonoscopy
FOBT and FIT
1 min
Colorectal Cancer Interventions
Interventions
Surgical Colon Resection
Radiation
Chemotherapy
Considerations
Bowel Cleansing
Screening
Colostomy
Dietary Consult
Body Image
2 mins
Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer)
Characteristics
Autosomal Dominant
Defective DNA Mismatch Repair
80% Risk of Colon Cancer Development
Proximal (Right) Colon
Type II associated with Endometrial, Ovarian and Skin Cancers
3-2-1 Rule
3 Relatives with Colon Cancer
Occurs Across 2 Generations
1 Relative Diagnosed < 50 Years Old
Treatment
Frequent Screening
Colectomy
2 mins
Types of Hernias
Hiatal
Gastroesophageal Reflux Disease (GERD)
Inguinal
Men
Femoral
Women
Incisional
Umbilical
Consideration
Strangulation
1 min
Hernia Interventions
Reduce Intra Abdominal Pressure
Avoid Straining and Lifting
Open Mouth Sneezing
Excision
Herniorrhaphy
Hernioplasty
Consideration
Scrotal Support
1 min
Types of Intestinal Obstruction
Mechanical
Adhesions
Hernia
Volvulus
Intussusception
Tumor
Non-Mechanical
Mesenteric Artery Occlusion
Spinal Injury
Paralytic Ileus
2 mins
Intestinal Obstruction
Partial/Early Obstruction
Severe Abdominal Pain
Vomiting
High Pitched Bowel Sounds
Abdominal Distention
Increased Peristalsis
Total/Neurogenic Obstruction
Absent Bowel Sounds
Paralytic Ileus
1 min
Meckel's Diverticulum
Pathophysiology
True Diverticulum
Vitelline Duct
Yolk Stalk
Contain Ectopic Tissue
Pancreatic And Gastric Mucosa
Signs and Symptoms
Hemorrhage
Intussusceptions
Volvulus
Diagnosis
2 Feet From Ileocecal Valve
2 Inches Long
2% Population
First 2 Years Of Life
Pertechnetate T99
1 min
Hirschsprung Disease
Failure of Neuronal Crest Cell Migration
Involves Rectum
Lack of Auerbach and Meissner Plexus
Chronic Constipation
Failure to Pass Meconium
Congenital Megacolon
Increased Risk with Down Syndrome
1 min
Imperforate Anus
Mechanism
Congenital Anorectal Malformation
Signs and Symptoms
No Anal Opening
Absence of Meconium
Gradual Increase in Abdominal Distention
Considerations
Surgical Repair
Bowel Management
1 min
Whipple's Disease
Tropheryma Whipplei
Gram-Positive
Middle-aged, Caucasian men and Farmers
Malabsorption
Mesenteric Nodes
Arthralgias
Cardiac Symptoms
Neurologic Symptoms
PAS-positive Foamy Macrophages
1 min
Celiac Disease Diagnosis and Treatment
Diagnosis
Blunting of Intestinal Villi
Lymphocytes in Lamina Propria
Anti-gliadin Antibodies (IgA)
Anti-endomysial Antibodies (IgA)
Anti-tissue Transglutaminase Antibodies (IgA)
Treatment
Gluten-Free Diet
Corticosteroids
Dapsone
Complications
Intestinal Lymphoma
1 min
Celiac Disease Characteristics
Epidemiology
European Descent
HLA-DQ2
HLA-DQ8
Pathophysiology
Autoimmune-mediated Intolerance of Gliadin
Symptoms
Dermatitis Herpetiformis
Weight Loss
Failure to Thrive
Decreased Bone Density
Steatorrhea
Anemia
1 min
Fistula Causes
FRIEND Mnemonic
Foreign Body
Radiation
Inflammation or Infection
Epithelialization
Neoplasm
Distal Obstruction
1 min
Mesenteric Ischemia
Signs and Symptoms
Severe Abdominal Pain
Bloody Diarrhea
Metabolic Acidosis
Diagnosis
Increased WBC
Increased Lactate (Lactic Acid)
X-ray
Air Within Bowel Wall
CT Angiography
Bowel Wall Edema
Treatment
Antibiotics
Emergent Surgical Intervention
2 mins
Irritable Bowel Syndrome (IBS) Assessment
Abdominal Pain
Relieved by Defecation
Alternating Diarrhea and Constipation
Fatigue
Excessive Flatulence
Sensation of Incomplete Evacuation
Considerations
Stressors
Food Intolerances
More Common in Women
Rule Out Other Disorders
1 min
Irritable Bowel Syndrome (IBS) Interventions
Interventions
Identify Triggers
Increase Fiber Intake
Probiotics
Anticholinergics
Tricyclic Antidepressants (TCAs)
Loperamide
Linaclotide
Medications for Women
Tegaserod (Zelnorm)
Lubiprostone (Amitiza)
Alosetron (Lotronex)
1 min
Peutz-Jeghers Syndrome
Mechanism and Characteristics
Symptomatic Age: 10-30 Years
LKB1/STK11 Gene Mutation
Autosomal Dominant
Signs and Symptoms
Benign GI Hamartomatous Polyps
Mucocutaneous Hyperpigmentation
Positive Family History
Increased Risk of Colorectal Carcinoma
1 min

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