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int med exam 0828 > GI > Flashcards

GI Flashcards

1
Q

what are the indications for EGD?

A
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2
Q

what are relative contraindications to EGD?

A
  • recent MI
  • combative patient
  • intestinal perforaiton
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3
Q

what are indications for ERCP?

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4
Q

what are the contraindications in ERCP? exceptions?

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5
Q

what can MRCP be used for?

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6
Q

outisde of MRCP and ERCP, what other tests can be used? what would you see? (4)

A
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7
Q

what are the indications for EUS? what is it?

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8
Q

what is colonoscopy procedure of choice for?

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9
Q

what are the 3 causative factors for cholelithiasis? (pathophys etiologies)

A
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10
Q

what is cholelithiasis associated with? MC composition of stones?

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11
Q

classic symptoms of cholelithiasis?

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12
Q

how do you diagnose cholelithiasis?

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13
Q

Treatment of symptomatic gallstones?

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14
Q

treatment of asymptomaitc gallstones?

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15
Q

treatment of gallstones in those who too ill or refuse surgery?

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16
Q

Dx of acalculous cholecystitis? options in management?

A
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17
Q

Dx of common duct stones? what patient presentation do you consider this? Treatment?

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18
Q

what is cholestasis?

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19
Q

what is cholangitis? symptoms? tx?

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20
Q

what is the treatment of emphysematous cholecystitis?

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21
Q

what do you see on imaging for porcelain gallbladder?

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22
Q

what is sphincter of oddi dysfunction?

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23
Q

how do you diagnose sphincter of oddi dysfunction?

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24
Q

how do you treat sphincter of oddi dysfunction?

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25
Q

what is primary billiary cirrhosis? radiological signs? pathophys?

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26
Q

what are symptoms of PBC?

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27
Q

what is the survival/prognosis of pBC?

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28
Q

how do you diagonse pBC? what would be elevated? Autoantibodies in PBC, drug induced hepatitis, autoimmune hepatitis?

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29
Q

how do you treat PBC?

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30
Q

what is PSC?

A
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31
Q

symptoms of PSC?

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32
Q

diagnosis of PSC?

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33
Q

what do you need to rule out for dx of PSC?

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34
Q

what is the tx of PSC?

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35
Q

what is the sim/diff btw PBC vs PSC?

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36
Q

ddx of increased transaminases?

A
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37
Q

what are the causes of increased alk phos? what do you check?

A
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38
Q

define cholestasis and causes of hyperbilirubenemia?

A
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39
Q

describe pathway of jaundice and consequence of bilirubinuria

A
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40
Q

ddx of jaundice + unconjugated hyperbilirubinemia? (6)

A
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41
Q

ddx of jaundice + conjugated hyperbilirubinemia? (5)

A
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42
Q

what are the 3 most common causes of jaundice and age groups?

A
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43
Q

For acute viral hepatitis, what is the:

  • Bilirubin
  • AST/ALT
  • Alk Phos
  • Albumin/Globulin
  • PT/aPTT
  • Serologies
  • Abdominal U/S
A
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44
Q

For chronic cirrhosis, what is the:

  1. Bilirubin
  2. AST/ALT
  3. Alk Phos
  4. Albumin/Globulin
  5. PT/aPTT
  6. Serologies
  7. Abdominal U/S
A
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45
Q

For obstructive: common duct stone/pancreatic cancer, what is the:

  1. Bilirubin
  2. AST/ALT
  3. Alk Phos
  4. Albumin/Globulin
  5. PT/aPTT
  6. Serologies
  7. Abdominal U/S
A
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46
Q

U/S findings + Jaundice that determine next step in evaluation:

  1. Dilated CBD and stones:
  2. Dilated CBD adn no stones:
  3. Dilated intrahepatic ducts:
  4. Dilated ducts and testing to exclude PSC
  5. No dilated ducts
A
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47
Q

transmission routes for Hepatitis A?

A
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48
Q

diagnosis of Hep A and time series for vaccination? incubation period and time when HAV virus appears?

A
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49
Q

indications for Hep A vaccine?

A
50
Q

define serology markers

A
51
Q

what do the following markers mean?

  1. HBsAg
  2. HbsAb
  3. HBeAg
  4. HbeAb
A
52
Q

describe the when each Hepatitis B marker appears?

A
53
Q

what diseseases is Hep B associated with?

A
54
Q

Name the scenarios where you would give Hep B immunoglobulin?

A
55
Q

define chronic hepatitis b?

A
56
Q

describe the chronic Hep B serology timeline?

A
57
Q

Describe the carrier states of hep b?

A
58
Q

what complications do you need to be aware of chronic Hep B and management of those complications?

A
59
Q

When to initiate tx of chronic active Hep B?

A
60
Q

what are the tx options for chronic active hep B?

A
61
Q

when is screening for HCV indicated? (12)

A
62
Q

what is the hep C rule of 2s? (5)

A
63
Q

what complications do you need to screen for a chronic Hep C patient chronically?

A
64
Q

what disease is associated with chronic HCV infection? what does it look like?

A
65
Q

what is the extrahepatic diseases associated with Hep C?

A
66
Q

In order for Hep D virus replication to occur, co-infection with which other virus is necessary?

