Important Clues Flashcards
Alarming symptoms indicating endoscopy for esophageal disorders
- Weight loss
- Blood in stool
- Anemia
Pills that cause esophagitis with prolonged contact
- Doxycycline
- Alendronate
- KCl
Indications of stress ulcer prophylaxis
- Mechanical ventilation
- Burns
- Head trauma
- Coagulopathy
Causes of failure of Ulcer treatment
- Non-adherence to medications
- Alcohol
- Smoking
- NSAIDs
When to scope patients with non-ulcer dyspepsia
- Patient is over 45 to 55 years old
- Presence of alarming symptoms
Severity of blood loss based on hemodynamics
- Orthostasis (> 10-point rise in pulse rate when going from lying down to sitting or standing up or > 20 points drop in blood pressure when going from lying down to sitting up) indicates 15-20% blood loss
- Pulse rate more than 100 per minute indicates 30% blood loss
- Systolic BP < 100 mmHg indicates 30% blood loss
Indication of nuclear bleeding scan in GI bleeding
When endoscopy is unrevealing in a massive acute hemorrhage
Indication of angiography in GI bleeding
Specific vessel or site of bleeding needs to be identified prior to surgery or embolization of the vessel (used only in massive nonresponsive bleeding)
Indication of capsule endoscopy in GI bleeding
Small bowel bleeding (upper and lower endoscopy do not show the etiology)
When to screen for colon cancer in patients with IBD
After 8-10 years of colonic involvement, with colonoscopy every 1-2 years
Indications of surgery in diverticulitis
- No response to medical therapy
- Frequent recurrences of infection
- Perforation, fistula formation, abscess, strictures or obstruction
Colon cancer screening (All conditions)
- Routine: begins at age 50 every 10 years
- Family history:
- Single member: begins 10 years earlier than the age at which the family member developed their cancer or age 40, whichever is younger
- 3 family members, 2 generation, 1 premature (before 50): hereditary nonpolyposis colon cancer syndrome (HNPCC) comprises these factors. Begins at age 25 every 1-2 years
- Familial adenomatous polyposis (FAP): begins at age 12 every year with sigmoidoscopy
- Previous adenomatous polyp: every 3-5 years
- Previous history of colon cancer: patient should have colonoscopy at 1 year after resection, then at 3 years, then every 5 years
- Other polyposis syndromes: need no increase in frequency of screening
When should we perform paracentesis in ascites
- New onset ascites
- Abdominal pain and tenderness
- Fever
Causes of Serum Ascites Albumin Gradient (SAAG) < 1.1 g/dL
- Infections (except spontaneous bacterial peritonitis)
- Cancer
- Nephrotic syndrome
Causes of Serum Ascites Albumin Gradient (SAAG) > 1.1 g/dL
- Portal hypertension
- CHF
- Hepatic vein thrombosis
- Constrictive pericarditis
