Gastrointestinal Flashcards
Are younger patients more likely to have gastric or duodenal ulcers?
Duodenal
In what type of ulcer is pain relieved after eating?
Duodenal
In what type of ulcer is pain worse after eating?
Gastric
Coffee ground emesis suggests what type of ulcer?
Duodenal
If you suspect PUD, what class of med should you start with?
PPI
Sulcrafate is associated with what?
Decreases in nosocomial PNA
What is the general tx for H. pylori eradication?
2 antibiotics + PPI with or without bismuth for 10-14 days
What is a classic sign of GERD in the elderly population?
Dysphagia
How long should a pt have GERD sx before doing an EGD to r/o Barrett’s esophagus, CA, etc?
5-10 years
Barrett’s esophagus can lead to what?
Esophageal CA
How is hepatitis B transmitted?
Via all body fluids
How is hepatitis A transmitted?
Oral-fecal route as well as blood and stool during infectious period
Which hepatitis is related to injection drug use?
Hepatitis C
What will ALT/AST be in hepatitis?
500-2000
Anti-HAV antibody with IgM indicates what?
Acute Hep A
Anti-Hav antibody with IgG indicates what?
Recovered Hep A
What is the antigen for Hep B?
HBsAg
What is the serology for active Hep B?
HBsAg, HBeAg, anti-HBc, IgM
What is the serology for chronic Hep B?
HBsAg, Anti-HBc, Anti-HBe, IgM, IgG
What is the serology for recovered Hep B?
Anti-HBc, anti-HBs
How to distinguish acute from chronic Hep C?
Via PCR
Diverticulitis is more common in pts with what kind of diet?
Low in fiber
Why is an xray done on pts with suspected diverticulitis?
To look for pneumoperitoneum (free air under the diaphragm)
What diet should an inpatient w/diverticulitis be on?
NPO
Murphy’s sign is seen in what?
Cholecystitis
What is the most common complication of an ERCP?
Pancreatitis
What is the number one cause of pancreatitis?
Heavy ETOH use
What is the number two cause of pancreatitis?
Gallbladder disease
What makes pain worse in pancreatitis?
Walking and lying supine
What makes pain better in pancreatitis?
Sitting and leaning forward
What are two signs of hemorrhagic pancreatitis?
Grey Turner’s sign and Cullen’s sign
What do you see in Grey Turner’s sign?
Flank discoloration
What do you see in Cullen’s sign?
Umbilical discoloration
What two values will be elevated in 90% of pancreatitis cases?
Amylase and lipase
How is pancreatitis diagnosed?
CT scan
What are the Ranson’s criteria for pancreatitis at admission?
Greater than 55 years of age, WBCs > 16k, glucose > 200, LDH > 350, AST > 250
Vomiting at onset of pain suggests what type of bowel obstruction?
Proximal
Vomiting a couple hours after the development of pain suggests what type of bowel obstruction?
Distal
More distended abd suggests what type of bowel obstruction?
Distal
What kind of bowel sounds are there in bowel obstruction?
High pitched, tinkling
What is seen on xray in bowel obstruction?
Dilated loops of bowel and air fluid levels
Does ulcerative colitis or Crohn’s disease involve the rectum?
Ulcerative colitis
What two types of suppositories are used in the management of ulcerative colitis?
Mesalamine and hydrocortisone
What is psoas sign and what does it suggest?
Pain w/right thigh extension - appendicitis
What is obturator sign and what does it suggest?
Pain w/internal rotation of flexed right thigh - appendicitis
What is Rovsing’s sign and what does it suggest?
RLQ when pressure applied to LLQ - appendicitis
