Egyptian Board Gastroenterology & Hepatology flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Chicago Classification v4.0

High-resolution manometry scheme defining esophageal motility disorders by integrated relaxation pressure and distal contractile integral, diagnosing achalasia subtypes and esophagogastric junction outflow obstruction.

Barrett esophagus definition

Columnar-lined esophagus with intestinal metaplasia extending at least 1 cm above the gastroesophageal junction, requiring endoscopic surveillance intervals determined by dysplasia grade.

Los Angeles grade D

Reflux esophagitis with mucosal breaks involving at least 75% of the esophageal circumference, representing the most severe grade and predicting higher relapse risk.

H. pylori test-and-treat

Strategy using urea breath test or stool antigen to detect active infection in dyspeptic patients without alarm features, followed by eradication and confirmation testing.

Forrest classification

Endoscopic stigmata of peptic ulcer bleeding: Ia spurting, Ib oozing, IIa visible vessel, IIb adherent clot, IIc flat pigmented spot, III clean base; grades Ia-IIb need hemostasis.

Correa cascade

Stepwise gastric carcinogenesis from Helicobacter pylori chronic gastritis through atrophy, intestinal metaplasia, and dysplasia to intestinal-type adenocarcinoma.

Tissue transglutaminase IgA

Preferred serologic test for celiac disease; requires concurrent total IgA measurement because IgA deficiency causes false-negative results.

Marsh-Oberhuber grading

Histologic classification of celiac enteropathy ranging from intraepithelial lymphocytosis alone to total villous atrophy with crypt hyperplasia.

SeHCAT test

Nuclear medicine study measuring bile acid retention; retention below 10% at seven days supports bile acid diarrhea, which responds to bile acid sequestrants.

Travis criteria

Day-3 assessment after intravenous steroids in acute severe ulcerative colitis; more than eight stools or C-reactive protein above 45 mg/L predicts need for rescue therapy or colectomy.

Fecal calprotectin thresholds

Stool marker of neutrophilic inflammation; values below 50 micrograms per gram suggest mucosal healing, values above 250 suggest active inflammatory bowel disease.

Primary sclerosing cholangitis association

Chronic cholestatic disease with multifocal biliary strictures, strongly associated with ulcerative colitis and increased colorectal neoplasia risk requiring surveillance colonoscopy.

Adenoma surveillance interval

Follow-up colonoscopy timing based on polyp findings: three years for advanced neoplasia, seven to ten years for one or two small tubular adenomas.

Lynch syndrome screening

Universal tumor testing with mismatch repair immunohistochemistry or microsatellite instability, followed by germline testing, identifies hereditary nonpolyposis colorectal cancer.

Serum-ascites albumin gradient

Difference between serum and ascitic albumin; a value of 1.1 g/dL or greater indicates portal hypertension as the cause of ascites.

Spontaneous bacterial peritonitis

Ascitic fluid polymorphonuclear cell count of 250 per cubic millimeter or more, requiring prompt antibiotics, usually a third-generation cephalosporin plus albumin.

MELD 3.0

Liver transplant allocation score incorporating bilirubin, international normalized ratio, creatinine, sodium, albumin, and sex, replacing earlier MELD-Na versions.

LI-RADS 5

Multiphasic imaging category diagnostic of hepatocellular carcinoma in cirrhosis, showing arterial phase hyperenhancement with washout or capsule, obviating biopsy.

Gallstone pancreatitis management

Urgent endoscopic retrograde cholangiopancreatography for cholangitis or persistent obstruction, with cholecystectomy during the index admission for mild disease.

Autoimmune pancreatitis type 1

IgG4-related pancreatic disease with sausage-shaped pancreas and elevated IgG4, responding to corticosteroids; type 2 is linked to inflammatory bowel disease.

Glasgow-Blatchford score

Risk score using urea, hemoglobin, blood pressure, heart rate, and presentation features; a score of 1 or less identifies very low-risk upper gastrointestinal bleeding.

Ischemic colitis distribution

Segmental mucosal injury at watershed zones such as the splenic flexure and rectosigmoid; the rectum is usually spared because of dual collateral blood supply.

Post-ERCP pancreatitis prophylaxis

Rectal indomethacin plus aggressive intravenous hydration, with prophylactic pancreatic stent placement in high-risk patients, reduces pancreatitis after endoscopic retrograde cholangiopancreatography.

Adenoma detection rate

Quality metric for screening colonoscopy; target of at least 25 percent overall reflects adequate mucosal inspection and correlates with reduced interval colorectal cancer.

Refeeding syndrome

Hypophosphatemia, hypokalemia, and hypomagnesemia after reintroducing nutrition in malnourished patients; start low-calorie feeding and supplement thiamine before feeding.

Bariatric surgery thresholds

Body mass index of 35 or more with comorbidity, or 40 or more regardless of comorbidity, qualifies for metabolic and bariatric surgical evaluation.

Fidaxomicin first-line

Preferred treatment for initial Clostridioides difficile infection, associated with lower recurrence than vancomycin; vancomycin is an acceptable alternative.

Amebic liver abscess

Entamoeba histolytica infection of the liver with positive serology in most patients; treated with metronidazole followed by a luminal agent such as paromomycin.

Strongyloides hyperinfection

Disseminated Strongyloides stercoralis infection during corticosteroid therapy, causing gram-negative sepsis; screen and treat at-risk patients before immunosuppression.

Number needed to treat

Reciprocal of absolute risk reduction; estimates how many patients must receive an intervention to prevent one additional adverse outcome.

Likelihood ratio

Ratio of the probability of a test result in diseased versus nondiseased patients; unlike predictive values, it is independent of disease prevalence.

Informed consent elements

Capacity, adequate disclosure, comprehension, and voluntariness; delirium impairs capacity regardless of surrogate or family preference.