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PANCE/EOC > GI #5 > Flashcards

GI #5 Flashcards

1
Q

Treatment for Ascites

A
  • Sodium restriction

- Spironolactone

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2
Q

What is a Bezoar?

A
  • Solid mass of indigestible material that accumulates in the digestive tract sometimes causing blockage.
  • Typically forms in the stomach or sometimes the small intestines.
  • Can occur in children and adults
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3
Q

What diagnostic is used to confirm a bezoar?

A

Endoscopy

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4
Q

What chemical agents help dissolve a bezoar?

A

Cola or cellulase

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5
Q

What is Budd-Chiari Syndrome?

A

Hepatic Venous Outflow obstruction leading to decreased liver drainage with subsequent portal HTN and cirrhosis

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6
Q

Budd-Chiari Syndrome is the MCC of

A

portal HTN in children

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7
Q

Symptoms of Budd-Chiari Syndrome

A

-Ascites, Hepatomegaly, RUQ abdominal pain

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8
Q

Initial screening of choice for Budd-Chiari Syndrome

A

-US

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9
Q

However, gold standard for Budd-Chiari syndrome is

A

Venography

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10
Q

May present with hematemesis, tachycardia, difficulty breathing.

Can be a complication of procedures such as EGD

A

-Esophagus Perforation

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11
Q

Clinical intervention for Ileus

A
  • Needs NPO and have NG tube placed
  • Electrolyte and fluid replacement
  • Treat underlying cause
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12
Q

For Malnutrition, what is the clinical intervention?

A
  • If due to anorexia nervosa
  • -1) hospitalization required for < 75% expected weight
  • -2) CBT
  • -3) Supervised meals, weight monitoring
  • -4) SSRI’s, atypical antipsychotics
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13
Q

How to manage an overdose of ethylene glycol (antifreeze)

A

-Block alcohol dehydrogenase with ethanol or fomepizole

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14
Q

How to manage organophosphates (insecticides) poisoning?

A

Atropine and Oxime therapy (Pralidoxime)

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15
Q

What is short bowel syndrome?

A

Body unable to absorb enough nutrients from foods you eat because you don’t have enough small intestine

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16
Q

Short Bowel Syndrome occurs after

A

Surgery to correct things such as cancer, Crohn’s disease, intussception

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17
Q

Clinical intervention for short bowel syndrome

A
  • Often initially fed by TPN (total parenteral nutrition)
  • Fluid and electrolyte replacement
  • Provide small frequent meals and slowly advance the diet as tolerated
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18
Q

Explain the conversion of alcohol in the body

A

-Alcohol broken down into acetylaldehyde and then into acetic acid radicals

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19
Q

For Vitamin K deficiency, what would you expect the labs to be

A

Prolonged PT (INR > 3.5)

  • Normal fibrinogen
  • Normal platelets
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20
Q

Symptoms of Hepatitis A

A
  • Spiking fever
  • Jaundice
  • Hepatomegaly
  • May be asymptomatic
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21
Q

How to diagnose Hepatitis A

A
  • LFT: elevated ALT, AST, bilirubin

- Acute: IgM anti-HAV

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22
Q

How to prevent Hepatitis A

A

-Handwashing and improved sanitation has greatest impact to reduce transmission

23
Q

Postexposure Prophylaxis for Hepatitis A

A
  • If healthy: HAV vaccine

- If immunocompromised: HAV vaccine + HAV immunoglobulin

24
Q

Hepatitis E has the highest mortality due to

A

fulminant hepatitis during pregnancy (third trimester)

25
Q

Hepatitis D requires ______ to cause co or superimposed infection

A

Hepatitis B

26
Q

How is Hepatitis C transmitted?

