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GI 2 Exam 2 Flashcards

1
Q

Endocsopy shows rings that look like a trachea in side the esophagus. Dx

A

Eosinophilic esophagitis

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2
Q

What can strictures be caused by?

A

GERD and basic ingestions

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3
Q

Which dysphasias are progressive

A

Yes:

  • Eso stricture
  • SSC Eso
  • Achalasia
  • Webs

NOT:

  • diffuse esophageal spasm
  • Nutcracrker esophagus
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4
Q

Pt presents with alkalosis, renal failure and hypercalcemia. What drug is she on

A

Calcium carbonate antacid, this is milk alkali syndrome

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5
Q

What 5HT3 inhibitor treats IBS-D

A

Alosetron

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6
Q

What H1 antagonist is good for pregnancy only

A

Doxylamine +B6

H2

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7
Q

What can you use as antidiarrheal?

A
  • 5HT3 (Alosetron)
  • Cl- channel (Crofelemer)
  • opioids (x3)
  • bismuth???
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8
Q

What do you use as antiabdominal pain?

A
  • Antimuscarinic (antispasm)

-

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9
Q

Tx for constipation?

A

-Guanylate cyclase C (linaclotide)
- Peripheral opioid
- C2 Cl- channels (lubiprostone)
Laxatives
- Osmotics (lactulose, polyethylene glycol)
- Salines
- Bulk forming psyllium
- emollient (docusate)
- senna (stimulant/irritant)

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10
Q

Sever UC and CD

A

Corticosteroids

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11
Q

What ar the UC drgus?

A

5 ASA
TNF
Integrin
Jak INhibitors

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12
Q

What are the Crohn’s inhibitors

A
  • IL 12 and 23 inhibitors
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13
Q

A female patient with IBS diarrhea is treated a month ago. She comes in today with bloody stool and acute abdomen. What drug was she on?

A

5HT3 alosetron; causes ischemic colitis

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14
Q

Pt presents with melanosis coli. What medication was used for his pre-colonoscopy?

A

it’s a stimulant laxative; propokik or senna

Prepopkik is for pre colonscopy only

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15
Q

When do you use olsalazine? balsalazide

A

when UC is Over.

For acute males

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16
Q

What are some of the contraindications//things you need to do before TNF a or integrin

A

TNF inhbiitors: TB testing; liver toxicity

Integrin a: PML with JC virus

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17
Q

What are the treatments for the following:
UC only
CD only
Both

A

UC only
5ASA
JAK stat inhibitor

CD only
IL12/23 inhibitors
Natalizumab (A-4 integrin)

Both
TNF inhibitors
A-4 integrin vedolizumab

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18
Q

Enlarged salivary glands, yellow eyes, dysuria, bright yellow pee are side effects for what tx

A

Nitazoxanide

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19
Q

What are the contraindicatinos of ribavirin?

A

Pregnancy, anemia

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20
Q

how do you prevent Curling ulcer in burn patinets?

A

Enteral nutrition, H2, PPI

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21
Q

How to you treat ZE?

A

Chemo or PPI

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22
Q

What are the 3 ulcer complications

A

obstruction

hemorrhage perforation

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23
Q

A pt’s blood sample shows an extremely high BUN number and a low Creatine. about 30:1 ratio. What’s the dz/

A

UGIB

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24
Q

What is gastric outlet syndrome caused by

A

fibrous stuff around the pylorus

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25
Q

Most common causes of LGIB in persons less than 50

A 
Infectious colitis
Anorectal disease (bright red blood drips out after BM)
IBD
Neoplasm (most common)
ISchemic colitiis - cocaine users
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26
Q

A pt has currant jelly stools. The doctor has you do a CT angiogrpahy to dx. Tx with lapartomy

A

acute mesenteric ischemia

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27
Q

What are the top 3 things that can cause (+) occult blood test?

What pushes the dx to neoplasm?

A
  1. Neoplasm with anemia especially!!
  2. Vascular lesions
  3. Acid/Peptic lesion
  4. Infection
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28
Q

What causes acute paralytic ileus

A

abdominal surgeries, opioids, hypokalemia, sepsis

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29
Q

Who is at risk for ectopic preg

A

infertile pts, appendicitis

30
Q

SAAG over 1.1, but portal htn tests are negative

A

Myxedema

31
Q

When you see an elevated lipase count, what should you discount first before assuming pancratic insufficiency?

A

Salivary gland disease and intestinal perforation

32
Q

When you see an elevated amylase count, what should you discount first before assuming pancratic insufficiency?

A

Opioids, Mumps, Gastroenteritis, Ectopic preg

33
Q

A pt with the following will have a worse progrnosis of chronic pancreatits:

A

high LDH, low Ca, hypoalbuminemia

34
Q

It pt is in shock and PRBCs didn’t help, whatchu do now

A

Vasopressor

35
Q 
What test goes to what organ?
Ranson
BISAP
ATLANTA
APACHE

MELD
MADDREYS
Glascow
ROME

A

Pancreas

MELD - Glascow Liver

IBS

36
Q

Imaging differences between acute and chronic pancreatitis

A 
Acute = Cut Off sign
Chronic = chain of lakes calcifications
37
Q

Name the TIGAR O thing

A 
Toxic
- Alcohol, tobacco
Idiopathic
Genetic
- CF, SPINK, PRSS1
Autoimmune
- IgG4 thing 
- Corticosteroids are good here
Recurrent acute 
- SAPE
Obstructive
38
Q

Difference between cholecystitis and ascending cholangitis

A

Cholecystitis is in the gall bladder inflammation; no jaundice here, but murphys sign yes.

