GI Flashcards
(121 cards)
1
Q
celiac markers
A
anti-endomysial antibody and anti-tissue transglutmainase
2
Q
celiac markers
A
anti-tissue transglutaminase and anti-endomysial antiboidy
3
Q
alk phos
A
marker of bone turnover and biliary tract disease
4
Q
systemic sclerosis makers
A
anti-topoisomerase antibody (anti-Scl 70) and anticentromere antibody
5
Q
systemic sclerosis complications, lung
A
interstitial lung disease, pulmonary artery hypertension
6
Q
systemic sclerosis complications, kidney
A
HTN, scleromderma renal crisis (oliguria, thrombocytopenia)
7
Q
systemic sclerosis complications, heart
A
myocardial fibrosis, pericarditis, pericardial effusion
8
Q
sclerodactyly
A
puffy digits
9
Q
CREST in full
A
Calcinosis cutis, Raynaud, Esophageal dysmotility, Sclerodactyly, Telangiactasias
10
Q
primary sclerosing cholangitis association
A
ulcerative colitis
11
Q
pyloric stenosis age of presentation
A
3-6 weeks
12
Q
splenic vein thrombosis risk factor
A
pancreatitis or pancreatic cancer
13
Q
Budd-Chiari cause and symptoms
A
thrombosis of hepatic veins or IVC –> RUQ pain, hepatomegaly, and ascites (rapidly developing)
14
Q
diverticulitis presentation
A
fever, nausea, vomiting, abdomoinal pain, nonbloody diarrhea
15
Q
celiac disease serologies
A
immunoglobulin a anti-tissue transglutaminase
16
Q
nutritional deficiencies in celiac disease
A
iron, calcium, vitamin D, folic acid, sometimes thiamine
17
Q
type 1 autoimmune hepatitis marker
A
anti-smooth muscle antibodies
18
Q
primary biliary cholangitis treatment
A
ursodeoxycholic acid
19
Q
vitamin B1 (thiamine) deficiency symptoms
A
neurocognitive dysfunction, atxia, encephalopathy, amnesia (Wernicke Korsakoff) or wet beriberi (dilated cardiomyopathy, polyneuropathy)
20
Q
H pylori treatment
A
omeprazole + clarithromycin + amoxicillin
21
Q
ascites management
A
sodium restriction, loop inhibitor (furosemide) and potassium-sparing diuretic (spironolactone)
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
23
Q
Common causes of Exudate
A
Infection, malignancy, connective tissue disease, PE, pancreatitis, post-CABG
24
Q
Common causes of transudate
A
Cirrhosis, nephrotic syndrome, heart failure, constrictive pericarditis
25
octreotide
decreases elevated pressure in esophageal varices by decreasing splanchnic blood flow
26
obstructive dysphagia
difficulty swallowing solid foods, prolonged and careful chewing, and swallowing small portions (associated with peptic strictures)
27
Charcot's Triad
Fever, Jaundice, and RUQ pain (acute cholangitis)
28
Reynold's Pentad
Fever, jaundice, RUQ pain, hypotension and AMS (acute cholangitis)
29
Esophageal Spasm treatment
calcium channel blockers or nitrates/tricyclics
30
Dumping syndrome symptoms and treatment
Abdominal pain, diarrhea, nausea, vomiting; treatment is with high protein diet
31
Drug Induced Pancreatitis Causes
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
32
Dyspepsia definition
pain or fullness in the epigastric area without heartburn
33
PPI example
omeprazole
34
H2 blocker example
ranitidine
35
Gallstone pancreatitis treatment
cholecystectomy within 7 days
36
Cause of breastmilk juanudince
high beta-glucuronidase activity
37
toxic megacolin xray findings
dilated colon wiht air-fluid levels
38
Hepatic adenoma treatment
stop oral contraception; if symptomatic or >5cm needs surgical resection
39
Diverticulitis complication, most frequent
colonic abscess (in 15-55% of patients!)
