GI Flashcards
What are the standard three drug regimens for H. Pylori eradication?
ECA — Esomeprazole, Clarithromycin, and Amoxicillin or
ECM — Esomeprazole, Clarithromycin, and Metronidazole
What is the standard three drug regimen for H. Pylori eradication if there is penicillin allergy and no recent macrolide use?
ECM — Esomeprazole, Clarithromycin, and Metronidazole
What is the standard four drug regimen for H. Pylori eradication which is especially useful if there is a penicillin allergy and recent macrolide use?
EBMT — Esomeprazole, Bismuth Subsalycylate, Metronidazole, and Tetracycline
What serologies would be present in a patient with acute Hep A virus infection?
Anti-HAV, IgM
What serologies would be present in a patient with acute Hep B virus infection?
HBsAG, HBe-AG, anti-HBc, IgM
What serologies would be present in a patient with chronic Hep B virus infection?
HBsAG, anti-HBe, anti-HBc, IgM, IgG
What serologies would be present in a patient with recovered Hep B virus?
Anti-HBs, anti-HBc
What serologies would be present in a patient with acute Hep C virus infection?
Anti-HCV, HCV RNA
What serologies would be present in a patient with chronic Hep C virus infection?
Anti-HCV, HCV RNA
How is current HCV infection differentiated between prior exposure?
PCR
What clinical scoring system is used to evaluate risk of mortality in acute pancreatitis?
Ranson’s criteria
What are the components of Ranson’s criteria?
George — age greater than 55 (>70 for gallstones)
Washington — WBC > 16,000
Got — glucose >200
Lazy — LDH >350
After — AST >250
He — Hct drop >10
Broke — BUN elevation >5
C — calcium <8
A — arterial 02 <60
B — base deficit >4
E — estimated fluid sequestration >6L
The presence of 5 of Ranson’s criteria is associated with what mortality rate?
5-6 risk factors = 40% mortality
The presence of 5 of Ranson’s criteria is associated with what mortality rate?
5-6 risk factors = 40% mortality
The presence of 8 of Ranson’s criteria is associated with what mortality rate?
> 7 risk factors = 100% mortality
How many calories are required to meet basic metabolic demands?
25-30 kcal/kg/day nutritional support
What are indications for stress ulcers prophylaxis?
Mechanical ventilation >48 hours, use of vasopressors, coagulopathy, steroid use, TBI, severe burn, sepsis, hx of PUD/GI bleeding.
What diagnostic test is a priority for a patient presenting with diverticulitis?
Plain abdominal films to look for pneumoperitoneum.
What is the gold-standard diagnostic test for cholecystitis?
Abdominal ultrasound
What is the gold-standard diagnostic test for pancreatitis?
CT (more useful than US)
What is the gold-standard diagnostic test for appendicitis?
US or CT
What electrolyte derangements are characteristic of refeeding syndrome?
Hypocalcemia, hypokalemia, hypophosphatemia, hypomagnesemia, and thiamine deficiency.
What drugs are used in the treatment of ulcerative colitis?
Mesalamine and hydrocortisone suppositories and/or enemas
What drugs are used in the treatment of diverticulitis?
NPO, IVF, abx — cipro + flagyl or levo + flagyl
