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Step 3 and Residency Flashcards > Aaron: GI > Flashcards

Aaron: GI Flashcards

1
Q

Epigastric pain plus or minus N/V, epigastric fullness, heartburn is what?

A

dyspepsia

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2
Q

Dyspepsia plus NSAID use, gastric or esophageal cancer, what should be evaluated?

A

H.Pylori possible gastritis

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3
Q

Copious bloody stools, hemodynamically stable, next step?

Copious bloody stools, hemodynamically unstable, next step?

Patient is 68 years old, reliable historian

A

Stable: Colonoscopy first

Unstable: Resuscitate, then EGD

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4
Q

What type of GI bleed is suggested by the following?

Elevated BUN/CR ratio, hemodynamic compromise, NG aspirate has blood?

A

Upper GI bleed

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5
Q

Bloody diarrhea, young female, what is the first thing to rule out?

A

Infection

Look at stool culture

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6
Q

Young female (15-30), bloody diarrhea, waxing and waning course, fever, and weight loss?

Not food or travel

A

Irritable Bowel Syndrome

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7
Q

Recent Variceal bleeding, admitted for work up, what is the most common complication?

History of ascites and cirrhosis

A

Spontaneous Bacterial Peritonitis

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8
Q

Young female
weight loss, shin pain, abdominal pain, no fever or night sweats
Vitiligo
Anemia, hypocalcemia

What could I be?

A

Celiac’s Disease

anti-tissue transglutaminase antibody test

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9
Q 
Stable vital signs
Unresponsive
Sudden bloody vomiting
Active alcohol use
Next best step?
A

Intubate patient
Stabilize patient
Endoscopy

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10
Q

What platelet level indicates a transfusion?

A

less than 50,000 platelets

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11
Q

Systemic Sclerosis would show what type of esophageal motility?

A

hypomotility not random unsynchronized contractions

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12
Q

What type tests can evaluate chronic pancreatitis?

A

MRCP and Abdominal CT

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13
Q

If I have Hypertriglyceridemia induced pancreatitis, what is the best long-term therapy to use?

A

Fibrates, help lower triglycerides, cholesterol is lowered by -statins

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14
Q

What drug/hormone can be used to help move triglycerides in genetic induced hypertriglyceridemia?

A

Insulin, works through lipoprotein lipase activation

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15
Q

Assuming I have a 1st degree relative with colon cancer, when does the colonoscopy screening start?

A

40 years old or 10 years earlier of first-degree family member’s age

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16
Q

If there is a strong likelihood of pancreatitis, what is the next best test?

Assuming the patient has very bad abdominal pain, that gets better when they lean forward

A

Blood drawn for lipase levels

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17
Q

Chronic diarrhea is longer than how many weeks? Assuming there is a long period of diarrhea, no blood or fever, what is the next best step?

A

4 weeks

Look at stool microscopy, electrolytes, and fat content

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18
Q

A patient has long term diarrhea, hypothyroidism, with a high TSH, what is the underlying issue?

A

Poor medication absorption

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19
Q

If an alcoholic has pancreatic cancer, what needs to be there?

If not, but persistent abdominal pain, then what?

A

Weight loss, fever, night sweats, and anorexia

Think Pancreatic Pseudocysts

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20
Q

Isolated bleeding 2/2 gastric varices alone is code for what?

A

Splenic Vein Thrombosis, portal HTN, ascites, and congestive Splenomegaly

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21
Q

Intestinal Malabsorption, iron deficiency anemia, and diarrhea should trigger what thinking?

A

Celiac’s disease

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22
Q

Dyspepsia under 60 is what treatment, over 60 years old is what treatment?

A

Over 60 is endoscopy
Under 60 is H. pylori testing

Look for alarm symptoms (weight loss, anemia, or difficulty swallowing or dyspepsia)

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23
Q

MELD score is a 90-day mortality prognosis calculator, what are the five components?

A 
Bilirubin
INR
Serum Creatinine
Sodium
Dialysis 2x a week
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24
Q

Angiodysplasia has cherry red lesions that can cause GI bleeding. What are other disease associations?

