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PANRE > GI > Flashcards

GI Flashcards

Review GI for PANRE

1
Q

Types of Esophagitis

A
  1. Infectious
  2. Candidiasis
  3. Herpes
  4. CMV
  5. Pill Induced
  6. Radiation induced
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2
Q

Treatment for Herpes Esophagitis?

A

Valacyclovir/Famciclovir

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3
Q

Tx for CMV Esophagitis?

A

IV Ganciclovir

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4
Q

Motor disorder to dysphagia to solids and liquids, Dx of choice?

A

Modified Barium Swallow

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5
Q

Most common Esophageal motor disorder?

A

Achalasia

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6
Q

What happens in Achalasia?

A

increase in :LES pressure, incomplete relaxation of the LES with swallowing, and aperistalsis in the esophagus

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7
Q

What does Barium swallow show in Achalasia?

A

Classic “Birds Beak” Deformity in the LES and is confirmed by Esophageal manometry

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8
Q

What is one of the main causes of upper GI bleeding?

A

Mallory Weiss tear

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9
Q

Where does MW tear occur

A

Distal Esophagus at GI junction 2 to bouts of wretching and vomiting, seen in alcoholic binges.

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10
Q

Dx MW tear?

A

Endoscopy

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11
Q

Distal esophagus typically involves what type of cancer?

A

Adenocarcinoma

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12
Q

Middle or distal esophagus typically involves?

A

Squamous cell carcinoma

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13
Q

SS of esophageal cancer?

A

Most common presenting sxm is progressive dysphagia to solids, then liquids. Wt loss, anorexia, chest pain….

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14
Q

Initial workup of esoph cancer?

A

Barium esophagram then confirm with upper endoscopy with biopsy

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15
Q

Barrett’s Esophagus leads to…..

A

Adenocarcinoma of esophagus

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16
Q

GERD leads to

A

Barretts Esophagus

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17
Q

What is the diagnostic study of choice for a Schatzki ring

A

Barium Esophagram

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18
Q

What is a Zenker Diverticulum?

A

Outpouching of esophagus between the inferior pharyngeal constrictor and cricopharyngeal muscles—spontaneous regurgitiation of food s/p ingestion of food several hours post. Dysphagia common also. DX Barium esophogram.

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19
Q

Portal Hypertesion can cause?

A

Esophageal Varices, can cause massive upper GI bleeding.

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20
Q

Diagnostic of choice for Varices?

A

Endoscopy

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21
Q

Hallmark of GERD?

A

Reccurrent Heartburn: If persistent think stricture of adenocarcinoma

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22
Q

Gold standard for ID GERD?

A

Esophageal PH Monitoring

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23
Q

TX of GERD?

A

Try trial of PPI also antacids, H2 receptor agonists.

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24
Q

H Pylori common cause of?

A

Gastritis

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25
Q

H Pylori testing?

A

Triple TX: PPI plus 2 abx ( Amoxicillin plus Metronidazone) or other 3-4 treatment therapy similar
Stop NSAIDS if possible.

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26
Q

Most common cause of upper GI bleeding?

A

Peptic Ulcer Disease

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27
Q

Projectile nonbilious vomiting, +/- blood tinged with a palpable Olive Shaped oval mass in mid epigastrum in a 3 week to 5 month old?

A

Pyloric Stenosis

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28
Q

Abd US shows what in Pyloric Stenosis?

A

Elongated pyloric channel and thickened pyloric wall and on Radiograph look for “String Sign”

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29
Q

Tx for Pyloric Stenosis

A

Pyloromyotomy

30
Q

Obstruction of a cystic duct is known as?

A

Acute Cholecystitis

31
Q

SS Cholecystitis

A

Severe RUQ pain greater than 6 hours, + Murphy’s sign

32
Q

Murphy’s sign?

A

asking the patient to breathe out and then gently placing the hand below the costal margin on the right side at the mid-clavicular line (the approximate location of the gallbladder). The patient is then instructed to inspire (breathe in). Normally, during inspiration, the abdominal contents are pushed downward as the diaphragm moves down (and lungs expand). If the patient stops breathing in (as the gallbladder is tender and, in moving downward, comes in contact with the examiner’s fingers) and winces with a ‘catch’ in breath, the test is considered positive. In order for the test to be considered positive, the same maneuver must not elicit pain when performed on the left side

33
Q

US for choleycystitis?

A

*Pericholeycystic fluid, stones, gallbladder wall thickening,

34
Q

Tx for Choleycystitis?

