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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
Q

check when Fasting lipid panal

A

acute pancreatitis bc we get hyperglycemia

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26
Q

check Tylenol level

A

acute liver failure/ acute hepatitis (really high AST/ALT)

27
Q

check ammonia levels

A

hepatic encephalopthy (cirrhosis pts who come in confuseD)

28
Q

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 _______

A

porcelain gallbladder

GB cancer

29
Q

when might we see cholangiocarcinom or bile duct cancer

A

primary sclerosing cholangitis (beads on a string appearance)

30
Q

what can lead to food bolus impaction

A
  1. EOSINOPHILIC ESPHAGITIS
31
Q

HIDA scan + CCK

A

bilary dyskenisia (gallbladder pain on PE but everything else is NL)

  1. RUQ US = NL => HIDA CCK => cholecytemoy
32
Q

ECRP

A

choledocolithiasis

ascending cholangitis

33
Q

Lipase

A

acute pancreatitis = dx when 3x NL limit

34
Q

Blood cultures

A

bacteremia in ascending cholangitis

35
Q

KUB XR

A

chronic GB (porcalean GB);

36
Q

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

A

Ruman MAtthew Nomogram

37
Q

Ranson Criteria

A

acute pancreatiits

38
Q

ROME 4 Criteria

A

IBD

39
Q

BISAP score

A

acute pancreatitis

40
Q

HAPS

A

acute pancreatitis

41
Q

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

A

has acute pancreatitis

Chovets sign => hypocalemia due to saponification

42
Q

Migratory thrombophlebitis

A

seen in pancreatic cancer

43
Q

tardive dyskeninsia

A

repetitive lip smacking due with metclopromide for gastroparesis

44
Q

complication of ERCP for choledocolithaisis. what is a complication

A

pancreatitis; to to check => check lipase levels and do ransons criteria

45
Q

fecal chymotrpyin and elastase***

A

chronic pancreatiits

46
Q

BISAP for acute pancreatitis

A 
BUN
Impaired mental statis 
SIRs criter
Age >60 
Pleural effusion = ausculatate diminesh breath sounds
47
Q

CT evidence of a pseudocysts hints what?

A

acute pancreatitis

48
Q

how to treat mild acute cholecystitsi

if severe

A 
FLUID REUSUCATIONS IV (LOTS 
Vigoursous hydration (IV NS at 250 cc/hr) = can result in ARDS

if severe = ICU

49
Q

band ligation

A

esophageal varices

50
Q

pantopraxole 40 mg IV q day

A

PUD

51
Q

What is the initial episode of chronic pancreatitis called?

A

SAPE (senintal acute pancreatitis) = inflammatory response that results in injury and fibrosis (IgG4 AI pancreatiis)

52
Q

TIGAR -O

A

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
Q

80% of people with chronic pancreatitis will develop

A

T2 DM = high Hemoglobin A1C (14%

54
Q

High fasting gastrin level

A

ZE

55
Q

Herniation of kilians triangles

A

Zenkers diverticulum

56
Q

Pt comes in + H.pylori and hematemesis.

  1. Two large IVs are placed and fluid resucitpation is initated. What is the next step?
A

Emergent EGD + biopsy to rule out malignany bc of hematemesis

57
Q

Intravenous octreotide is done with

A

variceal bleeds to decrease portal pressuer

58
Q

coffee ground emesis

A

PUD

59
Q

Complication of gastric ulcer

A

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
Q

perforated viscus happens where

A

any hollow organ

61
Q

Pain bgan 3 days ago; pt has uncontroll DM ; if ALP and bilirubin are elevated higher than AST/ALT, what is the problem

A

GB!!!!

emphsemtatous GB

62
Q

New onset DB in orlder people= what do we think?

What can we use to dx?

A

pancreatic cancer

CA-19-9;

63
Q

prolong PT INR

A

liver failure; partof the liver function test

64
Q

CA 19-9

A

pancreatic cancer is no biliary source is found

GI II Exam 1 (19 decks)

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