Gastro Flashcards
Acute Gastroenteritis
Sx: N/V, Anorexia, Pain, Diarrhea, Tachycardia, Hypotension
PE: Skin turgor
Labs: CMP, CBC, Stool
Ddx: IBS, Acute Pancreatitis
Pathogens: Rota/Norovirus, Salmonella, Campylobacter, Giardia
Tx: Fluide, Charcoal, Rest
Acute Intestinal Obstruction
Sx: Pain, Constipation/Diarrhea, N/V, Loud borborygmi, Shock
Imx: Xray (bubbles)
Ddx: Crohns, CA, Constipation
Tx: Refer to ER
Appendicitis
Sx: RLQ pain worse w movement, N/V, fever, urinary sx
PE: + Rovings and + McBurney’s test, Obturator Sign, Psoas sign, Cough sign, Pain w pelvic/rectal exam
Labs: CBC (>WBC)
Imx: US
Ddx: Pancreatitis, PID, Gastroenteritis, IBS, Crohns
Tx: ER
Biliary Obstruction
Sx: Colicky RUQ pain w inhalation, Pale stools, Jaundice
PE: +Murphy sign, anemia
Labs: CBC, CMP, Amylase, Lipase
Imx: US
Ddx: Appendicitis, IBS, Pancreatitis, CA, Kidney Stone
Tx: ER
Candida Albicans
Sx: Diarrhea, Gas, Brain fog, Sugar craving, Halitosis
PE: Oral thrush
Labs: CBC, Stool
Imx: Endoscopy
Ddx: Diarrhea, Gastritis
Tx: Decrease sugar, Probiotics, Azole meds
Colon CA
Sx: SAD diet, bleeding, wt loss
PE: +Stool blood, Mass
Labs: Stool, CBC, Liver enzymes, CEA antigens, Colonoscopy
Ddx: IBD, Polyps, Diverticula, Ischemic colitis
Crohn’s
Sx: Contant RLQ pain not relieved by BM
PE: RLQ mass, erythema nodosum shins, aphthous ulcers
Labs: CBC, ESR, Stool
Imx: Xray (string sign), Colonoscopy (skip cobblestone)
Ddx: Appendicitis, UC
Tx: Antidiarrheal (Imodium), Corticosteroids, Anti-inflammatory, Fish oil, D, B12/folate
Gastritis
Sx: Pain, blood
Labs: CBC, Stool, Liver, H.Pylori
Imx: Endoscopy, Xray (thick folds)
Ddx: Peptic Ulcer, AI dz
GERD
Sx: Heartburn, non-cardiac chest pain, Respiratory complaints
Imx: Barium esophagram, EGD
Ddx: Barrett esophagus*, Asthma, Laryngitis, Esophagitis, Hiatal hernia
Tx: Diet change, exercise, papaya
Hypochlorhydria
Sx: Worse w eating, bloating, diarrhea/constipation, GERD, Myalgia,Dry skin/nails
Labs: String test (pH), CMP (low Mg & Cl), CBC (low B12), Stool
Ddx: Hyperchlorhydria*, Gastritis, Peptic Ulcer
Tx: Apple cider vinegar, Bitters (Gentian), Betain Hal, Zn, B12/folate
IBS
RO ALARM FEATURES: Sx oust after 50, severe diarrhea, nocturnal sx, wt loss, hematochezia, fm hx of GI disease
Sx: Pain 3d/m relieved w defecation, change in stool frequency, appearance or consistency
PE: Increased bowel sounds, tender colon
Labs: CBC, CMP, Stool (Lysozyme normal vs IBD)
Ddx: Celiac, Colorectal CA, UC
Tx: Increase fiber, stress mngmt, probiotics
Pancreatic CA
Hx: Smoking, Alcohol
Sx: Pain radiating to lower back, Dark urine/stool change, migratory bussing
PE: Epigastric tenderness, Jaundice, Ascites (endstage)
Labs: CA 19-9, CEA, Fetal protein
Imx: US
Ddx: CA, Biliary obstruction
Tx: Refer to ER
Acute Pancreatitis
Sx: Hx of Dull boring pain better, suffer onset LUQ pain supine wo movement. N/V
PE: Tachycardia, fever, hypoactive bowels, distention, +Cullen’s (blue at pancreas), + Grey-Turner (red/brown flanks), Jaundice
Labs: Amylase & Lipase, CMP, CBC.
Imx: US
Ddx:Cholecystitis, Kidney stones, Peritonitis, MI
Tx: Hospitalize
Chronic Pancreatitis
Sx: Chronic- Intermittent attacks of pain radiating like a band to back, diarrhea, wt loss
PE: Same as acute
Labs: Fecal test, Bentriomide test, Serum trypsin
Imx: Abd xray (calcifications)
Tx: Hospitalize
Peptic Ulcer
Sx: Duodenal- epigastric pain worse 2-3 hours after meal/when the stomach is empty. Relieved with milk and antacids. Awaken at night. Ground emesis
Gastric-Eating causes pain. Awaken at night.
PE: TTP
Labs: CBC, Amylase, Lipase, Gi panel
Imx: Endoscopy
Ddx: Zollinger Ellison, Hypo/Hyperchlorhydria
