Gastroenterology Flashcards
Short gut syndrome refers to ___________________.
patients who have anatomically or functionally decreased small intestinal length; anatomically this is typically less than 1/4 over the intestines and children and less than 1/6 of the intestines in adults
Patients with short gut syndrome will require what?
TPN
Common causes of short gut syndrome include ___________________.
NEC, volvulus, and trauma
___________ is characterized by a paucity of bile ducts on liver biopsy.
Alagille syndrome
Alagille syndrome has what inheritance pattern?
Autosomal dominant w/ variable penetrance
What are the diagnostic criteria of pancreatitis?
Two of the following:
- Elevated lipase
- Imaging findings
- Epigastric pain
Start feeding on ___________ days of no appetite in acute pancreatitis.
3
Colitis comes in three categories: __________.
infectious, ischemic, and inflammatory
Ischemic colitis typically affects what area of the colon?
The watershed area between the IMA and SMA, which is the splenic flexure
What are advantages and disadvantages to G-tubes and GJ-tubes?
G-tubes have the benefit of being easy to replace (can be done at bedside) and the ability to bolus feeds, but they carry a risk of aspiration. GJ-tubes have a decreased aspiration risk and have two ports, but they require fluoroscopy and must be continuous feeds through the J.
What kinds of abdominal pain present with abrupt, sudden-onset pain?
- Torsion (both ovarian and testicular)
- Aortic dissection
- Nephrolithiasis
- Ruptured ovarian cyst
To help get the best abdominal tenderness exam, _______________.
don’t tell them you’re going to press on their abdomen; instead, tell them you’re going to listen with your stethoscope and then slowly progress to palpation
When should you get a lactate in assessing abdominal pain?
Mesenteric ischemia
True or false: for suspected pancreatic cancer (e.g., painless jaundice) the first test to order is an abdominal CT with contrast.
False
For all suspected biliary disorders, an ultrasound is still the right first test. The other reason this might be helpful is that if it shows a pancreatic head mass then the next test may be an MRCP.
What medical things can help with achalasia if someone is obstructed?
- Glucagon
- NO
GI bleed in a person who’s had a AAA repair could be _____________.
aorto-enteric fistula, usually through the duodenum which is closest to the aorta
____________ is the most common complaint in acute diverticulitis.
Constipation
Review the four categories of causes of ascites.
Portal HTN:
- Cirrhosis
- Thrombosis
Hypoalbuminemia (loss of intravascular oncotic pressure):
- Protein-losing enteropathy
- Malnutrition
Volume overload:
- ESRD
- CHF
Malignancy:
- Peritoneal metastasis
- Hepatic metastasis
- Lymph blockage
What two criteria are diagnostic of SBP?
- WBC > 1,000 cells/mL
- PNMs > 250 cells/mL
Low glucose and high protein are suggestive of infection (and should be sent with cell count and culture) but not diagnostic.
_____________ is first line for SBP.
Cefotaxime
Review the causes of constipation and bowel obstruction.
Pharmacologic:
- Anticholinergics
- Antihistamines
- Opiates
- Antipsychotics
Neurologic:
- Neuropathies
- Parkinson’s
Endocrine:
- Hypothyroidism
- Diabetes
- Hyperparathyroidism (hypercalcemia)
Metabolic:
- Hypokalemia
- Hypomagnesemia
- Hypercalcemia
Toxicologic:
- Iron
- Lead
Malignant:
- GI cancers
Functional:
- Anal fissures
- Ileus
- Ogilvie
Review the three groups of causes of acute diarrhea.
Infectious:
- Bacterial
- Viral
- Protozoal (e.g., E. histolytica, Giardia, Cryptosporidium)
Ischemic:
- Mesenteric ischemia
- Ischemic colitis
Intoxication:
- Meds (e.g., metformin, NSAIDs)
- Alcohol
True or false: never treat ETEC.
False
EHEC should not be treated with abx because of the increased likelihood of HUS. ETEC should be treated with ciprofloxacin.
What are the two antibiotics of choice for most traveler’s diarrhea (like ETEC, Campylobacter)?
Ciprofloxacin or Bactrim