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PANCE/EOC > GI #3 > Flashcards

GI #3 Flashcards

1
Q

MCC of Esophageal Varices in adults

A

Cirrhosis

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2
Q

Diagnostic of choice for esophageal varice

A

Upper endoscopy

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3
Q

Treatment for esophageal varice

A
  • Stabilize patient: 2 large bore IV lines, IVF
  • Endoscopic variceal ligation (initial)
  • Octreotide is first-line management
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4
Q

What beta blockers prevent re-bleeds of esophageal varices

A

Nadolol or Propanolol

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5
Q

Symptoms of Celiac Disease (Sprue)

A
  • Malabsorption (diarrhea, bloating, steatorrhea, growth delays)
  • Dermatitis Herpetiformis: rash on extensor surfaces, neck, trunk, and scalp
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6
Q

Screening of choice for Celiac Disease

A

-Transglutaminase IgA antibodies

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7
Q

Definitive and confirmatory for Celiac Disease

A

Small Bowel Biopsy (Atrophy of the villi)

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8
Q

Diagnostic of choice for Lactose Intolerance

A

Hydrogen Breath Test

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9
Q

MCC of Peptic Ulcer Disease

A
  • Helicobacter Pylori

- NSAIDs and Aspirin

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10
Q

Symptoms of a Gastric Ulcer

A
  • Dyspepsia (burning, gnawing, epigastric pain)
  • Worse with food
  • Weight loss
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11
Q

Symptoms of Duodenal Ulcers

A
  • Dyspepsia
  • Symptoms relieved with food
  • N/V
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12
Q

Diagnostic test of choice for PUD

A

-Upper endoscopy with biopsy

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13
Q

True or False: All Gastric Ulcers need repeat upper endoscopy to document healing

A

True

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14
Q

Diagnostics for H. Pylori Ulcers

A
  • Endoscopy with biopsy: GOLD STANDARD

- Urea Breath Test, Stool Antigen, Serologic Antibodies

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15
Q

management for H. Pylori infection

A
  • Quad Therapy: Bismuth + Tetracycline + Metro + PPI

- Triple Therapy: Clarithromycin + Amoxicillin + PPI

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16
Q

In regards to ulcers and age ranges, explain.

A
  • Duodenal: Younger patients (30-35)

- Gastric: Older patients (55-70)

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17
Q

MOA for PPI

A

-Block H+/K+ ATPase of parietal cell, reducing acid secretion

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18
Q

When should you suspect a gastrinoma in a patient?

A

-Severe, recurrent, multiple, or refractory ulcers + diarrhea

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19
Q

What is a gastrinoma?

A

Gastrin-secreting neuroendocrine tumor in duodenal wall

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20
Q

Diagnostics for Gastrinoma

A
  • Screening: elevated fasting gastrin levels (initial)

- Confirmatory: secretin test ; persistent gastrin elevations

21
Q

Treatment for Gastrinoma

-MC sites for METS for a Gastrinoma

A
  • Tumor resection
  • Lifelong PPI

-Liver and abdominal lymph nodes

22
Q

What is carcinoid syndrome?

A

Periodic episodes of diarrhea (Serotonin release), flushing, tachycardia, and bronchoconstriction (histamine release) and hypotension

23
Q

Risk Factors for gastric carcinoma

A
  • H. Pylori
  • Preserved foods
  • Obesity
  • Non-Hodgkin Lymphoma
24
Q

Pyloric Stenosis is MC in what population and what other risk factors?

