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CDM2 - Final > GI/Renal Cases > Flashcards

GI/Renal Cases Flashcards

1
Q

what renal/GI conditions is a KUB useful in diagnosing (6)

A

SBO
constipation
calcification
perforated viscous
+/- nephrolithiasis > 5mm
+/- gallstones (in ~20% of people)

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2
Q

mc cause of perforated viscous

A

gastric ulcer

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3
Q

t/f: all cholangitis patients need US prior to ERCP

A

t!
no surgeon will touch them without imaging

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4
Q

what type of gallstones are visible on US

A

all! regardless of composition

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5
Q

what imaging do you need to evaluate the extent of pancreatitis

A

CT

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6
Q

2 complications of pancreatitis

A

necrosis
abscess

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7
Q

besides US, what test do cholangitis pt’s need prior to ERCP

A

EKG

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8
Q

what labs would you order for a pt with suspected gallstone pancreatitis (3)

A

CMP
Ca
lipids

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9
Q

what is cholecystitis

A

inflammation of the gallbladder

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10
Q

what is cholelithiasis

A

gallstones

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11
Q

what is cholangitis

A

redness and swelling/inflammation of the bile duct system

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12
Q

what is choledocholithiasis

A

gallstones w.in CBD

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13
Q

difference between cholecystitis and cholangitis

A

cholangitis presents w. RUQ pain, fever, leukocytosis, or jaundice

cholecystitis presents w. RUQ pain and less e.o infxn

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14
Q

meds for pain control for pancreatitis

A

IV opioids:
IV morphine
vs
Fentanyl
vs
Dilaudid

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15
Q

gs choice for nausea control in pancreatitis

A

zofran 4 mg

if EKG shows QT prolongation -> compazine or raglan

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16
Q

fluids for pancreatitis pt

A

normal saline TKO

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17
Q

are abx needed for pancreatitis

A

per GI consult

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18
Q

what is Charcot’s triad

A

fever
jaundice
RUQ pain

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19
Q

what does elevated direct (conjugated) bilirubin indicate

A

liver pathology

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20
Q

what does elevated indirect (unconjugated) bilirubin indicate

A

pathology outside of liver -> ex hemolytic anemia

body is not clearing RBC

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21
Q

what is Reynold’s pentad

A

fever
jaundice
RUQ pain
confusion
shock

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22
Q

which is more sensitive for pancreatitis: amylase or lipase

A

lipase

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23
Q

how elevated is lipase in pancreatitis

A

> 3 x nl

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24
Q

what are the 4 f’s of cholelithiasis

A

fat
forty
female
fertile

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25
Q

mc cause of pancreatitis

A

gallstone pancreatitis

26
Q

what LFT abnormalities suggest a cholestatic pattern

A

elevated alk phos
direct bilirubin

27
Q

what LFT abnormality suggests alcohol related pathology

A

elevated AST

28
Q

what is functional rectal retention

A

constipation in peds

29
Q

what imaging is best for eval of constipation

A

KUB

30
Q

what lab may be useful in constipation work up

A

UA

31
Q

med for pediatric constipation

A

miralax 0.4-0.8 g/kg/day
max: 17 g/day

32
Q

what antidiarrheal meds are safe for peds

A

dicyclomine 10 mg po TID-QID
loperamide 2 mg PO x 1 after each loose stool

33
Q

your patient has a BUN:Cr ratio > 30 - are you thinking upper GIB or lower GIB

A

upper GIB

34
Q

gs test for h.pylori

A

urea breath

35
Q

if urea breath test is positive for h.pylori, what is you next step

A

start PPI

36
Q

2nd line test for h.pylori if urea breath is not available

A

serum

37
Q

PPI can affect which h.pylori test

A

urea breath

do test before starting PPI

38
Q

do you need to endoscopy a pt w. PUD who tests positive for h.pylori

A

not necessarily
can just do PPI trial

39
Q

what med can cause false positive on FOBT

A

pesto bismol

tell pt to take tums instead

40
Q

2 tx for arthritis if pt can not take NSAIDs

A

PT
votaren gel

41
Q

5 causes of lower GI bleeds

A

malignancy
hemorrhoids
polyps
fissures
diverticulitis

42
Q

causes of upper GI bleeds

A

gastric ulcer
other stomach pathology

43
Q

what do you suspect when you see elevated BUN w. nl Cr

A

GI bleed

44
Q

which type of ulcer is improved with food

A

duodenal

45
Q

which type of ulcer is worse with food

A

gastric

46
Q

what med do you give a pt with a confirmed and actively bleeding ulcer

A

H2 blocker:

famotidine
cimetidine

47
Q

what med is best for chronic management of ulcers

A

PPI

48
Q

presentation of upper GI bleed

A

hematemesis and/or melena (black/tarry stool)
BUN:Cr > 30

49
Q

presentation of lower GI bleed

A

hematochezia (BRBPR)

50
Q

rf for neonatal jaundice

A

jaundice w.in 1st 24 hr of life
a sibling w. jaundice as neonate
unrecognized hemolysis
non-optimal sucking/nursing
deficiency of g6pd
infxn
cephalohematoma/bruising (birth trauma)
east asian/north indian

51
Q

management of breast milk jaundice

A

-reassurance
-education that jaundice is commonly seen in neonates 2-3 weeks old
-sclera can take a while to go back to normal
-let baby eat!! increases liver activity
-repeat vitals/weight

52
Q

breast milk jaundice is due to ___ production in some breast milk jaundice

A

beta-glucoronidase

53
Q

__% of babies develop breast milk jaundice

A

60

54
Q

what labs are helpful in work up of neonatal jaundice

A

TSB (total serum biluribin)
direct serum bilirubin
CBC
reticulocyte count
DAT (direct antiglobulin) if concern for Rh incompatibility
serum albumin
BMP
G6PD

55
Q

big do not miss with neonatal jaundice

A

kernicterus

56
Q

sx of kernicterus

A

AMS
floppy baby
poor feeding

57
Q

first sign of neonatal jaundice

A

icterus of sclera

58
Q

sclera icterus occurs around __ mg/dL bilirubin

A

3

59
Q

2 deadly genetic conditions related to neonatal jaundice

A

criggler-najaar
dubin-johnson

60
Q

what anatomic feature separates upper GI from lower GI

A

ligament of treitz

CDM2 - Final (9 decks)

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