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Final Exam Prep > GI > Flashcards

GI Flashcards

1
Q

What are the main causes of peptic ulcer disease

A

H. Pylori is 1
NSAIDS, Aspirin, Steroids, Smoker, stress

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2
Q

Are younger patients more likely to have duodenal or gastric ulcers?

A

Duodenal

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3
Q

What are the s/s of peptic ulcer disease?

A

Gnawing pain from the inside out, relief of pain w/ food is duodenal, worse with food is gastric, GIB, melena, hematesis, coffee ground emesis

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4
Q

S/S of bowel perforation

A

Board-like abdomen, quiet bowel sounds, rigidity

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5
Q

Diagnostic testing for peptic ulcer disease

A

Endoscopy

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6
Q

Peptic ulcer disease treatment

A

PPI (watch for rebound GERD), sucrafate

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7
Q

What xray results indicate pneumoperitoneum

A

Free air

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8
Q

What x ray result indicates a bowel perf?

A

Air under the diaphragm

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9
Q

Hep ABC transmission

A

A: Oral fecal
Hep B: blood born
Hep C: Blood IV drug use

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10
Q

Which type of hepatitis can be chronic

A

B and C

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11
Q

General management of Hepatitis infection

A

Supprotive, IVF, avoid alcohol, low to no protein diet, serex, vitamin K, lactulose

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12
Q

Who is diverticulitis more common amungst

A

Women and those with low dietary fiber

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13
Q

S/s of diverticulitis

A

Mild to moderate LLQ aching and pain, constipation or loose stools, N/V, low grade fever

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14
Q

Labs and Diagnostics of Diverticulitis

A

Labs: leukocytosis, ESR, positive heme occult
CT abdomen: colonic diverticula and >4cm wall thickening

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15
Q

Treatment of diverticulitis

A

NPO, bowel rest, IVF, ? Surgery

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16
Q

S/S of cholecystitis

A

Precipitated by a large fatty meal
RUQ/epigastric pain, vomiting, +murphy’s sign, fever, leukocytosis, elevated bili/LDH/Alk phos/AST/ALT/Amylase

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17
Q

What scan can be used to find a gallbladder stone in kidney patients

A

HIDA

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18
Q

What is the treatment for cholecystitis

A

ERCP, IVF, pain management, lap Chole, NPO
ABX: Rocephin and Flagyl

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19
Q

What is Choledocholithiasis

A

Gall stone in the common bile duct

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20
Q

Dx and TX for Choledocholithiasis

A

MRCP/ ERCP, lap Chole, sphinceterotomy
ABX: Unasyn OR Zosyn OR Rocephin if infection

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21
Q

Causes of pancreatitis

A

ETOH, trauma, Chole

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22
Q

S/s of pancreatitis

A

Abrupt onset of epigastric pain with radiation to the back
N/V, pain worse lying flat, tripod positioning, tender to palpation, no rebound pain, fever, tachycardia

23
Q

Pancreatitis work up

A

Elevated amylase and lipase
Hypocalcemia
Elevated CRP
CT ABD

24
Q

What is cullens and grey turners sign

A

Hemorrhagic pancreatitis
Cullens sign: umbilical discoloration
Grey Turners sign: Flank discoloration

25
Q

Pancreatitis treatment

A

Bedrest, NPO, LR, pain medications

26
Q

Pancreatitis complications

A

Azotemia
Necrotic to MODS
Pleural effusion

27
Q

What does a bowel obstruction show on XRay

A

Dilated bowel loops with air fluid levels \
Called Frame pattern

28
Q

Why does a mesenteric infarct occur

A

Inadequate blood flow tend ischemia/gangrene of the bowel
Arterial venous embolus, smoking, athlerosclerosis, post cardiac/thorasic surgery

29
Q

S/s of mesenteric infarct

A

Sudden onset of abdominal cramps, colicky abd pain out of proportion to exam, N/V, hyperactive bowel sounds, shock, Afib with post parandial abdominal pain

30
Q

Labs and diagnostics for mesenteric infarct

A

Leukocytosis
CT

31
Q

What are the causes of appendicitis

A

Undigested food particles or neoplasms that get stuck

32
Q

S/s of appendicitis

A

Starts as umbilical pain and progresses to RLQ with rebound tenderness
N/V
Psoas: right thigh extension pain
Obturator: pain in the opposite side of the abdomen that is palpated

33
Q

H pylori treatment for patients with NO PCN allergy and have not had a macrolide

A

ECA: PPI, Clarithromycin, Amoxicillin
EBMT: PPI, Bismuth, Metronidazole, Tetracycline
ECAM: PPI, clarithromycin, amoxicillin, metronidazole

34
Q

What is the h pylori treatment for a patient who has a PCN allergy and is unable to tolerate bismuth

A

ECM: PPI, clarithromycin, metronidazole

35
Q

H pylori treatment for patients who are allergic to PCN and previously had a macrolide

A

EBMT: PPI, Bismuth, Metronidazole, Tetracycline

36
Q

GERD treatment

A

H2 blocker

37
Q

Hep A serology Active vs Recovered

A

Active: Anti-HAV, IgM
Recovered: Anti-HAV, IgG

38
Q

Hep B Active, Chronic, and Recovered serology (HBsAg, HBeAg, Anti-HBC, Anti HBe, Anti HBs, IgM, IgG)

A

Active: HBsAg, HBeAg, Anti-HBc, IgM
Chronic: HBsAg, Anti-HBC, Anti-HBe, IGM, IgG
Recovered: Anti HBc, anti HBs

39
Q

Acute vs Chronic Hep C serology

A

Acute: Anti-HCV, HCV RNA
Chronic: Anti HCV, HVC RNA
Need a PCR to determine differences

40
Q

What is the gold standard imaging for cholecystitis

A

ABD US

41
Q

Major complications of ERCP

A

Pancreatitis, perforation, hemorrhage, cholangitis

42
Q

What is Ranson’s criteria

A

Evaluate prognosis of pancreatitis
At Admission: George Washington Got Lazy After
->55 yrs old, WBC >16, Glucose >200, LDH > 350, AST> 250
48 hours: He Broke CABE
-Hct Drop >10, BUN >5, Ca <8, A O2 <60, Base deficit <4, fluid sequestration >6K

5-6 risk factors= 40% mortality
>7= 100% mortality

43
Q

What bowel sounds are present in a bowel obstruction

A

High pitched tinkling sounds

44
Q

What is the hallmark sign of ulcerative colitis

A

Bloody diarrhea

45
Q

Treatment of UC

A

Mesalamine and hydrocortisone suppositories

46
Q

What happens to untreated appendicitis

A

Gangrene and perf

47
Q

What is Mc burney’s point

A

Tenderness 1/3 of the way between umbilical and iliac crest indicative of appendicitis

48
Q

What is the Psoas sign

A

Pain with right thigh extension sign of appendicitis

49
Q

Obturator sign

A

Pain with internal rotation of flexed right thigh indicative of appendicits

50
Q

What is a Rovsing sign

A

RLQ pain when LLQ is palpated sign of appendicitis

51
Q

What should not be used to treat diverticulitis

A

Enemas

52
Q

A patient who is 85 with renal history asks if he should have colorectal cancer screening

A

No

53
Q

At what age should a patient be offered if they want to or not for colorectal cancer screening

A

75

Final Exam Prep (19 decks)

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