GI 1 Flashcards
top 3 causes of pancreatitis
alcohol
gallstones
hypertriglyceridemia (over 1,000)
what liver enzyme elevated in biliary pancreatitis
ALT
more than one episode of acute pancreatitis with unknown cause.. next step?
ERCP
tx of IBD induced toxic megacolon
IVF
ATBs
IV corticosteroids
if doesn’t resolve, subtotal colectomy with end ileostomy
GB wall thickening and pericholecystic fluid. dx?
acalculous cholecystitis
subcutaneous crepitus and pneumomediastinum
esophageal rupture
bloody stools and travel to endemic area (southeast asia, africa, central and south america)
entamoeba histolytica
benign, unconj hyperbilirubinemia
Gilbert
benign, conj hyperbilirubinemia WITHOUT pigmented granules
Rotor syndrome
benign, conj hyperbilirubinemia WITH pigmented granules
Dubin Johnson
bad unconj hyperbilirubinemia
- tx
Crigler Najjar
phototherapy and plasmapharesis in short term
liver transplant to cure
ATB that can tx nausea secondary to gastroparesis
and mechanism
erythromycin
motilin receptor agonist
FAST exam shows fluid in splenorenal angle
- next step
if hemodynamically stable: CT to look for grade of injury
if not hemodynamically stable: ex lap
sxs of small bowel obstruction
management
abd pain, vomiting can't pass flatus or stool hyperactive BS distended, tympanitic abd distended loops of small bowel with air fluid lvls
bowel rest, NGT, IVF
surgery for signs of complications (ischemia, bowel perf)
differential and management of dysphagia to solids and liquids
achalasia, pseudoachalasia (esophageal ca)
endoscopic evaluation
imaging of ischemic colitis
bowel edema
air (pneumatosis) in bowel wall
med to prevent vatical hemorrhage, and alternative
nonselective beta blocker (like propranolol)
endoscopic variceal ligation
lab diagnoses of wilson’s disease
low serum ceruloplasmin, less than 20
increased urinary copper excretion
liver biopsy shows hepatic copper level greater than 250 dry weight
pathology of GI problems in polymyositis
problems with striated muscles of upper 1/3 of esophagus
2 options to dx achalasia, and best dx of achalasia
manometry (best)
barium esophagram
air under diaphragm from perforated peptic ulcer. next step
surgery
gastroschisis associated problems
short gut syndrome
NEC
dysmotility
management gastroschisis
sterile saline dressings and plastic wrap
surgery asap
omphalocele associated defects
cardiac
NTD
trisomies
acute mesenteric ischemia labs
incr amylase
metabolic acidosis - from incr lactate (or can see decr bicarb)
incr wbc
incr Hb
what type of GI bleed gives incr BUN/Cr
upper GI bleed
chronic epigastric pain worse supine and at night
pancreatic cancer
signs of biliary obstruction
painless jaundice
conj bilirubinemia
incr alk phos
common postgastrectomy syndrome
sxs
tx
dumping syndrome
N/D/cramps
sweat, palpitations
small, frequent, high fiber and protein foods
lactose intolerance tests
positive hydrogen breath test
positive stool for reducing substances
low stool pH
high stool osmotic gap
