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Step 3 > GI > Flashcards

GI Flashcards

1
Q

Hepatomegaly

Elevated Alk Phos and GGT

A

Infiltrative (Granulomatous) liver disease

Can also have hypercalcemia, hilar adenopath on CXR (in hepatic sarcoi)

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2
Q

Pain over both shins
Iron deficiency anemia
Vitilgo

A

Celiac dz
Anti-transglutaminase Ab
Look for Fx of endocrine disease
Leads to nutritional malabsorption despite good diet

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3
Q

epigastric pain d/t postpradial fullness or nausea

A

dyspepsia

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4
Q

work up for pt > 60 with new onset dyspepsia

A

EGD to r/o malignancy

Recommended for pts < 60 if they have significant weight loss or bleeding

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5
Q

Abdominal pain
Steatorrhea
Heavy alcohol intake

A

Chronic pancreatitis

MRCP is preferred but CT is diagnostic (pancreatic calcifications)

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6
Q

First line tx of chronic pancreatitis

A

Lifestyle modification (alcohol cessation, tobacco cessation, dietary modification)
2nd - pancreatic enzyme replacement, analgesics
Surgical management if there is refractory dz

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7
Q

Why should ICU patients have protonix?

A

Prophylaxis against stress ulcer and ultimately avoid GI bleeds
Believed that critially ill pts have uremic toxins and reflux of bile salts into the stomach
head trauma increases gastric section

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8
Q

When to transfuse with platelets?

A

<50k or if on anti-platelet

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9
Q

C-scope with small rectal hyperplastic polyps

A

q10yr screening

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10
Q

C-scope with 1-2 small (<1cm) tubular adenomas

A

q5yr screening

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11
Q 
C-scope with
 3-20 adenomas, OR 
adenoma of any grade >1cm, OR 
adenoma w/ high grade dysplasia OR
adenoma with villous features
A

q3yr screening

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12
Q

C-scope with more than 10 adenomas

A

<3yr screening and consider familial syndromes

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13
Q

C-scope

large > 2 cm sessile polyp removed by piecemeal excision

A

Screening q 2-6 months

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14
Q

C-scope with

polyp w/ adenocarcinoma (must have minimal invasion and 2 mm margin)

A

Screening 2-3 months

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15
Q

What can set off hepatic encephalopathy in a cirrhotic previously well controlled on lactulose?

A

Excessive diuresis –> reduces intravascular volume –> hypokalemia, metabolic acidosis
Tx - volume, replete electrolytes, continue lactulose

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16
Q

If a kiddo has gastro symptoms, what regular food item should you ask the mom to avoid giving?

A

Fruit juice

Exacerbates diarrhea via osmotic diuresis in the colon

17
Q

Management of dumping syndrome?

A

High protein, low carb diet

Smaller but more frequent meals

18
Q

What lab findings can you use to estimate severity in pancreatitis?

A

HCT >44%
C-reactive protein >150
BUN >20

19
Q

Infant with episodic cramps abdominal pain, currant jelly stools

A

Intussusception

Get a air or water-soluble contrast enema

20
Q

Intussesception s/p air enema, an hour later the infant has severe pain. Now what?

A

Get an X ray to look for free air in the abdomen 2/2 perforation

21
Q

Guy swallowed something sharp and thinks it is stuck in his throat. Now what?

A

Urgent EGD to remove object

22
Q

Patient has hematemesis and pancreatitis but on EGD only has gastric varies. Dx?

A

Splenic v. thrombosis

Varices 2/2 to blood redirective to the collateral gastroepiploic system and short gastric veins

23
Q

Esophageal varices in the setting of pancreatitis is concerning for?

A

splenic v. thrombosis

24
Q

Pt with dysphagia, manometry has premature simultaneous contractions of the distal esophagus. Dx and Tx?

A

Esophageal spasm
Tx with CCB’s
Can have corkscrew appearance on barium swallow

25
Q

Pt w/ h/o diverticulosis presenting with BRB per rectum. Why?

A

Erosion of a small artery

painless hematochezia

26
Q

Antibody in primary biliary cholangitis?

A

antimitochondrial

27
Q

Tx of primary biliary cholangitis

A

Ursodeoxycholic acid
slows progression of dz and need for transplant
Steroids, immunosuppressants are not helpful

28
Q

RF’s for pyloric stenosis

A

Erythromycin, azithromycin use in early infancy

29
Q

Gastroparesis is associated with what chronic condition?

A

DM and poor glucose control

Dx with nuclear gastric emptying study

30
Q

How can you divide dysphagia into two different thought processes?

A

Oropharyngeal dysphagia - difficulty initiating swallow, cough, gag
Esophageal dysphagia - delayed realization of food sticking to the chest

31
Q

2 main types of esophageal cancers?

A

Adenocarcinoma

Squamous cell carcinoma

32
Q

Most common complication of diverticulitis?

A

Colonic abscess

33
Q

In which demographic are hepatic adenocarcinomas most common?

A 
Young women on OCPs
Usually asymptomatic
Well demarcated w/ enhancement on CT
Tx w/ d/c of OCPs if <5cm
If >5cm --> surgery

Step 3 (12 decks)

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