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PANCE > GI > Flashcards

GI Flashcards

1
Q

gold standard to diagnose celiac

A

small bowel biopsy by egd

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2
Q

calot triangle

A

important for hepatic artery

inferior border of liver, cystic duct, hepatic duct

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3
Q

does increase in acid secretion in stomach cause gastric ulcers

A

no (h pylori and nsaids cause gastric cancers)

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4
Q

first test for gerd

A

barium swallow

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5
Q

barrets esophagus

A

change from squamous to columnar

precancer for adenocarcinoma

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6
Q

infectious esophagitis

A

usually immunocompromised or HIV
white plaques (canadiasis)- fluconazole
shallow ulcers- cmv- gancyclovier
deep ulcers- herpes- acyclovir

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7
Q

achalasia

A

increased LES tone
bird beak appearance
tx- nitrates, ca channel blocker, surgery (esophamyomectomy)

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8
Q

dx for esophageal dysmotility

A

barium swallow

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9
Q

most common esophageal cancer

A

squamous cell

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10
Q

boerhaave syndrome

A

esophageal rupture

hammans crunch- crepitus in pericardium

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11
Q

esophageal varices

A

h/o of cirrhosis/ portal htn
prophylactic- beta blocker if varices w/out bleeding
acute- octreotide (somatostatin) if no EGD available

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12
Q

most common cause of esophageal strictures

A

GERD
sxs- progressive dysphagia (solids then liquids)
tx- egd w/ dilation or stenting

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13
Q

tx for h pylori

A

triple thearpy (PAC)
PPI, amoxicillin, clarithromycin x14 days
TOMB (tetracyline, omperazole, metroniadazole, bismuth salicate)

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14
Q

perforated peptic ulcer

A

IV PPI, NPO, EGD, NGT, fluids
can do a graham patch
if recurrent can do vagotomy

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15
Q

zollinger ellison syndrome

A

gastrinoma
assoc w/ MEN 1

most commonly in pancreas or duodenum
ulcers in uncommon sites like ileum, colon. lots of ulcers
dx- secretin test
tx- omeprazole, resection

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16
Q

gastric cancer

A

most common adenoma carcinom

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17
Q

most common site for GIST (gastrointestinal stromal tumor)

A

stomach

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18
Q

pyloric stenosis

A 
string sign on barium swallow
olive mass
projectile mass
first 4-6 weeks of life usually presents
tx- surgery
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19
Q

stones of gallbladder

A 
most cholesterol
some bilirubin (secondary to hemolysis)
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20
Q

gold standard for gallbladder

A

HIDA scan for questionable diagnosis

US first line

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21
Q

abx for gallbladder problems

A

ciprofloxacin and metronidazole

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22
Q

meds toxic to liver

A

tylenol
statins
warfarin
phenytoin, valproic acid

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23
Q

cirrhosis liver size

A

small liver due to scarring

big at first but then becomes small

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24
Q

liver function labs

A

decrease in albumin (changes level of warfarin)
increase in PT/PTT
increase in bilirubin

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25
Q

what cancer does hep c lead to

A

hepatocellular carcinoma (hcc)

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26
Q

hemochromoatosis

A

hemosiderin deposits in liver

bronze diabetes from pancreas fibrosis

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27
Q

budd chiari syndrome

A

clot of IVC or portal vein

associated with polycythemia, hepatocellular carcinoma, pregnancy

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28
Q

AFP

A

liver cancer

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29
Q

most common cause of pancreatitis

A

gall stones/sludge (US)
parasites (worldwide)
amount alcoholics (alcohol)

30
Q

what electrolyte abnormality can pancreas pseudocyst casue

A

hypocalcemia (due to saponification (soapmaking))

31
Q

should you do a sigmoidoscopy on acute flare of UC or crohns

A

NO at risk of perforation

32
Q

tx of UC or crohns

A

oral or topical aminosalicilates
steroids
if toxic megacolon- colectomy
metronidazole/tetracycline for infxn

33
Q

intussusception

A 
currant jelly stools
sausage mass on exam
usually in kids after a viral infection
can be seen in adults w/ a neoplasm 
baruim enema diagnosis and treats for kids
surgery for kids
34
Q

Ileus

A

dilated loop of bowels with NO AIR FLUID LEVELS (how to differentiate from obstruction)

35
Q

gold standard test for mesenteric ischemia

A

angiography

36
Q

celiac disease

A

villous atrophy and then malabsorption causing steatorrhea, weight loss, vitamin deficiency
IgA anti tissue transglutaminase
IgA endomysial antibody
antibodies against gliadin and transglutaminase
dx- serology or biopsy

