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OME GI Flashcards

1
Q

Dx cholelithiasis?

A

RUQ US = gallstones

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2
Q

Tx cholelithiasis?

A

Elective cholecystectomy or ursodeoxycholic acid if surgery not option

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3
Q

DX cholecystitis?

A

RUQ US

if negative, HIDA scan

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4
Q

Tx cholecystitis?

A

NPO, IVF, IV Abx and cholecystectomy

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5
Q

Dx choledocolithiasis?

A

RUQ US = dilated CBD

MRCP if uncertain

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6
Q

Tx choledocolithiasis?

A

NPO, IVF, urgent ERCP or cholecystectomy

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7
Q

Dx cholangitis?

A

RUQ US = dilated biliary duct

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8
Q

Tx cholangitis?

A

NPO, IVF, Abx and ERCP emergently

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9
Q

Abx for cholangitis? (2)

A

Cipro and metronidazole

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10
Q

How do you diagnose esophagitis?

A

EGD with biopsy

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11
Q

Dx eosinophilic esophagitis?

A

Trial of PPI

EGD with Bx if refractory

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12
Q

Tx pill-induced esophagitis?

A
  1. remove pill with EGD
  2. remove offending agent
  3. time and PPI
  4. water with pills
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13
Q

Tx for candida esophagitis?

A

fluconazole

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14
Q

Tx for cmv esophagitis?

A

valacyclovir or acyclovir

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15
Q

Tx for HIV esophagitis?

A

HAART

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16
Q

TX for eosinophilic esophagitis?

A

oral aerosolized steroids

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17
Q

Tx of caustic esophagitis?

A

Low severity = liquid diet
High severity = NPO and EGD
NEVER NEUTRALIZE!!

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18
Q

How to diagnose esophageal motility disorders?

A

EGD, manometry and barium swallo

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19
Q

How to diagnose mechanical esophageal disorders?

A

Barium swallow and EGD

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20
Q

Dx achalasia? 3

A

Barium swallow = birds beak
Manometry = high LES tone
EGD with bx to r/o cancer

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21
Q

Dx of esophageal scleroderma?

A

Barium swallow = normal
Manometry = LES low tone
EGD with Bx = collagen deposition

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22
Q

Tx for achalasia? 3

A
  1. Botulinum
  2. Dilation
  3. Myotomy (best)
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23
Q

Tx for esophageal scleroderma?

A

PPI

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24
Q

Dx of diffuse esophageal spasm?

