GI Flashcards
High triglycerides increase the risk of?
pancreatitis.
What will be elevated in a patient with Hep C? AST, ALT, or both?
ALT
1st line treatment for GERD
PPI
What does a positive Psoas maneuver indicate? (pain with straightening R leg against resistance)
appendicitis.
What is a positive Rovsing’s sign and what does it indicate?
push LLQ= rebound pain in RLQ. Appendicitis.
Next step for a pt with GERD and Barrett’s esophagus?
Refer to GI oncologist.
5 week old infant with projectile vomiting after feeding, olive-like mass is palpated.
Pyloric stenosis.
What HTN medication can contribute to GERD?
CCB.
gastrinomas (tumors) in the intestine or pancreas produce excessive amounts of gastrin which increased stomach acid producing ulcers of the stomach or duodenum. What is it and what is the treatment?
Zollinger- Ellison syndrome
TX: 1st line PPIs
then chemo/surgery
Screening for colon cancer?
start age 50 (now age 45) baseline colonoscopy (repeat every 7-10 years)
Ribbon-like stool in the older adult with iron-def. anemia. What could this be?
Colon cancer
normal ALT
normal AST
ALT 0-40 (more specific to the liver)
think L for liver and lower number (40)
AST 0-45
What does the ast/alt ratio mean
ratio of 2.0 and higher indicates alcohol abuse
what is higher in hepatitis, alt or ast?
ALT
Hep A and E
vowel comes from the bowel
fecal-oral (contaminated food/water)
Vaccine for Hep A
Hep B
Bodily fluids (Blood, semen, saliva)
sex, mom-baby
has a vaccine
can be chronic
Hep C
Circulation (blood, semen) IV drug abuse refer to GI NO vaccine chronic- high rate for cirrhosis and cancer
hep D
D needs B (Blood)
can’t get hep D without having hep B
prevention with hep B vaccine
enterobiasis infection
pinworms, scotch-tape test
itchy anus, especially at night
treat with oral agent
When to refer to GI to rule out Barretts?
10+ years of GERD
tx for Barretts
REFER for biopsy
PPI (pantoprazole) and H2 blocker (ranitidine, famotidine)
palpate RLQ midway between umbilicus and superior iliac spine:
Is this Rosving’s sign, McBurney’s point, Psoa’s sign, or Obturator sign?
McBurney’s point
push LLQ, rebound pain in RLQ:
Is this Rosving’s sign, McBurney’s point, Psoa’s sign, or Obturator sign?
Rosving’s sign
right knee 90*, pain with flexion/rotation of hip:
Is this Rosving’s sign, McBurney’s point, Psoa’s sign, or Obturator sign?
Obturator sign
pain with straightening R leg against resistance:
Is this Rosving’s sign, McBurney’s point, Psoa’s sign, or Obturator sign?
Psoa’s sign
mild episodic epigastric pain relieved by food or antacids
Gastric/Peptic ulcer disease
upper abdomen rad. to flank pain
pancreatitis
LLQ pain with fever, N/V
diverticulitis
RUQ or epigastric pain after eating a fatty meal
cholecystitis
RLQ or periumbilical pain that is steadily getting worse
appendicitis
Diarrhea with mucus
Crohn’s Dx
What is Murphy’s sign and when is it (+)?
pain with deep palpation of RUQ during inspiration
(+) for cholecystitis
Cullen and Grey Turner signs
Cullen: blue umbilicus
GreyTurner: blue flank
Emergency signs of pancreatitis
urea breath test is (+) for?
H.pylori
PPI + Pepto Bismol + metronidazole + tetracycline is treatment for????
H. pylori
treatment for acute diverticulitis
flagyl + cipro x 10-14 days
dietary treatment for diverticulitis
increase fiber (metamucil or citrucel)
treatment for c.diff
PO vanco or flagyl
serum GGT
indicator of etoh abuse
two labs to diagnose pancreatitits
amylase and lipase
increased weight, BP, sugar, cholesterol
metabolic syndrome
aphthous stomatitis
canker sores
HBsAg
surface antigen = current infection
HBeAg
active infection, highly contagious
AntiHBs
(+) antibodies= person has been exposed to Hep B and has the antibodies or they have been vaccinated
cramping and bloody diarrhea
UC or Crohns?
UC
mucus in diarrhea, and anal fissure
UC or Crohns?
Crohns