40
H pylori first line treatment regimen
PPI + clarithromycin + amox for 10-14 days
41
H pylori quadruple therapy
PPI + bismuth + metronidazole + tetracycline
42
MELD score components
bilirubin, INR, and serum creatinine; NA can also be important
43
Bad findings from a sigmoidoscopy
Large adenomatous polyps (>1cm)
Multiple adenomatous poplyps
Any polyps with villous or tubulovillous morphology
44
Chronic pancreatitis diagnostic test
MRCP showing pancreatic calcifications
45
SBO indications for surgical intervention
failed conservative therapy. incarcerated hernias, or mesenteric ischemia
46
GERD workup in patient over 55
EGD
47
Porcelain gallbladder
calcifications due to chronic cholelithiasis. Prophylactic colecystectomy is often needed to prevent increased cancer risk
48
Ursodeoxycholic acid
used for small noncalcified gallstones with mild biliary colic
49
ischemic colitis stool type
hematochezia, not melenic
50
Indications for stress ulcer prophylaxis
Coagulopathy, mechanical ventilation for >48 hours, Gi bleed or ulceration, head trauma, spinal cord injury or major burn
51
Colon cancer screening options for general population
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
radiation proctitis
diarrhea, mucus discharge, and tenesmus within 6 weeks of pelvic radiation treat with supportive measures if acute, suralfate or glucocorticoid enemas if chronic
53
Fecal impaction adult treatment
first disimpact manually, then enema, then prescribe stool softeners
54
Management of diarrhea in peds
normal, age-appropriate diet (not BRAT diet) and NO sugary foods as that increases osmolarity of stools
55
best predictor of severity in pancreatitis
elevated hematocrit (>44%) or BUN >20
56
Gallstone with biliary colic treatment
acute pain management and prophylactic cholecystectomy; can do UDCA if poor surgical candidate
57
risk if you give antibiotics to kids w E Coli
predisposes them to HUS
58
variceal hemorrhage treatment
octreotide
59
BUN to creatinine ratio
BUN:Cr ratio >20 is from decreased blood flow to the kidey
60
enteropathy-associated T cell lymphoma
complication from untreated celiac disease that primarily affects the proximal jejunum
61
acute calculous cholecystitis
gallstone obstructs cystic duct
62
HIDA scan (hepatobiliary iminodiacetic acid)
>90% specificity and sensitivity for acute cholecystitis
63
risk factor for pyloric stenosis
use of azithromycin or erythromycin
64
first colonoscopy?
if risk factor, 40 or 10 years before diagnosis of relative
65
serum-ascites albumin gradient (SAAG)
serum albumin minus ascitic fluid albumin (NOT the ratio); if >1.1, portal htn; if <1.1, not portal HTN
66
ascites with LOW SAAG
peritoneal carcinomatosis, peritoneal TB, nephrotic syndrome, pancreatitis, serositis
67
adenosine
used to terminarte paroxysmal supraventricular tachycardias
68
amiodarone
chronic rhythm control for patients with AF
69
drugs that increase warfarin effect
metronidazole, quinolones, amiodarone, acetaminophen
70
drugs that decrease warfarin effect
rifampin, phenytoin, contraceptives,leafy greens
71
CHADS VASC
congestive HF, HTN, age >75, diabetes, stroke, vascular disease, age 65-74, sex category (female)
72
HOCM treatment
beta blockers, verapamil, or disopyramide
73
ASCVD
acute coronary syndrome, stable angina, CABG, stroke, TIA, PAD, LDL >190, age 40-75 with diabetes, 10 year ASCVD risk >7.5
74
Niacin
increase HDL and decrase LDL
75
Fibrates
treatment for high triglycerides
76
Type A Aortic Dissection
sharp anterior chest pain; ascending
77
Type B Aortic dissection
back pain; descending
78
coronary revascularization indications
1. refractory angina despite maximal medical therapy
| 2. improved long term survival (left main coronary artery stenosis or multivessel disease)
79
trastuzumab-associated cardiotoxicity
decrease in LVEF in approx 5% with monotherapy and 25% with combo therapy; is reversible!!
