GI 4 Flashcards
IBS can have urinary frequency and urgency
oh ok
Rome criteria for IBS?
Recurrent abdominal pain 3 days per month for 3 months with 2 of the following
Relief with defecation
Onset associated with change in frequency
Change in form
Need
IBS types include constipation type, diarrhea type, and others
oh ok
IBS has normal labs!
Tx options?
makes sense.
Tx:
Physican assurance. Validate patient.
Avoid gas porducing food. Avoid lactose and stuff
Fiber and PEG might help
Antidiarrheals might help. SSRIs (helps comorbid stuff)
Fatigue, weight loss, abdominal pain, watery diarrhea?
Fever ,abdominal tendernesss, oral ulcers
Consider chrons. WILL HAVE TEST Q ON IT
left out perianal fissures and fistulas b/c too easy
Transumural bowel inflammation? Skip lesions?
IT IS GUM TO BUM
Imaging shows string sign from inflammation! Skipped areas of bowel
Crohns tx?
Steroids for exacerbations
Azathioprine is better than methotrexate
Anti TNF alpha agents like infliximab or adalimumab
Crohns mnemonic
Crohn gives GIFTS
Granuloma Ileum Fistula and fissures Transmural Skip lesions
Tenesmus and incontinence, bloody diarrhea with weight loss and abdominal pain, think what?
UC
Aminosalicylate
Glucocorticoids
Immunosuppressive
Supplemental iron
oh ok
Primary sclerosing cholangitis is associated with what?
IBD!
serologic markers for IBD?
ASCA is crohn
pANCA with UC! (pANCA also found with that Churgg strauss)
Most common benign small bowel cancer?
Malignant?
Leiomyoma
Carcinoid
GI issue with pain out of proportion to their unimpressive exam?
Ischemic colitis
WBCs on UA can happen with appendicitis how?
It irritates ureters. So don’t mess that up!
Appendicitis for 5 days before coming in tx/
Supportive, schedule removal for 8 weeks from there
Drugs for ileum?
Erythromycin for motility, neostigmine (makes sense), or metoclopramide
Old lady with vague recurrent abdominal pain and vomiting for 5 days?
Galltone inlets that repeated lodges and dislodges. IT GETS CAUGHT IN THE ILEUM
Volvulus imaging?
Double bubble (Air bubbles)
Pseudotumor cerebri tx?
Acetazolamide, weight loss, serial lumbar puncture
Diverticulitis outpatient tx?
metronidazole with fluoroquinolone (makes sense)
When do you admit diverticulitis?
CANT SWALLOW MEDS, old, comorbidities, immunocompromised…
Fistula from Crohns tx?
get disease to settle down with azothyopryine
First treatment of carcinoid?
Remember right sided valvular disease can happen
Octreotide to shut down affect
Cyproheptadine again (used for high 5ht)
IFN alpha can be combined with octreotide
Silicosis puts you at risk or what infection?
tb
CRC is 4-5 star topic! Adenocarcinoma is it
Hyperplastic is not precancerous
right. Villous is bad
What is mutated in gardner syndrome?
Lumpy bumpy gardner (colyn polyps, OSTEOMAS, soft tissue tumors)
APC gene (similar FAP)
Turcot syndrome has what? And what mutation?
APC
CNS tumors, Colonic adenomas
So if brain cancer and colon cancer, look for it!
Juvenile polyposis?
Polyps in vowels, GI bleeding. They are hamartoma
What is Peutz Seghers?
Hyper pigmentation of lips. Causes hamartomas!
Scary about HNPCC?
Nonpolyposis. Starts in proximal colon. Does not start as polyp
CEA is high in what?
Stomach, pancreatic, colon cancer!
Node involvment for CRC makes staging for what? What does it mean for treatment?
Stage III, REQUIRES CHEMO
CRC surveillance?
CEA every 4 months for years
CT every year for mets
Colonoscopy 1, 3, and 5 years
How do you decrease blood flow to stomach or esophagus?
SOMASTOSTATIN analogue like OCTREOTIDE so give it if acute bleeding!!!
also give PPI
GI bleed first step after stabilizing?
NG tube to see if stomach contents bloody
