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Emergency Med > GI > Flashcards

GI Flashcards

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1
Q

What is the diagnostic test of choice in a Mallory Weiss tear? Findings?

A

Upper endoscopy: SF longitudinal mucosal erosions

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2
Q

What is the MCC of esophageal varices in adults?

A

Cirrhosis

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3
Q

What is the MCC of esophageal varices in children?

A

Portal vein thrombosis

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4
Q

Upper endoscopy findings in esophageal varices

A

“red whale” markings & cherry red spots

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5
Q

What is the TOC in esophageal varices?

A

Endoscopic ligation

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6
Q

What is the pharmacologic DOC in acute esophageal varices bleeding?

A

Ocreotide

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7
Q

What is the pharmacologic DOC in prophylaxis to prevent esophageal varices bleeding?

A

Propronalol

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8
Q

What is the MCC of gastritis? 2nd MCC?

A
  1. H. Pylori

2. NSAIDs/ASA

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9
Q

Gastritis tx if H. pylori positive?

A

CAP= Clarithromycin + Amoxcillin + PPI

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10
Q

What diagnostic test is MCly used first in the evaluation of GERD?

A

Endoscopy

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11
Q

What is Gold Standard evaluation of GERD?

A

24h ambulatory pH monitoring

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12
Q

what are the complications of GERD?

A
  1. Esophagitis
  2. Barrets Esophagus
  3. Esophageal adenocarcinoma
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13
Q

GERD tx

A
  1. Antacids: Maalox, Mylanta
  2. H2 blockers: Ranitidine
  3. PPI’s: omeprazole
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14
Q

What is the MCC of upper GI bleed?

A

Peptic Ulcer Disease

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15
Q

What is the MC sx in PUD?

A

Dyspepsia

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16
Q

When should you suspect GI malignancy in PUD? Which malignancies?

A

Nonhealing Gastric Ulcer

  1. Zollinger-Ellison Syndrome (ZES): Gastrin producing tumor
  2. Gastric CA
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17
Q

H. pylori eradication tx in PUD?

A

CAP= Clarithromycin + Amoxcillin + PPI (same as gastritis)

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18
Q

GI protective meds in the tx of PUD?

A
  1. Sucralfate

2. Misoprostol

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19
Q

What are the 4 main si/sx’s of bowel obstruction?

A
  1. Cramping Abdominal Pain
  2. Vomiting
  3. Abdominal distentin
  4. Obstipation= absence of stool/flatus
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20
Q

What is the MCC of bowel obstruction? 2nd MCC?

A
  1. Post-surgical adhesions

2. Incarcerated hernias

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21
Q

Treatment in Nonstrangulated bowel obstruction?

A

NPO (bowel rest) + IV fluids + Bowel decompression=NG tube suction

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22
Q

Treatment in strangulated bowel obstruction?

A

Surgical intervention

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23
Q

What are the 2 MCC of ischemic colitis?

A
  1. Hypotension

2. Atherosclerosis: Superior and mesenteric arteries

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24
Q

Ischemic colitis si/sx’s?

A

LLQ. Pain + Bloody diarrhea (d/t sloughing of the colon)

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25
Q

Diagnosis of choice in ischemic colitis?

A

Colonoscopy

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26
Q

What dietary recommendation can you make to pt’s with hemorrhoids?

A

High-fiber diet

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27
Q

Ischemic colitis si/sx’s.

A
  1. Crampy LLQ pain
  2. Red/maroon colored stool
  3. Urgency w/ BM
  4. Nausea
  5. Diarrhea
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28
Q

List the causes for ischemic colitis

A
  1. Atherosclerosis
  2. Blood clot
  3. Hypotension
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29
Q

Diagnostic test of choice in evaluating ischemic colitis? Findings?

A

Colonoscopy: Segmental ischemic changes in areas of low perfusion–>splenic flexure*

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30
Q

Ischemic colitis tx

A

Restore perfusion

31
Q

Diverticulitis si/sx’s

A
  1. LLQ Pain
  2. Fever*
  3. Abd distention
  4. Rectal bleeding
  5. +/- bowel changes
32
Q

Diverticulitis diagnostic TOC

A

CT abd/pelvis WITH contrast

33
Q

Diverticulitis tx

A
  1. Cipro + Flagyl x7-10 days
  2. Clear liquid diet
  3. High fiber
34
Q

Acute pancreatitis lab findings

A
  1. Elevated lipase
  2. Elevated ALT 3x fold= suggest gallstone pancreatitis
  3. Hypocalcemia=necrotic fat binds to Ca+
35
Q

Acute Pancreatitis abd x-ray findings

A

Sentinel loop

36
Q

Chronic Pancreatitis si/sx’s

A
  1. Calcifications
  2. DM
  3. Stearorrhea
37
Q

Chronic Pancreatitis X-ray findings

A

Calcified pancreas

38
Q

What do you want to make sure you supplement your pt with who has chronic pancreatitis?

