IBS, achalasia, gastroparesis, and GERD mechanisms and distinguishing features tested on USMLE Step 1.
35 cards · basic cards · AI-written, checked twice. Edit anything.
- What are the Rome IV criteria for diagnosing irritable bowel syndrome (IBS)?
Show answer
Recurrent abdominal pain at least 1 day/week in the last 3 months, associated with defecation, a change in stool frequency, or a change in stool form- What are the three main subtypes of IBS based on predominant stool pattern?
Show answer
IBS-C (constipation-predominant), IBS-D (diarrhea-predominant), and IBS-M (mixed)- Name three red flag symptoms that argue against a diagnosis of IBS and suggest another cause
Show answer
Weight loss, blood in stool, and nocturnal symptoms (waking from sleep with pain/diarrhea)- What is the proposed underlying pathophysiology of IBS?
Show answer
Visceral hypersensitivity and altered brain-gut signaling, without structural or biochemical abnormality- What is first-line treatment for constipation-predominant IBS (IBS-C)?
Show answer
Increased dietary fiber and osmotic laxatives; if inadequate, agents like linaclotide or lubiprostone- What is a first-line pharmacologic option for diarrhea-predominant IBS (IBS-D)?
Show answer
Loperamide- What is functional dyspepsia?
Show answer
Chronic upper abdominal discomfort or pain without an identifiable structural or biochemical cause on workup- What is achalasia?
Show answer
A motility disorder characterized by failure of lower esophageal sphincter (LES) relaxation and loss of esophageal peristalsis- What causes the LES dysfunction seen in primary achalasia?
Show answer
Degeneration of inhibitory neurons in the myenteric (Auerbach) plexus of the esophagus- What are the hallmark esophageal manometry findings in achalasia?
Show answer
Increased LES resting pressure, incomplete LES relaxation with swallowing, and aperistalsis of the esophageal body- What barium swallow finding is classic for achalasia?
Show answer
A 'bird-beak' (or 'rat-tail') tapering of the distal esophagus with proximal dilation- What infectious disease can cause secondary achalasia?
Show answer
Chagas disease, caused by Trypanosoma cruzi- Long-standing achalasia increases risk for which esophageal cancer?
Show answer
Squamous cell carcinoma of the esophagus- What are the main treatment options for achalasia?
Show answer
Pneumatic dilation, surgical Heller myotomy, or botulinum toxin injection into the LES- What is pseudoachalasia?
Show answer
A condition mimicking achalasia on manometry/imaging that is actually caused by malignancy infiltrating the gastroesophageal junction
FlashKeepers