GI treatments

Question 1

Tx for cholangitis

Answer 1

Aggressive care and emergent removal of stones, Cipro + metronidazole

Antibiotics, fluids, and analgesia.

ERCP to remove stones, insert a stent, repair the sphincter

Cholecystectomy (performed post-acute)

Question 2

tx for campylobacter jejuni

Answer 2

erythromycin

Question 3

tx for upper GI bleed

Answer 3

• Supportive care
• Transfuse for hemodynamic instability despite fluids, Hgb < 9 in high-risk patients (elderly, CAD), Hgb < 7 in low-risk patients
• IV PPI until confirmation of the cause of bleeding - treat the underlying cause
• Surgery—duodenotomy or gastroduodenostomy, ligation of bleeding

Question 4

tx for giardiasis

Answer 4

1st line= tinidazole

Flagyl (Metronidazole) 250-750 mg PO TID

Symptoms resolve within 5-7 days

Question 5

tx for pinworms

Answer 5

mebendazole

Question 6

tx for tapeworms

Answer 6

Praziquantel

Question 7

tx for hookworm

(sxs= cough, weight loss, anemia recent travel… eosinophilia and anemia)

Answer 7

mebendazole or pyrantel

Question 8

tx for roundworm

Answer 8

albendazole, mebendazole, pyrantel pamoate

Question 9

Tx for amebiasis

(Bloody diarrhea, tenesmus. abdominal pain. liver abscess)

Answer 9

TX: Iodoquinol or paromomycin and Flagyl for liver abscess

Question 10

Tx for Schistosomiasis

(sxs: Symptoms include rash, abdominal pain, diarrhea, bloody stool, or blood in the urine)

Answer 10

Praziquantel

Question 11

Tx for ulcerative colitis

(only colon, mucosal only)

toxic megacolon mc than chrons

Answer 11

Colectomy is curative

Medications: Prednisone and mesalamine

Question 12

tx for chrons- flares vs maintenance

(transmural, mouth to anus, cobblestoning, skip lesions, fistulas/abscess common)

Answer 12

Flares: Prednisone +/- Mesalamine +/- Metronidazole or Ciprofloxacin

Maintenance: Mesalamine

Surgery is not curative. Adjacent portion of the bowel is affected post-op

Question 13

treatment for N/V

Answer 13

Treatment includes anti-emetics – scopolamine patch, dexamethasone (4mg), ondansetron (4mg)

Rescue antiemetics: prochlorperazine, droperidol

GI cocktail: Maalox, viscous lidocaine, droperidol

PO challenge

Question 14

tx for bowel obstruction

Answer 14

Bowel rest, NG tube placement, surgery as directed by the underlying cause

Question 15

tx for peptic ulcer disease?

Answer 15

H. pylori- CAP

NSAIDs- PPI x8wks

Others- PPI x4-8wks

Question 16

tx for acute prostatitis

Answer 16

Bactrim or cipro x4-6wks

sexually active= Rocephin + doxy