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GI Flashcards

1
Q

celiac markers

A

anti-endomysial antibody and anti-tissue transglutmainase

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2
Q

celiac markers

A

anti-tissue transglutaminase and anti-endomysial antiboidy

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3
Q

alk phos

A

marker of bone turnover and biliary tract disease

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4
Q

systemic sclerosis makers

A

anti-topoisomerase antibody (anti-Scl 70) and anticentromere antibody

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5
Q

systemic sclerosis complications, lung

A

interstitial lung disease, pulmonary artery hypertension

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6
Q

systemic sclerosis complications, kidney

A

HTN, scleromderma renal crisis (oliguria, thrombocytopenia)

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7
Q

systemic sclerosis complications, heart

A

myocardial fibrosis, pericarditis, pericardial effusion

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8
Q

sclerodactyly

A

puffy digits

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9
Q

CREST in full

A

Calcinosis cutis, Raynaud, Esophageal dysmotility, Sclerodactyly, Telangiactasias

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10
Q

primary sclerosing cholangitis association

A

ulcerative colitis

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11
Q

pyloric stenosis age of presentation

A

3-6 weeks

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12
Q

splenic vein thrombosis risk factor

A

pancreatitis or pancreatic cancer

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13
Q

Budd-Chiari cause and symptoms

A

thrombosis of hepatic veins or IVC –> RUQ pain, hepatomegaly, and ascites (rapidly developing)

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14
Q

diverticulitis presentation

A

fever, nausea, vomiting, abdomoinal pain, nonbloody diarrhea

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15
Q

celiac disease serologies

A

immunoglobulin a anti-tissue transglutaminase

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16
Q

nutritional deficiencies in celiac disease

A

iron, calcium, vitamin D, folic acid, sometimes thiamine

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17
Q

type 1 autoimmune hepatitis marker

A

anti-smooth muscle antibodies

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18
Q

primary biliary cholangitis treatment

A

ursodeoxycholic acid

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19
Q

vitamin B1 (thiamine) deficiency symptoms

A

neurocognitive dysfunction, atxia, encephalopathy, amnesia (Wernicke Korsakoff) or wet beriberi (dilated cardiomyopathy, polyneuropathy)

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20
Q

H pylori treatment

A

omeprazole + clarithromycin + amoxicillin

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21
Q

ascites management

A

sodium restriction, loop inhibitor (furosemide) and potassium-sparing diuretic (spironolactone)

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22
Q

Light Criteria for Exudate

A

pleural protein/serum protein >0.5 OR pleural LDH/serum LDH >0.6 OR Pleural LDH >2/3 upper limit of normal

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23
Q

Common causes of Exudate

A

Infection, malignancy, connective tissue disease, PE, pancreatitis, post-CABG

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24
Q

Common causes of transudate

A

Cirrhosis, nephrotic syndrome, heart failure, constrictive pericarditis

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25
Q

octreotide

A

decreases elevated pressure in esophageal varices by decreasing splanchnic blood flow

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26
Q

obstructive dysphagia

A

difficulty swallowing solid foods, prolonged and careful chewing, and swallowing small portions (associated with peptic strictures)

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27
Q

Charcot’s Triad

A

Fever, Jaundice, and RUQ pain (acute cholangitis)

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28
Q

Reynold’s Pentad

A

Fever, jaundice, RUQ pain, hypotension and AMS (acute cholangitis)

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29
Q

Esophageal Spasm treatment

A

calcium channel blockers or nitrates/tricyclics

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30
Q

Dumping syndrome symptoms and treatment

A

Abdominal pain, diarrhea, nausea, vomiting; treatment is with high protein diet

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31
Q

Drug Induced Pancreatitis Causes

A

Usual mechanism is increased viscosity of pancreatic secretions. Usual causing agents: heart faiulre or hypertension meds, autoimmune meds, chronic pain meds, seizure meds, HIV meds

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32
Q

Dyspepsia definition

A

pain or fullness in the epigastric area without heartburn

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33
Q

PPI example

A

omeprazole

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34
Q

H2 blocker example

A

ranitidine

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35
Q

Gallstone pancreatitis treatment

A

cholecystectomy within 7 days

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36
Q

Cause of breastmilk juanudince

A

high beta-glucuronidase activity

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37
Q

toxic megacolin xray findings

A

dilated colon wiht air-fluid levels

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38
Q

Hepatic adenoma treatment

A

stop oral contraception; if symptomatic or >5cm needs surgical resection

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39
Q

Diverticulitis complication, most frequent

A

colonic abscess (in 15-55% of patients!)

