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EOR: Family Medicine > GI > Flashcards

GI Flashcards

1
Q

4 cardinal signs of strangulated bowel…

A

fever
tachycardia
leukocytosis
localized abd. tenderness

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2
Q

MCC of large bowel obstruction

A

CA

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3
Q

KUB findings in bowel obstruction

A

dilated loops of bowel

air fluid levels

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4
Q

Tx of bowel obstruction

A

NG tube

general surgery referral

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5
Q

best initial test and gold standard test for cholelithiasis…

A

US –> HIDA

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6
Q

Patient p/w:

esophageal varicies

Terry’s nails (white nail beds)

palmar erythema

spider angiomata

A

cirrhosis

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7
Q

which labs should be monitored in cirrhosis and for how long?

A

CBC, CMP, LFTs, Coags + EGD q 3-4 mo

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8
Q

_____ should be performed every 6-12 months in cirrhosis to screen for _____

A

US

hepatocellular carcinoma

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9
Q

Familial adenomatous polyposis is inherited via…

A

autosomal dominant

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10
Q

Familial adenomatous polyposis screening with sigmoidoscopoy should begin at ____ because it will 100% result in colorectal CA by age 30-40

A

age 12

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11
Q

MC presentation of colon CA

A

Painless rectal bleeding and a change in bowel habits in a patient 50-80 years of age

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12
Q

Which is more likely to be malignant?

sessile polyps or pedunculated polyps?

A

sessile

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13
Q

no onset constipation in patients over 50…

A

colon CA

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14
Q

diarrhea outbreak in daycare…

A

rotavirus

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15
Q

diarrhea outbreak on cruise ship…

A

norovirus

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16
Q

3+ unformed stools in 24 h with at least one of the following:

fever
nausea
vomiting
abdominal cramps
tenesmus
bloody stools
A

ETEC/campylobacter

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17
Q

Tx for traveler’s diarrhea

A

cipro 500mg BID x 1-3 d + loperamide

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18
Q

Tx for campylobacter/shigella

A

FLQ

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19
Q

What cause of diarrhea comes from poultry, pork, or raw eggs?

A

salmonella

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20
Q

patient presents with:

Fever
Pea soup diarrhea
HA
rose spots (papular rash)

A

enteric fever (salmonella typhi)

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21
Q

Tx for enteric fever/salmonella typhi

A

ceftriaxone

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22
Q

a child presents with:

Abdominal pain and inflammatory diarrhea (small volume)

frequent, mucous and bloody stool,

nausea, vomiting (less common), possible fever

Tenesmus

A

shigella

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23
Q

Tx for shigella

A

TMP-SMZ

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24
Q

Dx of shigella

A

(+) fecal leukocytes

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25
Q

cause of EHEC e-coli

A

undercooked ground beef

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26
Q

Pt. p/w:

watery, voluminous non-bloody diarrhea with nausea and vomiting progressing to bloody diarrhea/dysentery

no fecal leukocytes

A

EHEC

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27
Q

complication of EHEC

A

hemolytic uremic syndrome

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28
Q

Tx for EHEC…

A

symptomatic

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29
Q

patient presents with:

hx of seafood/shellfish ingestion

rice water diarrhea 24-48 hours after consumption

A

cholera

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30
Q

tx options for cholera…

A

doxy, azithro, bactrim, cipro

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31
Q

Which type of esophagitis?

large solitary ulcers or erosions on EGD - infection at other sites

A

CMV

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32
Q

What type of esophagitis?

shallow punched out lesions on EGD…

A

CMV

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33
Q

Tx for CMV esophagitis…

A

ganciclovir x 3-6 weeks

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34
Q

barium swallow shows ribbed esophagus and multiple corrugated rings…

A

eosinophilic esophagitis

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35
Q

Tx for eosinophilic esophagitis

A

ICS inhaler

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36
Q

3 major causes of gastritis…

A

infx (H. pylori)

NSAIDs/EtOH

Pernicious anemia

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37
Q

patient presents with dyspepsia, bloating, and abdominal pain. They have a hx of EtOH abuse. What condition?

A

Gastritis

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38
Q

3 diagnostics for pernicious anemia…

A

(+) schilling test

decreased IF

parietal cell Abs

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39
Q

Gastritis tx

A

PPI x 4-8 weeks +/- UGI

H. Pylori testing

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40
Q

H. pylori triple therapy…

A

clarithromycin, amoxicillin,

PPI

41
Q

Gold standard of GERD dx…

A

pH probe

42
Q

odynophagia, GERD and dysphagia is concerning for…

A

esophageal ulcer

43
Q

hematemesis, retching, coughing is concerning for…

A

mallory-weiss tear

44
Q

jaundice, ascites, abd distension and hemorrhage is concerning for…

A

esophageal varices

45
Q

dysphagia, early satiety, weight loss, cachexia is concerning for…

A

malignancy

46
Q

odynophagia, dysphagia and retrosternal CP is concerning for…

A

severe erosive esophagitis

47
Q

bright red blood per rectum should be concerning for…

A

lower GI bleed

48
Q

6 common causes of lower GI bleed

A

hemorrhoids

anal fissures

proctitis

polyps

CA

diverticulosis

49
Q

Tx for giardiasis

A

tinidazole

50
Q

Tx for pinworms (enterobius vermicularis)

A

mebendazole or pyrantel pamoate

51
Q

What parasitic infection?

