5-uWorld Flashcards
(35 cards)
Medications that cause medication induced esophagitis
NSAID
Iron supplements
Bisphosphonate
KCl
Tetracycline
-You have identified a medication induced esophagitis, what is the treatment?
-And when you need an EGD?
-Discontinue medication of course
Fluids
Some advise trial of PPI/sucralfate
-Severe atypical symptoms: Hematemesis, weight lossHaving symptoms for a weekAfter drug withdrawal
First-line treatment for Schatzki’s ring
Endoscopic dilation for symptomatic relief
If recurrent symptoms: Repeat dilation and acid suppression-PPI
Etiology of Schatzki’s ring
Congenital
Acquired as a result of damage from GERD
Symptoms of Schatzki’s ring
Solid food dysphagia or reflux symptoms
Diagnostics for Schatzki’s ring
Barium esophagram more sensitive than endoscopy
Because rings are nonvisualized the best with EGD unless lower esophagus is widely distended
Recurrence rate of Schatzki’s ring
70 to 80% will recur in 5 years
Which upper GI bleed requires hospitalization for 3 days post EGD?
And what kind of diet
High risk ulcer
- Active arterial bleed
- Nonbleeding visible vessel
- Adherent clot
- Oozing without visible vessel
Diet: Clear liquid 2 days
Which kind of upper GI bleed requires hospitalization for 1 to 2 days
Work on a diet
Intermediate risk ulcer
- Flat pigmented spot
Diet clear liquid 1 day
Which kind of upper gastrointestinal ulcer can be early discharges
In which diet
Ulcer with clean base, Obviously not bleedingActively
Regular diet
Risk factors for stress ulcer
Coagulopathy, mechanical vent for over 48 hours, prolonged ICU stay, traumatic spinal cord or brain injury, thermal injury, history of prior GI bleed, high-dose steroid
Any of the risk factors above should get PPI or H2 blocker
What is most likely to reduce incidence of stress ulcer
Early enteral feeding alone Reduces the incidence of stress ulcers
Antisecretory therapy is more beneficial and high risk patient and does not receiving enteral nutrition
What is the antibiotic of choice for pancreatic necrosis
Carbapenem, due to superior penetration in the pancreatic tissue and covers good right bacteria
Alternative: Quinolone and Flagyl
How do you treat infected necrosis and pancreatitis ?
Antibiotics-fluoroquinolone with Flagyl or carbapenem
And
CT-guided aspiration with Gram stain/culture
(If she fails the antibiotics/does not get better after FNA–>surgical debridement/necrosectomy)
Peutz-Jeghers syndrome Has an increased risk of___and___in a long-term
Gastrointestinal cancer
Known gastrointestinal cancers like lung, testicular, breast, ovary
How long after treating gingival hypertrophy with vitamin C does it resolve?
2-week
Because of vitamin C deficiency
Alcoholism
Drug abuse
Severe malnourishment from lack of fruit vegetables consumption
What are the clinical signs of scurvy
Dental and gum disease, gingival bleed, gingival hypertrophy, scattered petechiae
Impaired wound healing
Periosteal hemorrhage
When a liver ultrasound shows coarse echotexture, what Does that mean?
Fibrosis
When a liver ultrasound finding shows increased echogenicity, what Does that mean?
Steatosis
What is the mechanism of metabolic syndrome? Like what is it thought to occur as a result of
Insulin resistance
What is the treatment for advanced PBC
Liver transplant
Some lab abnormalities and complications of PBC
Hyperlipidemia
Fat-soluble vitamin labs absorption issue such as ADEK
Osteoporosis osteomalacia
Hepatocellular carcinoma
First-line treatment for PBC, And why is it helpful?
Ursodeoxycholic acid
Slow the development of cirrhosis
