GI/GU

Question 1

gerd also known as

Answer 1

acid reflux- very common

Question 2

s/sx of GERD

Answer 2

cough
sore throat
regurgitation
chest pain

Question 3

risk factors for GERD

Answer 3

smoking
obesity
pregnancy
aging

Question 4

GERD diagnostic

Answer 4

generally exam but can use
EGD

Question 5

if pt c/o heartburn

Answer 5

and PPI or H2 blocker controls symptoms- not really a need to order EGD

Question 6

educated GERD pts

Answer 6

sitting up
weightloss
not drinking with meals

Question 7

The eternal debate: PPI or H2 blocker?

Answer 7

these are both first line for the correct pt
mild- H2
severe- PPI
if pt can’t afford PPI- they are more expensive.
H2 blocker not as strong at decreasing gastric secretion

Question 8

What is more effective for GERD, PPIs or H2 blockers?

Answer 8

PPIs more effective for GERD

Question 9

• Long-term complications of PPIs

Answer 9

osteoporosis
C Diff
B12 deficiency anemia

Question 10

Why is it so important for GERD pts to take their meds consistently?

Answer 10

Reflux put them at high risk for Barret’s esophagus.
trying to prevent this by actively treating GERD appropriately

Question 11

Prescription-strength proton pump inhibitors.

Answer 11

These include esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex) and dexlansoprazole (Dexilant).

Question 12

Gastric reflux symptoms

Answer 12

Symptoms
* Chest pain, chronic sore throat/hoarseness, dysphagia, erosion of teeth, chronic cough/asthma, postnasal drip, pyrosis (heartburn), lump in throat, fatigue, anemia

Question 13

GERD diff dx

Answer 13

asthma, cardiac disease, cholelithiasis, esophageal CA, H Pylori, hiatal hernia, IBS, lower resp infection PUD

Question 14

• Ulcerative colitis symptoms, diagnosis and

Answer 14

Symptoms
* Bloody/mucus diarrhea, rectal bleeding, fecal incontinence, tenesmus (cramping of anal sphincter), abd pain, decreased appetite, weight loss, fever, tachycardia, anemia, fatigue, clubbing of fingernails, peripheral edema

Question 15

ulceratice colitis treatment plan

Answer 15

treatment plan
* non pharm: bowel rest (for acute flareup), avoid triggers (caffeine, alcohol, carbonated beverages, lactose), stress management, exercise, healthy diet, surgery if unresponsive to 2-3 weeks of medical therapy
* Pharm: aminosalicylates (5-ASA); may use IV steroids during exacerbations
 Ex of 5-ASA: Asacol, Pentasa, Lialda
 Works by preventing leukocyte recruitment into the bowel wall

Question 16

Wilms’ tumor characteristics

Answer 16

Rare unilateral kidney cancer (nephroblastoma)
* Painless swelling/lump in the child’s abdomen
* Can cause hematuria

Question 17

Urge incontinence

Answer 17

Overactive bladder with a strong sensation of a need to urinate

Diagnosis
 Pelvic exam may show vaginal atrophy
 Ensure negative UA and culture

Question 18

Functional incontinence

Answer 18

• Inability to reach the toilet on time/unaware of need to void
• May find limited mobility or altered LOC
• Diagnosis
   Ensure negative UA and culture

Question 19

Stress incontinence

Answer 19

• Leaking urine with cough, sneeze, exercise
• Diagnosis
   Ensure negative UA and culture

Question 20

Chronic prostatitis diagnosis and treatment plan

Answer 20

s/s: urinary frequency, urgency, pressure, dysuria, hematuria, testicular or penile pain, abdominal pain, painful ejaculation
* Exam: swollen, firm, warm, tender prostate
* Diagnosis: UA with culture
* treatment plan
An antibiotic is used to treat prostatitis that is caused by an infection. Some antibiotics that might be used are trimethoprim-sulfamethoxazole, doxycycline, ciprofloxacin, norfloxacin and ofloxin.
* TMP/SMX
* Fluroquinolones
* Alpha-blockers to relax muscles in bladder

Question 21

Irritable bowel syndrome (IBS) Symptoms

Answer 21

• Abdominal cramping
• pain relieved after bowel movement or passing of gas
• feeling of incomplete passing of stool
• Constipation or diarrhea
• mucus in stools
• abdominal distention or bloating
• RED FLAGS: rectal bleeding, nocturnal pain, weight loss
  *

Question 22

Irritable bowel syndrome (IBS) Diagnosis*

Answer 22

CBC, CMP, IGA SED RATE, STOOL CULTURES, COLONOSCOPY
*

Question 23

Irritable bowel syndrome (IBS) treatment

Answer 23

Treatment plan
* Non-pharm: consider lactose-free diet, exclude gas producing foods, stress management, heat to abdomen, avoid triggers/stimulants
* Pharm: do NOT use SSRIs; do use stool softeners (colace), bulk-producing agents (psyllium), stimulants (bisacodyl/Dulcolax), bentyl (antispasmodic)

Question 24

Diverticulitis diagnosis and treatment plan

Answer 24

• LLQ pain
• Diagnosis: CT abdomen
• treatment plan
• low-fiber diet
• antibiotics (Flagyl)

Question 25

Difference between unlcerative collitis and IBS

Answer 25

Colitis is a whole-body disease, while IBS is a syndrome that mainly affects the gut. Doctors do not yet know the triggers of colitis, although certain foods may be suspect. IBS may include triggers such as stress or particular food groups. Colitis results in physical damage to the colon, while IBS does not.