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PANRE > GI > Flashcards

GI Flashcards

1
Q

What is the difference between Type I and Type II hiatal hernias?
(phys, and difference?)

A

I: fundus slides into mediastinum, tx like GERD

II: fundus rolls into diaphragm, tx with surgery

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2
Q

MC type of esophageal cancer

location + cause

A

scc
upper 1/3 esoph
from smoking, etoh

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3
Q

what type of esophagus cancer occurs in the lower 1/3

A

adenocarcinoma

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4
Q

for barretts esoph how often do you need to repeat EGD

A

q3y

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5
Q

what is the gold standard dx study for gastritis

A

endoscopy

“thick, edematous erosions”

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6
Q

what is the gastritis tx if + H Pylori

A

clarithromycin
amoxicillin / flagyl
PPI

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7
Q

what is the gastritis tx if - H Pylori

A

PPI
antacids / H2RB
sucralfate

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8
Q

what 2 signs/symptoms should make you think Z-E Syndrome

A

recurrent pud

kissing ulcers

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9
Q

gold standard dx test for z-e syndrome

A

fasting gastrin level

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10
Q

gastric cancer:
mc type?
biggest risk?
EGD findings?

A

MC adenocarcinoma
Biggest risk H Pylori
EGD: “linitus plastica” - diffuse thickening of the stomach wall

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11
Q

upper GI shows “string sign”

A

pyloric stenosis

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12
Q

young woman with new onset RUQ pain, ascites and hepatomegaly - dx?

A

budd-chiari syndrome

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13
Q

budd-chiari: best first screening test, and best gold standard test?

A

first: u/s
gold: venography

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14
Q

how do you treat budd-chiari

A

shunts (TIPS)
angioplasty w stent
if acute, no ivc, then anticoags
diuretics for ascites

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15
Q

dx test of choice for cholelithiasis?

A

us

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16
Q

how do you treat choledocholithiasis

A

ercp

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17
Q

patient with sudden onset of RUQ pain, with F/C and jaundice.
what is this called and what is it indicative of

A

charcot’s triad

dx = cholangitis

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18
Q

what is reynold’s pentad

A

charcot’s triad + shock and ams

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19
Q

what is dx and tx for cholangitis

A

ercp

+ abx

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20
Q

what is the test of choice and the gold standard test for cholecystitis

A

choice: US
gold: HIDA (shows non-visualization of the gb)

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21
Q

what bili level causes jaundice

A

> 2.5

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22
Q

MC cause of jaundice? what causes it?

A

Gilbert’s syndrome

genetic decrease of UGT enzyme

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23
Q

MC cause of 1st week of life jaundice?

A

Crigler Najjar Syndrome

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24
Q 
Prehepatic jaundice:
AKA?
what causes this?
what labs will be elevated?
appearance of urine and stool?
A 
AKA Hemolytic
Cause: RBC hemolysis
Labs: inc. indirect bilirubin
Urine: normal
Stool: dark
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25
Q 
Post-hepatic jaundice:
AKA?
what causes this?
what labs will be elevated?
appearance of urine and stool?
A 
AKA Obstructive
Cause: cholestasis or tumor
Labs: inc. direct bili, ALP, GGT
Urine: dark
Stool: acholic
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26
Q 
Intrahepatic jaundice:
AKA?
what causes this?
what labs will be elevated?
appearance of urine and stool?
A

AKA Hepatocellular
Cause: liver damage (etoh, hepatitis)
Labs: inc. direct bili, indirect bili, ALT/AST

Urine/stool: n/a

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27
Q

when does newborn physiologic jaundice occur and how do you treat

A

3-5 days p birth

tx with observation and phototherapy

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28
Q

what is the treatment of hepatitis?

what is definitive tx?

A
  1. lactulose
  2. neomycin
  3. lower protein
    definitive = transplant
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29
Q

which liver disease is autoimmune in women 40-60yo, with vague liver sx?

A

primary biliary cirrhosis

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30
Q

what autoimmune lab will be elevated in primary biliary cirrhosis?

A

anti-mitochondrial Ab

31
Q

how do you treat primary biliary cirrhosis

A

ursodeoxycholic acid

cholestyramine + UV light for itching

32
Q

which liver disease is autoimmune in men 20-40y, usually with IBD and progressive liver symptoms?

A

primary sclerosing cholangitis

33
Q

what autoimmune lab will be elevated in primary sclerosing cholangitis?