A
67
Q

Hepatitis E is associated with which risk factor?basics? when is it the highest risk for clinical disesase?

A
68
Q

Ddx of chronic hepatitis?

A
69
Q

what antibodies are positive in AI chronic hepatitis?

A
70
Q

age groups/demographics of pBC vs IAH vs PCS?

A
71
Q

scoring system to diagnose AIH?

A
72
Q

Tx of AIH?

A
73
Q

two categories of drug induced hepatitis and common causes?

A
74
Q

which drugs associated with cholestasis?

A
75
Q

effect of tylenol? what do you need to watch out for?

A
76
Q

Side Effect of MTx, isoniazid and OCPs on the liver?

A
77
Q

what is NAFLD and risk factors?

A
78
Q

Tx of NAFLD?

A
79
Q

basics of HCC? etiology, labs, complications, tx?

A
80
Q

basics of the treatment of liver cancer?

A
81
Q

what are the caues of cirrhosis?

A
82
Q

what are the complications of cirrhosis?

A
83
Q

prophylaxis for cirrhosis?

A
84
Q

how do you manage active bleeds with cirrhsois?

A
85
Q

what is the treatment for esophageal varices?

A
86
Q

what are the causes of hepatic encephalopathy?

A
87
Q

how do you treat hepatic encephalopathy?

A
88
Q

sign of hepatic encephalopathy?

A
89
Q

what is hepatorenal syndrome?

A
90
Q

how does PT affected in alcoholic patients?

A
91
Q

what are the causes of ascites?

A
92
Q

how do you diagnosis the cause of ascites?

A
93
Q

causes of ascites and associated albumin and protein findings?

A
94
Q

Primary peritonitis definition and risk factors?

A
95
Q

secondary bacterial peritonitis and tx?

A
96
Q

tx of ascites?

A
97
Q

what is gilbert’s syndrome?

A
98
Q

what is AAT deficiency?

A
99
Q

what are the two types of hemochromatosis?

A
100
Q

what are the clinical findings in hemochromatosis?

A
101
Q

what are the lab findings suggestive of hemochromatosis? dx?

A
102
Q

treatment for hemochromatosis?

A
103
Q

what is wilson’s disease?

A
104
Q

how do you screen for wilson’s disease?

A
105
Q

how do you treat wilson’s disease?

A
106
Q

what do you need to watch out for causes of liver disease in the 1st and 2nd trimester of pregnancy?

A
107
Q

what do you need to watch out for liver disease in the 3rd trimester of pregnancy?

A
108
Q

how do you acute liver failure and symptoms?

A
109
Q

how would you work up acute liver failure?

A
110
Q

how do you treat acute liver failure?

A
111
Q

when do you consider liver transplant?

A
112
Q

what are contraindications of liver transplant? Relative/controversial/absolute?

A
113
Q

symptoms/lab values/location of

  1. Cholelithiasis
  2. Acute cholecystitis
  3. Ascending cholangitis
  4. gallstone pancreatitis
A
114
Q

which patients require US screening for HCC? (5)

A
  1. All patients with cirrhosis
  2. asina male HBV carriers >40
  3. Asian female HBV carriers >50
  4. Any HBV carrier with FH of HCC
  5. African/Black patients with HBV infection.

If lesions, CT abdomen/MRI of liver.

115
Q

what vitamins are missing by going to a vegan diet? (MC?)

A

Calcium, vitamin D, vitamin b12, iron and protein.

Most common is b12 (missing animal, fish, eggs, dairy)

116
Q

when do you recommend bland diet ?

A

bland diet is soft, low in dietary fibers, cooked, and not spicy, recommended typically after intestinal surgery

117
Q

what diet do you recommend recovering from pancreatitis?

A
  • mild acute pancreatitis - low fat diet
  • severe pancreatitis/persistent abdominal pain - NG
118
Q

which patients require stress ulcer prophylaxis?

A

TBI/burns

MV >48 hours

history of GI bleed

2 or more minor risk factors (sepsis, substantial steroids)

119
Q

define inactive Hep B carrier state serologies and what do you need to monitor (no HCC)

A
  1. Positive HBS antigen, negative Hep B e antigen, positive Hep B e antibody, normal ALT, and HBV DNA <2000.
  2. ALT q6 months, and HBV DNA q6-12 months. If ALT elevated or HBV>2000 on 2 lab tests 2 months apart, liver biopsy indicated.
120
Q

patients with chronic NSAID use, what are the moderate risk factors for GI bleeding. What would you do about it?

A
  • moderate risk factors: age>65, h/o of uncomplicated ulcers, use of anticoagulation/antiplatelet, and use of high dose NSAIDs (3200mg q daily).
  • If at least 2 or h/o of complicated ulcer, add misoprostol or regular dose PPI.
121
Q

in patients with cirrhosis + hematemsis, treatment?

A

Ceftriaxone - (bacteremia, UTI, SBP), Octreotide (splanchnic vasoconstrictor), EGD within 12 hours; nonselective beta blockers for secondary prophylaxis.

122
Q

indications for albumin in cirrhsois?

A
  1. SBP
  2. volume replacement after large volume paracentesis
  3. suspected hepatorenal syndrome

int med exam 0828 (24 decks)

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