GI 2 Flashcards
acute diverticulitis bowel habits
up to 50% will have constipation, some will have diarrhea
uncomplicated diverticulitis tx
liquid diet and oral analgesia for 2-3 days then reassess
chronic therapy for diverticulosis
5
high fiber diet with supplementation w/ psyllium/Metamucil or methlycellulose/Citrucel
stop smoking
activity
reduce meat intake
clay colored stools, dark colored urine
acute hepatitis
acute hepatitis - ammonia, prothrombin time, albumin
elevated ammonia and prothrombin time
decreased albumin
rapid onset and severe epigastric and LUQ pain
acute pancreatitis
acute pancreatitis - elevated pancreatitis enzymes include
amylase
lipase
trypsin
acute pancreatitis - calcium
hypocalcemia
sensitive serum tests for pancreatic inflammation
2
amylase
lipase
two testes for c diff
NAAT
stool assay
c diff abx
3
fidaxomicin or vanco
alt is metronidazole
c diff diet
early oral refeeding is encouraged, regular low residue diet; brat diet (bananas, rice, applesauce, toast) is not necessary
most common cause of viral gastroenteritis
norovirus
acute onset of high fever, blood diarrhea, severe abd pain with at least 6 stools in a 24 hour period
bacterial gastroenteritis
symptoms develop within 7 days of exposure and typically last 7 or more days; usually watery diarrhea
protozoal gastroenteritis
GERD can cause damange to squamous epithelium in the lower esophagus causing what
Barrett’s esophagus which increases risk of squamous cell cancer
first line tx for GERD
5
lifestyle changes
avoid large and/or fatty meals, typically 3-4 hours before bedtime
avoid foods/meds that relax sphincter
weight loss
stop smoking
first line treatment for mild to mod GERD or mild esophagitis
H2RA e.g. nizatidine, famotidine - take at bedtime
long term use of PPIs can cause
osteoporosis, bone/hip fractures in post menopausal women, acute interstitial nephritis, reduced absorption of irone, c diff
mod to severe esophagitis - first line
PPI
IBS is a
chronic functional disorder of the colon marked by exacerbations and remissions
bloating with flatulence, relief obtained after defecation
IBS
IBS - antispasmodics for abd pain
dicyclomine/Bentyl
hyoscyamine
IBS with constipation - begin a trial of
fiber supplements, then trial polyethylene glycol/miralax
IBS severe constipation - prescribe
lubiprostone or linaclotide
IBS w/ diarrhea - take what
loperamide before meals; bile acid sequestrants as second line
NAFLD is caused by
triglyceride fat deposits (steatosis) in the hepatocytes of the liver
NAFLD initial imaging
liver US
NAFLD gold standard for dx
biopsy
NAFLD tx plan
5
lose weight
exercise
watch diet
d/c alcohol intake
avoid hepatotoxic drugs
abd pain relieved by food or antacids with recurrence shortly after a meal
gastric ulcer
abd pain relieved by food or antacids with recurrence 2-4 hours after
duodenal ulcer
all patients dx with PUD should be tested for
h. pylori infection
urea breath test is indicative of
active H. pylori infection is commonly used to document eradication of H. pylori after tx
what two tests are more sensitive for active infection h. pylori
urea breath test
stool antigen
gold standard test for h. pylori
upper endoscopy and biopsy of gastric and/or duodenal tissue
tx for h. pylori positive ulcers
triple therapy -
clarithromycin + amoxicillin or metronidazole + PPI
tx for h. pylori negative ulcers
3
stop NSAIDs
use PPI or H2RA
stop smoking