A

Pancreatic enzymes

39
Q

List the hernias that require surgical repair

A
  1. “Rolling” Hiatal hernia= fungus of stomach protrudes through diaphragm
  2. Femoral hernia
  3. Inguinal
40
Q

Define Noninfectious Diarrhea

A
  1. Water, Voluminous diarrhea
  2. Vomiting
  3. NO blood or WBC’s
41
Q

What is S. aureus Noninfectious Diarrhea associated with?

A

Food contamination: Dairy products, meats, eggs

42
Q

What organism is associated with fried rice contamination in noninfectious diarrhea?

A

Bacillus Cereus

43
Q

List the organism that produces “rice water stools”

A

Vibrio Cholera

44
Q

What is V. Parahemolyticus associated with?

A

Shell Fish in Gulf of Mexico

45
Q

What is the MCC of traveler’s diarrhea

A

Enterotoxigenic E. coli

Unsanitary water/ice

46
Q

C. diff si/sx’s

A
  1. Abd cramps
  2. Diarrhea
  3. Fever
47
Q

C. diff lab and PEx findings

A
  1. Striking Lymphocytosis
  2. Pseduomembranous colitis
  3. Toxic Megacolon
48
Q

C. diff tx

A
  1. Metronidazole=1st line

2. Vanco=2nd line

49
Q

What is the MC Viral cause of gastroenteritis in adults? Associated with what?

A

Norovirus

Cruise ships, hospitals, restaurants

50
Q

What is the MC Viral cause of gastroenteritis in children?

A

Rotavirus

51
Q

When are anti-motility drugs CI? Why?

A

Invasive diarrhea

May cause toxicity

52
Q

List the anti-motility drugs used in Noninvasive diarrhea

A
  1. Loperamide (Immodium): Opiod agonist, inhibits peristalsis
  2. Anticholinergics: Phenobarbital, Hyoscyamine, Atropine, Scopolamine= inhibits Ach related GI motility
53
Q

Define Invasive Infectious diarrhea

A
  1. High Fever
    • Blood
  3. Fecal leukocytosis
54
Q

What is the MCC of bacterial enteritis in the US? What is the contaminated food source?

A

Campylobacter enteritis= C. Jejuni

Undercooked poultry

55
Q

Stool culture findings in Campylobacter enteritis

A

S, Comma, or Seagull shaped

56
Q

Campylobacter enteritis treatment

A

Erythromycin

57
Q

What is the MC antecedent even in post-infectious Guillan-Barre Syndrome?

A

C. jejuni

58
Q

What organism can cause febrile seizures in children with infectious diarrhea?

A

Shigella

59
Q

Shigella si/sx’s

A

Lower Abd pain + Explosive watery diarrhea–> mucoid, bloody*

60
Q

Shigella lab findings

A

Leukemoid reaction= WBC >50, 000

61
Q

Shigella abx tx

A

Bactrim=1st line

62
Q

Who is at the highest risk for Salmonella?

A
  1. Immunocompromised

2. Sickle cell dz

63
Q

Salmonella abx tx

A

Fluoroquinolone

64
Q

What is the only hepatitis associated with a spiked fever?

A

Hep A

65
Q

Hep A transmission

A

Fecal-oral

Outbreaks with water/food during international travel, day care workers, MSM, shellfish

66
Q

Hep A treatment

A

Self-limiting
Post exposure prophylaxis: HAV immune globulin
Pre-exposure: Hep A vaccine

67
Q

What hepatitis is associated with the highest mortality during pregnancy?

A

Hep E

Increased risk for fulminant hepatitis

68
Q

Hep C transmission

A

Parenteral: IV drug use*, Increased risk if blood transfusion before 1992

69
Q

Hep C Treatment? What do you also need to screen for?

A

Pegylated Interferon alpha-2b + Ribavirin

Screen for HCC via serum AFP & US

70
Q

What must you have in order to contract Hep D?

A

Hep B

71
Q

What hepatitis is over 90% perinatally acquired?

A

Hep B

72
Q

CI to Hep B vaccination

A

Allergy to Baker’s yeast

73
Q

Hep B treatment

A

Tenofovir, Entecavir, alpha-interferon 2b

74
Q

List the causes of cirrhosis

A
  1. ETOH=MCC
  2. Chronic Viral Hepatitis= Hep C, B, D
  3. Nonalcoholic Fatty liver dz: Obesity, DM, hypertriglyceridemia
  4. Hemochromatosis

Emergency Med (10 decks)

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