A

P-ANCA

34
Q

gold standard test for primary sclerosing cholangitis? and treatment?

A

Dx with ERCP

Tx with transplant

35
Q

what are the sx of meckel’s diverticulum?

what can it cause?

A

sx: asx or painless rectal bleeding

can cause intussusception, volvulus, obstruction, divertic

36
Q

how to dx meckel’s diverticulum?

A

meckel’s scan

37
Q

symptoms of SBO?

A

progressive cramping, N/V/D/obstipation

38
Q

how to treat SBO?

A

NPO and fluids
decompression with NG tube
surgery if strangulated

39
Q

what is it called when the intestinal segment telescopes into the lumen

A

intussusception

40
Q

when does intussusception happen in life, what often precedes it

A

6-18 months

preceded by viral info

41
Q

“currant jelly stool”

A

intussusception

42
Q

“sausage shaped mass in ruq”

A

intussusception

43
Q

baby presents with sudden abdominal pain, vomiting, and rectal bleeding. what is dx and tx for this

A

this is intussusception

barium enema

44
Q

what presents as a SBO but is caused by twisting of the bowel

A

volvulus

45
Q

how do you treat volvulus

A

endoscopic decompression 1st line

surg 2nd line

46
Q

what is the official definition of toxic megacolon?

A

colon dilation > 6cm with systemic toxicity

47
Q

what is the tx of toxic megacolon

A

decompression

bowel rest, ng, abx, +/- colostomy

48
Q

Which IBD?

  • occurs anywhere
  • occurs only in rectum/colon
A

crohns anywhere

UC isolated

49
Q

which IBD?

  • pain in LLQ
  • pain in RLQ
A
  • UC LLQ

- crohns RLQ

50
Q

which IBD?

  • assoc with diarrhea and wt loss
  • assoc with bloody diarrhea and tenesmus
A
  • D + wt loss = crohns

- D bloody + tenesmus = UC

51
Q

Which IBD?

  • assoc with “sandpaper appearance” on endo
  • assoc with “cobblestone appearance” on endo
A
  • sandpaper UC

- cobblestone crohns

52
Q

which IBD?

  • string sign (scarring + strictures) on Ba enema
  • stovepipe sign (loss of haustral markings) on Ba enema
A
  • string = crohns

- stovepipe = UC

53
Q

which IBD?

    • ASCA
    • P-ANCA
A
  • asca crohns

- p-anca uc

54
Q

what is the test of choice for crohns? for UC?

A

crohns - upper GI with SB follow-thru

UC - flex sig

55
Q

what test of choice is C/I in UC and why

A

barium enema C/I

risk of toxic megacolon

56
Q

what is 1st line tx for IBD?

A

Mesalamine

57
Q

which type of polyp is MC and is benign?

which type of polyp is precancerous?

A

MC benign hyperplastic

precanc adenomatous

58
Q

what are the 3 types of adenomatous polyps

A

1 tubulous adenoma (mc)
2 tubulovillous
3 villous adenoma (high risk)

59
Q

“rice water stools”

A

vibrio

60
Q

treatment for vibrio diarrhea

A

self-limited, fluid replacement

61
Q

tx for noninvasive E coli diarrhea

A

FQ BID x 3 days

62
Q

tx for shigella diarrhea

explosive, mucoid, bloody diarrhea; can cause seizures in kids

A

Bactrim

63
Q

tx for yersinia diarrhea

mimics appendicitis

A

FQ

64
Q

“pea soup stools”

A

salmonella

65
Q

typhoid fever: nonspp sx with diarrhea, intractable fever, “rose spots” later on

A

salmonella

66
Q

tx for salmonella diarrhea

A

FQ or ceftriaxone

67
Q

treatment for invasive enterohemorragic E coli

A

none

abx can increase risk of HUS in kids

68
Q

what is the MC bacterial enteritis in US

A

C Jejuni

69
Q

“S or Seagull shapes” in stool cx

A

campylobacter

70
Q

tx for campylobacter?

A

erythromycin or FQ

71
Q

which diarrhea is the MC antecedent in guillain barre

A

campylobacter

72
Q

giardiasis tx

frothy, greasy, foul stools

A

flagyl

73
Q

amebiasis tx

colitis, dysentery, liver abscess

A

flagyl

74
Q

what is the name of the chronic diarrhea in AIDS

A

cryptosporidium

PANRE (13 decks)

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