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GI Flashcards

1
Q

Gastric malignancy- Eti

A
  • Adenocarcinoma
  • Males > 40
  • H. pylori
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2
Q

Gastric malignancy- Sx

A
  • Wt loss
  • Early satiety
  • Abd pain, fullness
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3
Q

Gastric malignancy- Dx, Tx

A
  • Endoscopy, with bx

- Gastrectomy, chemo, rad

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4
Q

Zollinger ellison syndrome- Eti

A

Gastrinoma

- Gastric neuroendocrine tumor

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5
Q

Zollinger ellison syndrome- Sx

A
  • Peptic “kissing” ulcers
  • Duodenal wall MC
  • Diarrhea
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6
Q

Zollinger ellison syndrome- Dx, Tx

A
  • Secretin and fasting gastrin levels

- Resection, PPIs

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7
Q

Gastritis- Eti

A
  • NSAIDs, ETOH, stress, portal HTN

- H. pylori

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8
Q

Gastritis- Sx

A
  • UGIB

- Asymptomatic

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9
Q

Gastritis- Dx. Tx

A
  • Endoscopy

- PPI, H2

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10
Q

PUD- Eti

A
  • H. pylori = duodenum

- NSAIDs = stomach

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11
Q

PUD- Sx

A
  • Epigastric pain
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12
Q

PUD- Dx, Tx

A
  • PPI trial
  • D/c NSAIDs
  • Test for H. pylori
  • Tx: clarithromycin, amoxacillin, PPI
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13
Q

Sm bowel obstruction- Eti

A
  • Post surgical adhesions MC
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14
Q

Sm bowel obstruction- Sx

A
  • Crampy abd pain
  • Obstipation, vomiting
  • Hyperactive BS
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15
Q

Sm bowel obstruction- Dx

A
  • XR: air fluid levels in step ladder pattern

- Tx: NPO, IV fluids until resolution

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16
Q

Lg bowel obstruction- Eti

A

Malignancy

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17
Q

Lg bowel obstruction- Sx

A
  • Bloating, abd pain

- Progressive change in bowel habits

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18
Q

Lg bowel obstruction- Dx, Tx

A
  • XR: volvulus, coffee-bean sign
  • CT: Best for differentiating
  • Tx: Decompression, fluids, surg
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19
Q