A

Barium swallow = corkscrew esophagus
Manometry = random contractions
NO EGD

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25
Tx for diffuse esophageal spasms?
CCB, nitros
26
Dx Schatzki ring?
Barium swallow = narrowed lumen/ring | EGD with bx = ring
27
Tx of schatzki ring?
lysis during EGD
28
Dx of esophageal webs?
Barium swallow = webs | no egd
29
Tx for esophageal webs?
Iron for iron def anemia | EGD to rule out cancer
30
Dx zenker's diverticulum?
Barium swallow first = pouch | EGD with bx to visualize
31
Tx zenkers diverticulum?
surgical resection
32
Dx stricture?
Barium swallow = symmetric narrowing | EGD w bx = rule out cancer
33
Tx esophageal stricture?
PPI, dilation
34
Dx of esophageal cancer?
Barium swallow = asymmetric narrowing | EGD with bx shows cancer
35
5 etiologies of PUD?
1. NSAIDS 2. H pylori 3. Cushing ulcer 4. Curling ulcer 5. Gastrinoma
36
Dx of PUD?
EGD with bx to r/o malignancy and h.pylori
37
TX of pUD?
PPI, stop alcohol stop smoking stop NSAIDS
38
Dx H pylori?
Serology = test and treat urea breath test = initial test EGD with bx best
39
Tx of H pylori?
triple therapy with clarithromycin, amoxicillin and PPI
40
Tx MALToma?
Treat H pylori and MALToma will go away
41
Dx of zollinger-ellison gastrinoma?
Gastrin level greater than 1600 and CT
42
Tx for gastrinoma?
resection
43
Dx GERD?
24 hour pH monitoring is the best test PPI trial and lifestyle changes for 6 weeks EGD with Bx if alarm symptoms
44
Tx GERD?
PPI
45
Tx GERD metaplasia?
local ablation
46
Surgical treatment for GERD?
nissen fundoplication
47
Dx gastroparesis?
EGD to r/o other disease nuclear emptying study >60 gastric contents remain after 2 hours or >10% gastric contents after 4 hours
48
Tx gastroparesis? 4
avoid opiates, get blood glucose control, prokinetic agents like metoclopramide or erythromycin, and low fiber small volume diet
49
Tx for cyclic vomiting syndrome?
stop THC
50
Tx for c.diff diarrhea?
PO MTZ or PO Vanc (MTZ cheaper)
51
Dx C DIFF?
C DIFF NAAT
52
Dx for HUS/TTP?
Blood smear = schistocytes | Shiga like toxin
53
Dx carcinoid tumor?
urinary 5-HIAA
54
Dx celiac disease? 3
Antibodies to ttG, endomysial and EGD with bx to show blunted villi
55
Tx for celiac disease?
avoid gluten
56
Dx lactose intolerance?
avoid dairy
57
Tx lactose intolerance?
lactase
58
Dx whipple disease?
EGD with bx will show PAS positive and organisms
59
Tx whipple disease?
tmp-smx or doxy
60
Dx diverticular disease?
Colonoscopy
61
Tx diverticulosis?
high fiber diet
62
Dx diverticulitis?
KUB r/o frank perf | CT with IV and PO
63
Tx diverticulitis?
NPO, IV Abx
64
Tx diverticular abscess?
incision and drainage
65
Tx diverticular perforation?
ex lap
66
Tx refractory diverticulitis?
hemicolectomy
67
Risk factors for colon cancer? 6
1. Age >50 2. EtOH 3. Smoking 4. Obesity 5. Processed red meats 6. Inflammation like UC, Crohns, PSC
68
When do you start screening for colon cancer and how often?
age 50 and every 10 years
69
What is the premalignant lesion for colon cancer?
adenomatous polyps
70
Which polyps are bad vs good
``` bad = sessile, villous and large good = tubular and small ```
71
4 options for screening for colon cancer?
1. colonoscopy q10y 2. Flexible sigmoidoscopy q5y + FOBT q3y 3. FOBT yearly 4. FIT test every year
72
Gene for FAP?
APC gene
73
Tx for FAP?
prophylactic colectomy
74
Dx FAP?
Colonoscopy before 20
75
Lynch syndrome cancers? 3
Colorectal Endometrial Ovarian 3 family members over 2 generations and 1 premature cancer !!
76
Emergent Tx of GI bleed?
``` 2 large bore IV IVF bolus type and cross, transfuse if needed IV PPI Call GI for EGD ```
77
Tx for esophageal varices? 5 options
1. octreotide 2. balloon 3. banding 4. TIPs for refractory 5. transplant
78
Tx for hemorrhoids
Sitz baths | Banding if doesn't go away
79
Hypotension can cause which GI bleed disorder?
Ischemic colitis | hypotension then GI bleed and painful BRBPR
80
Dx wilson's disease?
1. slit lamp 2. ceruloplasmin 3. liver bx
81
Dx hemochromatosis
1. iron studies (ferritin >1000, transferring >50%) | 2. biopsy shows high iron
82
Tx hemochromatosis
1. phelobotomy | 2. deferoxamine
83
Dx PSC?
``` MRCP = beads on a string ERCP = bx shows onion skin fibrosis ```
84
Tx PSC?
transplant or ursodeoxycholic acid
85
Dx PBC?
AMA and biopsy
86
7 complications of liver cirrhosis?
1. jaundice 2. pruritus 3. bleeding 4. 3rd spacing fluids 5. ascites 6. estrogen = gynecomastia, spider angiomata, palmar erythema 7. splenomegaly from sequestering platelets
87
Tx hepatic encephalopathy? 3
1. rifaxamin 2. lactulose 3. Zinc
88
Tx for varices? 5
1. banding 2. cefriaxone 3. BB like nadolol or propranolol 4. TIPS 5. Octreotide
89
Dx ascites?
Paracentesis with bx = SAAG
90
Tx ascites? 3
1. furosemide 2. spironolactone 3. therapeutic tap
91
Dx SBP?
Paracentesis shows >250 neutrophils/polys
92
Tx SBP?
ceftriaxone
93
How to screen for HCC? 3
RUQ US in cirrhotics AFP level Triple phase CT
94
Tx of acute pancreatitis?
NPO, IVF and analgesia
95
Dx of necrotizing panreatitis?
CT scan shows necrosis
96
Tx of necrotizing pancreatitis?
IV meropenem
97
When does a pseudocyst occur after an acute episode of pancreatitis?
3-7 weeks

Medicine (8 decks)

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