A

Lap choley with abx

35
Q

Cholelitihiasis risk factors

A

Female, fat, forty, fertile

36
Q

Cholelitihiasis

A

stones pass out of the gallbladder and lodge in the hepatic and common bile ducts, obstructing the flow of bile into the duodenum.

37
Q

Type of pain involved with Cholelithiasis?

A

Episodic pain due to obstruction of cystic duct. RUQ pain with radiation to the right shoulder of scapula.
Wave-like, cramping, pain develops 15 min to 2 hours post eating a fatty meal. N/V also possible

38
Q

DX cholelithiasis?

A

US gold standard, ERCP is diagnostic and theraputic

39
Q

Ursodeoxycholic acid?

A

Stones less than 1.5 cm and non-pigmented ok with this

tx Also can use Litrhotripsy

40
Q

3 phases of hepatitis

A

1) Incubation phase: virus detected but pt asymptomatic with normal labs
2) Pre-icteric phase: Symptomatic with viral specific antibodies detected and increase in Liver enzyme labs
3) Icteric Phase: Symptoms worsen, Jaundice appears, liver labs 10 times upper limit (AST/ALT), Urine darkens, stool lighter in color

41
Q

What 2 hepatitis don’t cause chronic Hep?

A

Hep A and E

42
Q

What 2 hep are Fecal and Oral route?

A

Hep A and E

43
Q

What 3 hepatitis are chronic?

44
Q

What Hep vaccine recommended at birth

45
Q

Tx for Hep C

A

Pegylated Interferon-alpha and Ribavirin

46
Q

Wilson’s disease?

A

or hepatolenticular degeneration is an autosomal recessive genetic disorder in which copper accumulates in tissues; this manifests as neurological or psychiatric symptoms and liver disease. It is treated with medication that reduces copper absorption or removes the excess copper from the body, but occasionally a liver transplant is required

47
Q

Kayser–Fleischer rings

A

Think Wilson’s disease, copper accumulation of copper around the cornea of eyes

48
Q

Most common sign of chronic liver disease?

A

Fatigue with liver tenderness

49
Q

Most common primary malignancy of liver?

A

Hepatocellular carcinoma: s/s obstructive jaundice can metastasize to lymp and lung

50
Q

What is elevated in hepatocellular carcinoma?

A

Alpha-Fetoprotein

51
Q

Jaundice is a…

A

Failure to metabolize bilirubin

52
Q

S/S of Chirrosis?

A

Jaundice, Variceal bleeding, Ascites, spont bacterial peritonitis

53
Q

Tx of Wilson’s disease?

A

A chelating agent, Pencicillamine

54
Q

Epigastric pain with radiation to the back, think of?

A

Acute Pancreatitis, also with N/V/abd pain

55
Q

Risk factors for Pancreatitis?

A

ETOH, Gallstones, Pancreatic obstruction, Drugs/toxins, Hypertriglyceridemia

56
Q

Severe Pancreatitis signs

A

Grey Turners Sigh (Echymosis of flanks)

Cullen’s sign ( Periumbilical ecchymosis)

57
Q

An autosomal recessive liver disease that causes increased Ferritin and Hepatic Iron Index?

A

Hemochromatosis

58
Q

What labs elevated with Acute Pancreatitis?

A

Serum Lipase and Amylase also can have hypercalcemis

59
Q

Tx of acute Pancreatitis?

A

Fluids
NPO until pain resolved
Pain control
may need cholecystectomy/ERCP

60
Q

Most common cause of Chronic Pancreatitis?

A

Alcoholism

61
Q

Most sensitive/specific test for chronic Pancreatitis?

62
Q

Most common location for Pancreatic Adenocarcinoma?

A

Head of Pancreas

63
Q

Tumor Marker for Pancreatic Cancer?

64
Q

Diagnostic of choice for possible Pancreatic Cancer?

A

CT scan of abdomen

65
Q

Tx of Pancreatic cancer

A

surgical resection, Whipple, 5 FU post resection/Radiation tx

66
Q

What is cause of Appendicitis?

A

Obstuction by a Fecalith

67
Q

SS of appendicitis?

A

Colcky RLQ pain. Vomitting, anorexia, later fever

68
Q

Positive signs of appendicitis?

A

Rovsing, Psoas, and Obturator signs

69
Q

Osmotic Laxitives?

A

Works to soften stool, Lactulose, Sorbitol. Works in colon, osmotic effect, increases peristalsis

70
Q

Saline Laxitives?

A

Magnesium Hydroxide

71
Q

Emollient laxatives?

A

Docusate sodium/mineral oil. Promotes stool softening

72
Q

Stimulant laxatives?

A

Senna/Biscodyl

PANRE (14 decks)

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