GI Rosh Flashcards
what helps distinguish c diff from from other benign antibiotic-associated diarrhea
fecal leukocytes (C diff)
tx Cdiff
oral vancomycin or oral fidaxomicin
primary treatment for Giardia infection
Tinidazole 2 grams orally as a single dose
avoid lactose containing foods
dx sigmoid volvulus
XR - bent inner tube, coffee bean sign
Abdominal CT scan
Contrast enema
tx sigmoid volvulus
sigmoidoscopy
surgery
tx hepatic encephalopathy
lactulose and rifaximin
What is the recommended protein intake in a patient with hepatic encephalopathy?
1–1.5 g/kg/day.
in what dz is Dermatitis herpetiformis commonly seen
celiac
what is Dermatitis herpetiformis
vesicobullous, pruritic lesions on the elbows, knees, and buttocks
MCC SBO
adhesions from prior abdominal surgery
dx SBO
XR
CT
tx SBO
NG tube decompression
What type of hernia is most commonly associated with small bowel obstruction?
inguinal hernia
Mallory-Weiss syndrome is characterized by
longitudinal mucosal lacerations in the distal esophagus and proximal stomach, commonly associated with violent or repeated vomiting
sx mallory-weiss
dysphagia, odynophagia, and upper GI bleeding (mild)
dx mallory weiss
upper endoscopy
tx mallory weiss
All patients with Mallory-Weiss syndrome should be treated with proton pump inhibitors for acid suppression and antiemetics
if active bleeding - thermal coagulation, hemoclips, or endoscopic band ligation
what is Boerhaave syndrome
full-thickness esophageal perforation and a surgical emergency
how to patients with Boerhaave syndrome present
severe chest pain that begins acutely after vomiting
The most common cause of upper gastrointestinal (GI) bleeding
duodenal ulcer – usually due to H pylori
The second most common cause of peptic ulcer formation
NSAID use
classic sx for gastric vs duodenal ulcers
gastric ulcers cause pain immediately after meals, whereas food relieves the pain caused by duodenal ulcers
tx H pylori infection
quadruple therapy: 14 days of PPI, bismuth, tetracycline, metronidazole
where do anal fissures MC occur
posterior midline
tx anal fissure
high fiber diet, softening stool to prevent recurrent trauma, and normalization of bowel movement
if no response –> topical nitroglycerin or topical diltiazem In cases that do not respond to conservative treatment, topical nitroglycerin or diltiazem ointment
what lab can aid in the diagnosis of acute mesenteric ischemia
serum lactate
incarcerated vs strangulated hernia
incarcerated - Firm and painful, nonreducible by direct manual pressure
strangulated - Painful due to impaired blood flow, ischemia, and
necrosis, overlying skin changes
Any patient with an exam indicative of a strangulated hernia should receive
cefoxitin intravenously and emergent surgical consultation
tx for thrombosed hemorrhoids
anesthetizing the lesion and evacuating with an elliptical incision
CT findings for cholecystitis
thickened gallbladder wall (> 4–5 mm), pericholecystic fluid, or dilated intra- or extrahepatic biliary ducts
Which form of IBD is more likely to develop a malignancy
UC
