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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
Most common causes of LGIB in persons less than 50
``` Infectious colitis Anorectal disease (bright red blood drips out after BM) IBD Neoplasm (most common) ISchemic colitiis - cocaine users ```
26
A pt has currant jelly stools. The doctor has you do a CT angiogrpahy to dx. Tx with lapartomy
acute mesenteric ischemia
27
What are the top 3 things that can cause (+) occult blood test? What pushes the dx to neoplasm?
1. Neoplasm with anemia especially!! 2. Vascular lesions 3. Acid/Peptic lesion 4. Infection
28
What causes acute paralytic ileus
abdominal surgeries, opioids, hypokalemia, sepsis
29
Who is at risk for ectopic preg
infertile pts, appendicitis
30
SAAG over 1.1, but portal htn tests are negative
Myxedema
31
When you see an elevated lipase count, what should you discount first before assuming pancratic insufficiency?
Salivary gland disease and intestinal perforation
32
When you see an elevated amylase count, what should you discount first before assuming pancratic insufficiency?
Opioids, Mumps, Gastroenteritis, Ectopic preg
33
A pt with the following will have a worse progrnosis of chronic pancreatits:
high LDH, low Ca, hypoalbuminemia
34
It pt is in shock and PRBCs didn't help, whatchu do now
Vasopressor
35
``` What test goes to what organ? Ranson BISAP ATLANTA APACHE ``` MELD MADDREYS Glascow ROME
Pancreas MELD - Glascow Liver IBS
36
Imaging differences between acute and chronic pancreatitis
``` Acute = Cut Off sign Chronic = chain of lakes calcifications ```
37
Name the TIGAR O thing
``` Toxic - Alcohol, tobacco Idiopathic Genetic - CF, SPINK, PRSS1 Autoimmune - IgG4 thing - Corticosteroids are good here Recurrent acute - SAPE Obstructive ```
38
Difference between cholecystitis and ascending cholangitis
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
Which imaging is best in ascending cholangitis? Acute pancreatic pseudocyst drain? Biliary dyskinesia? Cholecystitis?
ECRP EUS HIDA HIDA
40
Complications of cholelithiasis?
Gangrene, Emphymatous gallbladder,
41
What are the common infections in ascending cholangitis?
E. Coli, Klebsiella, Enterococcus
42
Most common infections in primary spontaneous bacterial peritonitis? How do you prevent these? How do you treat?
E Coli, Kleb, Entero, Strep Viridans/pneumo Fluorquinolone 4rd gen ceph with amoxicillin
43
Pt presents with serositis in his joints and lungs and peritonitis. What do you give him to prevent future attacks? What kills these guys/
Family Mediterranean Fever Colchicine Secondary amyloidosis in kidney
44
What do you treat acetaminophen overdose with? Score with
n-acetyl cysteine | Nomach - Matthew nomogram
45
Pt presents with prolonged PT; cerebral edema, encephalopathy within 8 weeks of High AST/ALT. What do these dudes die from
Fulminant hepatitis | GI Bleeding, Respiratory failure, CV COllapse, Renal failure
46
Hepatorenal syndrome
pentoxyifylline
47
Pts with hemochromatosis have increased risk of infection with
Yersinia, LIsteria, Vibrio
48
Liver enzymes AST/ALT are greater than 5000mg/
Heart failure liver dz nutmeg liver
49
What are 3 causes of non cirrhotic PHTN?
- Prtal vein thrombosis - Splenic vein thrombosis - SChistosoma
50
You see pancytopenia, WHy
Cirrhosis due to hypersplenism
51
Tell me about MELD and Child Peugh
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
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?
He got HEP E
53
#1 child killer virus
Rotavirus
54
Common causes of secretory diarrhea
Endocrine tumors
55
What are the sx of micrsoscopic colitis? Tx?
women watery diarrhea | treat with loperamide
56
FAP/Lynch Syndrome + Malignant CNS (medulloblastoma
Turcot
57
How do you treat perianal disease?
Metronidazole
58
Pt presenst with moon facies, striae and stuff after being given what drug?
Corticosteroids
59
What cause acute interstitial nephritis?
Hep B and also ASA
60
What do you administer with folate always?
AZO type of ASA
61
What is the MOA of the following: - Infliximab - Adalimumab: - Natalizumab: - Vedolizuman
``` 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
Most common cause of jaundice?
Hemolysis
63
What are the phases of kernicturus?
1-2 days: poor suckling, stupor, high pitched cry, hypotonia First week of life: opishtotonus AFter: Hypertonia
64
Signs and sympetoms o fbiliary atresia
** 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
Pt with anemia, thrombocytopenia, and elevated creatine
EHEC hemolytic uremic syndrome
66
Contraindicatios of bismuth?
If pt is on antiplatelets or has renal failure; | absolute: GI Bleed
67
Uses of misoprostal
Abortion Induce labor PGE for ulcers
68
Diphenyhydramine, dimenhydramine, hydroxyizne, myclozine, are examples of what?
H1 antagonist for anti-emetic
69
Chlorpromazine, perphenazine, prochlorperazine are examplse of what?
D2 antagonists
70
If a pt is having pancreatic trouble, what diarrahetic do you not want to give them?
not opioid eluxamide bc decreases pancreatic secretions and could cause acute pancreatitis
71
``` Crofelemer Hoscyamine Linaclotide Lubiprostone Salines Tofcitinab Ustekinumab ```
``` 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
What cause anal leakage
Docusate

GI (2 decks)

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