37
Q

diverticulosis

A

asymptomatic

painless spontaneous bleedin

38
Q

can you do a colonoscopy during acute diverticulitis

A

NO, do after acute resolved

39
Q

Toxic megacolon

A

extreme dilation w/ inflammation of colon
Hirschbrung in kids
UC and crohns in adults
tx- surgical decompression

40
Q

volvulus

A 
rotation of intestine on its axis
sigmoid in older
cecum in younger pts 
barium enema- bird beak sign
tx- decompression w/ sigmoidoscopy
41
Q

colon cancer

A

usually adenocarcinoma
CEA
CT scan and CXR for metastasis

42
Q

most common surgical abdominal emergency

A

appendicits

43
Q

IBS

A

pencil thin stools
defacation alleviates the pain
tx- reassurance, bulking agents, high fiber diet

44
Q

celiac diet

A

mneumonic NO BROW; EAT CRAP
NO barley, rye, oats (some can eat), wheat
EAT corn, rice, arrowroot, potatoes

45
Q

tx for anal fisure

A

bulking agents, stool softner

46
Q

tx for hemmorhoids

A

stool softner, topical hydrocortizone, sitz baths, band if not going away

47
Q

anal cancer

A

associated with HPV

most common is squamous cell

48
Q

travelers diarrhea caue

A

E coli

49
Q

giardia

A

get while camping
bloating, frothy, foul smelling
tx metronidazole

50
Q

salmonella

A

poultry, turtles

51
Q

ecoli

A

ground beef

52
Q

campylobacter

A

poultry

53
Q

tx for invasive diarrhea

A

CHESS (organisms that cause bloody diarrhea)
campylobacter, hemorrhagic e coli, entamoeba histolytica, salmonella, shigella
salmonella, e coli, shigella, campylobacter
usually blood in diarrhea and abdominal cramping
fluorquinolone

54
Q

C DIFF

A

pseudomembranous colitis
test stool for TOXIN
oral metronidazole (can use oral vancomycin- has to be oral vanco)
must wash hands (spore forming)

55
Q

does UC or crohns cause fistulas

A

crohns

56
Q

tx for entamoeba colitis

A

metronidazole

57
Q

kwashiokor

A 
protein deficiency
large belly (from ascites)
58
Q

marasmus

A

energy deficiency and protein deficiency

very cachectic

59
Q

what is dermatitis herpetiformis associated with (pruritic papulovesicle)

A

celiac disease

60
Q

what does anorexia nervosa have low levels of

A

hypothyroid

decreased LH/FSH

61
Q

anorexia nervosa diagnosis

A

loss of body weight >15% of IBW

loss of 3 menstrual cycles

62
Q

b1 deficiency- thiamine

A

alcoholics (ethanol inhibits absorption of thiamine)
wet beri beri- high output heart failure from peripheral dilation (sxs of CHF)
dry beri beri- CNS. peripheral neuropathies. wernickes encephalopathy (ataxia, opthalmoplegia, AMS), korsakoff psychoss- confabulation,short term memory loss (usually later)

63
Q

B3- Niacin

A

Pellagra
4 d’s (dermatitis, diarrhea, dementia, death)
casal necklase (around neck)

64
Q

B6 pyridoxine

A

glossitis, cheliosis
peripheral neuropathy, seizure
tx- gram for gram of INH (5 g of INH 5 of b6)

65
Q

b12 deficiency (cobalmin)

A 
nitric oxide causes
crohns disease
ileal resection
atrophic gastritis
pernicious anemia
ppi/h2 blockers
dx- schilling test, 
hypersegmented neutrophils
66
Q

folic acid

A 
neural tube defects
elevated homocysteine (atherosclerosis)
67
Q

vitamin c

A

scurvy (gum disease, poor wound healing, skin hemmorhages, anemia)

68
Q

vitamin a deficiency

A

night time blindness 1st sx
bitot spots on eyes
toxicity- orange skin, can cause increased ICH (pseudo tumor cerebri)

69
Q

vitamin d

A

rickets (bowing, impaired growth, dental)
adults- chronic bone pain, osteomalacia
RACHICTIC ROSARY
too much-hypercalcemia- (stones, bones, groans,..)
tx for too much- IV fluid, loop diuretics, bisphosphonates

70
Q

vitamin k

A

deficiency- hemorrhage disease of newborn (get IM shot of vitamin K)

71
Q

first line medical tx for prolactinoma

A

bromocriptine
can also use cabergoline
if need surgery trans-sphenoidal resection

72
Q

most common cause of brain lesion in HIV pt

A

toxoplasmosis

tx w/ bactrim (prophylactic when cd4

PANCE (14 decks)

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