Internal Med GI Flashcards
s/s of acute hepatitis
- malaise
- fever
- distaste for smoking
- RUQ pain
- jaundice
treatment for acute hep A
symptomatic
treatment for acute hep B
- immune globulin within 7 days of exposure
- initiation of vaccine series
treatment of acute hep C
Harvonni
treatment of acute hep D
supportive
treatment of hep E
Ribavirin
treatment of chronic hep C
- HVC protease inhibitors
- HCV polymerase inhibitors
mayret and epclusa (-vir)
etiology of acute pancreatitis
- gallstones
- alcohol
s/s of acute pancreatitis
- epigastric pain that radiates to the back
- improves with leaning forward
- cullen and grey turner sign
diagnosis of acute pancreatitis
amylase and lipase
treatment of acute pancreatitis
- NPO
- IV Fluids
- IV pain Meds
- NG Tube
etiology of chronic pancreatitis
alcoholism is MC
s/s of chronic pancreatitis
- LUQ pain radiated to back
- worse 15-20 minutes after eating
- malabsorption
diagnosis of chronic pancreatitis
- slightly elevated amylase and lipase
- CT
treatment of chronic pancreatitis
- low fat diet
- avoid alcohol
- pain management (no opioids)
- puestow procedure (for alcoholic pancreatitis)
- ERCP if biliary cause
etiology of anal fissure
consrtipation
s/s of anal fissure
- tearing pain w defecation
- bleeding
treatment of anal fissures
proper toileting
s/s of anal abscesses
- throbbing
- perianal pain
- erythema
- swelling
treatment of anal abscesses
I&D (+ abx i think you would use Augmentin or (cipro+metro))
s/s of anal fistulas
- itching
- tenderness
- pain
often occur in patients with IBD and Chrons Disease
treatment of anal fistula
fistulotomy
s/s of colon cancer
- asymptomatic
- change in bowel habits
- hematochezia
diagnosis of colon cancer
colonoscopy
treatment of colon cancer
- surgical resection
- chemo/radiation
s/s of esophageal cancer
- weight loss
- dysphagia
diagnosis of esophageal cancer
endoscopy with biopsy
treatment of esophageal cancer
- surgery
- chemo/radiation
s/s of gastric adenocarcinoma
- dyspepsia
- vague epigastric pain
- weight loss
- hematemesis
- postprandial vomiting
- palpable gastric mass
mets = Left supraclavicular lymph node (virchow’s node)
Umbilical nodule (Sister Mary Joseph nodule)
Rigid rectal shelf (Blumer shelf)
diagnosis of gastric adenocarcinoma
EGD
treatment of gastric adenocarcinoma
- surgery
- chemo
- radiation
s/s of celiac disease
- diarrhea
- steatorrhea
- flatulence
- dermatitis herpetiformis
diagnosis of celiac disease
IgA TTG antibody test
treatment of celiac disease
remove all gluten
etiology of cholangitis
bacterial infection with obstruction of the CBD
s/s of cholangitis
- RUQ pain
- fever
- jaundice
- hypotension
- mental status change
diagnosis of cholangitis
ERCP
treatment of cholangitis
- ERCP with stone extraction and sphincterotomy
- cipro + flagyl
etiology of cholecystitis
gallstones
s/s of cholecystitis
- RUQ pain
- shoulder blade pain
- precipitated by fatty meal
- murphy sign
diagnosis of cholecystitis
US
treatment of cholecystitis
lap chole
s/s of cholelithiasis
- RUQ pain
- diaphoresis
- N/V
diagnosis of cholelithiasis
US
treatment of cholelithiasis
- NSAIDs for pain
- lap chole
s/s of cirrhosis
- weakness
- esophageal varices
- spider angioma
- abdominal pain
- jaundice
- ascites
diagnosis of cirrhosis
- US
- liver biopsy
treatment of cirrhosis
- avoid alcohol
- liver transplant
s/s of chron’s
- skip lesions
- cobblestoning
- RLQ pain
- diarrhea
- steatorrhea
- erythema nodosum
diagnosis of chrons
colonoscopy with biopsy
treatment of chrons disease
- steroids
- TNF blockers (-imab’s)
- azathioprine
etiology of diverticulosis
constipation
s/s of diverticulosis
asymptomatic
s/s of diverticulitis
- LLQ pain
- palpable mass
- bowel changes
diagnosis of diverticulitis
CT scan
treatment of diverticulitis
cipro + flagyl or zosyn
s/s of esophageal strictures
- regurgitation
- dysphagia
- heartburn
diagnosis of esophageal stricture
- endoscopy
- barium swallow
treatment of esophageal stricture
dilators
etiology of esophageal varices
- portal hypertension
- cirrhosis
s/s of esophageal varices
- hematemesis
- coffee ground emesis
- melena
diagnosis of esophageal varices
endoscopy
treatment of esophageal varices
- fluids
- octreotide
- rocephin
- banding
s/s of esophagitis
- odynophagia
- dysphagia
- chest pain
- reflux
diagnosis of esophagitis
endoscopy
s/s of gastritis
- anorexia
- epigastric pain
- heartburn
- nausea
- GI bleed
diagnosis of gastritis
endoscopy
treatment of gastritis
- PPI
- H Pylori: Omperazole, amoxicillin and clarithromycin
s/s of gastroenteritis
abd pain, cramping, N/V, fever, stomach pain, diarrhea
diagnosis of gastroenteritis
clinical
treatment of gastroenteritis
- Fluids
- antidiarrheals
s/s of GERD
- heartburn
- dysphagia
- odynophagia
diagnosis of GERD
- clinical
- Upper endoscopy
treatment of GERD
- H2 antagonists
- PPI
etiology of hemorrhoids
increased pressure
internal hemorrhoids
rectal bleeding
(mc sign? idk)
treatment of hemorrhoids
- proper toileting
- banding
- hemorrhoidectomy
etiology of liver cancer
cirrhosis
s/s of liver cancer
- cachexia
- hepatomegaly
- RUQ pain
diagnosis of liver cancer
- elevated liver enzymes
- liver biopsy
treatment of liver cancer
transplant
s/s of hiatal hernia
- heartburn
- may be aymsptomatic
treatment of hiatal hernia
- lifestyle modifications
- surgery
s/s of irritable bowel syndrome
- change in stool frequency
- change in stool form
- crampy, lower abdominal pain
- bloating
diagnosis of IBS
clinical
treatment of IBS
- antispasmodics
- antidiarrheal
- lifestyle modifications
Etiology mallory-weiss syndrome
retching due to vomiting
s/s of mallory weiss tear
hematemesis
Diagnosis of Mallory-Weiss tear
endoscopy
Treatment of Mallory Weiss tear
- fluids
- blood transfusions
- PPIs
s/s of PUD
- gnawing epigastric pain
- relieved by food
- nocturnal pain
diagnosis of PUD
endoscopy
treatment of PUD
- PPI
- d/c NSAIDs
- h.pylori abx
s/s of ulcerative colitis
- bloody diarrhea
- crampy lower abdominal pain
diagnosis of ulcerative colitis
sigmoidoscopy
management of ulcerative colitis
- mesalamine
- steroids
