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Surgery Shelf > Pestana studying - GI > Flashcards

Pestana studying - GI Flashcards

1
Q

NSAID use/chronic pain

A

Look for iron deficiency anemia caused by ulcers

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2
Q

Epigastric pain

A

Could be cholecystitis, pancreatitis, PUD, or MI. Get EKG to check for MI first.

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3
Q

Perf PUD

A

Peritoneal irritation

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4
Q

Acute pancreatitis

A

Radiates to back

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5
Q

Acute cholecystitis

A

Radiates to right scapula

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6
Q

Duodenal ulcer

A

> 90% have H. pylori. Tx with acid suppression and eradication of organism (2 Abx and PPI). Amoxicillin + Clarithromycin

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7
Q

Dyspepsia

A

Epigastric pain, postprandial fullness, early satiety

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8
Q

Heartburn

A

GERD

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9
Q

Dyspepsia in H. pylori areas

A

Test for H. pylori first

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10
Q

Dyspepsia in non H. pylori area

A

PPI first

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11
Q

Dyspepsia in pt >55 yrs or alarm sx like weight loss, dysphagia, or persistent vomiting

A

Endoscopy

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12
Q

Celiac

A

Elevated IgA anti-endomysial antibody and elevated TTG. Don’t have to have them.

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13
Q

Celiac features

A

Bulky, foul smelling floating stools, loss of muscle mass, pallor/fatigue, bone pain/fracture, easy bruising, hyperkeratosis, villous atrophy

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14
Q

IBD

A

Ab pain, bloody diarrhea, tenesmus.

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15
Q

Toxic megacolon (sepsis)

A

WBC, fever, hypotension, and tachy. Do ab XR to confirm

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16
Q

Pt with IBD and worsening sx accompanied by sepsis

A

Think toxic megacolon –> ab XR to dx

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17
Q

Diffuse Esophageal Spasm

A

Severe, non-cardiac chest pain due to uncoordinated contractions of esophageal body. Multiple contractions on tracings middle and lower esophagus

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18
Q

Ascites tx

A

Na/water restriction, spiro, furosemide. Then paracentesis. Peritoneo-jugular shunt is for ascites tx.

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19
Q

Chronic panc

A

Caused by drinking, CF, or autoimmune. Epigastric pain, big drinker, diarrhea, weight loss. Diarrhea and weight loss due to panc insufficiency. Eventually becomes Diabetes. Panc calcification on CT is diagnostic.

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20
Q

Upper GI endoscopy

A

PUD, gastritis, dysphagia, or hematemesis

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21
Q

Steatorrhea

A

Panc insufficiency

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22
Q

Uncomplicated diverticulitis

A

Clinical diagnosis.

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23
Q

Complicated diverticulitis

A

Use CT to figure out what is going on.

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24
Q

Increased BUN/Cr

A

prerenal azotemia, GI bleed, pts on systemic corticosteroids

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25
Q

UGIB

A

NPO, IVF, and monitor blood counts and vital signs for ongoing bleed

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26
Q

PRBC admin

A

Hgb<7

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27
Q

FFP

A

All clotting factors and plasma proteins

28
Q

Acute pancreatitis

A

Lipase and amylase take several hours to rise and remain elevated for days

29
Q

CT scan and acute panc

A

Used if dx is unclear or if pt fails to improve with conservative mngmt.

30
Q

Primary Sclerosing Cholangitis

A

Stricturing of intrahepatic and extrahepatic bile ducts. Causes liver disease and portal hypertension. Associated with IBD in 90% of pts

31
Q

ZES

A

Multiple ulcers beyond duodenal bulb, prominent gastric folds. Check serum gastrin levels

32
Q

Secretin and Gastrin

A

Secretin inhibits Gastrin cells usually but in ZES it stimulates it

33
Q

Secretin

A

Stimulates release of bicarb from pancreas and inhibits acid release by inhibiting gastrin release

34
Q

Tropical sprue

A

Chronic diarrhea and living in endemic areas. Like celiac has a malabsorption of nutrients and blunting of villi with chronic inflamm cells

35
Q

B12 malabsorption

A

Causes macrocytic anemia

36
Q

Inflamm diarrhea

A

Usually IBD. Weight loss, anemia, elevated ESR, and thrombocytosis. Can be infectious (though usually doesn’t cause chronic diarrhea).

37
Q

Secretory diarrhea

A

Usually due to a medication

38
Q

Osmotic diarrhea

A

Usually ingestion of osmo active, poorly absorbable substance (lactose intolerance)

39
Q

Motor diarrhea

A

Hyperthyroid

40
Q

Factitial diarrhea

A

Psych substances

41
Q

Epigastric pain radiating to back

A

Pancreatitis, cholecystitis, PUD, MI, aortic dissection

42
Q

DES

A

Radiation of pain to back, brought on by stress and hot/cold food, improved by nitrates. Do manometry to dx

43
Q

Iron deficiency anemia

A

Due to bleeding. Causes microcytic anemia. Right sided colon cancer, PUD

44
Q

Shingles

A

Causes constant burning pain in one dermatome. Active in immunocompromised people (chemotx). Reactivation –> pain and vesicular rash.

45
Q

Liver span

A

Usually 6-12 cm

46
Q

Cirrhosis complications

A

Ascites –> hepatic encephalopathy and SBP

47
Q

SBP

A

Dx with paracentesis. Look for PMN>250 and positive culture. Do it before abx tx bc abx kills bacteria

48
Q

AFP levels

A

Hepatocellular adenoma

49
Q

Cryptosporidium parvum

A

Causes severe diarrheal disease in immunocompetent and immunocompromised

50
Q

Mycobacterium avium and Pneumo jirovecci

A

Lung diseases

51
Q

IBD bimodal distribution

A

Usually 20s or 30s but also 60

52
Q

Neutrophilic cryptitis

A

Seen in both Crohns and UC

53
Q

Epithelial necrosis

A

Seen in ischemic colitis

54
Q

Acute panc causes

A

Alcohol, gallstones, infection (CMV), hyperlipidemia, infection, trauma, iatrogenic

55
Q

Esophagus issue

A

Do barium study first, then endoscopy, then manometry if necessary. CT is no good for esoph

56
Q

Acute panc

A

Can cause pleural effusion, ARDS, ileus, and renal failure

57
Q

Scleroderma esophageal dysmotility

A

Sticking sensation in throat, heartburn, absence of peristaltic waves in lower 2/3 of esoph.

58
Q

Achalasia

A

No peristalsis and increased LES tone

59
Q

GERD

A

No LES tone, but still have peristalsis

60
Q

Drugs that cause esophagitis

A

Antibiotics, Aspirin and NSAIDs, Bisphosphonates, KCl, Quinidine, Iron

61
Q

Caustic esophagitis

A

Caused by some meds –> direct mucosal injury

62
Q

C. diff

A

Look for leukocytosis, confusion, watery diarrhea, and ab tenderness. Tx with metronidazole or oral vanc

63
Q

Elderly pt with Fe deficient anemia

A

Assume GI blood loss UPO. Do colonoscopy to look for potential polyps, angiodysplasia, or cancer

64
Q

Pt with active GI bleed

A

Use scintigraphy or angiography

65
Q

GI bleeds

A

Elderly pt - assume lower –> colonoscopy. Younger pt - assume upper –> upper GI endoscopy. Scintigraphy finds active bleed location

66
Q

Retroperitoneal hemorrhage

A

warfarin anticoag, back pain, and hemodynamic compromise

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