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ABFM First Aid > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

8 drugs/supplements that commonly cause esophagitis?

A

Abx(tetracycline, doxycycline, clindamycin), Vit C, FeSO4, KCl, NSAIDs/ASA, Bisphosphonates

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2
Q

First line management of GERD?

A
  1. Weight loss
  2. Elevate head of bed 6 inches
  3. Dietary modification: no chocolate, peppermint, alcohol, fatty foods, acidic foods
  4. PPI or H2 for 8 weeks
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3
Q

Complications of PPI use?

A

Osteoporosis, pneumonia, increase CV risk, increase risk of enteric infections, absorption of(B12, Mag, Fe)

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4
Q

Treatment of H.Pylori? What if pt has PCN allergy?

A

PPI BID + Clarithromycin 500 mg BID + Amoxicillin 1g BID x14 days +/- Bismuth 525 QID.

*if PCN allergy use Flagyl in place of amoxicillin

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5
Q

When should you repeat testing for H.Pylori after finishing treatment?

A

4 weeks

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6
Q

When should you get a stool O&P for a patient with diarrhea?

A

If they have risk factors/travel to developing countries OR persistent diarrhea > 2 weeks

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7
Q

What is CHRONIC diarrhea?

A

diarrhea > 4 weeks

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8
Q

Treat fat-soluble vitamin deficiencies by supplementing — to — times the recommended daily value.

A

5-10 x

*often needs water soluble preparations

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9
Q

Individuals with celiac disease are at risk for which vitamin deficiencies?

A

iron, folic acid, Ca, vitamin D & rarely B12

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10
Q

Pt with short gut syndrome should be checked for — deficiency & replaced every —.

A

B12, month IM B12 injections

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11
Q

Bacterial overgrowth in the gut can be caused by – & lead to —.

A

abnormal gut stasis(decreased motility, fistulas)
*lead to: cabohydrate malabsorption(bacteria consume), Fat malabsorption (de conjugation of bile), B12 deficiency(bacteria consume)

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12
Q

Which IBD is more commonly associated with pyoderma gangrenosum?

A

UC! – may also see in crohns but more common in UC

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13
Q

Which IBD is associated with ankylosing spondylitis, VTE, Sclerosing cholangitis, uveitis, erythema nodosum?

A

UC!

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14
Q

1st line management of IBS

A

FODMAP diet

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15
Q

Which is best for IBS TCA or SSRI?

A

can use both but TCA > SSRI

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16
Q

whats the minimum period a patient must be abstinent to be consider for liver transplant?

A

6 months

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17
Q

Treatment of acetaminophen toxicity

A

N-acetyl cystine

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18
Q

Why is it recommended pt with hemochromatosis avoid shellfish?

A

they are at increased risk for vibrio vulnificus infection

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19
Q

Gene mutations associated with hemochromatosis

A

HFE gene on chromosome 6 - causes inappropriate absorption of Fe & elevated ferritin.

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20
Q

What supplement can be used to manage wilsons disease?

A

PO Zinc = interferes with copper absorption in the GI tract

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21
Q

Mutation & inheritance pattern of wilsons disease?

A

AR, mutation in ATP7B causing decrease trans membrane transport(excretion) of copper = builds up in multiple tissues

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22
Q

Which has neurological symptoms: wilsons disease of hemochromatosis?

A

wilsons

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23
Q

What is Primary Biliary Cirrhosis? Mutation? tx? Association?

A

autoimmune disorder causing granulomatous destruction of intrahepatic bile ducts and cholestasis. Usually effects females - insidious & usually starts with puritis & fatigue.
+anti-mitochondrial antibodies
+treatment with ursodeoxycholic acid(delays progress & improves survival), cholestyramine(for itching) & liver transplant
+associated w/Sjogren & CREST Scleroderma

24
Q

What is Primary Sclerosis Cholangitis? Mutation? tx? Association?

A

diffuse inflammation, fibrosis, and stricturing of the biliary tract as well as an increased risk of cholangiocarcinoma. M > F;
+ANCA, +ANA, +cardiolipin, TPO+, RF+
+treatment - bx to r/o carcinoma, stent placement, balloon dilation - liver transplant
+associated with Ulcerative colitis

25
Q

What is the MELD score used for? What do you use to calculate it?

A

Used to determine 90-day mortality risk in patients with end stage liver disease.
+T.Bili, INR & Creatinine

26
Q

Patients with ascites should have Na restricted to —- a day.

