PANCE GI 8/14/20 Flashcards
what is the MC cause of esophagitis (2)
- GERD
2. Immunocompramised
small deep ulcers eophagitis cause and Tx
HSV acyclovir
large shallowd ulcers eophagitis cause and Tx
CMV ganciclovir
what are the two MC causes for pill induced esophagitis
- NASID
- bisphosphanates
GERD TX 2
- H2
- PPI
what is the gold standard for GERD
- 24 hr PH
dysphagia of both solids and liquids
achalasia
increased LES pressure
achalasia
how do you tx nutcracker esophagitis
CCB
Botox
how do you tx zenkers divericulum
diverticulectomy
how do you dx zenkers divericulum
barium esophagram
full thickness rupture of the distal esophagus
boerhve syndrome
boerhve syndrome dx
CT with contrast
how do you tx mallory weiss tear
epi
band ligation
how do you tx esophageal varices
- octreotide
- non selective BB (propanolol)
esophageal webbs tx
endoscopic dialation
two types of esophageal cancer
- squamous cell WW upper 1/3, smoking, ETOH
- adenocarcinoma US lower 1/3, GERD
dyspagia to solids
- esopahgeal neoplasms
test of choice for esphageal neoplasms
upper endoscopy
what are the three MCC of gastritis
- H pylori
- NASID
- acute stress
how do you dx gastritis
endoscopy
how do you tx gastritis
- CAP
MC cause of upper GI bleed
PUD
how do you dx PUD
- endoscopy
- upper GI series
when should someone take a PPI
30 min before meals
what is a SE with a PPI
b12 deficiency
what should you give someone if they are on an NSAID to protect their stomach
- Misoprostol
what is a SE of cimetidine
gynecomastia
gastrin secerting tumor
zollinger ellison
what two hormones are increased with zollinger ellison
gastrin
secritin
what is the MCC of gastric carcinoma
- adenocarcinoma
smoked, fish
what type of bili with dubin johnson
direct (conjugated)
what type of bili with Gilbert’s
unconjugated
jaundice with ETOH with normal LFT
Gilbert’s
tx for Gilbert’s
none
tx for Dubin Johnson
none
what bone hormone is increased with cholestasis
alk phos
what is the test of choice for cholelitaisis
US
does acute cystitis have jaundice
no
does cholelithiasis have jaundice
no
what is the primary cause of acute cholecyctitis
ecoli
what is the MC cause of acute hepatitis
acetaminophen
labs with acute hepatitis 4
- Inc ALT/ AST
- Inc Ammonia
- inc PT/INR
- Hypoglycemia
fever
malase
fatigue
decreased smoking
viral hepatitis
what hep is spiking fever
hep A
what is the triad for hepatic vein obstruction
- ascites
- hepatosplenomegaly
- RUQ pain
hepatic vein obstruction what test
ultrasound
AFP is associated with what pathology (GI)
HCC
what are lactulose and rifamfin used for
cirrhosis
autoammune distruction of intrahepatic and small bile ducts
primary biliary cirrhosis
autoimmune distruction of intra and extra hepatic ducts
PSC
how do you tx PBC
urodeoxucholic
how do you tx PSC
liver transplant
what autoimmune disease is associated with the gallbladder
PSC
what lab value is associated with wilsons disease
- decreased ceruloplasmin
how do you tx wilsons disease
- D Pencillamine
what bite can cause acute pacreatitis
scorpion
what is the triad with chronic pacreatitis
calcifications
steatorrhea
DM
what part of the pancreas gets cancer
- head
what is courvoisier sign and what is it associated with
palpable non tenxder gallblader
- associated with pancreatic cancer
pancreatic cancer how do you dx
- CT
what lab value is associated with pancreatic cancer
CA 19-9
how do you tx pancreatic cancer
wipples procedure
pain around the umbilicas and painless rectal bleeding
- meckles diverticulum
what do you here on PE for SBO
- high pitched tinkles
what is the radiograph for SBO
- step ladder pattern
what is the name for just a slow moving bowel
paralytic illius
how do you dx a lactulose intolerance
hydrogen breath test
MCC of lower GI bleeding
diverticulits
what is the Tx for diverticulitis
cipro+Flagyl
what do you call a twisting of the colon
volvulus
what labs are associated with CUC
P anca
when is CI contraindicated
acute colitis
how do you dx crohns
upper GI series
how do you dx UC
barium enema
how often for a colonoscopy if they have a history of colon cancer
- > 60: start at 40 Q10
- < 60: start at 40 Q5
how often for the cologuard
anually
how often for the flex sig
Q5
severe pain with bowel movements
anal fissure
tx for anorectal abcess or fistula
- sitz bath
tx for anal fissure 2
- nitro, CCB
