Gastroenterology Flashcards
(55 cards)
8 drugs/supplements that commonly cause esophagitis?
Abx(tetracycline, doxycycline, clindamycin), Vit C, FeSO4, KCl, NSAIDs/ASA, Bisphosphonates
First line management of GERD?
- Weight loss
- Elevate head of bed 6 inches
- Dietary modification: no chocolate, peppermint, alcohol, fatty foods, acidic foods
- PPI or H2 for 8 weeks
Complications of PPI use?
Osteoporosis, pneumonia, increase CV risk, increase risk of enteric infections, absorption of(B12, Mag, Fe)
Treatment of H.Pylori? What if pt has PCN allergy?
PPI BID + Clarithromycin 500 mg BID + Amoxicillin 1g BID x14 days +/- Bismuth 525 QID.
*if PCN allergy use Flagyl in place of amoxicillin
When should you repeat testing for H.Pylori after finishing treatment?
4 weeks
When should you get a stool O&P for a patient with diarrhea?
If they have risk factors/travel to developing countries OR persistent diarrhea > 2 weeks
What is CHRONIC diarrhea?
diarrhea > 4 weeks
Treat fat-soluble vitamin deficiencies by supplementing — to — times the recommended daily value.
5-10 x
*often needs water soluble preparations
Individuals with celiac disease are at risk for which vitamin deficiencies?
iron, folic acid, Ca, vitamin D & rarely B12
Pt with short gut syndrome should be checked for — deficiency & replaced every —.
B12, month IM B12 injections
Bacterial overgrowth in the gut can be caused by – & lead to —.
abnormal gut stasis(decreased motility, fistulas)
*lead to: cabohydrate malabsorption(bacteria consume), Fat malabsorption (de conjugation of bile), B12 deficiency(bacteria consume)
Which IBD is more commonly associated with pyoderma gangrenosum?
UC! – may also see in crohns but more common in UC
Which IBD is associated with ankylosing spondylitis, VTE, Sclerosing cholangitis, uveitis, erythema nodosum?
UC!
1st line management of IBS
FODMAP diet
Which is best for IBS TCA or SSRI?
can use both but TCA > SSRI
whats the minimum period a patient must be abstinent to be consider for liver transplant?
6 months
Treatment of acetaminophen toxicity
N-acetyl cystine
Why is it recommended pt with hemochromatosis avoid shellfish?
they are at increased risk for vibrio vulnificus infection
Gene mutations associated with hemochromatosis
HFE gene on chromosome 6 - causes inappropriate absorption of Fe & elevated ferritin.
What supplement can be used to manage wilsons disease?
PO Zinc = interferes with copper absorption in the GI tract
Mutation & inheritance pattern of wilsons disease?
AR, mutation in ATP7B causing decrease trans membrane transport(excretion) of copper = builds up in multiple tissues
Which has neurological symptoms: wilsons disease of hemochromatosis?
wilsons
What is Primary Biliary Cirrhosis? Mutation? tx? Association?
autoimmune disorder causing granulomatous destruction of intrahepatic bile ducts and cholestasis. Usually effects females - insidious & usually starts with puritis & fatigue.
+anti-mitochondrial antibodies
+treatment with ursodeoxycholic acid(delays progress & improves survival), cholestyramine(for itching) & liver transplant
+associated w/Sjogren & CREST Scleroderma
What is Primary Sclerosis Cholangitis? Mutation? tx? Association?
diffuse inflammation, fibrosis, and stricturing of the biliary tract as well as an increased risk of cholangiocarcinoma. M > F;
+ANCA, +ANA, +cardiolipin, TPO+, RF+
+treatment - bx to r/o carcinoma, stent placement, balloon dilation - liver transplant
+associated with Ulcerative colitis
