GIT Flashcards
Acute LGIB w/ hemodynamic instability: after initial resuscitation, what is the next diagnostic step?
Upper endoscopy
UGIB: Change in hemoglobin may not be evident up to ____ hours after bleeding event
72 hours
Most frequent PE finding of GU or DU
Epigastric tenderness
First step in a patient with new onset dyspepsia <40 y/o and without alarm symptoms
Non-invasive H. pylori testing
Melena is blood that has been in the GIT for at least _____ hours
14 hours
Gold standard of H. pylori testing
Histologic evaluation of endoscopic biopsy
Scleral icterus means bilirubin is >___ mg/dL
3
Best way to initially assess GIB
BP and HR
Most reliable marker of severity of liver disease and it’s hallmark symptom
Jaundice
Single most common risk factor for hep C infection:
Injection drug use
Often the only clinical finding in alcholic liver disease
Hepatomegaly
Treatment of ALD with severe hepatitis, discriminant function >32 or MELD >20
Steroids (Prednisolone)
Components of MELD
Bilriubin, INR, Creatinine
Medical management for portal hypertension
Nonselective beta blockers Splanchnic vasoconstrictors (Somatostatin, octreotide)
Chylous ascites indicates a TG level of
> 200 mg/dL
Remains the gold standard of determining cause of ascites
Laparotomy/laparoscopy with peritoneal biopsy
Patients with small amounts of ascites can be initially managed by:
Sodium restriction
Moderate amounts of ascites are managed with:
Diuretics (initially spironolactone)
Management for refractory ascites
Repeated large volume paracentesis and TIPS
In colonic adenoCA, obstruction here leads to hematochezia, narrowing of stool caliber, tenesmus
Rectosigmoid area
Colon CA: Best predictor of long-term prognosis
Pathologic stage at diagnosis
Urgent endoscopy is recommended in cirrhotics with UGIB within how many hours?
12 hours
Single best acute measure of hepatic synthetic function
Coagulation studies
Earliest radiologic change in ulcerative colitis
Fine granular changes
Earliest macroscopic finding in Crohn’s disease
Aphthous ulcers
Defining lesions of UC
Crypt abscesses and ulcers
Treatment of SBP
Cefotaxime/Ofloxacin/Ciprofloxacin + IV Albumin
Cornerstone of therapy in dumping syndrome
Dietary modificiation
Treatment of choice for stress prophylaxis
PPIs
The two principal gastric secretory products that induce mucosal injury
HCl and Pepsinogen
In pancreatitis, lipase stays elevated for _____ days
7-14 days
Most important clinical finding in regard to severity of the acute pancreatitis episode
Persistent organ failure >48h
Initial imaging modality of choice for acute pancreatitis
Abdominal ultrasound
Patients with gallstone pancreatitis with signs of acute cholangitis should undergo _____ within 24-48 hrs
ERCP
Most common cause of chronic pancreatitis in the USA
Alcoholism
Test with the best sensitivity and specificity for chronic pancreatitis
Secretin test
Becomes abnormal when 60% or more of the exocrine pancreas has been lost
Diffuse calcifications noted on plain film the of the abdomen are pathognomonic for:
Chronic pancreatitis
Cornerstone of therapy in chronic pancreatitis
Pancreatic enzyme replacement
Most common congenital anatomical variant of the human pancreas
Pancreas divisum
Most common histologic response to hepatotoxic stimuli
Fatty liver
Cornerstone of treatment of alcoholic liver disease
Complete abstinence
Most common cause of ascites
Portal hypertension
Nutritional vitamin D deficiency is best assessed by obtaining serum ________
Serum 25-hydroxyvitamin D
Most common site of inflammation in Crohn’s disease
Ileum
Most common gastrointestinal cause of hypernatremia
Diarrhea
Pneumococcal vaccine should be administered 2 weeks [before/after] splenectomy
2 weeks before splenectomy
Usually the first indicator of portal hypertension
Hypersplenism
Perhaps the most reliable physical finding in the liver examination
Hepatic tenderness
Most common symptoms in Hep C
Fatigue
Most important factor in progression of Hep B into cirrhosis and HCCA
Level of HBV replication
Best therapy for hepatorenal syndrome
Liver transplant
Acetaminophen dose associated with fatal fulminant liver disease
25g and above
Most distinguishing serologic feature of chronic hep D
Anti-LKM3
Best prognostic factor in chronic Hep C
Liver histology
Mainstay of treatment of autoimmune hepatitis
Glucocorticoids
