Gastroenterology Flashcards
Oropharyngeal vs Esophageal dysphagia: sx and dx procedures
Oropharyngeal: liquids > solids (aspiration)
Dx: video flouroscopy
Esophageal: solids> liquids (obstruction/motility)
Dx: barium swallow
Corkscrew-shaped esophagus: dx and tx
Diffuse esophageal spasm
Tx: nitrate, Ca ch blocker, surgery
Bird beak esophagus: dx and tx
Achalasia (degeneration inhib neurons auerbach plexus)
Tx: nitrate, ccp, endoscopinc inj, Heller myotomy
Etiology curling vs cushing ulcer
Curling: burn injuries
Cushing: TBI
Type A vs Type B gastritis:
Etiology, location
Type A: Autoantibodies to parietal cells, causes pernicious anemia, fundus
Type B: H. pylori or NSAID, antrum
Triple therapy for H. pylori
Amoxicillin, clarithromycin, omeprazole
Organisms that cause bloody diarrhea (4)
Salmonella, Shigella, E colie (EHEC), Campylobacter
Chronic diarrhea in AIDS pt (2)
Cryptosporidium, isospora
Campylobacter: Labs and Tx
Fecal RBCs and WBCs
Tx: erythromycin
Entamoeba histolytica: presentation, labs/imaging, tx
Presentaton: severe abd pain, fever, hx of travel
Labs/imagining: fecal rbcs, wbcs; “flask-shaped” ulcers
Tx: metronidazole
Causes of watery diarrhea (5)
V cholerae,rotavirus, e coli (ETEC), cryptosporidium, giardia
Grouped, papulovesicular, pruritic skin
located symetrically elbows, knees, buttocs, post scalp (disease + associated dx)
Dermatitis herpetiformis
Celiac disease
Diarrhea, dementia, dermatitis and death
pellagra
Carcinoid syndrome: assoc deficiency + tx
Assoc def: pellagra (B3 def) tryptophan (precursor to niacin) used to make serotonin
Tx: octreotide
Tx of diverticulitis
Bowel rest, NG tube placement, Broad spectrum abx (metronidazole + flouroqin or 2nd/3rd cephalo)
Indirect vs direct hernia: etiology and location
Indirect: congenital patent processus vaginalis; lateral to in epigastric vessels
Direct: defect in transversalis fascia (Breakdown with age)
medial to epigastric vessels
Extraintestinal manifestations of UC (4)
Primary sclerosing cholangitis, aphthous stomatitis, erythema nodosum, pyoderma gangrenosum
Sx and Tx of choledocolithiasis
Sx: biliary colic, jaundice, fever, pancreatitis
incr alk phos, t and dbili
Tx: ERCP with sphicterotomy + cholecystectomy
MRCP/ERCP shows “beading”: Dx and Tx
Dx: Primary sclerosing cholangitis
Tx: ursodiol, ERCP and stenting, liver transplant
Primary sclerosing cholangitis: associated dx and malignancy
Assoc with ulcerative colitis and cholangiocarcinoma
presents with incr unconjugated bilirubin, no other abnormalilities
Gilbert’s (decr activity of glucoronyl transferase)
Drugs causing hepatitis (4)
Alcohol
Acetominophen
INH
methyldopa
Hyperbilirubinemia: Causes for unconj (4) and conjugated (2)
Unconj: hemolytic anemia, gilbert, crigler-najjar
Conj: Dubin-Johnson, Rotor’s
+ anti-smooth muscle antibodies
autoimmune hepatitis
Hep B serology:
- Acute early infxn
- Immunity
- during window period
- High vs low transmissibility
- Acute early infxn: HBsAg
- Immunity: HBsAb
- during window period: HBcAb
- High transmissibility: HBeAg
- Low transmissibility: HBeAb
Tx of chronic HCV and HBV
HCV: interferon and ribavirin
HBV: Interferon and lamivudine or adefovir
SAAG dx of ascitis
SAAG> 1.1: Portal hypertension
SAAG
+ Antimitochonrdrial Ab: Dx + Tx
Dx: Primary biliary cirrhosis
Tx: Ursodeoxycholic acid, cholestyramine, liver transplant
Spontaneous bacterial peritonitis: Dx and Tx and ppx
Dx: >250 PMNs/ml
Tx: 3rd gen cephalosporin, IV albumin
Ppx: flouroquinolone
Tx Wilson’s disease
penicillamine, zinc
