GI Disease Part 2 Flashcards
What medication treatment should start with GERD?
PPI, not pepcid
Functional Dyspepsia is what?
Postprandial fullness, early satiety, epigastric pain or epigastric vomiting
Achlasia, what is it?
What is the treatment?
Achlasia is defined by inadequate relaxation of the LES and aperistalsis
Tx: Calcium Channel Blockers, botulism toxin, pneumonic dilation, and surgical myotomy
Gastroparesis, what the test of choice?
Scintigraphy (Gastric Emptying Study)
Entoembia Histolytica, if liver abscess seen, think what?
Flagyl
Duodenal Ulcer is what with food?
Better with food
Gastric Ulcer is what with food?
Worse with food
Gastric Polyps have what characteristics that make them concerning for cancer?
Hyperplastic Polyps greater than 1cm and pedunculated morphology
Do fundic gland polyps (in the stomach) require routine follow up?
No
Lynch Syndrome and Familial adenomatous polyposis may have gastric polyps. If they are found, when should a repeat EGD be done?
1 year after resection and then 3-5 years after resection
Entecavir and Tenofivir are the first line treatments for what disease?
Hepatitis B infection, usually wait 6 months to clear on its own
Achalasia, what type of food problem will the patient have?
Solid and Liquid Problem
Solid food dysphagia episodically for years suggests what?
Schatzki Ring
Progressively increasing solid-food dysphagia for several months suggests what?
Peptic Stricture or Carcinoma
If patient states that their 1st bite is difficult to swallow, but the repeat bites are ok, what is this?
Schatzki Ring
This is seen on GI imaging
A patient has abdominal cramps, nausea, and loose stools 15 minutes after eating. 90 minutes later, the patient has lightheadedness, diaphoresis, and tachycardia. The patient had gastric bypass surgery, what is this?
Dumping Syndrome
Treatment is small frequent meals and low carb meals, followed by liquids
If a patient is diagnosed with Hepatitis A, what should be done in 2 weeks from disease onset?
If a patient is over 40 years old with a Hepatitis A infection, what else can be given besides a vaccine?
Hepatitis A vaccine
Immunoglobulin Administration
When are colonoscopies started and stopped?
The normal person age range
45-75 years old
What is the treatment for the following?
Mild to moderate ulcerative colitis
5-ASA oral and topical treatments
If fails, think oral budesonide
What medication should not be used in Ulcerative Colitis?
Methotrexate
Can be used with Crohn’s Disease
Azaithroprine and 6-MP are effective in maintaining remission in what GI disease?
Ulcerative Colitis
What autoimmune disease has architectural crypt distortions and diffuse lymphocytic infiltrate expanding into the lamina propria, is what?
Ulcerative Colitis
What autoimmune disease has transmural inflammation, non-caseating granulomas, cobblestone appearance, skip lesions, patchy pattern of inflammation, is what?
Crohn’s Disease
How do we treat the following?
Mild to moderate Ulcerative Colitis Flare
5-ASA Suppossitories
A patient has the following:
Abdominal pain that has worsened despite increased opiod doses, scans/imaging is negative, what is this? What should be done?
Centrally Mediate Abdominal Pain Syndrome
Wean off opiods, therapy/psychotherapy
When should a colonoscopy be done?
Colon Cancer diagnosed in a first degree relative less than 60 years old or 2 first degree relatives of any age
Begin at age 40 or 10 years earlier than the youngest family member colon cancer diagnosis, whichever comes first
Repeat Colonoscopy every 5 years
When should a colonoscopy be done?
Colon Cancer diagnosed in a first degree relative greater than 60 years old
Begin at age 40, repeat every 10 years
When should a colonoscopy be done?
Personal history of colon cancer
Time of diagnosis then 1 year and 3 years
If negative, for both, then every 5 years
When should a colonoscopy be done?
Adult patients with cystic fibrosis
At 40 years old, every 5 years afterward
When should a colonoscopy be done?
Familial Adenomatous Polyposis
Begin at age 10-12 years, flexible sigmoidoscopy/colonoscopy, repeat every 1-2 years until colectomy
When should a colonoscopy be done?
Lynch Syndrome
Begin at age 20-25 years old or 10 years earlier from youngest family member cancer detection, repeat every 1-2 years
When should a colonoscopy be done?
Crohn’s Disease or Ulcerative Colitis
8 years after diagnosis, colonoscopy with biopsies, repeat every 1-3 years
What is primary biliary cholangitis?
What is the treatment?
Fibrosis of the intrahepatic ducts
Tx: Ursodeoxycholic Acid
What are the following diseases assoicated with?
Primary Biliary Cholangitis ->?
Primary Sclerosing Cholangitis ->?
PBC -> Sjogren’s Syndrome
PSC -> Ulcervative Colitis
What disease is seen from the following picture?
Patient may have ulcerative colitis as well
Primary Sclerosing Cholangitis
Intrahepatic and Extrahepatic fibrosis, will need a Liver transplant long term
When should a colonoscopy be done?
1-2 tubular adenoma polyps that are less than 10mm
5-10 years
When should a colonoscopy be done?
3-10 adenomas, greater than 10 mm, villous histology, or high grade dysplasia
3 years
When should a colonoscopy be done?
More than 10 adenomas on a single exam
less than 3 years, find a genetic cause
What GI disease could this be?
Arthralgia
Fever
Neurologic Disease
Ocular or Cardiac Disease
Whipple Disease
Nedd a small bowel biopsy and Trop. whippelli PCR
What GI disease is the following?
India or Puerto Rico travel, malabsorption, weight loss, malaise, and steatorrhea
Tropical Spure
Small Bowel biopsy
What disease has the following antibodies?
IgA anti-tTg or IgA anti-endomysial antibody assay
Celiac’s Disease
What two electrolytes should be tested when doing a diarrhea evaluation?
Sodium and Potassium (Stool Levels)
What types of diarrhea, most likely cause the following:
Secretory Diarrhea -> ?
Osmotic Diarrhea -> ?
Secretory Diarrhea -> Celiac’s Disease (unchanged by eating, nocturnal, does not improve with fasting)
Osmotic Diarrhea -> Lactase Deficiency (follows eating, improves with fasting, not nocturnal)
Nocturnal diarrhea and DM or Scleroderma cause what disease?
Small Bowel Bacterial Overgrowth
What chronic medication use can lead to benign pigmentation of the colon (melanosis coli)?
Chronic Senna
What disease has the following picture?
Ischemic Colitis (Thumbprint Sign)
What score is needed to get steroids in Cirrhosis patients?
Maddrey Discriminant Function
MELD score
Maddrey Discriminant Function score > 32
MELD score > 18
These treatment regimens are for what disease?
Glecaprevir/pibrentasvir, 8 weeks
Sofosbuvir/velpatasvir, 12 weeks
Hepatitis C
Upper GI bleed, impending EGD, unsure if varicies exist, what should be given?
Patient has a liver cirrhosis background
IV abx
