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GI Flashcards

1
Q

s/s of acute pancreatitis

A

fever, N/V, epigastric abd pain that radiates to the back

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2
Q

clinical signs of pancreatitis

A

Cullen’s sign (bluish discoloration around umbilicus) and Grey-Turner sign (blue around flank)

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3
Q

s/s of diverticulitis

A

fever, N/V, anorexia, LLQ abd pain, positive Rovsing sign, boardlike abd

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4
Q

s/s of appendicitis

A

periumbilical pain –> RLQ pain –> anorexia, vomiting, fever

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5
Q

s/s of cholecystitis

A

severe RUQ or epigastric pain that occur within 1 hour after eating a fatty meal; may radiate to right shoulder; N/V, anorexia

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6
Q

risk factors for colon cx

A

age greater than 40, hx of multiple polyps, IBD, consumption of red meat, obesity, smoking, alcohol

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7
Q

A gastrinoma located in the pancreas or stomach that secretes gastrin and high levels of acid causing ulcers

A

Zollinger-Ellison Syndrome

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8
Q

s/s of Zollinger-Ellison Syndrome

A

epigastric abd pain, tarry stools

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9
Q

labs for Zollinger-Ellison Syndrome

A

serum fasting gastrin level

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10
Q

s/s of Crohn’s disease

A

intermittent RLQ pain that occurs 1 hour after eating; diarrhea with mucus, fever, malaise

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11
Q

s/s of Cdiff

A

watery diarrhea 10-15 times a day with lower abd pain and cramping; fever

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12
Q

causes of Cdiff

A

abtx, PPI

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13
Q

route of food from mouth

A

esophagus –> stomach –> duodenum –> jejunum –> ileum –> colon –> cecum –> rectum –> anus

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14
Q

organs in LUQ

A

stomach, pancreas, descending colon, left kidney

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15
Q

organs in RUQ

A

liver, gallbladder, ascending colon, right kidney

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16
Q

organs in LLQ

A

sigmoid colon

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17
Q

organs in RLQ

A

appendix, ileum, cecum

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18
Q

psoas sign

A

patient is supine, bend knee 90 degrees and ask patient to push against hand to straighten leg

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19
Q

obturator sign

A

patient lies supine, rotate right hip, positive if pain

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20
Q

rovsing’s sign

A

deep palpation on LLQ causes pain in RLQ

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21
Q

Markle (Heel Jar) test

A

ask patient to jump in place

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22
Q

Murphy’s sign

A

pressing into the RUQ during inspiration causes the patient to gasp for air

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23
Q

associated with acidic or sour odor to breath

A

GERD

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24
Q

gold standard for diagnosing GERD

A

esophageal motility study

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25
Q

trial of PPI for GERD

A

omeprazole x 4-6 weeks

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26
Q

untreated GERD can lead to

A

Barrett’s esophagus (precancerous)

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27
Q

Barrett’s esophagus is diagnosed by

A

upper endoscopy with biopsy

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28
Q

avoid these foods in GERD

A

mints, alcohol, caffeine

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29
Q

s/s of IBS

A

cramping, bloating, gas, relief after pooping

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30
Q

cause of duodenal and gastric ulcers

A

H. pylori, chronic NSAIDs, biphosphonates

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31
Q

s/s of duodenal ulcer

A

burning epigastric pain relieved by foods; pain occurs mostly at night

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32
Q

s/s of gastric ulcer

A

N/V, pain worse with eating, weight loss

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33
Q

quad therapy trx for H. pylori ulcers

A

Bismuth tab 600 mg QID + metronidazole 250 mg QID + tetracycline 500 mg QID x 2 weeks + PPI daily x 4-6 weeks

34
Q

trx for diverticulitis

A

cipro 500 mg bid + metronidazole 500 mg tid x 10-14 days

35
Q

diagnostics for acute pancreatitis

A

amylase, lipase, trypsin; AST/ALT; CBC; abd US

36
Q

trx for nonsevere C.diff

A

metronidazole tid x 10-14 days; avoid antimotility agents

37
Q

IgG Anti-HAV positive means

A

the patient is immune to hep A

38
Q

IgM Anti-HAV positive means

A

acute infection with Hep A; patient is contagious

39
Q

Anti-HCV

A

screening test for Hep C

40
Q

If a patient is positive Anti-HCV, next step is

A

order HCV RIBA; if positive then patient has Hep C

41
Q

If a patient is positive Anti-HCV and has negative RIBA, then

A

it is a false positive.