Hx of raw/undercooked meat

B12 deficiency

GI sxs

Weight loss

A

Tapeworm

52
Q

Tx for tapeworm

A

praziquantel

53
Q

Which parasitic GI Infection?

recent travel

anemia

cough

weight loss

A

hookworm

54
Q

hookworm treatment?

A

mebendazole

55
Q

Which parasitic GI infection?

most common

pancreatic duct, common bile duct, or bowel obstruction

vague abdominal symptoms

A

roundworm

56
Q

Roundworm tx options (3)

A

albendazole, mebendazole, pyrantel pamoate

57
Q

What parasitic GI infx?

a/w liver abscess

bloody diarrhea

tenesmus

abd. pain

A

amebiasis

58
Q

amebiasis tx?

A

iodoquinol and flagyl (if liver abscess)

59
Q

Which parasitic GI infx?

rash

abdominal pain

bloody stool

blood in urine

hx of contaminated fresh water consumption

A

schistosomiasis

60
Q

schistosomiasis tx?

A

praziquantel

61
Q

Dx of parasitic GI infections?

A

stool sample examination

62
Q

Which hemorrhoid?

pain/pruritis

no bleeding

palpable mass with purplish hue

A

external hemorrhoid

63
Q

Which hemorrhoid?

BRBPR

pruritis

rectal discomfort

A

internal hemorrhoid

64
Q

Tx options for internal hemorrhoids

A

fiber/sitz bath –> rubber band ligation –> closed hemorrhoidectomy

65
Q

Barium enema sows a lead pipe appearance…

A

ulcerative colitis

66
Q

Which type of IBD?

mucosal surface only

continuous lesions

A

ulcerative colitis

67
Q

Which type of IBD?

transmural

skip lesions/cobblestoning

fistula forming

apthous ulcers

A

crohn disease

68
Q

Medical and surgical tx for ulcerative colitis?

A

Surgery: Colectomy

Medicine: prednisone, mesalamine

69
Q

Tx options for crohn disease?

A

Flares: predisone/mesalamine +/- flagyl/cipro

Maintinance: mesalamine

70
Q

jaundice indicates a serum bilirubin > ____

A

2 mg/dl

71
Q

Why order CT in evaluation of pancreatitis?

A

r/o necrotizing pancreatitis

72
Q

serotonin agonist used for IBS…

A

tegaserod maleate

73
Q

Abx for IBS-D

A

rifamixin

74
Q

Ransom criteria for poor prognosis of pancreatitis at admission… (5)

A 
Age > 55
Leukocyte: >16,000
Glucose: >200
AST: >250
LDH: >350
75
Q

IBS defined as recurrent abd. pain at least ____ days per week in the last ______ months with 2 of the below:

defecation related

change in stool frequency

change in stool form/appearance

A

one day a week x 3 months (Rome IV criteria)

76
Q

The below would elevate which bili?

hemolysis

G6PD deficiency

Hereditary spherocytosis

hematoma

Gilbert syndrome

A

UCB

77
Q

flank bruising in presence of pancreatitis is called…

A

Grey Turner’s sign

78
Q

Bruising near umbilicus in presence of pancreatitis is called…

A

cullen’s sign

79
Q

Complication of pancreatitis…

A

pancreatic pseudocyst

80
Q

What condition?

Hx of pancreatitis

well circumsized pancreatic mass on imaging

A

pancreatic pseudocyst

81
Q

Triad of chronic pancreatitis…

A

pancreatic calcifications on XRay

steatorrhea

DM

82
Q

what type of peptic ulcer is relieved with eating?

A

duodenal

duodenal = decreased pain

83
Q

what type of peptic ulcer is painful after eating?

A

gastric

84
Q

What condition?

tea colored urine

vague abdominal discomfort

pruritis

pale stools

A

viral hepatitis

85
Q

What diagnostic lab confirms HAV infection?

A

(+) IgM anti-HAV

86
Q

Which diagnostic lab indicates that someone has had/hadn’t had HBV?

First look lab in HBV infection…

A

Anti-HBc

87
Q

Which lab indicates immunity to HBV?

A

Anti-HBs

88
Q

A (+) HBeAg indicates what type of HBV infection?

A

highly infectious

89
Q

A (+) HBsAg indicates what type of HBV infection?

A

ongoing infection

90
Q

Which types of hepatitis increase the risk of hepatocellular carcinoma?

A

B, C

91
Q

Which hepatitis infection is most commonly caused by IVDU?

A

HCV

92
Q

Dx of HCV…

A

RNA quantitation

93
Q

This form of hepatitis only occurs when coinfected with HBV

A

HDV

94
Q

This type of hepatitis infx occurs in mothers

A

HEV

95
Q

Alcoholic hepatitis has an AST/ALT ratio of ______ or higher…

A

AST/ALT > 2:1

96
Q

Tx of acetominophen induced toxic hepatitis?

A

N-acetylcysteine w/in 8-10 hours

97
Q

Fatty liver disease should be suspected when ___ is greater than ___

A

ALT > AST

98
Q

What is seen on liver bx in fatty liver disease?

A

macrovesicular fatty infiltrates

EOR: Family Medicine (14 decks)

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