GI Flashcards
what are the indications for EGD?
what are relative contraindications to EGD?
- recent MI
- combative patient
- intestinal perforaiton
what are indications for ERCP?
what are the contraindications in ERCP? exceptions?
what can MRCP be used for?
outisde of MRCP and ERCP, what other tests can be used? what would you see? (4)
what are the indications for EUS? what is it?
what is colonoscopy procedure of choice for?
what are the 3 causative factors for cholelithiasis? (pathophys etiologies)
what is cholelithiasis associated with? MC composition of stones?
classic symptoms of cholelithiasis?
how do you diagnose cholelithiasis?
Treatment of symptomatic gallstones?
treatment of asymptomaitc gallstones?
treatment of gallstones in those who too ill or refuse surgery?
Dx of acalculous cholecystitis? options in management?
Dx of common duct stones? what patient presentation do you consider this? Treatment?
what is cholestasis?
what is cholangitis? symptoms? tx?
what is the treatment of emphysematous cholecystitis?
what do you see on imaging for porcelain gallbladder?
what is sphincter of oddi dysfunction?
how do you diagnose sphincter of oddi dysfunction?
how do you treat sphincter of oddi dysfunction?
what is primary billiary cirrhosis? radiological signs? pathophys?
what are symptoms of PBC?
what is the survival/prognosis of pBC?
how do you diagonse pBC? what would be elevated? Autoantibodies in PBC, drug induced hepatitis, autoimmune hepatitis?
how do you treat PBC?
what is PSC?
symptoms of PSC?
diagnosis of PSC?
what do you need to rule out for dx of PSC?
what is the tx of PSC?
what is the sim/diff btw PBC vs PSC?
ddx of increased transaminases?
what are the causes of increased alk phos? what do you check?
define cholestasis and causes of hyperbilirubenemia?
describe pathway of jaundice and consequence of bilirubinuria
ddx of jaundice + unconjugated hyperbilirubinemia? (6)
ddx of jaundice + conjugated hyperbilirubinemia? (5)
what are the 3 most common causes of jaundice and age groups?
For acute viral hepatitis, what is the:
- Bilirubin
- AST/ALT
- Alk Phos
- Albumin/Globulin
- PT/aPTT
- Serologies
- Abdominal U/S
For chronic cirrhosis, what is the:
- Bilirubin
- AST/ALT
- Alk Phos
- Albumin/Globulin
- PT/aPTT
- Serologies
- Abdominal U/S
For obstructive: common duct stone/pancreatic cancer, what is the:
- Bilirubin
- AST/ALT
- Alk Phos
- Albumin/Globulin
- PT/aPTT
- Serologies
- Abdominal U/S
U/S findings + Jaundice that determine next step in evaluation:
- Dilated CBD and stones:
- Dilated CBD adn no stones:
- Dilated intrahepatic ducts:
- Dilated ducts and testing to exclude PSC
- No dilated ducts
transmission routes for Hepatitis A?
diagnosis of Hep A and time series for vaccination? incubation period and time when HAV virus appears?
indications for Hep A vaccine?
define serology markers
what do the following markers mean?
- HBsAg
- HbsAb
- HBeAg
- HbeAb
describe the when each Hepatitis B marker appears?
what diseseases is Hep B associated with?
Name the scenarios where you would give Hep B immunoglobulin?
define chronic hepatitis b?
describe the chronic Hep B serology timeline?
Describe the carrier states of hep b?
what complications do you need to be aware of chronic Hep B and management of those complications?
When to initiate tx of chronic active Hep B?
what are the tx options for chronic active hep B?
when is screening for HCV indicated? (12)
what is the hep C rule of 2s? (5)
what complications do you need to screen for a chronic Hep C patient chronically?
what disease is associated with chronic HCV infection? what does it look like?
what is the extrahepatic diseases associated with Hep C?
In order for Hep D virus replication to occur, co-infection with which other virus is necessary?
Hepatitis E is associated with which risk factor?basics? when is it the highest risk for clinical disesase?
Ddx of chronic hepatitis?
what antibodies are positive in AI chronic hepatitis?
age groups/demographics of pBC vs IAH vs PCS?
scoring system to diagnose AIH?
Tx of AIH?
two categories of drug induced hepatitis and common causes?
which drugs associated with cholestasis?
effect of tylenol? what do you need to watch out for?
Side Effect of MTx, isoniazid and OCPs on the liver?
what is NAFLD and risk factors?
Tx of NAFLD?
basics of HCC? etiology, labs, complications, tx?
basics of the treatment of liver cancer?
what are the caues of cirrhosis?
what are the complications of cirrhosis?
prophylaxis for cirrhosis?
how do you manage active bleeds with cirrhsois?
what is the treatment for esophageal varices?
what are the causes of hepatic encephalopathy?
how do you treat hepatic encephalopathy?
sign of hepatic encephalopathy?
what is hepatorenal syndrome?
how does PT affected in alcoholic patients?
what are the causes of ascites?
how do you diagnosis the cause of ascites?
causes of ascites and associated albumin and protein findings?
Primary peritonitis definition and risk factors?
secondary bacterial peritonitis and tx?
tx of ascites?
what is gilbert’s syndrome?
what is AAT deficiency?
what are the two types of hemochromatosis?
what are the clinical findings in hemochromatosis?
what are the lab findings suggestive of hemochromatosis? dx?
treatment for hemochromatosis?
what is wilson’s disease?
how do you screen for wilson’s disease?
how do you treat wilson’s disease?
what do you need to watch out for causes of liver disease in the 1st and 2nd trimester of pregnancy?
what do you need to watch out for liver disease in the 3rd trimester of pregnancy?
how do you acute liver failure and symptoms?
how would you work up acute liver failure?
how do you treat acute liver failure?
when do you consider liver transplant?
what are contraindications of liver transplant? Relative/controversial/absolute?
symptoms/lab values/location of
- Cholelithiasis
- Acute cholecystitis
- Ascending cholangitis
- gallstone pancreatitis
which patients require US screening for HCC? (5)
- All patients with cirrhosis
- asina male HBV carriers >40
- Asian female HBV carriers >50
- Any HBV carrier with FH of HCC
- African/Black patients with HBV infection.
If lesions, CT abdomen/MRI of liver.
what vitamins are missing by going to a vegan diet? (MC?)
Calcium, vitamin D, vitamin b12, iron and protein.
Most common is b12 (missing animal, fish, eggs, dairy)
when do you recommend bland diet ?
bland diet is soft, low in dietary fibers, cooked, and not spicy, recommended typically after intestinal surgery
what diet do you recommend recovering from pancreatitis?
- mild acute pancreatitis - low fat diet
- severe pancreatitis/persistent abdominal pain - NG
which patients require stress ulcer prophylaxis?
TBI/burns
MV >48 hours
history of GI bleed
2 or more minor risk factors (sepsis, substantial steroids)
define inactive Hep B carrier state serologies and what do you need to monitor (no HCC)
- Positive HBS antigen, negative Hep B e antigen, positive Hep B e antibody, normal ALT, and HBV DNA <2000.
- 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.
patients with chronic NSAID use, what are the moderate risk factors for GI bleeding. What would you do about it?
- 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.
in patients with cirrhosis + hematemsis, treatment?
Ceftriaxone - (bacteremia, UTI, SBP), Octreotide (splanchnic vasoconstrictor), EGD within 12 hours; nonselective beta blockers for secondary prophylaxis.
indications for albumin in cirrhsois?
- SBP
- volume replacement after large volume paracentesis
- suspected hepatorenal syndrome
