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Step 2 Study > GI > Flashcards

GI Flashcards

1
Q

Weight loss, anemia, Heme-positive stool

Next best test

A

Endoscopy

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2
Q

Recent travel to south america and new onset dysphagia

A

Chagas

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3
Q

Achalasia Tests
first?
best?

A

Barium esophagram
“Bird’s beak”

Best? manometry

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4
Q

Achalasia Tx:

A

Pneumatic dilation
botulinum
Heller Myotomy

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5
Q

50 y o, dysphagia, alcohol and tobacco use, >5 yr GERD

A

Esophageal Cancers

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6
Q

I think Esophageal cancer what test do I order?

A

Endoscopy

No tissue no issues

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7
Q

Tx for esophageal cancer?

A

Surgical resection

Chemo/radiation adjuvant therapy

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8
Q

Suddent onset chest pain, not related to exertion. EKG and stress r/o Cardiac origins
Dx?
Best initial test?
Accurate Test?

A

Diffuse Esophageal spasm
Esophagram
Manometry

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9
Q

Tx for DES

A

Nitrates

Calcium channel blockers

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10
Q

Difficulty swallowing
+ HIV
CD4 count

A 
Tx: fluconazole
Doesn't resolve?
Endoscopy with biopsy
HSV small vesicles Tx: acyclovir
CMV large vesicles Tx: ganciclovir and foscarnet
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11
Q

Schatzki Ring

A

Steak house syndrome

tx: pneumatic dilation

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12
Q

Plummer vinson syndrome Triad

A
  1. Dysphagia
  2. Iron Def.
  3. Glossitis
    Test: barium esophagram
    Tx: Iron def.
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13
Q

Zenker’s

A

True lumen involving all three layers person wake s up with snacks and halitosis tx. with surgery

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14
Q 
Calcinosis
Raynauds
Esophageal webs
Sclerodactyl
Telangiectasia
A

Scleroderma

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15
Q

hemoptysis after drinking

A

Mallory weiss tear
only in the muscosal layers
Dx: endoscopy tx with epinephrine injections if bleeding doesn’t resolve

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16
Q

Hemoptysis after drinking + crepitus

A

Surgical emergency

the pt has a esophageal rupture aka Boerhaave Syndrome

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17
Q

Right Upper Quadrant

A

Cholelithiasis
Biliary Colic
Cholangitis
Perforated duodenal ulcer

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18
Q

Left Upper Quadrant

A

Splenic rupture

IBD

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19
Q

Right lower Quadrant pain

A 
Ectopic pregnancy
Ovarian torsion
cecal volvulus
cecal diverticulitis
Appendicitis
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20
Q

Left Lower Quadrant pain

A

sigmoid volvulus
sigmoid divierticulitis
ovarian torsion
Ectopic pregnancy

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21
Q

Midepigastric pain

A

Pancreatitis
Aortic rupture
duodenal ulcer

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22
Q

epigastric plus Pain worse with food

A

gastric ulcer

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23
Q

Epigastric plus pain better with food

A

duodenal ulcer

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24
Q

epigastric pain + weight loss

A

cancer, gastric ulcer

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25
Q

Epigastric Pain +tender

A

pancreatitis

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26
Q

epigastric pain _ Bad taste, cough, horseness

A

GERD

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27
Q

epigastric pain + nothing

A

non-ulcer dyspepsia

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28
Q

Epigastric Pain Tx:

A

PPI
H2 Blocker
Liquid antacids
Misoprostol (used in NSAID gastric damage)

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29
Q

Heartburn, metallic taste, cough
Dx:
test?

A

GERD

24 hr. pH monitoring

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30
Q

When do I do endoscopy for Barrett’s

A

5 years after having GERD

or when there is odynophagia, weight loss, anemia, heme-pos stools

31
Q

Barrett’s Endoscopy results show
Tx if it shows dysplasia?
Tx if it shows Low grade dysplasia
Tx if it shows high grade dysplasia

A

D: PPI rescope every 2-3 years
LG: PPI and rescope 6-12 mo
HG: Ablation with endo, photodynamic therapy, radiofreq ablation, surgical removal

32
Q

Causes of gastritis

A

alcohol, NSAID, H pylori, Portal HTN, stress

33
Q

Gastritis Test?