A

2g

27
Q

SAAG score of — is associated with portal HTN.

A

SAAG > 1.1

28
Q

What is the PMN cut off for dx of spontaneous bacterial peritonitis?

A

PMN > 250 cell/mm3

29
Q

Patient with alcoholic hepatitis presents with ascites. Tap shows PMN < 250, cultures are negative. Continue abx?

A

continue abx for 48 hrs then discontinue if all cultures negative

30
Q

Pt w/ascites. Tap shows PMN >250, cultures negative. continue abx?

A

yes! treat like SBP & complete full course of abx.

31
Q

Pt with esophageal varicies should be started on —- for ppx & rx titrated to —–.

A

nonselective BB(propranolol or nadalol) & titrated to HR 50-60 bpm

32
Q

1st line imaging for acute pancreatitis?

A

US > CT w/contrast > MRI/MRCP

33
Q

Does all acute pancreatitis need abx?

A

no! only if sx of extra pancreatic infection

34
Q

When should you feed the patient with acute pancreatitis?

A

As soon as they can tolerate it! = fat restricted diet.

*if unable to eat within 5-7 days consider J-tube

35
Q

Esophageal squamous cell carcinoma is associated with…

A

chronic alcohol use & smoking

36
Q

Esophageal adenocarcinoma is associated with…

A

barretts esophagus

37
Q

Most common gastric cancer? risk factors?

A

Adenocarcinoma
RF: hispanic, african american, asian, H.Pylori, diet high in salt, nitrous compounds, tobacco use, alcohol use, chronic atropic gastritis, pernicious anemia, hx of gastric resection

38
Q

CRC is the —- leading cause of death in America.

A

3rd

39
Q

Risk factors for hepatocellular carcinoma?

A

alcohol use, tobacco use, aflatoxin exposure, hemochromatosis, A1AT deficiency, NAFLD, Diabetes

40
Q

Lubiprostone(amitiza) and linaclotide(Linzess) are effective for…

A

IBS-C — fiber is an ineffective treatment

41
Q

I’m order to diagnose celiac disease you need to check…

A

Serological(IGA anti-tissue transglutaminase antibody > endomysial antibody) THEN endoscopy if test are positive

42
Q

When do you need to start colonoscopies on someone who has ulcerative colitis? How often do they need this?

A

First colonoscopy 10 years after diagnosis then repeated every 2 to 5 years depending on findings

43
Q

Window of time kids can receive rotavirus vaccination?

A

Kid must be a minimum of six weeks old up to 15 weeks for the first dose. No doses of the vaccine can be given after eight months of age

Normal: Two months, four months, six months

44
Q

Drug of choice for treatment of Campylobacter?

A

 usually resolves on its own, if needed can use azithromycin

45
Q

Treatment of shigella diarrhea?

A

Bactrim

46
Q

Treatment of salmonella diarrhea?

A

Self limiting, no treatment necessary. If for some reason patient becomes toxic can use Levaquin 500 mg a day for 7 to 10 days

47
Q

Treatment of pseudomembranous enter colitis? What is the most common cause?

A

Vancomycin is used for treatment, stop other antibiotics. Most commonly caused by amoxicillin however does occur with other antibiotics

48
Q

What medication can you use for treatment of travelers diarrhea if it’s needed?

A

Single dose of a flora quinolone however there is increasing resistance. Alternatively you can use azithromycin 500 mg a day for 1 to 3 days. Loperamide is safe to use for diarrhea

49
Q

Antibiotics for treatment of cholera?

A

Doxycycline and rehydration

50
Q

LONG TERM PPI therapy increases your risk of…

A

low magnesium, B12 deficiency, C.Diff infection, risk of fracture

51
Q

SHORT TERM PPI therapy increases your risk of…

A

CAP

52
Q

Hiatal hernia will increase your risk for…

A

Barrett’s Esophagus - adenocarcinoma

*alcohol increases risk for SCC

53
Q

Who needs screening for Barrets esophagus?

A

MEN w/5+ years GERD with 2+ risk factors(white, 50+, central obesity, hx smoking, FH of esophageal cancer or barretts)
**if completely normal then NO REPEAT NEEDED

54
Q

Which type of esophageal cancer is obesity and tobacco use a risk for?

A

adenocarcinoma

55
Q

Which type of esophageal cancer is alcohol & tobacco a risk for?

A

SCC

ABFM First Aid (22 decks)

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