A

Parenteral: IVDU MC

27
Q

Diagnostics for Hep C

  • Screening: _____
  • Confirmatory: _____
A

Screening: HCV antibodies
Confirmatory: HCV RNA

28
Q

Treatment for Hepatitis C

A

-Ledipasvir-Sofosbuvir (or two other antiviral options)

29
Q

MC type of gastric carcinoma

A

-Adenocarcinoma

30
Q

Symptoms and Exam findings of gastric carcinoma

A
  • Weight loss
  • Persistent abdominal pain
  • Early satiety
  • Palpable abdominal mass sign of MET
  • -Supraclavicular nodes (Virchow’s Node)
  • -Umbilical (Sister Mary Joseph’s Nodule)
31
Q

Dumping Syndrome is often a complication of _____

A

Bariatric surgery

-Symptoms due to rapid gastric emptying and rapid fluid shifts when large amounts of carbs are ingested

32
Q

Diagnostics for dumping syndrome

A
  • Barium fluoroscopy and radionuclide scintigraphy are used to confirm rapid gastric emptying
  • But most times, it is a clinical diagnosis
33
Q

Treatment for dumping syndrome

A
  • Decreased carbohydrate intake
  • Eat more frequently with smaller meals (protein rich)
  • Separate solids and liquids by 30 minutes
34
Q

Treatment for TCA overdose

A

Sodium bicarbonate

35
Q

Treatment for BB overdose

A

-Glucagon

36
Q

Treatment for Warfarin overdose

A

Vitamin K and fresh frozen plasma

37
Q

Reversal agent for Heparin

A

-Protamine sulfate

38
Q

Reversal agent for Ethylene Glycol

A

IV ethanol infusion (Fomepizole)

39
Q

Treatment for G6PD deficiency

A

-Usually self-limited (avoid offending food and drugs)

40
Q

What are some offending drugs that exacerbate G6PD deficiency?

A
  • Dapsone
  • Primaquine
  • Methylene Blue
  • Nitrofurantoin
  • Phenazopyridine

-Infection or Fava Beans

41
Q

Pathophysiology of Acute Pancreatitis

A

-Acinar cell injury –> intracellular activation of pancreatic enzymes –> auto digestion of pancreas

42
Q

MCC of acute pancreatitis

A
  • Gallstones and alcohol abuse

- Medications (Thiazides, Protease inhibitors, Valproic acid)

43
Q

Symptoms of acute pancreatitis

A
  • Epigastric pain: constant, boring and radiates to the back
  • Exacerbated if supine and relieved with leaning forward
  • N/V, fever
  • Cullen’s Sign (umbilical ecchymosis)
  • Grey Turner Sign (flank ecchymosis)
44
Q

What are the best initial labs for pancreatitis

A
  • Increased amylase and lipase

- Hypocalcemia

45
Q

What is the best diagnostic imaging for pancreatitis?

A
  • Abdominal CT (imaging of choice)

- Abdominal radiograph: sentinel loop, localized ileus

46
Q

Treatment for pancreatitis

A
  • Rest the pancreas: 90% recover in 3-7 days without complications
  • Supportive: NPO, IVF
  • ABX not routinely used
47
Q

What is the triad of symptoms seen in CHRONIC pancreatitis?

A
  • DM
  • Steatorrhea
  • Calcifications
48
Q

70% of pancreatic carcinomas are found

A

in the head of the pancreas

49
Q

What type of pancreatic carcinoma is the MC

A

Adenocarcinoma (ductal)

50
Q

Risk factors for pancreatic carcinoma

A
  • Smoking
  • > 55 years old
  • DM
  • Males
  • Obesity
  • AA
51
Q

Symptoms of pancreatic carcinoma

A
  • Painless jaundice
  • Weight loss
  • Abdominal pain radiating to the back
  • Pruritus
  • Courvoisier’s Sign: palpable, nontender, distended gallbladder
52
Q

Initial diagnostic of choice for pancreatic carcinoma

A

-CT scan

53
Q

What tumor marker is associated with pancreatic carcinoma?

A

CA 19-9

54
Q

Surgical treatment for Pancreatic Carcinoma

A

-Whipple Procedure (pancreaticoduodenectomy)

PANCE/EOC (63 decks)

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