34
Q

Stress ulcer prophylaxis indication

A

Mechanical ventilation
Burn’s -curling ulcers
Head trauma- cushing ulcers
Coagulopathy

35
Q

PUD

A

Gastric and duodenal ulcers

36
Q

MCC of PUD

A

H. Pylori and NSAID

37
Q

Gastric Ulcer + H pylori

A

cancer in 4%

38
Q

Duodenal ulcer + H. Pylori

A

no cancer.

39
Q

Tx of H Pylori

A

Clarithromycin and amoxicillin

PCN allergy? metronidazol and clarithromycin

40
Q

If H. Pylori doesn’t resolve and you have a duodenal ulcer what do you do?

A

Tx. With metronidazol

41
Q

If H. Pylori doesn’t resolve and you have gastric ulcer

what do you do?

A

CANCER r/o CANCER with another endoscopy

42
Q

Diarrhea, abdominal pain, anemia, heme-positive stool.
Ulcers larger than 1 cm
Multiple
Past 3rd part of the duodenum

A

Gastrinoma

43
Q

Persistent high gastrin levels despite injecting secretin

A

Most accurate test for gastrinoma

44
Q

After diagnosis of gastrinoma what tests do you order?

A

Somatostatin receptor scintingraphy +endoscopic ultrasound

45
Q

long standing diabetes stops motility in the stomach treated with erythomycin

A

Diabetic Gastroparesis

Succussion splash

46
Q 
Stabilizing Tx:
Fluids
pRBC
FFP
Platelets
A

Fluids: 1-2 L an hour
pRBC: Hct 1.3
Platelets

47
Q

What antibiotic is most associated with C Diff

A

clindamycin

48
Q

Diarrhea suspecting c. diff what is the test?

A

stool c diff toxin

Most accurate PCR C Diff.

49
Q

C diff. treatment

A

oral metronidazole

50
Q

c diff treatment not working with first line what do you give?

A

vancomycin and fidaxomicin

51
Q

Celiac disease tests
best?
accurate

A

best? anti-tissue transglutaminase

Accurate? small biopsy

52
Q

Whipple’s Disease features

A

arthralgias, ocular findings, neurologic abnormalities, fever, lymphadenopathy

53
Q

Whipple’s most accurate test

A

bowel wall biopsy showing specific organism

54
Q

Whipple’s treatment

A

ceftriaxone or TMP/SMX

55
Q

Chronic pancreatitis test

A

secretin stim test

NG tube normal pancrea releases large volume of bicarbonate-rich fluids after IV secretin

56
Q

Carcinoid Syndrome Tx

A

Octreotide

57
Q

Lactose Intolerance initial test

A

stool osmolality test

58
Q

Lactose intolerance accurate test

A

cessation of symptoms after diet change

59
Q

IBS

A

relieved by bowel movement

Tx: fiber, antispasmodic agent, TCA, antimotility agents

60
Q

Diverticulosis vs Diverticulitis

A

-litis has LLQ pain and tenderness, fever, leukocytosis, palpable mass sometimes occurs

61
Q

Diverticulitis Tx

A

ciprofloxacin +metronidazole
Amoxicillin/clavulanate
Ticarcillin/clavulanate
piperacillin/tazobactam

62
Q

HNPCC colonoscopy

A

25 y.o. every 1-2 year

63
Q

FAP colonoscopy

A

12 y.o. and every year

64
Q

Previous adenomatous polyposis colonscopy?

A

every 3-5 years

65
Q

Acute epigastric pain, tenderness, n/u

A

Pancreatitis

“like a spear to the back”

66
Q

Around the side to my back pain?

A

cholecystitis

67
Q

Worst prognostic factor for pancreatitis

A

low calcium

68
Q

spontaneous bacterial peritonitis

Test? treatment?

A

cell count >250 neutrophils

tx: cefotaximine or ceftriaxone

69
Q

woman in 40s, fatigue, itching, normal bili, elevated alk phos

A

Primary biliary cirrhosis

70
Q

PBC accurate test?

A

liver biopsy

71
Q

PBC accurate blood test?

A

antimitochondrial antibody

72
Q

PBC tx?

A

Ursodeoxycholic acid

73
Q

Primary Sclerosis Cholangitis

A

Pruritus, elevated alk phosp, GGTP, elevated bili

Tx: cholestyramine/Ursodeoxycholic acid

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