GI Flashcards

Question

cirrhosis

Answer 1

irreversible fibrosis - cause: hep c, ETOH liver diz 2 main complications: portal HTN, liver insufficiency s/s: weakness, fatigue, weight loss, PE: enlarged liver, muscle atrophy, spider angiomata late dz; ascites, ecephaltis dx: low albumin, anemia., high alk pos, ascites, low plts tx: stop drinking and hepatic drugs -ascites- salt restrict varices; propanolol octreotie encephalopathy bacterial peritonitis - lactulose - TIPS surgery: liver transplant

Answer 2

bening: cavernous hemangioma - hepatocellular adenoma -liver is most common site from lung /breast RF: viral hep, cirrhosis, aspergillus s/sx: anorexia, cachexia, abd pain, wt loss dx: AFT> 200 , 95-100% specificity CT/MRI with contrast need bx no recommended for resectable tumors. tx; bening- avoid trauma, surgical resection if early -liver transplant.

Answer 3

most common cause; gallstone and ETOH abuse s/s: ab pain ( epigastric, boring radiating to back), n/v tachycardia hypotension Grey-Turner- flank ecchymosis Cullen sign: umbilical ecchymosis dx: labs: amylase 3x normal value - elevated WBC Ransons' Criteria: - incr mortality with each additional factors imaging: CT more accrue

Answer 4

``` on admission: age> 55 WBC> 16, 000 Glucose> 200 LDH> 350 IU/ L SGOT> 250 IU/ L ```

Answer 5

npc, pain management( dilaudi), fluid resuscitation, n/v ( pheneragn), zofran when to progress to solid diet--> she appetite, enzymes better

Answer 6

- irreversible permanent fibrosis - secondary to ETOH abuse Classic triad: pancreatic calcification/ steatorrhea/DM s/s: abd pain dx; high fecal fat( ADEK, fat soluble vit) DM pancreatic calc tx; definitie: treat underlying cause - analgesics: tramadol pancreatic enzyme steroids if autoimmune

Answer 7

genetic predisposition, smoking, most in head of pancreas s/x: abd pain, n/v, diarrhea, wt loss, jaundice dx; labs: anemia, impaired glucose tolerance, steatorrhea Imaging: Ct scan tumor marker: Ca 19-9 tx: no mets: surgery then chemo - unresectable tumor: chemo+ rad tx mets: managed pain/ complications

Answer 8

most common acute abs surgery - fecolith ``` s/s: abd ain peri-umbilical pain McBurney's- 1/2 belly button and SI posts sign- raise right leg -obturator sign- have hip and knee flex and internal rotate hip ``` dx: CT scan tx: laparoscopic appendectomy abx: cefotean/ ticarcillin-clavulanate if perforation: rocephin/

Answer 9

inlamm condition of small intestine - RF: HLA DQ2, high risk groups: 1st degree relative, Type 1 d s/s: wt loss, diarrhea, abd distention, dermatitis herpetiforms dx: Iga enomysia ab Ina tTg tx; institue gluten-free diet -supplement: vitami D,calcium, b12 , folate bone density studies

Answer 10

-happens and women - 1st step in eval: causes: inadequate fluid/ fiber intake, poor bowel habits secondary etiology; medication, SE dx: colonic transit studies tx: d 30 g fiver okay to take osmotic laxative complication: fecal impactions dec appetite, abd pain, and dissension tx: saline/ mineral oil enema - digital disimpaction -maintain soft bowel movements

Answer 11

- uncomplicated mucosa/ submucosa herniating - western diet - sigmoid colon - high fiber diet, fiber supplements s/s: LLQ pain, fever, anorexia dx: elevated WBC , CT scan barium study colonoscopy-wait till sxs better tx: uncomplciationed: cipro/ levaquiin and flagyl unresponsive - admit _+ IV abx complication--> surgical drainage

Answer 12

UC and Crohns dz RF: cig smoking, fan hx, Ashkenazi jewish crohns- skip lesions UC: continous dz, curative ( total colectomy), hematochezia extra intestinal: join pain dx: if pt having acute flair up --> no colonoscopy bx: Crohns- cobblestone UC: diffuse leions tx: reduce inflaamm and maintain clinical remission 5-ASA- Asacol, pentasa flair up: abx, steroids refractor dx: immunomodularots abx for acute flair up- cirp, levquin, surgery: crohns' incr risk for colon cancer- screening colonoscopy every 8-10 years

Answer 13

- bening - recurrent abd discomfort ( improved with defecation) - F> M - associated with menses/ stress s/s: anemia, wt loss, fam hx, PE: normal tx: fiber therapy, antispasmodics, antidepressants, cognitive therapy

Answer 14

older age, arterial embolus, arterial occlusion, low flow states, extensive surgery, most common side: SMA s/s: acute pain out of proportion -chornic if developed collateral circulation, eat and with pain dx: labs, plain film, angiography tx: volume replacement, abx, gangrene ( OR)

Answer 15

- being- non adenoma malignant- adenoma sessile, flat, penduculaeted bening: 90% of large bowel adenoma: > 2 cm has high RF removing adenomatous polpls lower risk for tx: flex sig only finds some but colonsopy was better

Answer 16

- cecum most common - age, fhx, familiar polyposis, UC s/s; slow grwoing, low H/H, fatigue/ weakness, hematochezia, tenesmus, urgency dx: colonoscopy, barium enema CT screening: colonoscopy q 10 years, ( 50-75) FOB/ FIT annually RF: if 1st degree relative began screening at 10 years young or 2 relative every 5 years tx: resection,chem otx chemoprevention: ASA, fruits/ veggies

Answer 17

causes: adhesions, hernias s/s: early: diffuse, crampy colicky pain, ab pain, hyperactive BS late: steady abd pain, better localized, quite BS dx; abd xray- dialated loops CT scan tx: nGT, IV flids, pain mets surgery for strangulated source

Answer 18

slow in presentation - cause: neoplasm. s/s: abd distension, anoreain, vomting Late: vomit poop dx: ab cry Ct scan tx: surgery more likely with LBO

Answer 19

thumbprint on ab xray EMERGENCY cause: abx, US, Crohns s/s: fever, abd cramping, distension, rigid belly dx: abd xray, colonic dilation > 6 cm tx; abx, NG suction to decompress colon, IV fluids, surgery

Answer 20

-reducible- blood flow okay and bring back into abd cavity reducible: able to return to contents incarcerated; contents cannot be returned strangulated: incarcerated hernia with compromised blood supply types: umblinia, hiatal, incisions, inguinal, femoral s/s: no sxs, pain with stating or lifting, constant discomfort with incarceration tx: surgery `

Answer 21

affects young adults - posterior midline - any fissure off midline should be cancer, syphysiila, crowns, HIV s/s: based on Hx and PE triad: fissure,sentinel skin take and hypertrophic anal paella tx: fiber, fluid intake, sitz bath

Answer 22

infection of anal gland, trauma, anal surgery, cancer s/s: swelling, local erythema, swelling fistula: recurrent abscess in same location tx: access; I and D abx alone not enough fistula: surgery

Answer 23

access in the sacrococcynea cleft - pain low back I and D

Answer 24

veins in rectum BRBRR, painless internal: painless BRBPRB external: pain and swelling tx: external: supporting, analgesics, sits baths opioids thrombosed elliptical incision any grade 4 tx is surgery

Answer 25

related to HPV squamous cell ca s/s: bleeding, pain,mass dx: ct/ Mri- look for mets LN needle bx tx: chemo

Answer 26

acute 4 weeks inflame- with blood non-inflammaroty- no blood issue

Answer 27

osmotic- lactose intolerance- stops with out food secretory diarrhea- gastronoma , malabsortption if still is greasy--. CF, pantreactiis, ZE if blood/ pus- inflame community outbreak - tx: depends on reason midl dx: loperamide, nutrition support opioids- not for infectious diarrhea

Answer 28

``` giardia- flagyl shigella: bacterium or cipro campylobacter: erythromycin or copra c. diff;- stop abx if possible, consider flagyl traveler's diarrhea: copra or bactrim ``` no abx on salmonella no ETOh with flagyl foodborn toxigen - no abx lopermide- caution with coli O157: H7 doxy/ bacterium

Answer 29

- rare autosomal condition - unable to metabolic phenylanalina and cover it to tyrosine screen pts at birth dx: s/p age 3> brain damage complicaitons: developed delay movement disorder management: low phenylalanine diet

Answer 30

osmotic diarrhea bette with no dirty s/s: bloating, flatuence, diarrhea, s/p ingestion management: avoid dairy use OTC lactase enzyme tablets/ drops

Answer 31

A, D, E, K- malabsorption - fatty diarrhea Niacin--flusig thiamine dry beriberi- neuron wet beribi-cardiac folate- megablastic anemia no green tea for preggers