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family medicine EOR exam > gastrointestinal > Flashcards

gastrointestinal Flashcards

1
Q

hematemesis or melena

A

upper GI bleed

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2
Q

diagnostic study for upper GI bleed?

A

endoscopy and erythromycin IV to help gastric emptying/improve quality of endoscopy

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3
Q

labs to get if GI bleed

A

CBC, PT INR, creatinine, liver enzymes, blood type and cross

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4
Q

when might you suspect a stricture?

A

gradual development of solid food dysphagia

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5
Q

most common cause of gastritis

A

Hpylori

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6
Q

hpylori tx

A

PPI BID plus clarithromycin 500mg BId plus amoxil 1g po BID x 10-14 days

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7
Q

jaundice differential

A

acute cholangitis, viral hepatitis, extrahepatic biliary obstruction, unconjugated or congugated hyperbilirubinemia, alcoholism

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8
Q

fever, chill, RUQ pain and maybe hx prior biliary surgery

A

acute cholangitis

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9
Q

portal htn, hepatomegaly, ascites, abdominal pain, fatigue, anorexia, skin telangectasis, clubbing, jaundice

A

cirrhosis

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10
Q

definitive tx cirrhosis

A

liver transplant

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11
Q

fatigue, malaise, anorexia, nausea, tea colored urine, abdominal discomfort

A

acute hepatitis

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12
Q

HBsAb

A

antibody (immunity)

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13
Q

HBcAb

A

core antibody (window period) prior or current infection

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14
Q

HBsAg

A

surface antigen (carrier state)

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15
Q

IgM HAVAb

A

acute hepatitis A

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16
Q

HAVIgG

A

resolved Hep A

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17
Q

anti-HBc, HBsAG, HBeAg

A

active infection

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18
Q

dull steady abdominal then suddently becomes epigastric and worse, may radiate to back, N&V, anorexia, diarrhea, tachy, fever, abd tenderness//guarding

A

acute pancreatitis

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19
Q

you suspect pancreatitis. next step?

A

serum lipase and amylase, CB with diff, CMP, CRP, abdominal US to r/o gallstones, CT if needed

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20
Q

pancreatic calcifications, steatorrhea, DM is a classic triad of what?

A

chronic pancreatitis

21
Q

test of choice for chronic pancreatitis

A

MRCP to demonstrate duct obstruction and calcifications

22
Q

tx chronic pancreatitis

A

low fat diet, surgical removal, no alcohol

23
Q

tenesmus, bloody diarrhea, LLQ pain, weight loss, malaise

A

UC

24
Q

toxic megacolon and malignancy complications of what?

A

UC

25
Q

skip lesions, diarrhea and abd cramps, low grade fever, anemia

A

chrons

26
Q

most common place for chrons and what is spared

A

terminal ileum and right colon….rectum spared

27
Q

tx chrons

A

prednisone for acute attacks, metronidazole and cipro if perianal disease/fissures, infliximab or mesalamine, segmental resection

28
Q

tx UC

A

aminosalicyclates and corticosteroids…surgery can be curative

29
Q

tx UC

A

aminosalicyclates and corticosteroids…surgery can be curative

30
Q

labs to get during appendicitis

A

CBC, amylase and lipase, pelvic US

31
Q

insidious onset of low grade fever, diarrhea, RLQ pain, abdominal mass…hx prior surgery

A

bowel obstruction

32
Q

you suspect bowel obstruction. dx step?

A

CT

33
Q

causes of lower GI bleed

A

diverticulosis, angioectasis, neoplasms, IBD, anorectal disease, ischemic colitis

34
Q

tx giardia

A

metronidazole and fluid resuscitation

35
Q

dx of giardia

A

3 stool samples on 3 different days

36
Q

severe pain during bm with pain lasting several hours after. bleeding

A

anal fissure

37
Q

tx anal fissure

A

fiver supplements and stool softeners, sitz baths. second line nitroglycerine ointment…botox….surgery if sxs remain after a month with no resolution of conservative therapy

38
Q

itching or irritation of anal region…painless bleeding or painful BM

A

hemorrhoids

39
Q

grade of hemorrhoids:

A

1–projects to anal canal does not prolapse
2–protrude with straining but spontaneously reduce
3–protrude spontaneously and need manual reduction
4–chronic prolapse and cant reduce/strangulated

40
Q

tx hemorrhoids

A

fiber supplements, increase water intake, sitz baths, topical steroids…hemorrhoidectomy if grade 4 or incarcerated

41
Q

when is surgery on hernia for sure indicated?

A

incarcerated

42
Q

hiatal hernia tx

A

PPIs or surgery

43
Q

dx hiatal hernia

A

barium contrast study, upper GI

44
Q

40 yo obese woman with elevated alk phos, bilirubin, and pruritis, dark urine, and clay colored stool

A

biliary tract obstruction

45
Q

causes of drug induced hepatitis

A

tylenol, TB medications, tetracycline

46
Q

charcot’s triad and what is it a sign of?

A

RUQ pain, jaundice, fever/chills. sign of ascending choangitis

47
Q

4yo presents with oliguria, petechiae, jaundice following illness with bloody diarrhea

A

hemolytic uremic syndrome due to E coli

48
Q

epigastric pain that radiates to back and relieved by sitting forward. managment?

A

get amylase and lipase levels/confirm acute pancreatitis and make patient NPO with iv fluids, o2 and analgesia

family medicine EOR exam (14 decks)

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