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GI II Exam 1 > CIS7 > Flashcards

CIS7 Flashcards

1
Q

RUQ US

A

GB etiology

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2
Q

ECRP (Endoscopic Retrograde Cholangiopancreatography)

A

GB etiology if the common bile duct is blocked => which can lead to ascending cholangitis

shows a dilated CBD

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3
Q

ECG

A

MI

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4
Q

FOBT

A
  • screen for colon cancer
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5
Q

Urine antigen

A

pneumonia (strep and legionnarie)

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6
Q

Hydrogen breath test

A

lactate deficiency (lactose intolerance)

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7
Q

Fecal antigen

A

H.pylori

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8
Q

what can lead to esophgeal perforation

2 things we can see in PE

A

Boerhaves, (spontanous transmural tear that follows chronic throwing up)

PE: subQ emphysema, Hamans sign

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9
Q

H.pylori can leads to what 2 cancers

A

MALToma

gastric adenocarcinoma

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10
Q

secondary achalasia is caused by

A

chagas = trypanaoma cruzi

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11
Q

Acute cholecytisits

where is the stone
PE
labs
imaging
complications
A

PE = murphys sign

Imaging: RUQ US = acoustic shadow, GB wall thickening, sonographic murphys sign, fluid around GB
if plain film = not all will show.

Labs: increase bilirubin, leukocytosis, ALP

Complication: perforation, emphysematous cholecystasisis = seen in uncontrolled DB

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12
Q

Cholodocolithiasis

where is the stone
labs
imaging
complications

A
  • CBD
  • proximal stone = back up into GB and liver ( high AST/ ALT, bilibubin, lipase and amylase, leukocytosis)
  • distal (lipase and amylase)

Imaging = Emergent ECRP with sphinectomy and removal of stone; Abdominal US (Dilated CBD);

complication: ascending cholantitis

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13
Q

before doing an ECRP, we want to do what?

A

CHECK COAGULATION: INR

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14
Q

acholic stools =

A

acute hepatitis

can lead to tea colored urine

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15
Q

coffee ground emesis

A

PUD; increase risk with gastric bypass

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16
Q

olgavie syndrome

A

sponantous pseudoobstruction in colon in ICU patients

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17
Q

burn patient + NG tube + coffee ground emesis + mild anemia

A

curling ulcer

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18
Q

burn ICU patient with high ALP, WBC, AST, lipase

A

acute acholescytis

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19
Q

Charcots triad

A

RUQ pain + fever chills + janducice

ascending cholangitis =>

if + AMS + hyptoension => endoscopic MRGC

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20
Q

before any invasive study we need rto do what

A

Check INR (cogaulation)

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21
Q

emergent cholectesctomy

A

perform in acute cholecytisis

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22
Q

serial troponins

A

ECG + check every 6 hours if MI is suspected

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23
Q

Reynauds triad

A

if + AMS + hyptoension => endoscopic MRGC

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24
Q

In a patient with ascending cholangitis + Reynauds pentatd, what is the most common diagnostic study

A

blood cultures => before ABX

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25
check when Fasting lipid panal
acute pancreatitis bc we get hyperglycemia
26
check Tylenol level
acute liver failure/ acute hepatitis (really high AST/ALT)
27
check ammonia levels
hepatic encephalopthy (cirrhosis pts who come in confuseD)
28
PT has chronic cholestitis (intermittant pain for years, more common at NIGHT after fatty meals); CBC, CMP and lipase are NL; on plain field XR we can seE __________= increase risk of _______
porcelain gallbladder GB cancer
29
when might we see cholangiocarcinom or bile duct cancer
primary sclerosing cholangitis (beads on a string appearance)
30
what can lead to food bolus impaction
1. EOSINOPHILIC ESPHAGITIS
31
HIDA scan + CCK
bilary dyskenisia (gallbladder pain on PE but everything else is NL) 1. RUQ US = NL => HIDA CCK => cholecytemoy
32
ECRP
choledocolithiasis | ascending cholangitis
33
Lipase
acute pancreatitis = dx when 3x NL limit
34
Blood cultures
bacteremia in ascending cholangitis
35
KUB XR
chronic GB (porcalean GB);
36
pt has RUQ and ate a bottle of acetominophem on a dare. What test do you run is AST/ALT is high, INR is high
Ruman MAtthew Nomogram
37
Ranson Criteria
acute pancreatiits
38
ROME 4 Criteria
IBD
39
BISAP score
acute pancreatitis
40
HAPS
acute pancreatitis
41
severe boring epigastric pain that shoots straight through his back; lipase levels 600 UL. Has jerking otion on his face when his facial N is tapped. What does he have, what is the sign and etiology behind
has acute pancreatitis | Chovets sign => hypocalemia due to saponification
42
Migratory thrombophlebitis
seen in pancreatic cancer
43
tardive dyskeninsia
repetitive lip smacking due with metclopromide for gastroparesis
44
complication of ERCP for choledocolithaisis. what is a complication
pancreatitis; to to check => check lipase levels and do ransons criteria
45
fecal chymotrpyin and elastase***
chronic pancreatiits
46
BISAP for acute pancreatitis
``` BUN Impaired mental statis SIRs criter Age >60 Pleural effusion = ausculatate diminesh breath sounds ```
47
CT evidence of a pseudocysts hints what?
acute pancreatitis
48
how to treat mild acute cholecystitsi if severe
``` FLUID REUSUCATIONS IV (LOTS Vigoursous hydration (IV NS at 250 cc/hr) = can result in ARDS ``` if severe = ICU
49
band ligation
esophageal varices
50
pantopraxole 40 mg IV q day
PUD
51
What is the initial episode of chronic pancreatitis called?
SAPE (senintal acute pancreatitis) = inflammatory response that results in injury and fibrosis (IgG4 AI pancreatiis)
52
TIGAR -O
causes of chronic pancreatiis T- toxnic metabolic (alholic) Idiopathic (get CP at 23 or 62 YO) G (genetic = CF = get CP less than 30 YO) AI (IgG4 mediated = hypergammaglobeminia) Recurrent Obstruction (stricture/stone/tumor)
53
80% of people with chronic pancreatitis will develop
T2 DM = high Hemoglobin A1C (14%
54
High fasting gastrin level
ZE
55
Herniation of kilians triangles
Zenkers diverticulum
56
Pt comes in + H.pylori and hematemesis. 1. Two large IVs are placed and fluid resucitpation is initated. What is the next step?
Emergent EGD + biopsy to rule out malignany bc of hematemesis
57
Intravenous octreotide is done with
variceal bleeds to decrease portal pressuer
58
coffee ground emesis
PUD
59
Complication of gastric ulcer
perforamtion => free air under the diagrpahm or air in mediastium seen on CT or plain XR (pneumoperiteum- below diarphram and pneumoediatium (above diapgram) requires NP, IV ABXC, preop and MRGC surgery
60
perforated viscus happens where
any hollow organ
61
Pain bgan 3 days ago; pt has uncontroll DM ; if ALP and bilirubin are elevated higher than AST/ALT, what is the problem
GB!!!! | emphsemtatous GB
62
New onset DB in orlder people= what do we think? What can we use to dx?
pancreatic cancer CA-19-9;
63
prolong PT INR
liver failure; partof the liver function test
64
CA 19-9
pancreatic cancer is no biliary source is found

GI II Exam 1 (19 decks)

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