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40
Q

H pylori first line treatment regimen

A

PPI + clarithromycin + amox for 10-14 days

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41
Q

H pylori quadruple therapy

A

PPI + bismuth + metronidazole + tetracycline

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42
Q

MELD score components

A

bilirubin, INR, and serum creatinine; NA can also be important

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43
Q

Bad findings from a sigmoidoscopy

A

Large adenomatous polyps (>1cm)
Multiple adenomatous poplyps
Any polyps with villous or tubulovillous morphology

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44
Q

Chronic pancreatitis diagnostic test

A

MRCP showing pancreatic calcifications

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45
Q

SBO indications for surgical intervention

A

failed conservative therapy. incarcerated hernias, or mesenteric ischemia

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46
Q

GERD workup in patient over 55

A

EGD

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47
Q

Porcelain gallbladder

A

calcifications due to chronic cholelithiasis. Prophylactic colecystectomy is often needed to prevent increased cancer risk

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48
Q

Ursodeoxycholic acid

A

used for small noncalcified gallstones with mild biliary colic

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49
Q

ischemic colitis stool type

A

hematochezia, not melenic

50
Q

Indications for stress ulcer prophylaxis

A

Coagulopathy, mechanical ventilation for >48 hours, Gi bleed or ulceration, head trauma, spinal cord injury or major burn

51
Q

Colon cancer screening options for general population

A

colonoscopy every 10 years; guiaic-based fecalt occult blood test or fecal immunochemical test every year, FIT-DNA every 1-3 years or flex sigmoidoscopy every 5 years

52
Q

radiation proctitis

A

diarrhea, mucus discharge, and tenesmus within 6 weeks of pelvic radiation treat with supportive measures if acute, suralfate or glucocorticoid enemas if chronic

53
Q

Fecal impaction adult treatment

A

first disimpact manually, then enema, then prescribe stool softeners

54
Q

Management of diarrhea in peds

A

normal, age-appropriate diet (not BRAT diet) and NO sugary foods as that increases osmolarity of stools

55
Q

best predictor of severity in pancreatitis

A

elevated hematocrit (>44%) or BUN >20

56
Q

Gallstone with biliary colic treatment

A

acute pain management and prophylactic cholecystectomy; can do UDCA if poor surgical candidate

57
Q

risk if you give antibiotics to kids w E Coli

A

predisposes them to HUS

58
Q

variceal hemorrhage treatment

A

octreotide

59
Q

BUN to creatinine ratio

A

BUN:Cr ratio >20 is from decreased blood flow to the kidey

60
Q

enteropathy-associated T cell lymphoma

A

complication from untreated celiac disease that primarily affects the proximal jejunum

61
Q

acute calculous cholecystitis

A

gallstone obstructs cystic duct

62
Q

HIDA scan (hepatobiliary iminodiacetic acid)

A

> 90% specificity and sensitivity for acute cholecystitis

63
Q

risk factor for pyloric stenosis

A

use of azithromycin or erythromycin

64
Q

first colonoscopy?

A

if risk factor, 40 or 10 years before diagnosis of relative

65
Q

serum-ascites albumin gradient (SAAG)

A

serum albumin minus ascitic fluid albumin (NOT the ratio); if >1.1, portal htn; if <1.1, not portal HTN

66
Q

ascites with LOW SAAG

A

peritoneal carcinomatosis, peritoneal TB, nephrotic syndrome, pancreatitis, serositis

67
Q

adenosine

A

used to terminarte paroxysmal supraventricular tachycardias

68
Q

amiodarone

A

chronic rhythm control for patients with AF

69
Q

drugs that increase warfarin effect

A

metronidazole, quinolones, amiodarone, acetaminophen

70
Q

drugs that decrease warfarin effect

A

rifampin, phenytoin, contraceptives,leafy greens

71
Q

CHADS VASC

A

congestive HF, HTN, age >75, diabetes, stroke, vascular disease, age 65-74, sex category (female)

72
Q

HOCM treatment

A

beta blockers, verapamil, or disopyramide

73
Q

ASCVD

A

acute coronary syndrome, stable angina, CABG, stroke, TIA, PAD, LDL >190, age 40-75 with diabetes, 10 year ASCVD risk >7.5

74
Q

Niacin

A

increase HDL and decrase LDL

75
Q

Fibrates

A

treatment for high triglycerides

76
Q

Type A Aortic Dissection

A

sharp anterior chest pain; ascending

77
Q

Type B Aortic dissection

A

back pain; descending

78
Q

coronary revascularization indications

A
  1. refractory angina despite maximal medical therapy

2. improved long term survival (left main coronary artery stenosis or multivessel disease)

79
Q

trastuzumab-associated cardiotoxicity

A

decrease in LVEF in approx 5% with monotherapy and 25% with combo therapy; is reversible!!

