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ANCC Boards Review > GI > Flashcards

GI Flashcards

1
Q

57 year old female presents with LLQ pain

A

Diverticulitis

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2
Q

200 pound latina, lunch at KFC. Presents to office with RUQ pain

A

Gall bladder

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3
Q

21 year old male with worst peri-umbilical pain of his life

A

appendicitis

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4
Q

Rigid abdomen…

A

MOVE… consult surgery

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5
Q

PUD causes

A

H. pylori
NSAID/ASA
stress
smoker

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6
Q

Duodenal ulcers are more common in what age group

A

30-55

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7
Q

Gastric ulcers are more common in ages

A

55-65

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8
Q

Which type of ulcer feels better after eating?

A

Duodenal

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9
Q

Which type of ulcer gets WORSE after eating?

A

Gastric

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10
Q

Complications of Peptic Ulcer Disease.

A

20% GI bleed

5-10% Perf bowel

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11
Q

GI bleed

S/s

A

Melena
Hematemesis
Coffee-ground emesis

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12
Q

Melena

A

Black tarry stool

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13
Q

Hematemesis

A

Vomiting bright red blood

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14
Q

PUD - s/s

A

Gnawing epigastric pain
Relief w/ food - duo
Worse w/ food - gastric

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15
Q

PUD labs/diagnostics

A

H. pylori testing
CBC - anemia
Endoscopy after 8-12 weeks of treatment

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16
Q

PUD - H2 blockers

A

Initial dose is 1 time daily
- tidine
Increase to BID

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17
Q

PUD - PPI

A

30 minutes before meals

-azole

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18
Q

Coffee ground emesis

A

at least at duodenum

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19
Q

Perforation

A

Hole in lumen of bowel

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20
Q

Causes of perforation

A

PUD
Ruptured diverticulum
Appendicitis

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21
Q

PUD - stepwise approach

A

H2 blocker once daily

  • H2 blocker BID
  • -PPI daily in AM
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22
Q

Mucosal Protective Agents

A

Sucralfate
Bismuth subsalicylate
Misoprostol
Antacids - mylanta

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23
Q

Misoprostol (cytotec)

A

Prophylaxis against NSAID induced ulcers

  • can stimulate uterine contractions
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24
Q

H. Pylori - Eradication Therapy

PPI + 2 antibiotics

A

2 antibiotics and a PPI
MOC
AOC
MOA

25
Q

MOC - H.Pylori eradication

A

Metronidazole
Omeprazole
Clarithromycin

26
Q

AOC - H. Pylori eradication

A

Amoxicillin
Omeprazole
Clarithromycin

27
Q

MOA - H. Pylori eradication

A

Metronidazole
Omepraozle
Amoxicillin

28
Q

Bismuth regimens -

BMT for H. Pylori eradication

A

4 times a day makes it less attractive
Bismuth
Metronidazole
Tetracycline

29
Q

Bismuth regimens -

BMT + PPI for H. Pylori eradication

A

Bismuth
Metronidazole
Tetracycline
Omeprazole

30
Q

PUD - bleeding

Initial management

A 
CBC, BMP, PT/PTT
Endoscopy
Upright films - to r/o free air
IV H2 blockers
NPO
31
Q

Bowel sounds with perforation

A

Quiet
rigid
rebound tenderness

32
Q

Bowel sounds with obstruction

A

High pitched tinkling

33
Q

Hepatitis A

A

Oral - fecal

    • contamination
    • hurricanes
    • Mexico
    • oral sex
34
Q

Hepatitis B

A

Every BODY fluid

35
Q

Hepatitis C

A

Non-A, Non-B

    • 50% are IV drug use
    • leading cause of transplant
36
Q

Hepatitis viral subtypes

A

A, B, C, D, E, G

37
Q

Pre-icteric stage

A

Acute hepatitis

Anorexia
Fatigue
Malaise
aversion to smoking/alcohol

38
Q

Icteric stage

A

Acute hepatitis

Fluorescent yellow 
Clay colored stool 
Wt loss 
Dark urine 
Low grade fever
Hepatosplenomegaly
39
Q

Anti-HAV, IgG

A

recovered Hepatitis A exposure

40
Q

Anti-HAV, IgM

A

Current Hepatitis A virus

41
Q

Worker goes to Miami, sex worker encounter. 2 weeks later florescent yellow.

A

Hepatitis B

HBsAg

42
Q

HBsAg

43
Q

HBeAg

44
Q

Active Hep B

A

HBsAg
HBeAg
Anti-HBc
IgM

45
Q

Anti-HBe

A

Decreased infectivity

46
Q

Active Hep B

A

HBsAg
HBeAg
Anti-HBc
IgM

47
Q

Chronic Hep B

A 
HBsAg
Anti-HBc
Anti-HBe
IgM
IgG
48
Q

Recovered Hep B

A

Anti-HBc

Anti-HBsAg

49
Q

Anti-HBc

Anti-HBsAg

A

Recovered Hep B

50
Q 
HBsAg
Anti-HBc
Anti-HBe
IgM
IgG
A

Chronic Hep B

51
Q

HBsAg
HBeAg
Anti-HBc
IgM

A

Active Hep B

52
Q

Hep C serology

A

Anti-HCV, HCV RNA

PCR to determine acute versus chronic

53
Q

Hepatitis Mangement

A 
Increase fluids - 3-4,000L 
Avoid alcohol 
No protein - ammonia 
Serax - oxazepam 
Vitamin K - PT > 15 sec
Lactulose - > ammonia
54
Q

Diverticulosis

A

LLQ disease

Low fiber

55
Q

Diverticulosis

A

Constipation/loose stools
N/V
Low grade fever
LLQ tenderness

56
Q

Fair, fat, female - RUQ pain

A

Cholecystitis

57
Q

Murphy’s sign

A

Right rib cage pressure, elicits

58
Q

Pancreatitis - causes

A

Heavy alcohol use
HLD
Hypercalcemia
Meds - long time lasix users

ANCC Boards Review (9 decks)

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