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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
what cancer does hep c lead to
hepatocellular carcinoma (hcc)
26
hemochromoatosis
hemosiderin deposits in liver | bronze diabetes from pancreas fibrosis
27
budd chiari syndrome
clot of IVC or portal vein | associated with polycythemia, hepatocellular carcinoma, pregnancy
28
AFP
liver cancer
29
most common cause of pancreatitis
gall stones/sludge (US) parasites (worldwide) amount alcoholics (alcohol)
30
what electrolyte abnormality can pancreas pseudocyst casue
hypocalcemia (due to saponification (soapmaking))
31
should you do a sigmoidoscopy on acute flare of UC or crohns
NO at risk of perforation
32
tx of UC or crohns
oral or topical aminosalicilates steroids if toxic megacolon- colectomy metronidazole/tetracycline for infxn
33
intussusception
``` 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
Ileus
dilated loop of bowels with NO AIR FLUID LEVELS (how to differentiate from obstruction)
35
gold standard test for mesenteric ischemia
angiography
36
celiac disease
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
diverticulosis
asymptomatic | painless spontaneous bleedin
38
can you do a colonoscopy during acute diverticulitis
NO, do after acute resolved
39
Toxic megacolon
extreme dilation w/ inflammation of colon Hirschbrung in kids UC and crohns in adults tx- surgical decompression
40
volvulus
``` rotation of intestine on its axis sigmoid in older cecum in younger pts barium enema- bird beak sign tx- decompression w/ sigmoidoscopy ```
41
colon cancer
usually adenocarcinoma CEA CT scan and CXR for metastasis
42
most common surgical abdominal emergency
appendicits
43
IBS
pencil thin stools defacation alleviates the pain tx- reassurance, bulking agents, high fiber diet
44
celiac diet
mneumonic NO BROW; EAT CRAP NO barley, rye, oats (some can eat), wheat EAT corn, rice, arrowroot, potatoes
45
tx for anal fisure
bulking agents, stool softner
46
tx for hemmorhoids
stool softner, topical hydrocortizone, sitz baths, band if not going away
47
anal cancer
associated with HPV | most common is squamous cell
48
travelers diarrhea caue
E coli
49
giardia
get while camping bloating, frothy, foul smelling tx metronidazole
50
salmonella
poultry, turtles
51
ecoli
ground beef
52
campylobacter
poultry
53
tx for invasive diarrhea
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
C DIFF
pseudomembranous colitis test stool for TOXIN oral metronidazole (can use oral vancomycin- has to be oral vanco) must wash hands (spore forming)
55
does UC or crohns cause fistulas
crohns
56
tx for entamoeba colitis
metronidazole
57
kwashiokor
``` protein deficiency large belly (from ascites) ```
58
marasmus
energy deficiency and protein deficiency | very cachectic
59
what is dermatitis herpetiformis associated with (pruritic papulovesicle)
celiac disease
60
what does anorexia nervosa have low levels of
hypothyroid | decreased LH/FSH
61
anorexia nervosa diagnosis
loss of body weight >15% of IBW | loss of 3 menstrual cycles
62
b1 deficiency- thiamine
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
B3- Niacin
Pellagra 4 d's (dermatitis, diarrhea, dementia, death) casal necklase (around neck)
64
B6 pyridoxine
glossitis, cheliosis peripheral neuropathy, seizure tx- gram for gram of INH (5 g of INH 5 of b6)
65
b12 deficiency (cobalmin)
``` nitric oxide causes crohns disease ileal resection atrophic gastritis pernicious anemia ppi/h2 blockers dx- schilling test, hypersegmented neutrophils ```
66
folic acid
``` neural tube defects elevated homocysteine (atherosclerosis) ```
67
vitamin c
scurvy (gum disease, poor wound healing, skin hemmorhages, anemia)
68
vitamin a deficiency
night time blindness 1st sx bitot spots on eyes toxicity- orange skin, can cause increased ICH (pseudo tumor cerebri)
69
vitamin d
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
vitamin k
deficiency- hemorrhage disease of newborn (get IM shot of vitamin K)
71
first line medical tx for prolactinoma
bromocriptine can also use cabergoline if need surgery trans-sphenoidal resection
72
most common cause of brain lesion in HIV pt
toxoplasmosis | tx w/ bactrim (prophylactic when cd4

PANCE (14 decks)

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