42
Q

Hepatitis D requires the presence of

A

Hep B

43
Q

this liver enzyme is present in liver, heart, skeletal, kidney, and lung

A

AST

44
Q

this liver enzyme is liver specific

A

ALT

45
Q

AST/ALT ratio may be indicative of alcohol abuse

A

greater than 2.0

46
Q

sensitive indicator of alcohol abuse

A

serum GGT

47
Q

an enzyme derived from bone, liver, gallbladder, kidney, GI tract, and placenta

A

alkaline phosphatase

48
Q

High levels of this during growth spurts in children and teens

A

alkaline phosphatase

49
Q

transmission of Hep A

A

fecal/oral route

50
Q

transmission of Hep B

A

sexual, blood

51
Q

transmission of Hep C

A

IV drug use, blood, sex

52
Q

Anti-HAV means

A

the patient has antibodies to Hep A; the patient had a previous hep A infection or received vaccination

53
Q

HbsAg positive means

A

the patient has a current Hep A infeciton

54
Q

this type of hepatitis has highest risk of cirrhosis and liver cancer

A

Hep C

55
Q

olive shaped mass in RUQ

A

pyloric stenosis

56
Q

most children with fecal incontinence have

A

underlying constipation

57
Q

a chronic inflammatory condition characterized by relapsing and remitting episodes of inflammation limited to the mucosal layer of the colon

A

Ulcerative colitis

58
Q

characterized by transmural inflammation and by skip lesions.

A

Crohn’s disease

59
Q

IBD that mostly involves the rectum

A

ulcerative colitis

60
Q

IBD that may involve the whole colon

A

Crohn’s disease

61
Q

s/s of pyloric stenosis

A

projectile vomiting

62
Q

imaging for pyloric stenosis

A

US

63
Q

trx for pyloric stenosis

A

pyloromyotomy

64
Q

what medication may worsen symptoms of GERD?

A

amlodipine

65
Q

Risk of long term PPI use

A

decreases absorption of vitamins and iron (anemia, B12 deficiency)

66
Q

diarrhea alarm symptoms

A

rectal bleeding, weight loss, nocturnal abd pain, anemia

67
Q

recommended screening for colorectal cancer

A

colonoscopy every 10 years, flex sigmoidoscopy every 5 years, barium enema every 5 years, FOBT annually

68
Q

When ALT is greater than AST, think

A

viral hepatitis

69
Q

When AST is greater than ALT, think

A

acetaminophen, statins, tequila

70
Q

anti-HAV IgG

A

immunity to Hep A

71
Q

anti-HAV IgM

A

current Hep A infection

72
Q

HBsAg is

A

antigen = infection

73
Q

Anti-HBs is

A

antibody = immunity

74
Q

Rule for Hep B surface markers

A

can either have surface antigen or antibody, not both.

75
Q

+Anti-HBs, + Anti-HBc IgG means

A

patient is immune through previous infection

76
Q

+Anti-HBs, - Anti-HBc IgG means

A

patient immune through vaccine

77
Q

imaging study of choice for cholecystitis

A

US of RUQ

78
Q

s/s of bowel obstruction

A

dilated loop of bowel, tinkling bowel sounds, abd pain

79
Q

Elevated bilirubin but normal LFTs

A

Gilbert’s disease

80
Q

painful bleeding with BMs

A

anal fissure

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