Gastroparesis- Eti

A

DM MC

- scleroderma, lyte abns, meds

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20
Q

Gastroparesis- Sx

A

Nausea, bloating, vomiting

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21
Q

Gastroparesis- Dx

A

Gastric emptying study, EGD

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22
Q

Gastroparesis- Tx

A
  • Underlying dz

- Small portions, pro kinetics, metoclopramide

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23
Q

Diverticulosis

A
  • Small herniations in colon mucosa

- Tx: High fiber diet

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24
Q

Diverticulitis

A
  • Infxn of diverticula, decreased blood supply, micro perks
  • Sx: LLQ abd pain
  • Dx: Abd CT
  • Tx: Clear liquid diet, cipro or metro
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25
C. diff
- Invasion of C. diff spores d/t susceptability - Sx: Profuse watery diarrhea, leukocytosis - Dx: Stool EIA or PCR - Tx: Metro or vanc
26
Crohns- Sx
- RLQ pain - wt loss - No blood in diarrhea
27
Crohns- Dx
- Terminal ilium MC, affects mouth to anus - Skip lesions - Tx: Corticosteroids for acute flares
28
UC- Sx
- LLQ pain - Bloody diarrhea - Tenesmus, urgency
29
UC- Dx
- Rectum MC, limited to colon - Contiguous spread - Corticosteroids for acute flares
30
UGIB- Eti
- PUD MC | - Varices, mallory weiss tear
31
UGIB- Sx
- Hematemesis, coffee ground emesis - Melena - Epigastric pain
32
UGIB- Dx
- Hct + Hb decrease, H &P to determine eti | - EGD
33
LGIB- Eti
Diverticular hemorrhage MC | - CA, colitis, hemorrhoids
34
LGIB- Sx
- Diarrhea with tenses - BRBPR - Hematochezia
35
Variceal bleed- Eti
- Cirrhosis, portal vein HTN
36
Variceal bleed- Sx
Hematemesis, melena, hx of hepatitis
37
Variceal bleed- Dx, Tx
- EGD- red wale markings, cherry red spots | - Endoscopic ligation, octreotide drip
38
SBP- Eti
- Gram - rods - E. coli & klebsiella - 20% cirrhotics
39
SBP- Sx
- Asterixis | - Abd pain, fever, encephalopathy
40
SBP- Dx, Tx
- Paracentesis, PMNs > 250 | - Cefotaxamine or amox/ clav
41
Ascites-
- Portal HTN - Shifting dullness, + fluid wave - Tx: Na, fluid restriction, diuretics
42
Acute liver failure- Eti
- Liver failure w/in 8 wks of injury - Rapid liver failure + encephalopathy + coagulopathy - Reye's syndrome w/ asa usage - Acetamenophen MC cause - Viral hep- A, E
43
Acute liver failure- Dx
- Increased serum ammonia - PT/ INR > 1.5 - Hypoglycemia
44
Chronic liver failure
- > 8 wks liver injury | - Jaundice, variceal bleeding, encephalopathy & ascites
45
Cirrhosis- Labs
- Increased: bili, PT/INR, AST & ALT | - Decreased: albumin, Hct, Hb, throbocytopenia
46
Hepatorenal syndrome- Patho
- Renal vasoconstriction, decreased renal blood flow in response to splanchnic arterial vasodilation
47
Hepatorenal syndrome- Dx
- Cr > 1.5, rapid increase over 2 weeks - Cr doesn't improve after d/c diuretic, volume expansion - Low Na excretion
48
Hepatorenal syndrome- Tx
- Albumin, midodrine (pressor)
49
Hepatic encephalopathy
- Increased ammonia from protein breakdown - Confusion, lethargy, asterixis - Increased ammonia - Lactulose, neomycin, rifaxamin, low protein diet
50
Acute pancreatitis- Eti
- ETOH, gallstones
51
Acute pancreatitis- Sx
- Epigastric abd pain, radiates to back | - Constant, relieved by sitting forward, fetal position
52
Acute pancreatitis- Dx
- Abd CT - Increased lipase most specific - Increased amylase, ALT, triglycerides
53
Acute pancreatitis- Tx
- NPO, IV fluids, pancreas rest
54
Ranson criteria
- Glucose > 200 - Age >55 - LDH >350 - AST >250 - WBC >16,000
55
Chronic pancreatitis- Eti
- Chronic inflammation, loss of exocrine fun - ETOH MC, CF in children - Gallstones do not play role
56
Chronic pancreatitis- Sx
- Triad: Calcifications, steatorrhea, DM
57
Chronic pancreatitis- Dx
Abd XR: Calcified pancreas | - Amylase, lipase WNL
58
Chronic pancreatitis- Tx
Oral enzyme replacement
59
Pancreatic carcinoma- Eti
- Smoking, > 60 y - DDT exposure - ETOH, DM, males - Adenocarcinoma MC
60
Pancreatic carcinoma- Sx
- Painless jaundice, wt loss - Abd, back pain - Pruritis - Courvoisier sign- palpable, non-tender distended GB
61
Pancreatic carcinoma- Dx
- CT scan | - Tumor markers: CEA, CA 19-9
62
Pancreatic carcinoma- Tx
Whipple procedure- pancreaticoduodenal resection | - ERCP with stent
63
Pancreatic pseudocyst- Eti
- Encapsulated collection of pancreatic fluid | - d/t severe pancreatitis
64
Pancreatic pseudocyst- Sx
- Epigastric pain, mass - Fever, leukocytosis - Failure to recover from acute pancreatitis
65
Pancreatic pseudocyst- Dx, Tx
- CT scan | - Symptom mgmt, drain in > 12 wks

1 Inpt (12 decks)

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