JB GI Flashcards
Achalasia tx
botulinum toxin injection
nitrates
CCB
Acute Hepatitis B labs
+ HBsAg
- anti-HBs
anti-HBc IgM
Ascites management
Na restriction
spironolactone
TIPS procedure
Boerhaave syndrome Sx
Retrosternal chest pain worse w/ deep breath and swallowing
Hematemesis
Crepitus due to pseudomediastinum
Budd-Chiari syndrome
Obstruction of hepatic outflow: hepatomegaly, ascites, RUQ pain
Rapid development of acute liver dz (jaundice, hepatosplenomegaly)
Cholelithiasis risk factors
5 Fs: Fat, fair, female, forty, fertile
Cirrhosis tx
Lactulose - encephalopathy
Na restriction/spironolactone - ascites
cholestyramine - pruritus
Diverticular disease dx
CT scan TOC
Diverticulitis tx
NPO and IV abx (ciprofloxacin or bactrim + metronidazole)
Esophageal cancer dx
Upper endoscopy w/ bx
hypercalcemia - SCC
Esophageal ring dx
Barium esophagram TOC
Esophageal varices tx
BB- decrease portal HTN
Octreotide and balloon tamponade –> cyanoacrylate injection
TIPS or surgery
G6PD deficiency sx
Oxidative stress (infection, fava beans, sulfa drugs)
back/abdominal pain, jaundice, dark urine, splenomegaly
Giardiasis tx
Metronidazole/ tinidazole and nitazoxamide
albendazole or mebendazole
Hemorrhoid tx
rubber band ligation, sclerotherapy, infrared coagulation
hemorrhoidectomy
Chronic HCV labs
+ HCV RNA
+ anti HCV
Acute HCV labs
+ HCV RNA
+/- anti-HCV
Resolved HCV labs
- HCV RNA
+/- anti-HCV
Hirschsprung disease dx
anorectal manometry (BIT)
Rectal bx definitive
Hypercalcemia tx
IV saline –> furosemide 1st line
Severe: calcitonin, bisphosphonates (IV pamidronate)
Noninvasive infectious diarrhea
S. aureus
Bacillus cereus
Vibrio cholera
Enterotoxigenic E. coli
C. diff
Invasive infectious diarrhea
Campylobactor
Shigella
Salmonella
Yersinia
Enterohemorrhagic E. coli
IBD tx
Amino salicylates (sulfasalazine, mesalamine) –> CS (acute flares) –> immune modifying agents –> anti TNF agents
IBS tx
Diarrhea: anticholinergics/spasm (Dicyclomine), antidiarrheal (loperamide)
Constipation: Prokinetic, bulk forming laxatives, saline/osmotic laxative, lubiprostone
Pain: TCA/SSRI
Liver cirrhosis sx
ascites, hepatosplenomegaly, gynecomastia, spider angioma, caput medusa, jaundice, muscle wasting, hepatic encephalopathy, asterixis, esophageal varices, spontaneous bacterial peritonitis
Liver cirrhosis MCC
ETOH (in US), chronic viral hepatitis (HCV), NAFLD, hemochromatosis
Malnutrition tx
Anorexia: hospital if <75% expected body weight or medical complications
CBT, supervised meals, weight monitoring
Depression: SSRI, atypical antipsychotics
Neuroleptic malignant syndrome MCC and tx
MCC: drug (resperdil)
supportive care
DA agonist: bromocriptine, amantadine
OD ethylene glycol (antifreeze) tx
ethanol or fomepizole
Pneumoperitonium dx
Something perforated
Most sensitive test: free air under diaphragm
Pseudomembranous colitis sx
copious watery stools after recent abx use.
low grade fever, N, anorexia
Pseudomembranous colitis tx
mild: metronidazole (first line), PO vanco
Severe: PO Vanco
SBO dx
Abd xray: air fluid levels in step ladder pattern, dilated bowel loops
SBO tx
IV fluids, NG suction and NPO
Strangulation: surgical
Ulcerative colitis dx
TOC: flex signmoidoscopy in acute dz
Curative: surgery
Riboflavin deficiency sx
oral-ocular-genital syndrome
oral: mouth lesions, magenta tongue, angular chelitis, pharyngitis
Ocular: photophobia, corneal lesions
Genital: scrotal dermatitis
Vitamin K deficiency labs
Prolonged PT, normal fibrinogen, normal plt
wilson’s dz labs
low ceruloplasmin, increased urinary copper excretion
Zollinger Ellison syndrom labs
high fasting gastrin level (best screening)
+ secretin
increased chromogranin A