A

ESRD especially uremia
Aortic Stenosis
vWD

25
Dyspepsia alarm symptoms are what?
``` Persistent vomiting Progressive Dysphagia Palpable Lymphadenopathy Iron Deficiency anemia Family History of GI Malignancy ```
26
A patient has a perforated esophagus, Boerhave Syndrome, what is the first test that should be done?
Esophagogram with water soluble contrast, not Upper GI endoscopy (can cause further perforation)
27
Toxic Megacolon, what is the first treatment step, before surgical consultation?
Steroids
28
Toxic Megacolon, what medications should be avoided?
Sulfasalazine, opiates, and anti-cholinergic are contraindicated, they slow peristalsis
29
Bile Salt induced diarrhea, post cholecystectomy or short bowel syndrome (illeal dissection) should be given what medication?
Cholestyramine
30
Mental impaired women, constipation, decreased anal sphincter tone, what is the next step?
Manual disimpaction and enema
31
Barret's Esophagus is a pre-malignant condition, that does not cause what?
dysphagia (difficulty swallowing)
32
Diverticular Bleeding with a history of diverticulosis is usually caused by what? Patient also has painless hematochezia
Eroded small colon artery
33
Post prandial fullness, succession splash on examination, type 1 DM (HbA1C = 8.4), what is the most likely diagnosis?
Gastric Paresis, advise small volume meals
34
LARGE volume diarrhea right after meals, no blood in stool, no bowel tenderness, what is the most likely culprit?
Lactose Deficiency
35
Hemodialysis can cause what kind of colon issues? | What are the pathological samples?
Colonic Ischemia, CT scan (colonic wall thickening, fat stranding) Bloody Diarrhea (Salmonella and C. Diff are usually watery, not always bloody)
36
If a first degree relative has colon cancer, colonoscopy is every ___ years (under 60 years old)? If the first degree relative is over 60 years old, the screening is every ____ years?
5 years 10 years
37
How long do ulcerative colitis patients need to wait for colonoscopy screening?
8-10 years, then every 1-3 years
38
Anti-smooth muscle antibodies are associated with what?
Type 1 autoimmune hepatitis
39
Hemochromatosis diagnosis needs what lab tests?
Ferritin and Transferrin saturation
40
Wilson's Disease diagnosis needs what lab tests?
low serum ceruloplasmin
41
``` What disease am I? Diabetes Mellitus Hyperpigmentation Arthropathy Cardiomyopathy ```
Hemochromatosis
42
Elevated SAAG (>1.1) indicates what? Low SAAG (<1.1) indicates what?
Portal Hypertension Non-portal Hypertension
43
Cirrhosis, heart failure, Budd-Chiari Syndrome are high or low SAAG?
High SAAG, portal hypertension
44
Peritonitis (TB), cancer, pancreatitis, trauma, or nephrotic syndrome are high or low SAAG?
Low SAAG, non-portal hypertension
45
Systemic Sclerosis can cause pulmonary problems, how can they be identified?
PFT (pulmonary function testing), look out for interstitial lung disease here
46
Painless rectal bleeding, colon problems, what is this a not so common cause?
Angiodysplasia
47
C. Diff patients can have what on colonoscopy?
Pseudomembranes, raised yellow/off-white plaques scattered over the colonic mucosa
48
If I have an active Hep B infection, and I have a negative Hep A IgM and IgG, what should I do?
Give a Hep A vaccine
49
Post Gastrectomy, a patient has a lot of diarrhea, what dietary changes could/should be made?
High Protein Diet This is dumping syndrome
50
Standard H. Pylori triple therapy is what?
PPI Amoxicillin Clarithromycin
51
A patient with a first degree relative and colon cancer should receive screening when?
Age 40 or 10 years earlier than the family member that was diagnosed. Assuming under the age of 60-year-old
52
If acute diverticulitis is not relieved in 2-3 days what should be done next?
A repeat CT scan
53
What is the proper enteral feeding ratio? | Assuming a normal BMI and no underlying problems
30 kcal/kg, 1 g/kg of protein
54
Budd Chiari has congestion in what part of the liver?
Hepatic Veins not Portal Veins
55
Scleroderma can cause small intestinal bacterial overgrowth. What test helps determines if this is true or not?
Carbohydrate Breath Test
56
Gastroparesis via diabetes mellitus is due to what gastric pathology?
Decreased Gastric Pacemaker activity
57
Portal Vein Thrombosis will cause what kind of varices? Splenic vein thrombosis will cause what kind of varices?
Esophageal Varices Gastric Fundus Varices
58
Antimitochondrial antibodies are needed for PBC, what other lab test should you look at?
Alkaline Phosphatase
59
What three drugs cause drug induced SLE?
Procainamide Hydralazine Isoniazid Lab tests: Anti-nuclear, anti-histones antibodies

Step 3 and Residency Flashcards (19 decks)

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