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Step 3 and Residency Flashcards > Aaron: GI > Flashcards

Aaron: GI Flashcards

1
Q

Epigastric pain plus or minus N/V, epigastric fullness, heartburn is what?

A

dyspepsia

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2
Q

Dyspepsia plus NSAID use, gastric or esophageal cancer, what should be evaluated?

A

H.Pylori possible gastritis

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3
Q

Copious bloody stools, hemodynamically stable, next step?

Copious bloody stools, hemodynamically unstable, next step?

Patient is 68 years old, reliable historian

A

Stable: Colonoscopy first

Unstable: Resuscitate, then EGD

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4
Q

What type of GI bleed is suggested by the following?

Elevated BUN/CR ratio, hemodynamic compromise, NG aspirate has blood?

A

Upper GI bleed

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5
Q

Bloody diarrhea, young female, what is the first thing to rule out?

A

Infection

Look at stool culture

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6
Q

Young female (15-30), bloody diarrhea, waxing and waning course, fever, and weight loss?

Not food or travel

A

Irritable Bowel Syndrome

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7
Q

Recent Variceal bleeding, admitted for work up, what is the most common complication?

History of ascites and cirrhosis

A

Spontaneous Bacterial Peritonitis

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8
Q

Young female
weight loss, shin pain, abdominal pain, no fever or night sweats
Vitiligo
Anemia, hypocalcemia

What could I be?

A

Celiac’s Disease

anti-tissue transglutaminase antibody test

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9
Q 
Stable vital signs
Unresponsive
Sudden bloody vomiting
Active alcohol use
Next best step?
A

Intubate patient
Stabilize patient
Endoscopy

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10
Q

What platelet level indicates a transfusion?

A

less than 50,000 platelets

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11
Q

Systemic Sclerosis would show what type of esophageal motility?

A

hypomotility not random unsynchronized contractions

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12
Q

What type tests can evaluate chronic pancreatitis?

A

MRCP and Abdominal CT

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13
Q

If I have Hypertriglyceridemia induced pancreatitis, what is the best long-term therapy to use?

A

Fibrates, help lower triglycerides, cholesterol is lowered by -statins

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14
Q

What drug/hormone can be used to help move triglycerides in genetic induced hypertriglyceridemia?

A

Insulin, works through lipoprotein lipase activation

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15
Q

Assuming I have a 1st degree relative with colon cancer, when does the colonoscopy screening start?

A

40 years old or 10 years earlier of first-degree family member’s age

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16
Q

If there is a strong likelihood of pancreatitis, what is the next best test?

Assuming the patient has very bad abdominal pain, that gets better when they lean forward

A

Blood drawn for lipase levels

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17
Q

Chronic diarrhea is longer than how many weeks? Assuming there is a long period of diarrhea, no blood or fever, what is the next best step?

A

4 weeks

Look at stool microscopy, electrolytes, and fat content

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18
Q

A patient has long term diarrhea, hypothyroidism, with a high TSH, what is the underlying issue?

A

Poor medication absorption

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19
Q

If an alcoholic has pancreatic cancer, what needs to be there?

If not, but persistent abdominal pain, then what?

A

Weight loss, fever, night sweats, and anorexia

Think Pancreatic Pseudocysts

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20
Q

Isolated bleeding 2/2 gastric varices alone is code for what?

A

Splenic Vein Thrombosis, portal HTN, ascites, and congestive Splenomegaly

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21
Q

Intestinal Malabsorption, iron deficiency anemia, and diarrhea should trigger what thinking?

A

Celiac’s disease

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22
Q

Dyspepsia under 60 is what treatment, over 60 years old is what treatment?

A

Over 60 is endoscopy
Under 60 is H. pylori testing

Look for alarm symptoms (weight loss, anemia, or difficulty swallowing or dyspepsia)

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23
Q

MELD score is a 90-day mortality prognosis calculator, what are the five components?

A 
Bilirubin
INR
Serum Creatinine
Sodium
Dialysis 2x a week
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24
Q

Angiodysplasia has cherry red lesions that can cause GI bleeding. What are other disease associations?

A

ESRD especially uremia
Aortic Stenosis
vWD

25
Q

Dyspepsia alarm symptoms are what?

A 
Persistent vomiting
Progressive Dysphagia
Palpable Lymphadenopathy
Iron Deficiency anemia
Family History of GI Malignancy
26
Q

A patient has a perforated esophagus, Boerhave Syndrome, what is the first test that should be done?

A

Esophagogram with water soluble contrast, not Upper GI endoscopy (can cause further perforation)

27
Q

Toxic Megacolon, what is the first treatment step, before surgical consultation?

A

Steroids

28
Q

Toxic Megacolon, what medications should be avoided?