80
Q

ezetimibe

A

decreases cholesterol absorption in small intestine

81
Q

gemfibrozil

A

lowers LDL and VLDL by increasing extrahepatic function of lipoprotein lipase, thus clearing triglycerides

82
Q

bosentan and ambrisentan

A

endothelin receptor antagonists used to delay proression of disease in people wiht pulmonary rtery hypertension

83
Q

sildenafil mechanisml

A

phosphodiesterase 5 inhibitor; can be used for PAH

84
Q

prostacyclin inhibitors

A

epoprostenol, treprostinil, iloprost

85
Q

adenosine receptor antagonist name and uses

A

theophylline, used for management of asthma

86
Q

a-1 antagonists names and uses

A

doxazosin, terazosin, BPH

87
Q

angiotensin receptor blockers names

A

losartan, valsartan

88
Q

surgeries with high risk of cardiac death

A

aortic or other major vascular or peripheral vascular repair

89
Q

surgeries with intermediate risk

A

carotid endarterectomy, head and neck surgeries, intraperitoneal and intrathoracic surgeries, orthopedic and prpstate surgeries

90
Q

surgeries with ow cardiac risk

A

ambulatory or superficial procedures, endoscopic procedures, cataract and breast surgeries

91
Q

inferior MI leads

A

II, III, aVF

92
Q

lateral MI leads

A

I, aVL, V5, V6

93
Q

anterior MI leads

A

V3, V4

94
Q

Septal MI leads

A

V1, V2

95
Q

STEMI management

A
  1. O2 >90
  2. Nitrates unless RV infarct or severe aortic stenosis
  3. Antiplatelet therapy (Aspirin and clopidogrel)
  4. Anticoagulation w heparin
  5. Beta blockers unless heart failure or bradycardia
  6. PCI within 90 minutes
  7. Statin therapy
96
Q

acute coronary syndrome ED management

A

325 aspirin, sublinguial nitroglycerin, troonin levels 3 hours apart, serial EKGs

97
Q

retrograde P waves

A

paroxysmal subraventricular tachycardia

98
Q

paroxysmal supraventricular tachycardia treatment

A

valsalva maneuvers, adenosine

99
Q

fibrate therapy indication

A

triglycerides >800

100
Q

ASD murmur

A

wide and fixed splitting of second heart sound with mid-systolic ejection murmur

101
Q

mitral stenosis symptoms

A

dyspnea, orthopnea, hemoptysis, a fib, thromboemboli; can have “ortner syndrome” where you have a hoarse voice from laryngeal nerve compression

102
Q

NSTEMI treatment

A

dual antiplatelet therapy; nitrates; beta blockers; statins; anticoagulants

103
Q

cilostazol

A

phosphodiesterase 3 inhibitor that helps with symptoms (only after failed lifestyle control

104
Q

milrinone

A

selective phosphodiesterase 3 inhibitor, + inotropic

105
Q

nitroglycerin MOA

A

venouse dilator so decreases cardiac preload, resulting in reduced intracardialc filling pressures

106
Q

mobitz type I heartblock

A

asymptomatic and benigin

107
Q

mobitz type II heartblock

A

intermittent nonconducted p waves

108
Q

sodium bicarb infusion use

A

helps prevent worsening arrhythmias (QRS widening) in tricyclic overdoses and increases serum pH and extracellular sodiu

109
Q

aortic valve replacement for aortic stensosis

A

onset of symptoms, LV EF <50, ndergoing other cardiac surgery

110
Q

acute limb ischemia six P’s

A

pain, pallor, parasthesias, pulselessness, pokilothermia, paralysis

111
Q

contraindication for bveta blockers

A

acute decompensated heart failure –decrease HR and may worsen pulmonary edema

112
Q

nitroglycerin contraindication

A

RV MI

113
Q

LV systolic dysfunction treatment

A

ACE inhibitor, beta blocker, loop diuretic, aldosterone antagonist

114
Q

pulsus paradoxus

A

exaggerated drop in BPs >10mmHg due to bowing of the right ventricleinto the left ventricle during inspriation

115
Q

Management of Torsades in a conscious patient

A

magnesium sulfate

116
Q

V2 and V3 lead criteria for STEMI in men and women

A

> 1.5mm in women, > 2 mm in men 40, >2.5mm in men < 40

117
Q

VSD murmur

A

holosystolic murmur wiht max intensity over left 3rd and 4th intercostal spaces, often wtih a palpable thrill

118
Q

ASD murmur

A

fixed and split S2

119
Q

aortic regurg finding on physical exam

A

wide pulse pressure

120
Q

aortic stenosis physical exam findings

A

soft, single second heart sound; carotid pulse is parvus et tardus; loud and late peaking systolic murmur `

121
Q

Digoxin toxicity

A

nausea, vomiting, anorexia, fatigue, confusion, visual disturbances; can be worsened with verapamil, quinidine, amiodarone, and sprionolactone

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