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Emergency Medicine > GI > Flashcards

GI Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

MCC of cirrhosis in US?

A

alcohol

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2
Q

Skin changes associated with cirrhosis?

A

palmar erythema; dupuytren’s contractures

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3
Q

CM of hepatic encephalopathy:

A

confusion + lethargy; asterixis (flapping tremor) and fetor hepaticus

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4
Q

Tx of hepatic encephalopathy:

A

lactulose; rifaximin

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5
Q

Pruritus tx in hepatitis

A

cholestyramine

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6
Q

HCC screening:

A

US + AFP

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7
Q

Esophageal varices tx

A

BB (propranolol, timolol, nadolol)

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8
Q

Ruptured esophageal varices tx

A
  • stabilize, abx, octreotide

- Once stabilized, emergency GI endoscopy to ligate

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9
Q

MC complication of cirrhosis

A

ascites

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10
Q

Serum ascites albumin gradient of x makes portal HTN likely?

A

> 1.1 g/dL

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11
Q

MCC of gastritis

A

h. pylori

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12
Q

dx of gastritis

A

endoscopy (thick edematous erosions <0.5 cm)

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13
Q

Gastritis (h.pylori +) tx (3)

A

clarithromycin + amoxicillin + PPI

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14
Q

Gastritis (h.pylori +) tx (4)

A

PPI + bismuth + metronidazole + tetracycline

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15
Q

Gastritis (h.pylori -) tx

A

PPI, H2, antacids, sucralfate

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16
Q

If no response to gastritis treatment after x, one should pursue?

A

4-8 weeks

GI endoscopy, US, test for h.pylori

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17
Q

Backpacker’s diarrhea

A

Giardia

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18
Q

Gastroenteritis associated with: fried rice

A

bacillus cereus

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19
Q

Gastroenteritis associated with: raw shellfish in Gulf of Mexico

A

vibrio parahaemolyticus and vibrio

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20
Q

Gastroenteritis associated with: rice water stools

A

vibrio parahaemolyticus and vibrio

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21
Q

Gastroenteritis associated with: clindamycin use

A

c. diff

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22
Q

Tx for c. diff

A

metronidazole

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23
Q

MCC of bacterial enterits

A

camplobacter jejuni

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24
Q

MC antecedent event in post-infectious GBS

A

camplobacter jejuni

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25
Q

Gastroenteritis associated with: S comma, seagull shaped

A

camplobacter jejuni

26
Q

Camplobacter jejuni tx

A

Erythromycin

27
Q

Shigella tx

A

bactrim

28
Q

Gastroenteritis associated with: typhoid fever

A

salmonella

29
Q

Typhoid fever CM:

A

cephalic phase (HA, constipation, pharyngitis, cough) –> crampy abdominal pain, diarrhea, pea soup stools, tractable fever, relative brady, hepatospleno, blanching rose spots

30
Q

Gastroenteritis associated with: pea soup stools

A

salmonella

31
Q

Gastroenteritis associated with: large voluminous stools

A

non-invasvie

32
Q

Gastroenteritis associated with: many small volume stools

A

invasive

33
Q

Types of hepatitis assoc with chronicity

A

HBV, HCV, HDV

34
Q

Jaundice occurs when levels >

A

2.5 mg/dL

35
Q

Is bilirubin seen with conjugated or unconjugated bilirubin?

A

conjugated

36
Q

Dark urine is seen with conjugated or unconjugated bilirubin?

A

conjugated

37
Q

Is conjugated or unconjugated bilirubin toxic?

A

unconjugated

38
Q

AST; ALT >2

A

alcoholic hepatitis

39
Q

ALT > AST

>1000

A

acute viral hepatitis

40
Q

ALT > AST

<400

A

chronic viral hepatitis

41
Q

Increase alk phosphate assoc with

A

biliary obstruction

42
Q

What is the most sensitive indicator of biliary injury?

A

GGT

43
Q

What type of hepatitis is associated with spiking fevers?

A

hepatitis A

44
Q

Hep A transmission

A

fecal oral

45
Q

MCC of hep A

A

asymptomatic children <6 y/o

46
Q

Hep A tx

A

self-limiting

47
Q

Post-exposure Hep A

A

HAV immune globulin

48
Q

Which hep is most likely to become chronic?

A

hep c (80%)

49
Q

Tx of hep C

A

pegylated interferon a-2b and ribavirin

50
Q

Hep D requires Hep x co-infection

A

Hep B

51
Q

PID treatment

A

doxy + ceftriaxone +/- metro

52
Q

Chronic cases of Hep B are MC

A

perinatally acquired

53
Q

Hep B causes increase risk of?

A

hepatocellular cancer

54
Q

First evidence of Hep B infection?

A

HBsAg

55
Q

If HBsAg is + for >6 months –>

A

chronic

56
Q

HBsAb indicates?

A

distant resolved infection or vaccination

57
Q

If no development of HBsAb within 6 months?

A

chronic

58
Q

HBcAb indicates?

A

IgM vs. IgG

59
Q

HBeAg (envelope) indicates?

A

increase viral replication and increased infectivity; if increased for >3 mo, likelihood of developing chronic

60
Q

HBeAb (envelope) indicates?

A

waning viral replication

61
Q

Acute hep B tx?

A

supportive

62
Q

Chronic hep B tx?

A

a-interferon 2 b

Emergency Medicine (7 decks)

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