GI Exam 1 (Key) Flashcards
Most common cause of chronic dyspepsia
Functional (Inorganic)
Psychosocial stressors
Dyspepsia
MORE Severe pain (Differential) — a symptom of a more serious underlying condition
Pancreatic or Biliary Tract Disease
Alarm Sign
Unintended weight loss Dysphagia Recurrent Vomiting Evidence of GI bleeding Anemia
H Pylori Tx
Triple Therapy
PPI
Clarithromycin
Amoxicillin
Metronidazole (If PCN allergic)
14 days
H Pylori Tx
Quadruple
PPI
Bismuth
Tetracycline
Metronidazole
14days
Functional Dyspepsia Tx
Pharm
PPI
Metroclopromide
Antidepressants
N/V
Pharm (3)
Serotonin 5-HT3-Receptor Antagonist — Ondansetron
Dopamine Antagonist — Promethazine
Antihistamine — Pimenhydrinate, Meclizine
Persistent Hiccups
____ — Infection, trauma, Neoplasm
____ — HYPOcapnia
Chronic irritation of the _____ or ____ Nerve
CNS,
Metabolic
Vagus or Phrenic
Main cause of GI Gas
Aerophagia (swallowing excessive air)
Flatus — Farting
FODMAPs
Diary, Fruits, Corn Syrups, Mushrooms, Pasta, Wheat
Constipation
Pharm
osmotic laxative — put water back into stool
Stimulant laxative —
Stool Surfactants —
Polyethelyne Glycol, Magenisum Citrate
Bisacodyl, senna
Docusate
Complication of Constipation
Fecal Impaction — Require DRE
Hemorrhoids
Lab test for Diarrhea
Fecal Leukocytes — POS (Inflammatory), NEG (NON)
Stool Culture
Ova & Parasite (O&P) — Three samples
C Difficile assay — Recent Antibiotic use
Fecal Lactoferrin — Marker of intestinal inflammation
Signs of Inflammatory diarrhea
Fever
WBC 15,000 more
Bloody diarrhea
Severe Abdominal pain
General Tx (Acute Diarrhea)
Antidiarrheals Pharm
Loperamide
Bismuth
Diarrhea (Acute)
Antibiotic (Empiric)
DOC?
Fluoroquinolones (-xacin)
Ciprofloxacin
Ofloxacin
Levofloxacin
Traveler’s Diarrhea (Acute)
Antibiotics (Empiric Tx) for Diarrhea
DOC
Fluroguinolones (3 day course)
- NOT useful (Traveling to Southeast Asia)
Azithromycin (Alternative for someone traveling to Southeast Asia)
Main etiologies of Chronic Diarrhea
Medications
Types of Chronic Diarrhea
Osmotic Diarrhea — Resolve when Fasting
Secretory conditions — Little to NO change w/ Fasting
Inflammatory — Crohn & Ulcerative Collitis
Motility disorders — IBS, Pain W/O Organic
disease
Chronic infections — Parasitic
Systemic conditions — Thyroid disease, DM
Upper GI Bleeding
Follow on care (2)
EGD (to Duodenum)
- all pts w/ active UPPER GI Bleed within 24 hours or presentation
Pharmmacotherapy
Tx for Lower GI Bleeding (3) — Large Volume Bleeding
Therapeutic Colonoscopy
Intra-arterial embolization
Surgery (Last resort)
Obscure GI Bleeding
_________ — Requires persistent or recurrent visible evidence of bleeding per rectum
_______ — Persistently POSITIVE FOBT, Iron Deficiency Anemia,
Clinical Findings
+ FOBT W/O Anemia =
+ FOBT W/ Anemia =
Obscure-Overt
Obscure-Occult
W/O Anemia = Colonoscopy
W/ Anemia = EGD + Colonoscopy
Ascites
Serum-Ascites Albumin Gradient SAAG Test
> 1.1 —>
<1.1 —>
> 1.1 —> Portal HTN
< 1.1 —> Other cause (Malignancy)
Ascites
US —> ___________
CT —> ________
Detects presence of fluid
ID causes
