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gastrointestinal Flashcards

1
Q

a younger patient typically has what type of ulcer

A

duodenal ulcer - age 30-55

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2
Q

older people have what type of ulcer typically

A

gastric ulcer

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3
Q

this type of ulcer pain is better with eating

A

duodenal

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4
Q

his type of ulcer has increased pain with eating

A

gastric

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5
Q

s/s of ulcer perforation

A

severe epigastric pain, “board like” abdomen , quiet bowel sounds, rigidity, acute abdomen

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6
Q

air under diaphragm

A

pneumoperotenium

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7
Q

types of H2 receptor antagonists

A

cimetidine
famotidine
nizatidine

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8
Q

types of PPI and when to take

A

30 minute before a meal
lansoprazole
rabeprazole
pantoprazole
omeprazole
dexlansoprazole
esomeprazole

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9
Q

do antacids decrease gastric acidity

A

no

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10
Q

treatment for H. pylori eradication

A

two antibiotics + PPI with or without bismuth for 10-14 days

a. ECA: PPI BID + clarithromycin BID + amoxicillin BID
b. EBMT: PPI BID _ bismuth QUID+ metronidazole _ tetracycline
c. ECAM: PPI BID+ clarithromycin + amoxicillin + metronidazole

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11
Q

guidelines for 1st line therapy for suspected PUD

A

PPI

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12
Q

what medication is associated with decrease in nosocomial pneumonia

A

sucralfate

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13
Q

black box warning associated with PPI

A

increased risk of hip fx

increase Vitamin D

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14
Q

elderly pt presents with dysphagia and belchign that typically occurs at night and is relieved by sitting up what do you think

A

GERD

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15
Q

precursor for esophageal cancer

A

barretts esophagus

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16
Q

mtg of GERD

A

non-pharmacologic: elevate HOB, avoid alcohol, caffeine, spices, peppermint, stop smoking, decrease weight
Antacids PRN
H2blockers
PPI if H2blockers ineffective
GI/surgical consult prn

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17
Q

oral fecal route of hepatitis

A

hep A

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18
Q

Anti-HAV and IgM

A

acute hepatitis A

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19
Q

hepatitis associated with injection drug use

A

hep C

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20
Q

Anti-HAV , IvG

A

recovered hep A

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21
Q

HBsAg, HBeAg, Anti-HBc, Igm

A

hep b active

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22
Q

HBsAG, Anti-HBc, Anti-HBe, IGM, IgG

A

chronic hep B

23
Q

anti-HBc, Anti-HBs

A

recovered hep b

24
Q

anti-HCV, HCV RNA

A

acute/chornic hep C

25
Q

Mtg of hepatitis

A

supportive
increase fluids 3000-4000 ml/day
avoid alcohol/meds by liver
no/low protein diet
lactulose

26
Q

what is in all three hep b serology

A

anti-HBc

27
Q

education to patient for decreasing diverticulitis flare ups

A

quit smoking

28
Q

tx for diverticulitis

A

NPO
IV fluids
if GI bleeding - treat
surgical eval

29
Q

Murphys sign

A

deep pain on inspiration while fingers are placed under right rib cage - present in cholecystitis

30
Q

why do you obtain KUB on pt with diverticulitis

A

to r/o pneumoperitoneum (air under diaphragm)

31
Q

what bowel sounds are associated with SBO

A

tinkling high pitched

32
Q

what bowel sounds are associated with peritonitis

A

quiet bowel sounds

33
Q

what is common cause of pancreatitis

A

HEAVY alcohol use
cholelithiasis

34
Q

gold standard for diagnosis of cholecystitis

A

Ultrasound

35
Q

major complications of ERCP

A

pancreatitis

36
Q

what is GI angioplasty used to diagnose

A

hemorrhage of unknown cause

37
Q

pt with abrupt abdominal pain upon inspection the upper abdomen is tender to palpation and is with out guarding , rigidity or rebound. What do you suspect

A

acute pancreatitis

38
Q

Flank discoloration

A

grey turner sign (in pancreatitis if hemorrhagic)

39
Q

umbilical discoloration

A

Cullens sign (in pancreatitis if hemorrhagic)

40
Q

labs r/t acute pancreatitis

A

elevated serum amylase (50-180)
elevated lipase (14-280)
hypocalcemia <7

41
Q

ransons critera mortality risk

A

5-6 40%
>87 100%

42
Q

ransons criteria

A

assess pancreatitis
George - greater than 55 y/o
Washington - WBC >16000
Got - glucose > 200
Lazy - LDH >350.
After - AST >250

43
Q

management of ulcerative colitis

A

mesalamine suppositories or enemas x 3-12 weeks
hydrocortisone suppositories and enemas

44
Q

48 y/o presents with abdominal swelling and bloody diarrhea with a history of choric sinusitis, and resent DVT. Which represents the most likely dx and test to order

A

UC, sigmoidoscopy

45
Q

what is a major complication associated with UC

A

toxic megacolon

46
Q

where is UC

A

involves the rectum and may extend upward involving the whole colon

47
Q

when would you find “thumb print sign” on abdominal xray

A

mesenteric ischemia, colitis, IBD

48
Q

Icteric stage

A

in hepatits C /second state after pre-icteric
weight loss, jaundice, pruritus, RUQ pain, clay colored stool, dark urine

49
Q

DX and MTG of mesenteric ischemia

A

abdominal xray first then CT
emergent surgical intervention

50
Q

Rovsings sign

A

RLQ pain when pressure applied to LLQ in appy

51
Q

Obturator sign

A

pain with internal rotation of flexed right thigh
in appy

52
Q

psoas sign

A

pain with right thigh extension - in appy

53
Q

mcburneys point

A

associated with appy
one-third the distance from anterior superior iliac spine to the umbilicus

54
Q

how to dx appendicits

A

CT or ultrasound
WBC 10-20, 000

Review (16 decks)

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