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MJ- Family Med EOR > GI treatments > Flashcards

GI treatments Flashcards

1
Q

Tx for anal fissures

A
  • 1st line= fluid and fiber
  • stool softeners
  • protective ointments, sitz baths
  • NTG ointment, topical CCB, Botox injection
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2
Q

Triad for chronic anal fissure

A
  1. fissure
  2. sentinel pile
  3. hypertrophied anal papilla
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3
Q

tx for anal fissures following failure of conservative tx

A

lateral anal sphicterotomy

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4
Q

symptomatic tx for internal hemorrhoids

A
  • Stool softeners (docusate, psyllium)
  • warm sitz bath
  • Anesthetic ointments contining lidocain
  • Witch hazel (Hamamelis) compresses
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5
Q

tx for bleeding internal hemorrhoids

A

injection sclerotherapy w/ 5% phenol in vegetable oil

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6
Q

Tx for larger, prolapsing internal hemorrhoids or those that don’t respond to conservative tx

A

rubber band ligation

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7
Q

Tx for thrombosed external hemorrhoids

A

excision

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8
Q

which 2 anticholinergic drug can be used as an antispasmodic in IBS

A

Hyoscyamine or dycyclomine 30-60 min before meals

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9
Q

Tx for large bowel obstruction (4)

A

NPO

nasogastric suction

IV fluids

Monitoring

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10
Q

Tx of large bowel obstruction if mechanical obstruction is expected

A

Urgent surgery

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11
Q

What are 2 things you can do to prevent medication induced esophagitis (NSAIDs, bisphosphonates)

A
  • Drinking pills with at least 4 ounces of water
  • avoid laying down for at least 30-60 min after ingestion
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12
Q

Tx for eosinophilic esophagitis (2)

A
  • remove foods that incite allergic response
  • topical steroids via inhaler
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13
Q

how do you tx corrosive esophagitis

A

steroid

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14
Q
A
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15
Q

Tx for HSV esophagitis

A

Acyclovir

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16
Q

Tx for CMV esophagitis

A

Ganciclovir

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17
Q

Tx for uncomplicated GERD (lifestyle)? What should be avoided

A
  • elevating head of the bed 15cm (6in)
  • avoiding eating w/in 2-3 hrs of bedtime
  • avoid stimulants of acid secretion (coffee, alcohol)
  • avoid drugs (anticholinergics)
  • Foods (fats, chocolates, etc)
  • Avoid smoking
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18
Q

drug therapy for GERD

A
  • start w/ a low-dose H2 receptor antagonist (“-tidine”) QD then increasing to BID if needed
  • Switch to PPI (“-prazole”) if sxs persist (start low and increase)

tx for at least 8 wks once sxs controlled

19
Q

What are the 4 H2 receptor antagonists used to tx GERD

A

Famotidine

Ranitidine

Nizatidine

Cimetidine

20
Q

What class of meds are used to tx GERD and end w/ “-prazole”

ex: omeprazole, pantoprazole

A

PPIs

21
Q
A
22
Q

Tx for NSAID induced gastritis

A

stop NSAIDs, empiric therapy w/ acid suppression 4-8wk of PPI

23
Q

Tx for H.pylori gastritis

A

Clarithromycin

Amoxicillin +/- metronidazole

PPI (omeprazole)

24
Q

What surgical procedure is indicated for refractory GERD

A

Nissen fundoplication

25
Q

Tx for cirrhosis (specifically for encephalopathy, ascites and pruritis)

A

Avoid alcohol, restrict salt, liver transplant

  • Encephalopathy: Lactulose + neomycin
  • Ascites: Sodium restriction, paracentesis
  • Pruritis: Cholestyramine
26
Q

What 3 meds can be used for hepatic encephalopathy

A
  • Lactulose
  • Rifaximin (reduce risk of re-hosp for hep. enceph)
  • Flumazenil (lower blood ammonia levels)
27
Q

Tx of campylobacter jejuni gastroenteritis

A

usually self limited

can be treated effectively w/ erythromycin

28
Q

What 3 infectious agents can cause bloody diarrhea

A

Shigella, salmonella, enteroinvasive e. coli

29
Q

Tx for shigella gastroenteritis

A

Trimethoprim sulfamethoxazole

30
Q

Tx fro C. diff?

A

Flagyl x10-14d

Oral vanco?

31
Q
A
32
Q

Tx for rectal cancer

A

wide local surgical excision

radiation w/ chemo for large tumors w/ mets

33
Q
A
34
Q

Tx for colorectal cancer

A

surgical resection and chemo for nodal involvement

5FU is mainstay of chemo

monitor CEA w/ treatment

35
Q
A
36
Q

treatment for small bowel obstruction

A

bowel rest

NG tube placement

Surgery as directed by underlying cause

37
Q

What abx should be given prior to appendectomy

A

3rd gen cephalosporin

38
Q

Tx for upper and lower GI bleed (6)

A
  1. Endoscopic thermal pole
  2. Endoscopic clip
  3. Endoscopic injection
  4. Angiographic embolization
  5. Endoscopic intravariceal cyanoacrylate injection
  6. Band ligation (esophageal varices or hemorrhoids)
39
Q

In severe illness of salmonellosis what abx can you give

A

ciprofloxacin

40
Q

What is a common cause of osteomyelitis in children with sickle cell disease

A

salmonellis

41
Q
A
42
Q

What lab finding is indicative for spontaneous peritonitis in cirrhosis

A

ascitic fluid neutrophil count of 300

(Ascites fluid= PMNs >250, WBC >1000, Ph <7.34)

43
Q

tx for salmonellosis

A

ceftriaxone

44
Q

tx for shigellosis

A

TMP-SMX or ciprofloxacin

MJ- Family Med EOR (17 decks)

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