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Medicine > OME GI > Flashcards

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
Q

Tx for diffuse esophageal spasms?

A

CCB, nitros

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26
Q

Dx Schatzki ring?

A

Barium swallow = narrowed lumen/ring

EGD with bx = ring

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27
Q

Tx of schatzki ring?

A

lysis during EGD

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28
Q

Dx of esophageal webs?

A

Barium swallow = webs

no egd

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29
Q

Tx for esophageal webs?

A

Iron for iron def anemia

EGD to rule out cancer

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30
Q

Dx zenker’s diverticulum?

A

Barium swallow first = pouch

EGD with bx to visualize

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31
Q

Tx zenkers diverticulum?

A

surgical resection

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32
Q

Dx stricture?

A

Barium swallow = symmetric narrowing

EGD w bx = rule out cancer

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33
Q

Tx esophageal stricture?

A

PPI, dilation

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34
Q

Dx of esophageal cancer?

A

Barium swallow = asymmetric narrowing

EGD with bx shows cancer

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35
Q

5 etiologies of PUD?

A
  1. NSAIDS
  2. H pylori
  3. Cushing ulcer
  4. Curling ulcer
  5. Gastrinoma
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36
Q

Dx of PUD?

A

EGD with bx to r/o malignancy and h.pylori

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37
Q

TX of pUD?

A

PPI,
stop alcohol
stop smoking
stop NSAIDS

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38
Q

Dx H pylori?

A

Serology = test and treat
urea breath test = initial test
EGD with bx best

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39
Q

Tx of H pylori?

A

triple therapy with clarithromycin, amoxicillin and PPI

40
Q

Tx MALToma?

A

Treat H pylori and MALToma will go away

41
Q

Dx of zollinger-ellison gastrinoma?

A

Gastrin level greater than 1600 and CT

42
Q

Tx for gastrinoma?

A

resection

43
Q

Dx GERD?

A

24 hour pH monitoring is the best test
PPI trial and lifestyle changes for 6 weeks
EGD with Bx if alarm symptoms

44
Q

Tx GERD?

A

PPI

45
Q

Tx GERD metaplasia?

A

local ablation

46
Q

Surgical treatment for GERD?

A

nissen fundoplication

47
Q

Dx gastroparesis?

A

EGD to r/o other disease
nuclear emptying study
>60 gastric contents remain after 2 hours or >10% gastric contents after 4 hours

48
Q

Tx gastroparesis? 4

A

avoid opiates, get blood glucose control, prokinetic agents like metoclopramide or erythromycin, and low fiber small volume diet

49
Q

Tx for cyclic vomiting syndrome?

A

stop THC

50
Q

Tx for c.diff diarrhea?

A

PO MTZ or PO Vanc (MTZ cheaper)

51
Q

Dx C DIFF?

A

C DIFF NAAT

52
Q

Dx for HUS/TTP?

A

Blood smear = schistocytes

Shiga like toxin

53
Q

Dx carcinoid tumor?

A

urinary 5-HIAA

54
Q

Dx celiac disease? 3

A

Antibodies to ttG, endomysial and EGD with bx to show blunted villi

55
Q

Tx for celiac disease?

A

avoid gluten

56
Q

Dx lactose intolerance?

A

avoid dairy

57
Q

Tx lactose intolerance?

A

lactase

58
Q

Dx whipple disease?

A

EGD with bx will show PAS positive and organisms

59
Q

Tx whipple disease?

A

tmp-smx or doxy

60
Q

Dx diverticular disease?

A

Colonoscopy

61
Q

Tx diverticulosis?

A

high fiber diet

62
Q

Dx diverticulitis?

A

KUB r/o frank perf

CT with IV and PO

63
Q

Tx diverticulitis?

A

NPO, IV Abx

64
Q

Tx diverticular abscess?

A

incision and drainage

65
Q

Tx diverticular perforation?

A

ex lap

66
Q

Tx refractory diverticulitis?

A

hemicolectomy

67
Q

Risk factors for colon cancer? 6

A
  1. Age >50
  2. EtOH
  3. Smoking
  4. Obesity
  5. Processed red meats
  6. Inflammation like UC, Crohns, PSC
68
Q

When do you start screening for colon cancer and how often?

A

age 50 and every 10 years

69
Q

What is the premalignant lesion for colon cancer?

A

adenomatous polyps

70
Q

Which polyps are bad vs good

A 
bad = sessile, villous and large 
good = tubular and small
71
Q

4 options for screening for colon cancer?

A
  1. colonoscopy q10y
  2. Flexible sigmoidoscopy q5y + FOBT q3y
  3. FOBT yearly
  4. FIT test every year
72
Q

Gene for FAP?

A

APC gene

73
Q

Tx for FAP?

A

prophylactic colectomy

74
Q

Dx FAP?

A

Colonoscopy before 20

75
Q

Lynch syndrome cancers? 3

A

Colorectal
Endometrial
Ovarian

3 family members over 2 generations and 1 premature cancer !!

76
Q

Emergent Tx of GI bleed?

A 
2 large bore IV 
IVF bolus 
type and cross, transfuse if needed
IV PPI 
Call GI for EGD
77
Q

Tx for esophageal varices? 5 options

A
  1. octreotide
  2. balloon
  3. banding
  4. TIPs for refractory
  5. transplant
78
Q

Tx for hemorrhoids

A

Sitz baths

Banding if doesn’t go away

79
Q

Hypotension can cause which GI bleed disorder?

A

Ischemic colitis

hypotension then GI bleed and painful BRBPR

80
Q

Dx wilson’s disease?

A
  1. slit lamp
  2. ceruloplasmin
  3. liver bx
81
Q

Dx hemochromatosis

A
  1. iron studies (ferritin >1000, transferring >50%)

2. biopsy shows high iron

82
Q

Tx hemochromatosis

A
  1. phelobotomy

2. deferoxamine

83
Q

Dx PSC?

A 
MRCP = beads on a string 
ERCP = bx shows onion skin fibrosis
84
Q

Tx PSC?

A

transplant or ursodeoxycholic acid

85
Q

Dx PBC?

A

AMA and biopsy

86
Q

7 complications of liver cirrhosis?

A
  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
Q

Tx hepatic encephalopathy? 3

A
  1. rifaxamin
  2. lactulose
  3. Zinc
88
Q

Tx for varices? 5

A
  1. banding
  2. cefriaxone
  3. BB like nadolol or propranolol
  4. TIPS
  5. Octreotide
89
Q

Dx ascites?

A

Paracentesis with bx = SAAG

90
Q

Tx ascites? 3

A
  1. furosemide
  2. spironolactone
  3. therapeutic tap
91
Q

Dx SBP?

A

Paracentesis shows >250 neutrophils/polys

92
Q

Tx SBP?

A

ceftriaxone

93
Q

How to screen for HCC? 3

A

RUQ US in cirrhotics
AFP level
Triple phase CT

94
Q

Tx of acute pancreatitis?

A

NPO, IVF and analgesia

95
Q

Dx of necrotizing panreatitis?

A

CT scan shows necrosis

96
Q

Tx of necrotizing pancreatitis?

A

IV meropenem

97
Q

When does a pseudocyst occur after an acute episode of pancreatitis?

A

3-7 weeks

Medicine (8 decks)

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