GI (35) Flashcards
source of epigastric pain temporarily relieved by eating v. not relieved
relieved - duodenal ulcer (perforation = gastroduodenal a)
not relieved - gastric ulcer (perforation = left gastric a)
guarding and rigidity indicate
peritonitis
referred pain to shoulder means…
diaphragm irritation, causing phrenic n irritation to C3/4 dermatome
pANCA, lead pipe appearance (loss of haustra) in left colon), young male, mucosal and submucosal ulcerations
UC
chronic non-bloody diarrhea, abd pain relieved by defecation, ASCA, skip lesions, transmural, fistula formation, string sign terminal ileum seen on barium, granuloma MC in terminal ileum (RLQ), FHx of HLA-B27/autoimmune (psoriasis)
Crohn’s
bloody diarrhea with a fever in a child - next dx step?
bacterial stool sample –> test for bacterial enteritis
MCC of bacterial diarrhea dt food poisoning. Motile, spiral, non spore forming, gram negative.
Campylobacter jejuni
triple therapy for HPylori
14 days of PPI (omepr or lanospr), amoxicillin, clarithromycin
(OAC, LAC, BMT - bismuth/metro/tetracyclin)
Tx for moderate C diff (no leukocytosis, AKI, fever, sepsis, megacolon)
metronidazole
Tx for severe C diff (leukocytosis, AKI, fever, sepsis, megacolon) OR elderly/@risk pts with moderate Cdiff
po vancomycin
tx for acute onset of excruciating pain wiht thrombosed external hemorrhoids
surgical elliptical excision
tx for internal hemorrhoids
rubber band ligation
pt with ascites, fever, chills, jaundice, abd pain, tenderness and fluid wave on exam, and paracentesis fluid analysis with over 250 neuts per microliter
dx?
spontaneous bacterial peritonitis
tx of spontaneous bacterial peritonitis
cefotaxime
what can mumps cause?
acute pancreatitis (i.e. floating stool), parotid gland sialadenitis, orchitis
causes of pancreatitis
GET SMASHED - gallstones, ethanol, trauma, steroids, mumps, autoimmune, scorpion, hyperTG, (start statin) ERCP, drugs
test to dx enterobius vermicularis
pinworm - scotch tape test
CEA tumor marker for…
colorectal cancer
MCC of isolated unconjugated hyperBr in asx adults. Br UGT activity
gilbert syndrome
CA19-9 most useful for
assessment of whether tx for pancreatic cancer is working, GI malignancies, and pancreatitis
raw fish and B12 deficiency (neuro LCST/cerebellar/DC sx), think…
diphllobothrium latum - can be latent for a long time
MCC of bowel obstruction in infancy. Best dx test
pyloric stenosis.
US - show thickened pylorus muscle. Barium shows “double track” sign
medication ost associated with pyloric stenosis
azithromycin
infant presents wtih bilious nonbloody, nonprojectile vomiting withing first d-mo of life. intermittent, but progressive food intolerace, FTT, currant jelly stool (dt SMA ischemia) - dx and test?
malrotation (Around SMA), dx with upper GI barium endoscopy
see “birds-beak” and spiral/corkscrew duodenal configuration
hematochazia (BRB) v. melena (Dark) landmark
bleed below v. above ligament of treiz
cirrhotic patient with painless hematochazina - bleeding from where?
superior rectal vein
first week of life, presents with new onset jaundice, pale colored stool, hyperBr with elevated direct Br
associated with CMV, neovirus, rotavirus (and no palpable abdominal mass)
biliary atresia - surgically tx
if there is an abdominal mass, thing choledochal cyst
diagnostic and therapeutic for meconium ileus in CFTR-508 neonates
gastrografin enema
entamoeba histolytica-kind of diarrhea
bloody
anti-endomysial and anti-tissue transglutaminase IgA antibodies can est
Celiac dx, but require what?
normal IgA
fasting lipid panels are only viable if pt refrains from….
calories for 12 hrs and alcohol for 24 hours
