Easy to remember concepts in Gastroenterology

1. Halitosis is noticed in Zenker’s diverticulum. Ba swallow screens and EGD confirms. Tip: Junk smell
2. Eosinophilic Esophagitis shows Crepe paper sign. Six food elimination diet is used.
3. In Cirrhosis, gastric varices occur first and then gastric varices may develop. In splenic vein thrombosis, Only Gastric varices develop.
4. Patient has Pain, Fever, Jaundice [PFJ]=Acute Cholangitis. Treat with Zosyn.
5. UC-PSC. Ulcerative Colitis patients can develop Primary Sclerosing Cholangitis. Concentric fibrosis around bile ducts is seen.
6. Ig G4 elevated in Autoimmune pancreatitis.
7. BUN-Prognostic factor in Acute pancreatitis.
8. Pancreatic cyst worrisome features on CT scan: Size more than 3 cm, Solid components, Dilated duct more than 1cm and thickening of cyst. Do EUS FNA if more than 2 worrisome features. Resect if confirmed.
9. IBM wakes up at night with diarrhea. IBS does not dump at night.
   1. IBD, Bacterial overgrowth and Microscopic colitis wake up patient at night with diarrhea.
   2. IBS and Dumping syndrome do not wake patient up at night.
10. Osmotic Gap is high [>50] in Osmotic diarrhea. Lactulose, Sorbitol, Mg salts, Malabsorption, lactase deficiency etc. cause this. Stool Osmotic Gap=Stool osmolarity-[Na + K] X2.
11. Remember CheeseList. If patient develops diarrhea, fever, and confusion after eating soft cheeses, it could be due to Listeria.
12. Vibrio Cipro. If patient develops diarrhea after eating sea food, most likely it’s caused by vibrio parahemolyticus [comma shaped, Gr-]. Treat with Cipro.
13. Celia is a Trans. Anti-tissue transglutaminase Abs are present in Celiac sprue.
14. Yersinia Enterocolitica resembles Acute Appendicitis with RLQ pain, fever and diarrhea.
15. D-Xylose test is abnormal in Lymphatic and Mucosal malabsorption states.
16. Thumb printing can be seen in both Toxic Megacolon and Ischemic Colitis.
17. Angiography is done is Acute Mesenteric Ischemia and Angiogram is done is Chronic Mesenteric Ischemia.
18. Herpes and Hep B viruses are DNA viruses.
19. 95% of patients with Hep B infection clear it. Only 15% of those infected with Hep C clear it.
20. Asma aimed at signing AMA publicly. LOL.
    1. ASMA [Anti Smooth Muscle Abs] are seen in Auto Immune Hepatitis. Piecemeal necrosis of hepatocytes is seen.
    2. AMA [Anti Mitochondrial Abs] are seen in PBC [Primary Biliary Cirrhosis]. Lymphocytic destruction of bile ducts is seen.
21. Wilson urinates Copper. So, Serum Copper is low in Wilson’s disease.

Please remember that these are not actual exam questions. These just help to make your exam preparation easy adding one by one concept to your memory.