80
ezetimibe
decreases cholesterol absorption in small intestine
81
gemfibrozil
lowers LDL and VLDL by increasing extrahepatic function of lipoprotein lipase, thus clearing triglycerides
82
bosentan and ambrisentan
endothelin receptor antagonists used to delay proression of disease in people wiht pulmonary rtery hypertension
83
sildenafil mechanisml
phosphodiesterase 5 inhibitor; can be used for PAH
84
prostacyclin inhibitors
epoprostenol, treprostinil, iloprost
85
adenosine receptor antagonist name and uses
theophylline, used for management of asthma
86
a-1 antagonists names and uses
doxazosin, terazosin, BPH
87
angiotensin receptor blockers names
losartan, valsartan
88
surgeries with high risk of cardiac death
aortic or other major vascular or peripheral vascular repair
89
surgeries with intermediate risk
carotid endarterectomy, head and neck surgeries, intraperitoneal and intrathoracic surgeries, orthopedic and prpstate surgeries
90
surgeries with ow cardiac risk
ambulatory or superficial procedures, endoscopic procedures, cataract and breast surgeries
91
inferior MI leads
II, III, aVF
92
lateral MI leads
I, aVL, V5, V6
93
anterior MI leads
V3, V4
94
Septal MI leads
V1, V2
95
STEMI management
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
acute coronary syndrome ED management
325 aspirin, sublinguial nitroglycerin, troonin levels 3 hours apart, serial EKGs
97
retrograde P waves
paroxysmal subraventricular tachycardia
98
paroxysmal supraventricular tachycardia treatment
valsalva maneuvers, adenosine
99
fibrate therapy indication
triglycerides >800
100
ASD murmur
wide and fixed splitting of second heart sound with mid-systolic ejection murmur
101
mitral stenosis symptoms
dyspnea, orthopnea, hemoptysis, a fib, thromboemboli; can have "ortner syndrome" where you have a hoarse voice from laryngeal nerve compression
102
NSTEMI treatment
dual antiplatelet therapy; nitrates; beta blockers; statins; anticoagulants
103
cilostazol
phosphodiesterase 3 inhibitor that helps with symptoms (only after failed lifestyle control
104
milrinone
selective phosphodiesterase 3 inhibitor, + inotropic
105
nitroglycerin MOA
venouse dilator so decreases cardiac preload, resulting in reduced intracardialc filling pressures
106
mobitz type I heartblock
asymptomatic and benigin
107
mobitz type II heartblock
intermittent nonconducted p waves
108
sodium bicarb infusion use
helps prevent worsening arrhythmias (QRS widening) in tricyclic overdoses and increases serum pH and extracellular sodiu
109
aortic valve replacement for aortic stensosis
onset of symptoms, LV EF <50, ndergoing other cardiac surgery
110
acute limb ischemia six P's
pain, pallor, parasthesias, pulselessness, pokilothermia, paralysis
111
contraindication for bveta blockers
acute decompensated heart failure --decrease HR and may worsen pulmonary edema
112
nitroglycerin contraindication
RV MI
113
LV systolic dysfunction treatment
ACE inhibitor, beta blocker, loop diuretic, aldosterone antagonist
114
pulsus paradoxus
exaggerated drop in BPs >10mmHg due to bowing of the right ventricleinto the left ventricle during inspriation
115
Management of Torsades in a conscious patient
magnesium sulfate
116
V2 and V3 lead criteria for STEMI in men and women
>1.5mm in women, > 2 mm in men 40, >2.5mm in men < 40
117
VSD murmur
holosystolic murmur wiht max intensity over left 3rd and 4th intercostal spaces, often wtih a palpable thrill
118
ASD murmur
fixed and split S2
119
aortic regurg finding on physical exam
wide pulse pressure
120
aortic stenosis physical exam findings
soft, single second heart sound; carotid pulse is parvus et tardus; loud and late peaking systolic murmur `
121
Digoxin toxicity
nausea, vomiting, anorexia, fatigue, confusion, visual disturbances; can be worsened with verapamil, quinidine, amiodarone, and sprionolactone
