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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
UGIB
NPO, IVF, and monitor blood counts and vital signs for ongoing bleed
26
PRBC admin
Hgb<7
27
FFP
All clotting factors and plasma proteins
28
Acute pancreatitis
Lipase and amylase take several hours to rise and remain elevated for days
29
CT scan and acute panc
Used if dx is unclear or if pt fails to improve with conservative mngmt.
30
Primary Sclerosing Cholangitis
Stricturing of intrahepatic and extrahepatic bile ducts. Causes liver disease and portal hypertension. Associated with IBD in 90% of pts
31
ZES
Multiple ulcers beyond duodenal bulb, prominent gastric folds. Check serum gastrin levels
32
Secretin and Gastrin
Secretin inhibits Gastrin cells usually but in ZES it stimulates it
33
Secretin
Stimulates release of bicarb from pancreas and inhibits acid release by inhibiting gastrin release
34
Tropical sprue
Chronic diarrhea and living in endemic areas. Like celiac has a malabsorption of nutrients and blunting of villi with chronic inflamm cells
35
B12 malabsorption
Causes macrocytic anemia
36
Inflamm diarrhea
Usually IBD. Weight loss, anemia, elevated ESR, and thrombocytosis. Can be infectious (though usually doesn't cause chronic diarrhea).
37
Secretory diarrhea
Usually due to a medication
38
Osmotic diarrhea
Usually ingestion of osmo active, poorly absorbable substance (lactose intolerance)
39
Motor diarrhea
Hyperthyroid
40
Factitial diarrhea
Psych substances
41
Epigastric pain radiating to back
Pancreatitis, cholecystitis, PUD, MI, aortic dissection
42
DES
Radiation of pain to back, brought on by stress and hot/cold food, improved by nitrates. Do manometry to dx
43
Iron deficiency anemia
Due to bleeding. Causes microcytic anemia. Right sided colon cancer, PUD
44
Shingles
Causes constant burning pain in one dermatome. Active in immunocompromised people (chemotx). Reactivation --> pain and vesicular rash.
45
Liver span
Usually 6-12 cm
46
Cirrhosis complications
Ascites --> hepatic encephalopathy and SBP
47
SBP
Dx with paracentesis. Look for PMN>250 and positive culture. Do it before abx tx bc abx kills bacteria
48
AFP levels
Hepatocellular adenoma
49
Cryptosporidium parvum
Causes severe diarrheal disease in immunocompetent and immunocompromised
50
Mycobacterium avium and Pneumo jirovecci
Lung diseases
51
IBD bimodal distribution
Usually 20s or 30s but also 60
52
Neutrophilic cryptitis
Seen in both Crohns and UC
53
Epithelial necrosis
Seen in ischemic colitis
54
Acute panc causes
Alcohol, gallstones, infection (CMV), hyperlipidemia, infection, trauma, iatrogenic
55
Esophagus issue
Do barium study first, then endoscopy, then manometry if necessary. CT is no good for esoph
56
Acute panc
Can cause pleural effusion, ARDS, ileus, and renal failure
57
Scleroderma esophageal dysmotility
Sticking sensation in throat, heartburn, absence of peristaltic waves in lower 2/3 of esoph.
58
Achalasia
No peristalsis and increased LES tone
59
GERD
No LES tone, but still have peristalsis
60
Drugs that cause esophagitis
Antibiotics, Aspirin and NSAIDs, Bisphosphonates, KCl, Quinidine, Iron
61
Caustic esophagitis
Caused by some meds --> direct mucosal injury
62
C. diff
Look for leukocytosis, confusion, watery diarrhea, and ab tenderness. Tx with metronidazole or oral vanc
63
Elderly pt with Fe deficient anemia
Assume GI blood loss UPO. Do colonoscopy to look for potential polyps, angiodysplasia, or cancer
64
Pt with active GI bleed
Use scintigraphy or angiography
65
GI bleeds
Elderly pt - assume lower --> colonoscopy. Younger pt - assume upper --> upper GI endoscopy. Scintigraphy finds active bleed location
66
Retroperitoneal hemorrhage
warfarin anticoag, back pain, and hemodynamic compromise

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