GI Flashcards
tx achalasi
CCB - nifedipine
nitrates
botox
dilation
tx mallory weiss tears
self-limited
possible injection of epi w/ endoscopy
tx esophageal stricture
PPI
H2 blocker ("tidine")tx GERD
1) H2 blocker
2) PPI
RF gastric adenocarcinoma
male
smoking
h pylori
dx ZE syndrome
secretin stimulation test
fastin serum gastrin
tx: PPI or surgery
tx H pylori
PPI + clarithromycin + amoxicillin
PPI + pepto + tetracyclin + metronidazole
pyloric stenosis on barium swallow
string sign
railroad track sign
tx pyloric stenosis
pyloromyotomy - Ramstedt’s procedure
cholecystitis
infxn gallbladder
RUQ pain + N/V + fever
RF cholecystitis
native american female obesity diabetes prego crohn's
chlonangitis sx
charcot + reynolds
ERCP
prodrome - anorexia/nausea/vomit joint ache diarrhea fever jandice mild RUQ pain
Hep B
anti-HBc = acute infxn
single stranded RNA
prodrome sames as hep B
jaundice
PCR for HCV RNA
HCV antibody
tx: interferon alpha, pegylated interferon, ribavirin
tx hep D
peginterferon
fibrosis/scarring of liver
macrocytic anemia, increased PT
cirrhosis
tx: folate, iron
FFP for bleeding
fluids/Na for ascites
80 cases assoc w/ cirrhosis
cachexia
sudden ascites
deterioration of a pt w/ cirrhosis who has been stable
liver CA
CT/MRI + contrast
monitor: AFP + US
Ranson criteria
55 y/o WBC > 16000 LDH > 350 AST > 250 glucose > 200
RF pancreatitis
gallstones
etoh abuse
autoimmune
trauma
test for dx pancreatis
CT
pancreatic CA
MC adenocarcinoma
steatorrhea
whipple procedure = pancreaticoduodenectomy + gastro-jejuostomy + chlecystojejunostomy
psoas vs obturator
psoas = pain w/ right hip flexion or passive extension obturator = pain w/ flexion + internal rotation
cramping + bloating
diarrhea/constipation
dermatitis herpetiformis
celiac
anti-tTG, IgA
mild to moderate divericulitis tx
clear liquids
flagyl, cipro, augmentin
colonoscopy + bx = cobblestone and skip lesions (transmural inflammation)
crohn’s
tx: 5 ASA, steroids
limited to mucosa/submucosa
bloody diarrhea
high risk colon CA
ulcerative colitis
tx: sulfasalazine (5-ASA), steroids
protocolectomy
colicky abdominal pain child holding knees to chest pallor lethargy currant jelly stool
intussusception
FOBT +
sausage shaped mass
tx: air contrast enema
target sign US
intussusception
parts of Hesselbach’s triangle
inferior epigastric artery, inguinal canal, rectus muscle
hypogonadism + MCP arthropathy
heart failure
bronze diabetes
high serum iron, low trasferrin
transferrin saturation > 45%
tx: weekly phlebotomy, deferoxamine
complications hermochromatosis
cirrhosis + hepatocellular CA
wilsons
low ceruloplasmin
tx?
penicillamine
avoid shellfish, liver, legumes
CT “chain of lakes”
chronic pancreatitis
pancreatic CA
hx smoking, chronic pancreatitis adenocarcinoma of the head CA 19-9 CT scan + contrast whipple procedure
sudden, intermittent painless rectal bleeding in child < 2
meckel’s diverticulum
MC congenital abnormality of small intestine
technetium 99m scan = ectopic gastric tissue
tx: surgery
meckel’s rule of 2s
MC kids < 2 affect 2% population 2x more common M has 2 types tissue - pancreatic and gastric found 2 i w/in ileocecal valve
failure to pass meconium w/in 48H
bilious vomit, FTT
explosive poops after rectal exam
Hirschsprung
dx - barium enema = narrow distal colon w/ proximal dilation
definitive dx: rectal bx
tx: surgery colostomy + pull thru procedure
rectal bx of Hirschsprung
lack of:
myeneteric (Auerbach’s plexus)
submucosal (Meissner’s plexus)
1st mon life + bilious emesis
blood/mucus stool
AXR = bird-beak
volvulus + malrotation
tx: NG tube decompression, fluids, surgery
study of choice vovulus + malrotation
upper GI = abnormal location ligament of Treitz
what abnormality is Hirshsprung assoc w/
Down syndrome
tumor marker colon CA
CEA
MC place anal fissures
posterior midline
tx hemorrhoids
fiber, fluids, sitz
sclerotherapy, rubber band ligation, electrocoagulation, surgery
study choice hernia
CT
