Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IPAP > GI Exam 2 (Medications +Tx) > Flashcards

GI Exam 2 (Medications +Tx) Flashcards

1
Q

IBS Medication

Antispasmodic — Pain/Bloating (2)

A

(-mine)

Dicyclomine
Hyosycamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

IBS Medications

Anti-Constipation (IBS-C) — 3

A

Osmotic Laxatives — First
Lubiprostone — Female 18+
Linaclotide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

IBS Medication

Antidiarrheals (IBS-D)

A

Loperamide — First

Bile Salt Sequestrants — Fail
Loperamide

SSRA

  • Alosetron (Fail ALL other therapy — Female ONLY)
  • Ondansetron (Off-label use)

Non-absorbable antibiotics
-Rifaximin (Significant bloating)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

IBS Medication

Psychotropic agents (Pain + Bloating) — Better in IBS-D: Anticholinergic effect)

A

TCAs (-Triptyline)
Amitriptyline
Nortriptyline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Antibiotic Associated Colitis

Treatment

General

A

Admission
Discontinue offending antibiotic agent
Infection control procedures
Correct fluid and electrolyte disturbances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Antibiotic Associated Colitis

Treatment

Mild/Moderate

A

Metronidazole 500mg PO TID x 10 days (First line)

Can’t take Metro or therapy failure after 5-7 days —> Vancomycin

Vancomycin 125 mg PO QID x 10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Antibiotic Associated Colitis

Treatment

Severe

A

Vancomycin 125 mg PO QID x 10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Antibiotic Associated Colitis

Treatment

Fulminant

A

Vancomycin 500 mg PO QID
Metronidazole 500 mg IV
Vancomycin PR 500 mg QID

+ Early surgical Consultation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Antibiotic Associated Colitis

Treatment

Relapse

A

Repeat course of oral antibiotics
Subsequent relapse require 7 week taper of Vancomycin
Adjuvant Therapy (Probiotics, Fecal Transplantation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Toxic Megacolon

Treatment

A

Reduce Colonic distention to prevent perforation

Correct fluid and electrolyte disturbances

Treat toxemia and precipitating factors

Surgical consultation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diverticular Bleeding

Treatment

Pt w/ active bleeding

Pts w/o active bleeding

A

w/ active bleeding

Resuscitation and stabilization
Endoscopy (EGD)

W/O active bleeding

Refer —> Scope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diverticulitis

Treatment

Mild

A

Conservative Measures

Outpatient

Oral broad-spectrum antibiotics (7-10days)

1: Metronidazole 500mg + Ciprofloxacin 500mg
2: Metronidazole 500mg + TMP-SMX-DS (If pt cannot take Ciprofloxacin)

3: Amoxicillin-Clavulanate (Augmentin
NOT recommended unless pt cannot take both of Ciprofloxacin and TMP-SMX DS

Clear liquid diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Diverticulitis

Treatment

Severe

A

Inpatient

NPO
IV Broad-spectrum antibiotics
**Continued until inflammation is stabilized —> Transition to PO abx

IV fluid and electrolyte replacement
IV pain management
**Surgical consultation as indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Sigmoid Volvulus

Treatment

A

Flex sig —> Detorsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Crohn

Abscess, obstruction or Fistulas action

General

A

Surgery

General —> Symptomatic improvement & Control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Crohn

Symptomatic

A

Antidiarrheals

Loperamide,
Bile Acid Sequestrant (If significant involvement of terminal ileum

Oral steroid for aphthous ulcer

Triamcinolone (Topical steroid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Crohn

Active Disease

A

Non-Sysmetic Corticosteroids — Mild to Moderate

Budesonide

Systemic Corticosteroids — Severe

Prednisone

Pts who fail oral corticosteroid therapy —> Hospitalization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Crohn

Maintenance

Absence of maintenance therapy —> Symptom relapse in 80% of pts within 1 yr

A

Immunomodulators

Azathioprine
6-Mercaptopurine
Methotrexate

TNF Agents

Infliximab
Adalimumab
Certolizumab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ulcerative Colitis

Main difference from Crohn

A

5-ASA

Mesalamine
Sulfasalazine (w/ Folic acid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

UC

Mild-Mod Distal

Rectosigmoid colon

A

Topical Mesalamine (DOC) — Suppository or enema (PO if can’t tolerate or refuse)

Topical Corticosteroids

Hydrocortisone —> Suppository or enema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

UC

Refractory DIstal

Frequent relapse —> Maintenance

A

Oral + Topical 5-ASA

+ Oral Prednisone if symptoms still persist

Maintenance

Nightly (every other night) of topical 5-ASA
(PO = Less effective)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

UC

Mild-Mod EXTENSIVE

Extending proximal to the sigmoid

A

Oral 5-ASA

Mesalamine
Sulfasalazine (+Folic Acid)

NO improvement in 4 wks —> Oral Corticosteroids added to 5-ASAs

Prednisone OR Methylprednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

UC

Refractory Extensive

A

Immunomodulators

Anti-TNF Agents (Pick one) — (-mab)

Infliximab
Adalimumab
Golimumab

Anti-integrin therapy
(Moderate to severe UC who fail all other therapies)

Vedolizumab

24
Q

UC

Severe or Fulminant (Pan Colitis)

A

Inpatient care

Surgical consultation early
NPO
Parenteral fluid/electrolyte replacement
IV corticosteroids

