GI Flashcards
What are the common causes of esophagitis?
CMV and HSV
A pt presents with odynophagia or dysphagia and retrosternal pain and they have HIV – what dx do you think of?
Esophagitis
How would we dx esophagitis?
endoscopy
A pt presents with a dysphagia and receives a barium swallow that shows a birds beak deformity – dx? Tx?
Achalasia, tx = CCB and nitrates (eventually dilation)
If a pt has dysphagia what should be done first to find a cause?
endoscopy helps to r/o malignancy
Barium swallow is an okay place to start
If a pt has regurgitation of undigested food along with dysphagia and halitosis – dx? Tx?
Zenker diverticulum (out-pouching in the pharynx)
Tx w/ surgery
If dysphagia progresses from solids to liquids – what do you think of?
esophageal carcinoma
If a pt has chest pain and dysphagia that will occur even when they don’t eat– dx? Tx?
Diffuse esophageal spaspm AKA Nutcracker Diagnose with manometry Treat with CCB, nitrates, and botox
What disorder occurs in the proximal esophagus and is associated with iron deficiency anemia?
Plummer-vinson syndrome
Where does Schatski esophageal ring occur?
Distal esophagus
What is the most common type of esophageal cancer?
Adenocarcinoma – Associated with Barrett’s
What’s the most common risk factor for esophageal cancer?
Smoking and chronic alcohol
What is Budd-chiarii syndrome?
Thrombosis of the portal vein leading to esophageal varicies
What’s the most common cause for esophageal varicies?
cirrhosis leading to Portal HTN
A pt presents with hematemesis or coffee ground emesis what should you think of?
Esophageal varicie
How do we prevent an esophageal bleed?
If a pt has cirrhosis Tx with BB’s; Endoscopic band ligation (also for acute bleed)
Abx, shunts, liver transplant, STOP drinking
A pt was vomiting and then started to vomit blood – dx? Tx?
Mallory Weiss tear
Tx = generally resolves on it’s own; PPI can help
What’s the most common cause of acute hepatitis?
Viral – Hep A and E
What are the phases of sxs for viral hepatitis?
Prodoromal = malaise, myalgia, fatigue, N/V/D, abdominal pain
Icterus = jaundice, pruritis, liver tenderness
Convalescent = return to well being
How high would a bilirubin be in hepatitis?
Greater than 3.0
How high would AST/ALT be in hepatitis?
Greater than 5,000
If AST is greater than ALT what should you think?
Alcohol hepatitis
If ALT is greater than AST what should you think?
Viral hepatitis
Which two hepatitis are transferred fecal-orally?
Hep A and E
Which hepatitis can occur because of shellfish?
Hep A
Which Hepatitis can only occur with another form of hepatitis, and which one?
Hep D can only occur in the presence of Hep B
Which hepatitis is due to IV drug use, cirrhosis, or blood transfusion?
Hep C
If a pt has a positive HbsAg – Dx?
Active Hep B
If a pt has a positive Anti-HBs – Dx?
Resolved Hep B infection OR vaccinated
What does the presence of an IgG tell us about Hep B?
Chronic infection or Resolved infection (depending if it with the HBsAg or the Anti-HBs)
What’s the most common blood-borne infection in the US?
Hep C
If AST is greater than ALT by 2:1 what do you think of?
Cirrhosis
What type of anemia is seen in cirrhosis?
Megaloblastic
How do we treat someone with cirrhosis?
Abstinence from alcohol, vitamin supplementation, nutritional supplementation, immunizations, liver transplant
What are the tumor markers for liver cancer?
Alpha fetoprotein and GGTP
If a pt has edema form portal HTN what should we treat them with?
Spironolactone
How do we Dx and treat diverticulitis?
Cipro and flagyl
Diagnose with a CT