infectious esophagitis linear white plaques
candida
infectious esophagitis candida tx
PO fluconazole
urea breath test is associated with what pathology
PUD
gold standard DX for PUD
endoscopy
what do you replace ammoxacillin with in CAP for PUD of they are allergic to penacillin
metronightazole
what is the ending for a PPI
azole
what PUD is almost always benign
duodeneal
location of zollinger ellison syndrome 2
duodoneal wall
pancreacus
best screening test for zollinger ellison syndrome
fasting gastrin levels
zollinger ellison syndrome tx
local resection
what type of cancer is gastric carcinoma
adenocarcinoma
what is the MC risk factor to gastric carcinoma
Hpylori
dx for gastric carcinoma
upper endoscopy
what type of bili for crigler nagiar
indirect
what is charcots triad associated with
acute cholangitis
what is murpy’s sign associated with
acute cholecyctitis
PSC tx
liver transplant
tx for wilsons
D penicillamine
what may you see on X ray for acute pancreatitis
sentinal loop
what is the lab for acute pancreatitis
lipase
what is the triad for chronic pancreatitis
calcifications
steatorrhea
DM
what is the tx for chronic pancreatitis
pacreatic enzyme replacemnet
calcified pancreas think what
chronic pancreatitis
pancreatic carcinoma what tx
whipples procedure
painless rectal bleeding
mackles diverticulum
what is the stovepipe sign associated with
UC
what is P ANCA associated with
UC
tx for crohn and CUC
sulfasalazine
mesaamine
what are the three main types of polyps
- psudo
- hyperpastic
- adenomatous
3 types of adenomatous polyps
- tubular adenoma
- tubulovillious
- villious
what is CEA associated with
Colon cancer
what type of hernias can go into scrotum
indirect
what are the boarders for a direct hernia
Rectus abdominous: medial
Inferior epigastric: lateral
Piuoart’s ligamnet: inferior
what type of hemorrhoids hurt
external
3 tx for hemorrhoids 3
higher fiber
sits bath
band ligation
what is the location for anorectal abcess and fistula
posterior rectal wall
what is the tx for anorectal abcess and fistula 2
1. I and D Warm water Analgesic Sits bath High fiber
“severe pain with pooping”
anal fissure
skin tag poterior midline of anus
anal fissure
what anal pathology gets nitro
anal fissure
urine has a musty odor and the child is blond hair and blue eyes what pathology
phenylketonuria
night blindness is associated what vit
A
who gets a thymine diffecency
ETOH
what are
wernicke’s enchalopathy
Korsakoff demenia
associated with
ETOH
what class is odansetron
antiemetic
what class is kaopectate
antiemeric
what is a GI benefit of an anticholenergic
antidiarrheal
what is the MC cause of gatroenteritis in adults
norovirus
what is the MC cause of gatroenteritis in kids
rotovirus
what general class of diarrhea
vomiting
watery diarrhea no WBC of blood
noninvasive infectious diarrhea
what general class of diarrhea
fever
vomiting
diarrhea blood + leukocytes
invasive infectious diarrhea
invasive infectious diarrhea tx what do you not do
antimotility agents
what are the 5 types of noninvasive infectious diarrhea
- staphylococcus aureus
- bacillus cereus
- vibrocholerae
- exterotoxic e coli
- clostridium difficil
staphylococcus aureus diarrhea cause 4
diary
mayonnaise
meats
eggs
bacillus cereus cause
rice
noninvasive infectious diarrhea tx
supportive
rice water stools
vibro choleare
vibro choleare tx
supportive
tetracycline
what is travelers diarrhea that is trasmitted via water
enterotoxogenic e coli
enterotoxogenic e coli tx 2
fluids
fluorquinolones
diarrhea with high lymphocytes and psudomembranous colitis
C diff
Cdiff tx
metronidazole
what are the 5 types of invasive infectious diarrhea
- Campylobactor enteritis
- shigella
- salmonella
- enterohemorragic ecoli E 0157H7
- yersina
Campylobactor enteritis tx
erythromycin
Campylobactor enteritis transmitted
undercooked poultry
how is salmonella transmitted 2
poultry products
exotic animals
salmonella diarrhea tx
cipro
enterohemorragic ecoli E 0157H7
primary transmission
undercooked beef
how does someone get giardia
contaminated water such as backpacking
frothy greasy diarrhea
Giardia lamblia
Giardia lamblia tx
metronidazole
what is a risk factor for pancreatic carcinoma
smoking
pancreatic carcinoma type
adenocarcinoma
what is courvoisirs sign associated with
pancreatic carcinoma
what are the two tumor markers associated with
- CEA
- CA 19-9