Ascending cholangitis involves the tree. here you’ll see jaundice and

39
Q

Which imaging is best in ascending cholangitis? Acute pancreatic pseudocyst drain? Biliary dyskinesia? Cholecystitis?

A

ECRP
EUS
HIDA
HIDA

40
Q

Complications of cholelithiasis?

A

Gangrene, Emphymatous gallbladder,

41
Q

What are the common infections in ascending cholangitis?

A

E. Coli, Klebsiella, Enterococcus

42
Q

Most common infections in primary spontaneous bacterial peritonitis? How do you prevent these? How do you treat?

A

E Coli, Kleb, Entero, Strep Viridans/pneumo

Fluorquinolone

4rd gen ceph with amoxicillin

43
Q

Pt presents with serositis in his joints and lungs and peritonitis. What do you give him to prevent future attacks? What kills these guys/

A

Family Mediterranean Fever
Colchicine
Secondary amyloidosis in kidney

44
Q

What do you treat acetaminophen overdose with? Score with

A

n-acetyl cysteine

Nomach - Matthew nomogram

45
Q

Pt presents with prolonged PT; cerebral edema, encephalopathy within 8 weeks of High AST/ALT. What do these dudes die from

A

Fulminant hepatitis

GI Bleeding, Respiratory failure, CV COllapse, Renal failure

46
Q

Hepatorenal syndrome

A

pentoxyifylline

47
Q

Pts with hemochromatosis have increased risk of infection with

A

Yersinia, LIsteria, Vibrio

48
Q

Liver enzymes AST/ALT are greater than 5000mg/

A

Heart failure liver dz nutmeg liver

49
Q

What are 3 causes of non cirrhotic PHTN?

A
  • Prtal vein thrombosis
  • Splenic vein thrombosis
  • SChistosoma
50
Q

You see pancytopenia, WHy

A

Cirrhosis due to hypersplenism

51
Q

Tell me about MELD and Child Peugh

A

MELD = End StageLiver Disease, if over 14 then must have transplant.
Child Pugh = Assess teh prognosis of cirrhosis C = bad
MELD= **CMP, bilirubin, creatinine, PT/INR

52
Q

A patient recently has a transplant and is put on tacrolimus. A few months later the pt presents back with cirrhosis of the liver. WHat has happened?

A

He got HEP E

53
Q

1 child killer virus

A

Rotavirus

54
Q

Common causes of secretory diarrhea

A

Endocrine tumors

55
Q

What are the sx of micrsoscopic colitis? Tx?

A

women watery diarrhea

treat with loperamide

56
Q

FAP/Lynch Syndrome + Malignant CNS (medulloblastoma

A

Turcot

57
Q

How do you treat perianal disease?

A

Metronidazole

58
Q

Pt presenst with moon facies, striae and stuff after being given what drug?

A

Corticosteroids

59
Q

What cause acute interstitial nephritis?

A

Hep B and also ASA

60
Q

What do you administer with folate always?

A

AZO type of ASA

61
Q

What is the MOA of the following:

  • Infliximab
  • Adalimumab:
  • Natalizumab:
  • Vedolizuman
A 
Infliximab:
- monoclonal antibody to TNF
Adalimumab:
- Synthetic Anti-TNF 
Natalizumab:
- Anti integrin
- Can cause PML
Vedolizuman
- Super specific anti integrin 
- No serious side effects
62
Q

Most common cause of jaundice?

A

Hemolysis

63
Q

What are the phases of kernicturus?

A

1-2 days: poor suckling, stupor, high pitched cry, hypotonia
First week of life: opishtotonus
AFter: Hypertonia

64
Q

Signs and sympetoms o fbiliary atresia

A

** S/Sx
Cholestastic jaundice (direct hyperbilirubinemia)
Hepatomegaly
Pale stools (bilirubin is the pigment in stool)
This happens at the common bile duct before it hits the pancreas

65
Q

Pt with anemia, thrombocytopenia, and elevated creatine

A

EHEC hemolytic uremic syndrome

66
Q

Contraindicatios of bismuth?

A

If pt is on antiplatelets or has renal failure;

absolute: GI Bleed

67
Q

Uses of misoprostal

A

Abortion
Induce labor
PGE for ulcers

68
Q

Diphenyhydramine, dimenhydramine, hydroxyizne, myclozine, are examples of what?

A

H1 antagonist for anti-emetic

69
Q

Chlorpromazine, perphenazine, prochlorperazine are examplse of what?

A

D2 antagonists

70
Q

If a pt is having pancreatic trouble, what diarrahetic do you not want to give them?

A

not opioid eluxamide bc decreases pancreatic secretions and could cause acute pancreatitis

71
Q 
Crofelemer
Hoscyamine
Linaclotide
Lubiprostone
Salines
Tofcitinab
Ustekinumab
A 
Cl- inhibitor for diarrhea
antimuscarinics for abdominal pain
Guanylate Cyclase C
Cl- channel activator for constipation
Saline- Mg, sodium phosphate
Toficitaniab - Jak inhibitor for UC
Ustekinumab - Il12/23 inhibitor crohns
72
Q

What cause anal leakage

A

Docusate

GI (2 decks)

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