GASTRO Flashcards
Difference between acid stricture and plummer vinson
plummer = proximal, acid = distal
Treatment of non-infectious esophagitis (drugs: doxy, KCl, eosinophilic)
Steroid inhaler (swallow), PPI
Most accurate test for achalasia ________
Mannometry : huge pressures at GE junction
Indications for Scoping for Barrett’s Surveillance Among GERD patients
1) Alarm symptoms: Anemia, weight loss, FOBT +
2) Reflux symptoms for 5 - 10 years
3) Previous endoscopy positive: q2-3 years surveillance
_______ is usually beneficial to treat when there is ulcerative disease or gastric inflammation
H Pylori
Risk of PPI
Ca2+/Mg2+ malabsorption, bacterial invasion, interstitial nephritis
Indication for stress ulcer prophylaxis (PPI)
1) Head Trauma/Burns
2) Intubated
3) Sepsis
3) Coagulopathy
4) Steroid Use
Zollinger Ellison ulcers are usually present _______
Most accurate test _____
distal duodenum
Secretin suppression, but usually you get a hint with the serum gastrin level
_____ kidney stones are common among IBD patients
calcium oxalate (oxalate re-absorption failure)
Markers for Crohns _____, _____
ASCA, c-ANCA
When to start TNF in Crohns_____
Fistulized disease (Infliximab, Adalimumab)
Treatment Paradigm
Mesalamine—> AZT/6MP –> ______
Vedolizumab (Integrin a4b7 inhibitor, gut specific anti-inflammatory)
Salvage therapy for EHEC HUS ________
Eculizumab (complement inhibitor, hemolysis stop)
True/False : Drain amoeba liver abscess ______
False
______ GI infection is associated with Reiters syndrome
Shigella
diarrhea, wheezing after eating fish _______
Scramboid; Tx: Antihistamine
Bezlotoxumab is a salvage therapy for _____
C.diff (following dose escalated Vanc, fidaxomixin)
You can re-use vancomycin if it worked the first time, for re-infection
_____ is a hallmark of lactose intolerance
increased stool osmolarity
____ is a GI tumor, characterized by episodes of hypotension, wheezing, flushing, diarrhea. Treatment is _____
Carcinoid , Octreotide
D xylose test is used to assess _____
Celiac disease, malabsorption indicated by low serum/urine D xylose
______ is an idiopathic malabsorption condition suspected to be due to infectious disease, results in villi flattening and nutritional deficiencies (folate, ADEK). Treatment ________
Tropical Sprue
Metronidazole 3 - 6 months
PAS + stain organism, classic for _____
Whipple Disease (Male, Age 50, arthralgia)
_____ test helps diagnose chronic pancreatitis
Secretin challenge (like in Zollinger Ellison), high fecal bicarb
When antibiotics during pancreatitis_____
necrotizing, needs surgery
____ and ___ markers indicate PBC (primary billiard cirrhosis), this antibody helps in diagnosis ____
IgM, ALP (isolated), Anti-mitochondrial
Treatment of Wilsons_____
Penicilamine, Trientine
Bronze diabetes is pathopnemonic for _____. Treated with ____
Hemachromatosis , Deforoxamine
Hint: high iron, low TIBC
_____ is a marker for auto-immune hepatitis
anti-smooth muscle
Shigella, Campylobacter, ________ EHEC, Salmonella are examples of bloody diarrhea
Entaemeba histolytica
Common cause of chronic diarrhea in children _______
Fruit Juice
_______ is a stain used to test feces for fat malabsorption
Sudan Black, most accurate = 72hr fecal fat
Best initial test for pyloric stenosis ______
US Abdomen
Best initial test for mal-rotation, volvulus _____
US Abdomen with Doppler
Best initial test for esophageal atresia _____
Gastrograffin esophogram, choking when eating due to TE fistulization
CHARGE association
C : Coloboma/CNS H: Heart defect A: Choanal Atresia R: retarded growth G: GU (hypogonadism) E: Ear (Deaf)
Window Period
This patient has acute hepatitis B. The “window period” refers to that period in infection when neither hepatitis B surface antigen (HBsAg) nor its antibody (HBsAb) can be detected in the serum of the patient. It is an immunologically mediated phenomenon caused by the precipitation of antigen-antibody complexes in their zone of equivalent concentrations and, thereby, their removal from the circulation.
Because of this, the first thing that will happen in the window period is that the serum will become negative for the surface antigen (HBsAg) as that antigen is precipitated out of the serum by developing levels of its specific antibody (HBsAb). Serologic tests conducted during the window period will be positive for HBcAb and HBeAb.
hemachromatosis characterized by High serum iron/ferritin , _____TIBC (inverse of iron deficiency)
Low, pretend like anemia of chronic disease
45+ with epigastric pain ______
Automatic endoscopy EGD consult
Zollinger Ellison wit hypercalcemia ____
MEN syndrome
Zollinger Ellison Diagnosis ____
Secretin suppression test
Somatostatin Scan
EUS
Indication for antibiotics in Crohns____
Perianal Crohns
How to treat Cryptosporidium GI infection____
HAART,
Hepatitis A post-exposure prophylaxis
1) Age<12 months_____
2) Age> 12 months_____
Ig
Vaccine
Give both if immunocompromised
Hep B post exposure prophylaxis
1) Naive vaccine_____
2) Child_____
3) Vaccinated_____
Ig + Vaccine
Ig + Vaccine
Check serology, then vaccinate
Cirrhotics should get ultrasound q_____ for HCC screening
6 months
Treatment of PBC
1) Ursodeoxycholic acid
2) _____
Common complication____
Obeticholic acid
Osteoporosis
____ _disease is characterized by pseudogout, bronze diabetes, panhypo-pit (infiltration), cirrhosis
Dx_______
Hemachromatosis
Iron panel: High Iron/Ferritin low TIBC, high iron Sat —> MRI/HFe gene mutation
_____ associated with young woman with auto-immune disease (ITP, thyroiditis, hemolytic anemia), ANA + , Anti smooth muscle + , SPEP; Hypergamma
Autoimmune hepatitis
