GI Exam 1 (Key) Flashcards

1
Q

Most common cause of chronic dyspepsia

A

Functional (Inorganic)

Psychosocial stressors

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2
Q

Dyspepsia

MORE Severe pain (Differential) — a symptom of a more serious underlying condition

A

Pancreatic or Biliary Tract Disease

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3
Q

Alarm Sign

A
Unintended weight loss
Dysphagia
Recurrent Vomiting
Evidence of GI bleeding
Anemia
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4
Q

H Pylori Tx

Triple Therapy

A

PPI
Clarithromycin
Amoxicillin
Metronidazole (If PCN allergic)

14 days

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5
Q

H Pylori Tx

Quadruple

A

PPI
Bismuth
Tetracycline
Metronidazole

14days

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6
Q

Functional Dyspepsia Tx

Pharm

A

PPI
Metroclopromide
Antidepressants

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7
Q

N/V

Pharm (3)

A

Serotonin 5-HT3-Receptor Antagonist — Ondansetron

Dopamine Antagonist — Promethazine

Antihistamine — Pimenhydrinate, Meclizine

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8
Q

Persistent Hiccups

____ — Infection, trauma, Neoplasm

____ — HYPOcapnia

Chronic irritation of the _____ or ____ Nerve

A

CNS,

Metabolic

Vagus or Phrenic

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9
Q

Main cause of GI Gas

A

Aerophagia (swallowing excessive air)

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10
Q

Flatus — Farting

FODMAPs

A

Diary, Fruits, Corn Syrups, Mushrooms, Pasta, Wheat

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11
Q

Constipation

Pharm

osmotic laxative — put water back into stool

Stimulant laxative —

Stool Surfactants —

A

Polyethelyne Glycol, Magenisum Citrate

Bisacodyl, senna

Docusate

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12
Q

Complication of Constipation

A

Fecal Impaction — Require DRE

Hemorrhoids

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13
Q

Lab test for Diarrhea

A

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

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14
Q

Signs of Inflammatory diarrhea

A

Fever
WBC 15,000 more
Bloody diarrhea
Severe Abdominal pain

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15
Q

General Tx (Acute Diarrhea)

Antidiarrheals Pharm

A

Loperamide

Bismuth

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16
Q

Diarrhea (Acute)

Antibiotic (Empiric)

DOC?

A

Fluoroquinolones (-xacin)

Ciprofloxacin
Ofloxacin
Levofloxacin

17
Q

Traveler’s Diarrhea (Acute)

Antibiotics (Empiric Tx) for Diarrhea

DOC

A

Fluroguinolones (3 day course)
- NOT useful (Traveling to Southeast Asia)

Azithromycin (Alternative for someone traveling to Southeast Asia)

18
Q

Main etiologies of Chronic Diarrhea

A

Medications

19
Q

Types of Chronic Diarrhea

A

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

20
Q

Upper GI Bleeding

Follow on care (2)

A

EGD (to Duodenum)
- all pts w/ active UPPER GI Bleed within 24 hours or presentation

Pharmmacotherapy

21
Q

Tx for Lower GI Bleeding (3) — Large Volume Bleeding

A

Therapeutic Colonoscopy
Intra-arterial embolization
Surgery (Last resort)

22
Q

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 =

A

Obscure-Overt
Obscure-Occult

W/O Anemia = Colonoscopy
W/ Anemia = EGD + Colonoscopy

23
Q

Ascites

Serum-Ascites Albumin Gradient SAAG Test

> 1.1 —>

<1.1 —>

A

> 1.1 —> Portal HTN

< 1.1 —> Other cause (Malignancy)

24
Q

Ascites

US —> ___________

CT —> ________

A

Detects presence of fluid

ID causes

25
Q

Spontaneous Bacterial Peritonitis

Abdominal pain W/O TTP —>

Abdominal pain W/ TTP —>

A

W/O TTP —> bacterial Peritonitis

W/ TTP — Other source

26
Q

Gastroparesis (Tx)

Acute Exacerbation —>

General —>

A

Acute —> NG Decompresion and IV fluid & electrolyte replacement

General —> Dietary modification, Optimize Glycemic Control (DM), Prokinetic medications (Metoclopramide, Domperidone)

27
Q

First symptom of Whipple Disease

A

Migratory Arthralgias — Large joint involvement

28
Q

Anal Fissures

Tx for Chronic Fissures

A

Topical Vasodilators (Nifedipine, Nitroglycerin), Botulinum Toxin Injection

29
Q

PUD

General Treatment

______(First line) — Helps the recovery of damaged lining and also protect from further damange

Mucosal Defense
______ — FOrms viscous protective coating
______ —- Given as Prophylaxis for long-term NSAID pts

A

PPI

Sucralfate

Misoprostol