GI Flashcards
What among the following is a common cause of pancreatitis?
cholelithiasis
A question wanted to know the most common complication of ERCP. I picked pancreatitis.
Your pat is s/p liver transplant. He develops fever and his bile production decreases to 20 from 300. What should you do next?
Consider liver bx
Which of the following displays a current or recent Hepatitis A infection?
Anitbody-specific to IgM
Your patient is post-op cardiothoracic surgery. She develops nausea, periumbilical abdominal pain, moderate Lipase, LDH, ALT, ↓BS. What is the diagnosis?
Mesenteric Infarct
Your patient complains of tarry stools, change in stool caliper, and constipation. What intervention is appropriate?
Order more testing
Your pt has been on peritoneal dialysis long term, and develops a fever and cloudy peritoneal fluid. What do you order first?
Culture of the dialysis tube
Most critical symptom for diagnosing peritonitis/bowel perforation?
Rigidity
What is GI angioplasty used to diagnose?
Hemorrhage of unknown cause
Your pt with Sickle Cell Anemia is complaining of nausea and lack of sleep. What med is best?
Phenergan
Pt presents with RLQ pain, 1-2 episodes of vomiting, and + Psoas sign. What dx are confirmatory of appendicitis?
ABD US and WBC 10-20 (key is WBC. A CT would also work)
36 yo with h/o Crohn’s disease arrives in the ER with c/o ABD pain, freq. vomiting and water bowel movements. You notice high-pitched, tinkling bowel sounds and transabdominal US reveals partial SBO. Which is not necessary?
immediate surgical consult
A Nurse experiences a needle stick from a patient who has Non-A, Non-B hepatitis. She has already had the HepB vaccine series. What is the next step?
Obtain blood samples from the pt and the RN.
42 y M with epigastric pain that is better after he eats:
duodenal ulcer
65 yr ETOH use + 25 yr smoking. S/s: dysphagia and epigastric pain. What is Dx:
GERD
XR identification
Pneumoperitoneum. Note air under the diaphragm (d/t perforated bowel)
Avoid Diverticulitis flare ups:
quit smoking (also increased risk for perf/abcess)
Tx for diverticulitis
NPO dependent upon condition, IVF, IV abx (flagyl,Cipro, ceftazidime, clinda, ampicillin), Tx GI bleed
True/False: Barium enema is indicated in the conservative management of diverticulitis?
False
Lab values and acute pancreatitis
GWGLA HBCABE
Which disorder worsens epistaxis?
Cirrhosis, HIV
Bowel obstruction antibiotic
zosyn (piperacillin-tazobactam)
49 yo M presents with c/o abdominal swelling that progressed over 2 days. Patient also reports mucous-filled diarrhea and ABD pain. Exam is significant for profound ABD distention. You suspect an SBO. What type of bowel sounds are associated?
High pitched, tinkling bowel sounds
Profuse vomiting and variable epigastric pain are 2 symptoms of what diagnosis?
Proximal SBO
tx and presentation for Crohns
diarrhea, abd p, abscess/fistulas, abx: flagyl/Cipro
Who is at risk for Toxic megacolon
pts with both crohns and UC
48 yo with fever, ABD pain and bloody diarrhea with h/o chronic sinusitis, arthritis and recent DVT Which represents the most likely dx and test to order?
Ulcerative colitis, sigmoidoscopy
17 year old with UC, what is the worst complication
Toxic megacolon
young male with UC, what would be a probable finding?
Rectosigmoid stricture
Ulcerative colitis meds
Canasa (mesalamine) suppositories or enemas for 3-12 weeks, hydrocortisone suppositories and enemas.
What abx do you use for UC?
IV ciprofloxacin and metronidazole in severe colitis and high grade fever, leukocytosis with extreme numbers of immature neutrophils (bands > 700/microL), and peritoneal signs or megacolon. There is no role of antibiotics in patients with severe colitis without signs of systemic toxicity
When would you find “thumb printing sign” on abd XRAY?
Mesenteric ischemia (ischemic colitis), pseudomembranous colitis, and IBD (ulceratve colitis) = radiologic sign of thickening of the bowel wall
Woman ETOH has liver dz but husband does not:
Women are likely to get liver disease while drinking less than men
What causes GI bleed in elderly?
Thin gastric membranes (However, per Medscape: PUD in UGIB. Diverticulosis and colitis in LGIB. Both exacerbated by NSAID/ASA/Anticoag use)
When to not use protonix drip
increased risk of hip fx. Increase vitamin D
Why would you pick a PPI over phenergan for treatment:
PPI Can be used in combo with other drugs to control symptoms
Patient on PD Dialysis has an infected dialysis catheter:
Remove the catheter
