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532 > exam 2 - GI > Flashcards

exam 2 - GI Flashcards

1
Q

GI Meds: prokinetics

A

increase rate of motility

- metocloperamide (reglan)

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2
Q

GI meds: antiemetics

A

phenergan/zofran

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3
Q

GI meds: PPI

A

acide reflux - omeprazole, pantoprazole

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4
Q

GI meds: mucosal protecting agent

A

duodenal ulcer

- carafe syrup

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5
Q

GI meds: antidiarrheals

A

lomotil, loperamide
* not for acute episodes d/t most likely infectious etiology. Let patient’s body purge. Antidiarrheals would just prolong the illness

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6
Q

GI meds: ABX & antimicrobials

A
  • diverticulitis
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7
Q

Probiotics

A

Gut flora

- lactobacillus

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8
Q

GI red flags: malignancy

A
  • orthostatic hypotension
  • weight loss
  • age over 50
  • early satiety
  • palpable mass
  • fever
  • smoker or hx of smoking
  • hx of ETOH use
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9
Q

GI red flags: cont.

A
  • Iron deficiency anemia
  • new onset pain
  • change in bowel habits
  • fecal incontinence
  • melena/coffee ground emesis
  • guiac positive stools
  • dysphagia
  • odynophagia
  • long-term NSAID use
  • persistent hoarseness
  • Chest pain
  • failure to improve with tx
  • pain out of proportion to exam
  • abdominal distention (obstruction)
  • increase LFT/jaundice (blockage within bile system)
  • abnormal physical exam
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10
Q

How to assess for peritoneal irritation

A
  • obturator and psoas

ask to jump up and down

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11
Q

GI dx studies

A
  • UA + Culture
  • Serum studies
  • Stool studies
  • STI screen, Pap, vaginal cultures
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12
Q

GI dx studies:

- UA + Culture

A
  • r/o pregnancy, esp. if imaging needs t be done
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13
Q

GI dx studies:

-Serum studies

A

CBC, CMP, Sed Rate, CRP, Thyroid

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14
Q

GI dx studies:

- Stool studies

A

Ova&parasite, blood, WBC culture, pH, fecal fat collection if concerned for malabsorption

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15
Q

GI dx studies:

- STI screen, Pap, vaginal cultures

A

gonn/chlam

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16
Q

GI disorders indicated for ultrasound

A

(low dose radiation)

appendicitis, cholecystitis, pyloric stenosis, intussusception

17
Q

GI disorders indicated for CT

A

(exposure to radiation)

  • pancreatitis
  • intraabdominal mass
18
Q 
Specialized Studies:
duodenal aspirate - 
esophageal pH - 
capsule endoscopy 
breath hydrogen test -
sweat chloride test-
A

duodenal aspirate - active infection
esophageal pH - rule in GERD pH < 4
breath hydrogen test - lactose intolerance
sweat chloride test- CF

19
Q

Upper GI disorders

A

dysphagia, vomiting and dehydration, pyloric stenosis, PUD, abdominal pain

20
Q

Lower GI Disorders

A

infantile colic, foreign body ingestion, appendicitis, intussusception, anal fissure,
FTT, acute diarrhea, intestinal parasites

21
Q

Pyloric Stenosis patho & presentation

A

hypertrophy of pyloric muscle

  • non bilious projectile vomiting by 2-3 weeks of life
  • insatiable appetite
22
Q

Pyloric Stenosis at risk

A

first born male infants

23
Q

Pyloric Stenosis: initial work up

A

infant with nonbiloius projectile vomiting, no weight gain

  • ultrasound
  • refer to GI (surgical)
24
Q

Peptic ulcer disease patho & presentation

A

ulceration of the gastric lining a/o duodenum

  • epigastric pain/dyspepsia 2-5 hours after eating/worse at bedtime/alleviated by ingestion of food
  • alleviated by food/antacids
25
Q

Peptic ulcer disease: potential for perforated peptic ulcer

A

more common in duodenal ulcers

abrupt severe abdominal pain a/w peritonitis

26
Q

Peptic ulcer disease causes

A

H. Pylori - most common cause

- transmitted fecal-oral route in childhood - remains in stomach/duodenum for decades

27
Q

PUD H. pylori testing

A
  • ALL pts with documented ulcers need H. pylori testing via biopsy
  • ALL its being treated presumptively for H. pylori need testing via ELISA
  • Elisa IgG, urea breath test, or stool antigen test: need to be off PPI for 2 weeks prior to tes; test for cure (4 weeks after treatment) = urea breath or stool antigen
28
Q

PUD: H. pylori Tx

A

PPI + ABX (amoxicillin + clarithromycin)

  • recurrent/resistant = bismuth + tetracycline + PPI
  • stop NSAID use, smoking cessation
29
Q

PUD NSAID Use

A
  • suppresses mucosal barrier
  • /c use + PPI (for at least 1 year)
  • cause use sucralfate and misoprostol (active ulcer maintenance)
30
Q

PUD Dx

A

< 55 y.o. with classic symptoms - can treat with out EGD (endoscopy)

31
Q

Red flag GI: Dx testing

A 
EGD if red flag sx:
> 55 y.o.
not responding to empiric tx
return of sx
chronic NSAID use (assess for bleeding)
Barium radiography in its who are not eligible for EGD
32
Q

Repeat endoscopy for complicated/uncomplicated gastric ulcers _____ weeks after tx

A

8 weeks

- uncomplicated: no repeated EGD

532 (3 decks)

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