UWORLD GI Flashcards

1
Q

Tx pregnancy and gallstones

A

Asymptomatic: no treatment.
pregnancy-related gallstones resolve spontaneously within 2 months of delivery.

Symptomatic treated with IV fluids and pain control. if persistent: cholecystectomy during the second trimester.

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2
Q

Anal Abscess Sxs

A

severe, constant pain
fever or malaise.

PE: Erythematous, indurated skin or a fluctuant mass over the perianal or ischiorectal space.possibly Purulent drainage

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3
Q

Anal Abscess Tx

A

Most important: prompt incision and drainage (I&D) of the abscess

Oral antibiotics for pt with DMs, immunosuppression, extensive cellulitis, or valvular heart disease. Abx after I&D

Admit not necessary for localized infection

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4
Q

Anal abscess vs fistula

A

Anal abscess is an infection within one or more of the anal spaces

Anal fistula is a tunneling between the anus or rectum and another epithelial lined space (eg, the skin overlying the drainage site).

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5
Q

Anal fistula SXS and Tx

A

Typically present with an anal abscess that persists or with a pustule-like lesion in the perianal or ischiorectal area that continually drains.

Surgical repair is usually necessary to eliminate the fistula while preserving fecal continence.

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6
Q

GERD vs H. Pylori infection

A

Helicobacter pylori presentas as dyspepsia ( epigastric burning and symptoms of bloating, nausea, or early satiety)

GERD- substernal burning and regurgitation, sour taste

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7
Q

Drug induced pancreatitis

“Daily” drugs

A

Antihypertensive: thiazides, furosemide, enalapril, losartan

Antiepileptic: valproate acids, carbamazepine

Immunosuppressants: azathioprine, mercaptopurine, corticosteroids

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8
Q

Drug Induced Pancreatitis

“Occasional/ event” drugs

A

Antibiotics: Isoniazid, Tetracyclins, metronidazole, TMP-SMX

Antivirals: lamivudine, didanosine

Analgesics: NSAID, Acetaminophen, Pilates, mesalamine, sulfasalazine

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9
Q

Mechanism of Drug induced pancreatitis

A

-Hypersensitivity sulfonamide
-Ischemia due to decreases intravascular volume
-Increased viscosity of pancreatic secretions

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10
Q

White by baccal lesions that can be scrapped of leaving hyperremic spots

A

Oral thrush.

Plaques can be removed (even if difficult)

Residual area of inflammation normal after plaque removal

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11
Q

Small Flat Cherry-red Lesions in the colon

A

Angiodysplasia (vascular ecstasies or AV malformations)

Vascular anomalies composed of multiple aberrant blood located in GI tract. Frequent cause of occult bleeding.

Pathogenesis: chronic occlusion of submucosal veins- congestions- AV collaterals

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12
Q

Bleeding GI angiodysplasia associated with?

A

Small percent bleed. ^ bleeding associated with:
-ESRD
-Aortic stenosis
- Von Willebrand

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13
Q

Chronic Diarrhea MCC

A

IBS, IBD
Chronic Infection
Malabsorption Syndrome

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14
Q

Evaluation of Chronic Diarrhea

A

Complete Hx of Sxs

Routine Lab Tests
Electrolytes
Stool Analysis
Microscopic Stool examination (leukocytes, parasites, occult blood,pH, fat)
Stool Osmotic gap

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15
Q

Stool findings in celiacs

A

Increased stool osmotic gap
Micro cystic anemia, iron deficiency
Villous atrophy

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16
Q

Lactose intolerance stool findings

A

Diarrhea after lactose

Increased stool osmotic gap
Decreased stool pH
+ lactose hydrogen breath test

17
Q

Collagenous Colitis

A

Chronic watery diarrhea associated with fecal urgency and nocturnal diarrhea

Secretory diarrhea (decreased stool osmotic gap)

Thick subepithelial collagen band

18
Q

Further Management of celiacs (in addition initial tx: diet)

A

Monitor: iron, folate, calcium, and other vitamins (A, D, E, B12) monitored.

DXA scan to evaluate for bone loss (due to vitamin D deficiency)

pneumococcal vaccine due to associated hyposplenism.

19
Q

Eosinophilia Esophagitis
pathogenesis

A

Th2- mediated inflammatory response triggered by food antigen exposure

Conor bid atopic disease (asthma, eczema, food allergies)

20
Q

Eosinophilia esophagitis Sxs and Dx

A

Dysphasia
Heartburn & epigastric pain
Regurgitation
Food impaction

Dx: endoscopy and biopsy (eosinophils >15)

21
Q

Eosinophilic esophagitis Tx

A

Elimination diet (primary)
PPI
Topical glucocorticoids

22
Q

Risk factors infantile hypertrophic pyloric stenosis

A

Firstborn Male
Macrolide antibiotic exposure (< 2 weeks age)

23
Q

Infantile hypertrophic pyloric stenosis Tx

A

IV Fluids
Surgical Pyloromyotomy

24
Q

Infantile hypertrophic pyloric stenosis Sxs

A

Age 3-6 weeks

Projectile nonbilious emesis (immediate)
Hungry VOmiter
Visible peristalsis
Dehydration

Hypochloremic Hypokalemic metabolic alkalosis
Indirect hyperbilirubinemia

25
Initial studies of suspected esophageal mural injury
Malloy Weiss: UpperGI endoscopy Boerhaave: CXR (pneumothorax, pneumomediastinum, pleural effusion). CT water soluble contrast
26
Mallory Weiss vs Boerhaave
bothe present with hematemisis. Boerhaave: fever, chest pain, mediastinitis, pleural effusion, hemodynamic instability
27
Complications of untreated celiac disease
At risk for Entropy they associated T cell Lymphoma. Poor prognosis due to late presentation: 10 months
28
Sxs of Enteropathy associciated T-cell Lymphoma
(Aggressive hematologist malignancy that affects the jejunum) And Pain B Symptoms Bowel obstruction/ perforation GI bleed
29
pathogenesis of intussuscption
MCC: involves hyperplasia of intestinal lymphoid follicles (Peyer patches) in the ileocecal region following viral infection in children age 6 months to 3 years; intussusception due to a pathologic lead point (eg, Meckel diverticulum)
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clinical findings in intussusception
1. Sudden, intermittent abdominal pain & vomiting 2. Sausage-shaped mass in right abdomen 3. Currant jelly stools 4. Lethargy or altered mental status
31
next step in management of intussusception
1. Classic presentation:  Air or water-soluble both diagnostic and therapeutic. 2. Atypical presentation (eg, lethargy alone):  Ultrasonography is the diagnostic reveals a target sign.  An enema can be performed once the diagnosis is confirmed.
32
colon cancer screening with family
Colonoscopy at age 40 (or 10 years prior to age of diagnosis in FDR, whichever comes first)Repeat every 5 years (every 10 years if FDR diagnosed at age >60)
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