A

Sulfasalazine, opiates, and anti-cholinergic are contraindicated, they slow peristalsis

29
Q

Bile Salt induced diarrhea, post cholecystectomy or short bowel syndrome (illeal dissection) should be given what medication?

A

Cholestyramine

30
Q

Mental impaired women, constipation, decreased anal sphincter tone, what is the next step?

A

Manual disimpaction and enema

31
Q

Barret’s Esophagus is a pre-malignant condition, that does not cause what?

A

dysphagia (difficulty swallowing)

32
Q

Diverticular Bleeding with a history of diverticulosis is usually caused by what?

Patient also has painless hematochezia

A

Eroded small colon artery

33
Q

Post prandial fullness, succession splash on examination, type 1 DM (HbA1C = 8.4), what is the most likely diagnosis?

A

Gastric Paresis, advise small volume meals

34
Q

LARGE volume diarrhea right after meals, no blood in stool, no bowel tenderness, what is the most likely culprit?

A

Lactose Deficiency

35
Q

Hemodialysis can cause what kind of colon issues?

What are the pathological samples?

A

Colonic Ischemia, CT scan (colonic wall thickening, fat stranding)

Bloody Diarrhea (Salmonella and C. Diff are usually watery, not always bloody)

36
Q

If a first degree relative has colon cancer, colonoscopy is every ___ years (under 60 years old)? If the first degree relative is over 60 years old, the screening is every ____ years?

A

5 years

10 years

37
Q

How long do ulcerative colitis patients need to wait for colonoscopy screening?

A

8-10 years, then every 1-3 years

38
Q

Anti-smooth muscle antibodies are associated with what?

A

Type 1 autoimmune hepatitis

39
Q

Hemochromatosis diagnosis needs what lab tests?

A

Ferritin and Transferrin saturation

40
Q

Wilson’s Disease diagnosis needs what lab tests?

A

low serum ceruloplasmin

41
Q 
What disease am I?
Diabetes Mellitus
Hyperpigmentation
Arthropathy
Cardiomyopathy
A

Hemochromatosis

42
Q

Elevated SAAG (>1.1) indicates what?

Low SAAG (<1.1) indicates what?

A

Portal Hypertension

Non-portal Hypertension

43
Q

Cirrhosis, heart failure, Budd-Chiari Syndrome are high or low SAAG?

A

High SAAG, portal hypertension

44
Q

Peritonitis (TB), cancer, pancreatitis, trauma, or nephrotic syndrome are high or low SAAG?

A

Low SAAG, non-portal hypertension

45
Q

Systemic Sclerosis can cause pulmonary problems, how can they be identified?

A

PFT (pulmonary function testing), look out for interstitial lung disease here

46
Q

Painless rectal bleeding, colon problems, what is this a not so common cause?

A

Angiodysplasia

47
Q

C. Diff patients can have what on colonoscopy?

A

Pseudomembranes, raised yellow/off-white plaques scattered over the colonic mucosa

48
Q

If I have an active Hep B infection, and I have a negative Hep A IgM and IgG, what should I do?

A

Give a Hep A vaccine

49
Q

Post Gastrectomy, a patient has a lot of diarrhea, what dietary changes could/should be made?

A

High Protein Diet

This is dumping syndrome

50
Q

Standard H. Pylori triple therapy is what?

A

PPI
Amoxicillin
Clarithromycin

51
Q

A patient with a first degree relative and colon cancer should receive screening when?

A

Age 40 or 10 years earlier than the family member that was diagnosed. Assuming under the age of 60-year-old

52
Q

If acute diverticulitis is not relieved in 2-3 days what should be done next?

A

A repeat CT scan

53
Q

What is the proper enteral feeding ratio?

Assuming a normal BMI and no underlying problems

A

30 kcal/kg, 1 g/kg of protein

54
Q

Budd Chiari has congestion in what part of the liver?

A

Hepatic Veins not Portal Veins

55
Q

Scleroderma can cause small intestinal bacterial overgrowth. What test helps determines if this is true or not?

A

Carbohydrate Breath Test

56
Q

Gastroparesis via diabetes mellitus is due to what gastric pathology?

A

Decreased Gastric Pacemaker activity

57
Q

Portal Vein Thrombosis will cause what kind of varices?

Splenic vein thrombosis will cause what kind of varices?

A

Esophageal Varices

Gastric Fundus Varices

58
Q

Antimitochondrial antibodies are needed for PBC, what other lab test should you look at?

A

Alkaline Phosphatase

59
Q

What three drugs cause drug induced SLE?

A

Procainamide
Hydralazine
Isoniazid

Lab tests: Anti-nuclear, anti-histones antibodies

Step 3 and Residency Flashcards (19 decks)

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