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DT4 Exam 2 > Clinical > Flashcards

Clinical Flashcards

1
Q

workup of GERD

A

empiric trial of PPI

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2
Q

alarm symptoms GERD

A

dysphagia, unintentional weight loss, hematemesis or melena

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3
Q

confirm diagnosis of achalasia

A

manometry

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4
Q

sign barium radiography achalasia

A

bird beak

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5
Q

procedure of choice for diagnosis and treatment Mallory-Weiss tear

A

esophagogastroduodenoscopy

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6
Q

testing H pylori

A

serologic testing is not helpful

fecal antigen and urea breath

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7
Q

diagnosis peptic ulcer disease

A

mucosal break 5mm or larger in stomach or duodenum

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8
Q

gold standard diagnosis of PUD

A

upper endoscopy

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9
Q

confirm diagnosis of gastric cancer

A

upper GI endoscopy

staging on imaging is required

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10
Q

treatment early stage gastric cancer

A

surgery alone

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11
Q

locally advanced gastric cancer

A

surgery and post op chemo

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12
Q

common causes small bowel obstruction

A 
previous surgery
inguinal hernia
crohn disease
intestinal malignancy
appendicitis
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13
Q

non-operative treatment small bowel obstruction

A

fluid resuscitation
bowel decompression with NG tube to decompress air/fluid
analgesia (morphine)

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14
Q

operative treatment small bowel obstruction-indications

A

complete SBO
documented peritonitis
evidence of strangulation
patients non-responsive to nonoperative treatment

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15
Q

diagnosis celiac disease

A

positive serologic markers and small-bowel biopsy

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16
Q

serologic marker celiac

A

IgA tissue transglutaminase and endomysial antibodies

perform while still on gluten diet

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17
Q

imaging appendicitis

A

usually diagnosis made clinically

CT or US show dilation >6mm

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18
Q

diagnosis IBS

A

abdominal pain relieved by defecation

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19
Q

diagnosis crohns

A

colonoscopy with ileoscopy and tissue biopsy

20
Q

complications crohns

A

extraintestinal involvement, intestinal obstruction, abscess formation, sinuses, fistulae

21
Q

diagnosis ulcerative colitis

A

endoscopy with biopsy and negative stool culture

22
Q

complications ulcerative colitis

A

toxic megacolon with risk of perforation

adenocarcinoma

23
Q

treatment colon cancer

A

surgical resection

24
Q

imaging choice acute diverticulosis

A

CT scan

25
Q

treatment diverticulosis

A

bowel rest, ABX, surgical intervention

26
Q

complications diverticulosis

A

bleeding, segmental colitis, perforation, abscess, fistulas, obstruction

27
Q

first line therapy non-alcoholic steatosis

A

lifestyle modifications

28
Q

diagnostic imaging cholelithiasis

A

abdominal US

29
Q

treatment symptomatic cholelithiasis

A

laparoscopic cholecystectomy

30
Q

complications cholelithiasis

A

cholangitis, cholecystitis, pancreatitis

31
Q

treatment pancreatitis

A

IV fluids

correct electrolyte abnormalities, analgesia, glucose control

32
Q

hiatal hernia

A

upper GI series

shows Nissen fundoplication

33
Q

indications for medication

A

BMI>30

BMI>27 with obestiy related risk factors or disease

34
Q

orlistat

A

pancratic and gastric lipase inhibitor

safer for patients with CV, HTN, DM

35
Q

locaserin

A

5HT2c antagonist
can cause serotonin syndrome, neuroleptic malignant syndrome and valvular heart disease
safer for patient with HTN and CV

36
Q

phentermine/topiramate

A

NE/GABA

not for HTN or CV

37
Q

naltrexone/bupropion

A

opioid antagonist/dopamine NE inhibitor

suicidal warning

38
Q

liraglutide

A

GLP-1 agonist

medullary thryoid tumors warning

39
Q

continue weight loss medication

A

> 5% reduction of weight at 3 months

40
Q

dietary advice

A

10% weight loss goal
1-2lb per week
reduce calorie 500/day

41
Q

surgical candidates

A

BMI>35 with comorbidity

BMI>40

42
Q

types of surgeries

A

lap band
vertical sleeve
Roux en Y (takes month to recover from dumping)
biliary diversion with duodenal switch

43
Q

most effective

A

Roux en Y and vertical sleeve

44
Q

Vbloc

A

BMI 40-45 plus comorbidity

45
Q

time of workout to maintain weight

A

200-300/wk

46
Q

workout

A

30-60 on most days

>150min/wk

DT4 Exam 2 (4 decks)

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