Gastroenterology Flashcards
Chronic Hepatitis B treatment
Any of:
- Adefovir
- Lamivudine
- telbivudine
- Entecavir
- Tenofovir
- Interferon
Chornic Hepatitis C treatment
Genotype 1:
genotype 2 and 3:
Genotype 1:ladipasvir adn sofusbuvir
Genotype 2 and 3: sofusbuvir and rabavirin
Prmary biliary cirrhosis antibodies
Antimitochondrial Ab
Autoinmune hepatitis
Anti smooth muscle Ab
Serum-ascites albumin gradient
> 1.1g/dL
- portal hypertention
- CHF
- Hepatic vein thrombosis
spontaneous bacterial peritonitis
TX?
prophylacti?
Tx:ceftriaxone or cefotaxime
prophylactic: norfloxacin or TMP/SMX
when and what Abx is indicated in pancreatitis
> 30% necrosis, add imipenem or meropenem
Ulcerative colitis Ab
ANCA
chron Ab
ASCA
Alarm symptoms indication for endoscopy
weight loss
blood in stoll
anemia
when to add platelets to treatment
active bleeding
or PTL very low( below 10,000-20,000)
Low osmotic gap diarrhea
100 mOsm/kg
- celiac disease
- whipple disease
- pancreatic insufficiency
- laxative abuse
isolated hyperbilirrubinemia DDX
UNCONJUGATED
-overproducton(hemolytic or anemia)
-defective conjuntation(gibert or crigler-Najjar)
CONJUGATED
-Dubin-Johnson Sx(hyperpigmentet hepatocytes)
-Rotor Sx
gastrointestinal bleeding treatment
fluis,blood,platelet,plasma,PPI+ ENDOSCOPY
osctreotide->if variceal bleeding
esophageal varices treatment
octreotide
bands
propanolol
TICS(transjugular intrahepatic portosystemic shunting)
ACUTE hep C treatmen
interferon + ribavirina(tox:anemia)+ telapravir or boceprevir
msot accurate test for sclerosing cholangitis
ERCP
fatigue, itching, normal bilirubin with elevated alkaline phophasate, XANTELASMAS and OSTEOPOROSIS
Dx:
TX:
Primary biliary cirrhosis
- most accurate test: biosy
- most accurate blood test: antimitocondrial antibodies
- tx:ursodesoxicolic acid|
plummer-vison association
iron deficiency anemia
esophageal webs
squamous cell cancer
manometry is the most accurate test for the following deseases
- achalasia
- apasm
- scleroderma
GERD
DO NOT SCOPE
-PH monitoring is the most accurate test
most accurate test for PUD
upper endoscopy with BIOPSY
best initial therapy for H.pylory
FIRTS LINE:clarithro and amoxi with PPI
gastric ulcer doesnt get better after treatment
do a endoscopy EXCLUDE CANCER
Duodenal ulcer doesnt get better after treatment
persistent H.pylori switching the Abx to metronidazol and tetracycline
scope patients with dyspepsia
- patient over 55 y
- alarm symptoms(dysphagia,weight loss,anemia)
most accurate test for Gastrinoma
-persistent high gastrin leves despite injecting secretin
IF HYPERCALCEMIA LOOK FOR MEN(multiple endocrine neoplasia)
platelet transfusion indication in GI bleeding
platelets below 50 000 AND CURRENT BLEEDING
treatmetn for metronidazol resistent C.diff
vancomycin or Fidaxomicin
malapsorption diarrhea
- celiac
- chronic pancreatitis
- tropical sprue
- whipple disease(PAS positive macropages)
only way to distinc between chronic pancreatitis and gluten sensitive enteropathy
CELIA DISEASE HAS IRON DEFICIENCY
treatment of choice for whipple disease
ceftriaxone followed by TMP/SMZ
lactose intoleranse , H braath test
positive
when to screen IBD
8-10 years of colonic involvement(YERLY)
IBD treatment
acute:
chronic
- acute:prednisone or bodesonide
- -azathioprine adn 6mercaptopurine are used to wean patients off steroids.
- chronic:mesalamine
perineal crohn
cipro and metronidazol
worst prognosis criteria for acutte pancreatitis
low calcium
most accurate test for hemochromatosis
abdominal MRI and HFE (C282y)gene testing
most accurate test for wilsons disease
abnormally increase amount of copper excretion into the urine after giving penicillamine