A
  • First 3-12 weeks of life
  • Erythromycin use
  • Caucasians, males, first-borns
25
Q

Symptoms of Pyloric Stenosis

A
  • Nonbilious, projectile vomiting after feeding

- Olive-shaped, nontender mobile hard mass to right of epigastrium

26
Q

Diagnostics for Pyloric Stenosis

A
  • US (initial)
  • Upper GI series shows string sign, railroad track sign
  • Labs: Hypokalemia, Hypochloremic Metabolic Alkalosis
27
Q

Treatment for Pyloric Stenosis

A
  • Rehydration (IVF) and Potassium Repletion

- Definitive: Pyloromyotomy

28
Q

Hepatitis A is transmitted via

A

Fecal-Oral (fecally contaminated food and water, international travel)

29
Q

Transmission of Hepatitis C

A

IVDU Most common

-MC associated with chronic Hepatitis infection

30
Q

How to approach Hepatitis B Serology

A

-Look at Surface Antigen, if positive, either acute or chronic

  • If Positive, look at Core Antibody
  • If IgM is + –> Acute
  • If IgG is + –> Chronic
  • If Negative, look at Surface Antibody
  • If Positive, either vaccination or recovery (distant infection)
  • If surface antibody is only thing positive –> vaccination
  • If core IgG Antibody is positive –> recovery (resolved infection)
31
Q

Most common causes of cirrhosis of the liver

A
  • Chronic Hepatitis C

- Alcohol

32
Q

Symptoms of Cirrhosis

A
  • Ascites
  • Gynecomastia
  • Spider angioma, telangectias
  • Caput Medusa
  • Confusion, Lethargy
  • Increased ammonia levels
  • Asterixis (flapping tremor
  • Fatigue, weakness, weight loss
33
Q

Treatment for symptoms of Cirrhosis

A
  • Encephalopathy: Lactulose or Rifaximin
  • Ascites: Spironolactone, Furosemide
  • Pruritus: Cholestyramine
34
Q

Hepatocellular Carcinoma Surveillance

A

-US every 6 months with or without alpha-fetoprotein

35
Q

What is Wilson’s Disease?

A

-Autosomal Recessive disorder leading to copper accumulation in the body (liver, brain, kidney, joints, cornea)

36
Q

Symptoms of Wilson’s Disease

A

-Dysarthria (MC), Psychosis, Delusions, Kayser-Fleisher Rings

37
Q

Wilson’s Disease is a defect in what chromosome?

A

Copper transporting protein (chromosome 13) that leads to decreased biliary copper excretion due to decreased ceruloplasmin

38
Q

Diagnostic for Wilson’s Disease

A
  • Decreased serum ceruloplasmin

- Definitive: Liver biopsy

39
Q

Treatment for Wilson’s Disease

A
  • Copper-chelating agents (Trientine) or D-Penicillamine

- Zinc supplementation

40
Q

MC type of hernia in both sexes and where it occurs

A

Indirect Inguinal Hernia

Lateral to inferior epigastric artery

41
Q

Indirect Hernia is often congenital due to

A

persistent patent process vaginalis

42
Q

Symptoms of a strangulated hernia

A
  • Severe painful bowel movement

- Surgical emergency

43
Q

Direct inguinal hernias occur ______ within _______ which the components are

A

medial to inferior epigastric artery
Hesselbach’s Triangle

  • Rectus Abdominus
  • Inferior Epigastric Vessel
  • Poupart’s Ligament
44
Q

What are some hallmarks of G6PD Deficiency?

A
  • MC in AA males
  • Episodic hemolytic anemia
  • Infection and Fava beans are precipitating factors
  • Back or abdominal pain, anemia, jaundice
45
Q

What is seen on peripheral smear for G6PD deficiency?

A
  • Schistocytes (bite or fragmented cells)

- Heinz Bodies

46
Q

Vitamin C deficiency (Scurvy) is characterized by 3 H’s. What are they

A
  • Hyperkeratosis: coiled hair, papules
  • Hemorrhages: vascular fragility, recurrent hemorrhages in gums, skin, joints, impaired wound healing
  • Hematologic: anemia, malaise, weakness, increased bleeding time
47
Q

Vitamin A has symptoms such as

A
  • Visual changes (night blindness)
  • Squamous metaplasia (urinary tract, conjunctiva)
  • Bitot’s Spots: white spots on conjunctiva
  • Impaired Immunity
48
Q

B2 deficiency (Riboflavin) has symptom such as

A
  • Oral, ocular, genital

- Magenta colored tongue, photophobia, corneal lesions, scrotal dermatitis

PANCE/EOC (63 decks)

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