Maintenance therapy

Oral Mesalamine or Sulfasalazine (+Folic Acid) — Daily
Mercaptopurine OR Azathioprine (=2 relapses/yr)

25
Q

Microscopic Colitis

A

Discontinue offending medications if possible

Symptomatic care

Antidiarrheals

If diarrhea persists —> Budesonide x 4 wks

26
Q

IBS

Treatment

A

Reassurance and Education

Psychosomatic vicious cycle

Anxiety over symptoms —> worsening symptoms

27
Q

IBS

Adjunctive Pharmacologic Therapy

Antispasmodic (Pain/bloating)

A

Dicyclomine
Hyosycamine

(-mine)

28
Q

IBS

Adjunctive Pharmacologic Therapy

Anti-Constipation (IBS-C)

A

Osmotic laxatives — First
Lubiprostone — Female >18
Linaclotide

29
Q

IBS

Adjunctive Pharmacologic Therapy

Antidiarrheals (IBS-D)

A

Loperamide — First
Bile salt sequestrants — Fail Loperamide

SSRA (-setron)

Alosetron — Fail all other therapy (Female ONLY)
Ondansetron

Non-absorbable antibiotics

Rifaximin — significant bloating

30
Q

IBS

Adjunctive Pharmacologic Therapy

Psychotropic agents (pain + bloating)

A

TCAs (-Triptyline)

Ami
Nor

31
Q

Jaundice

A

Treatment aimed at underlying etiology

After initial lab testing, Referred for further testing and evaluation

32
Q

Acute Liver Faliure

A

Admission for inpatient management

IV fluid and electrolye replacement
Dietary monitoring

Gastroprotective measures (Prevention of stress Gastropathy)
-IV PPI or H2

Other treatments as indicated based on etiology

33
Q

Hepatitis A

A

Bed rest if needed

Symptomatic care
Antiemetic, Antidiarrheals, Fluids regular meals

Avoid strenuous exercise or work
NO ETOH or HEPATOTOXIC MEDS

34
Q

Hep B

A

Supportive

Encephalopathy or Coagulopathy — Severe disease

Inpatient management
Antiviral Therapy

35
Q

Hep C

A

Re-check HCV RNA (PCR) @ 12 wks after exposure or after diagnosis

Peginterferon for 12-24 wks

36
Q

Chronic Viral Hepatitis

HCV

A

Harvoni

37
Q

NAFLD (NAFL or NASH)

A

Lifestyle changes

Diet, exercise, weight loss
Vitamin E
Insulin sensitizing agents — Metformin

38
Q

Alcoholic Steatohepatitis

A

R/O other causes for acute hepatitis

US & Biopsy

Admit to GI

Alcohol abstinence
Prevention and Tx of alcohol withdrawal
Fluid management
Nutritional support
Infection surveillance
Prophylaxis against gastric mucosal bleeding — IV PPI
39
Q

Cirrhosis

A

Inpatient

Abstinence from ETOH
Dietary Consultation
Immunizations — HAV, HBV, Flu shot
Liver transplant — Ultimately

40
Q

Ascites

A

TIPS

41
Q

Spontaneous Bacterial Peritonitis

A

ADMIT

Ceftriaxone (IV)

Prophylaxis
Ciprofloxacin (Once Daily) OR TMP-SMX DS

42
Q

Hepatorenal Syndrome

A

Improving liver function

If can’t improve liver function in the short term —> Admit to ICU

43
Q

Hepatic Encephalopathy

A

Admission

Lactulose — Ammonia reducer

44
Q

Toxic Liver Injury

A

Discontinue offending agent

45
Q

Primary Biliary Cirrhosis

A

R/O Other etiologies of biliary tract obstruction — FIRST

Ursodeoxycholic acid

Bile salt sequestrants (Chole, Cole) — Pruritist

46
Q

Hemochromatosis

A

Deferoxamine

Phlebotomy

47
Q

Wilson

A

Chelation of Copper

48
Q

Budd-Chiari Syndrome

A

Directed at underlying cause and complications — Ascites

Admit any pt w/ suspected hepatic vein obstruction

49
Q

Cholelithiasis

A

NONE — Asymptomatic

NSAIDs — Intermittent, mild biliary colic

Cholecystectomy — Continued pain or frequent Cholecystitis

50
Q

Acute Cholecystitis

A

Admission for supportive care

Cholecystectomy — timing dependent on presentation and severity

51
Q

Choledocholithiasis

A

Endoscopic stone removal — even in ASYMPTOMATIC

Cholecystectomy — Prevent recurrence or complication

52
Q

Acute Cholangitis

A

Admission

ERCP — biliary drainage and removal of obstruction

Surgery — if ERCP fails or is unavailable

Cholecystectomy — once infection is cleared

53
Q

Acute Pancreatitis

General measures

A

ERCP for gallstone pancreatitis within 24 hrs of admission

If alcohol abuse —> NO ERCP

54
Q

Acute Pancreatitis

MIld

A

Admission
NPO
Bed Rest
IV Fluid and E

Morphine!!! — Pain control

55
Q

Acute Pancreatitis

SEVERE

A

ICU
Early surgical consultation
IV F and E// Monitoring of Hemodynamics status
Antibiotics

56
Q

Chronic Pancreatitis

A 
Referral to GI/Pancreatology
NO ETOH
Low fat diet
Non-opioid pain control 
Pancreatic enzyme supplementation

IPAP (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions