Gastrointestinal Disorders Flashcards
(100 cards)
1
Q
food poisoning as a result of mayonnaise sitting out too long
A
staph aureus
2
Q
rice-water stools
A
vibrio cholera
3
Q
diarrhea transmitted from pet feces
A
yersinia enterocolitica
4
Q
food poisoning resulting from reheated rice
A
bacillus cereus
5
Q
most common cause of traveler’s diarrhea
A
enterotoxigenic e. coli
6
Q
diarrhea after a course of antibiotics
A
c. diff
7
Q
diarrhea after recent ingestion of water from a stream
A
giardia lamblia or less commonly entamoeba
8
Q
mild intestinal infection that can become neurocysticerosis
A
taenia solium
9
Q
food poisoning from undercooked hamburger
A
EHEC
10
Q
diarrhea from seafood
A
vibrio cholera/vulnificus/paerahemolyticus
11
Q
bloody diarrhea from poultry
A
campylobacter or salmonella
12
Q
bloody diarrhea with liver abscess
A
entamoeba histolytica
13
Q
diarrhea in an AIDS patient
A
cryptosporidium or isospora (less commonly)
14
Q
dehydrated child with greenish diarrhea in winter months
A
rotavirus
15
Q
treatment for hepatitis B
A
IFN-alpha
lamivudine, adefovir, entecavir, telbivudine
16
Q
treatment for hepatitis C
A
IFN-alpha and ribavirin
17
Q
what does a barium swallow allow you to visualize
A
esophagus, LES, and stomach
18
Q
what does a gastric emptying study allow you to visualize
A
stomach, pyloric sphincter, duodenum
19
Q
what does a small bowel follow through allow you to visualize
A
stomach to terminal ileum
20
Q
what does a barium enema allow you to visualize
A
colon and appendix
21
Q
different types of esophageal diverticulum
A
zenker: upper esophagus
traction: middle esophagus
epiphrenic: lower esophagus
22
Q
treatment for entamoeba histolytica diarrhea
A
metronidazole
23
Q
treatment for giardia lamblia
A
metronidazole
24
Q
treatment for salmonella
A
none unless immunocompromised (cipro)
25
treatment for salmonella
none unless severe (cipro TMP-SMX)
26
treatment for campylobacter
erithromycin
27
Hep BsAg negative
Hep BsAB negative
Hep BcAb positive
window period of Hep B infection
28
Hep BsAg positive
Hep BsAb negative
Hep BcAb positive
chronic Hep B infection
29
Hep BsAg negative
Hep BsAB positive
Hep BcAb negative
Hep B vaccinated status
30
Hep BsAg negative
Hep BsAB positive
Hep BcAb positive
past Hep B exposure
31
next step in patient complaining of dysphagia
barium swallow followed by EGD
32
EGD reveals gastric cancer, what is the next step
CT scan to stage
33
next step in management of patient with recurrent duodenal ulcers on multiple EGDs
serum gastrin level to rule out ZES
34
most effective treatment for duodenal ulcers not due to ZES
triple therapy for h. pylori
35
chem 7 lab abnormality often elevated in patients with an upper GI bleed
BUN
| bacteria in gut breakdown hemoglobin with is reabsorbed increasing BUN
36
tumor markers for pancreatic cancer
CEA and CA19-9
37
tumor marker for gastric cancer
CEA
38
regimen for h. pylori treatment
PPI + clarithromycin + amoxicillin/metronidazole
39
treatment for gastric cancer
distal third: subtotal gastrectomy
| initial two-thirds: total gastrectomy
40
treatment for pancreatic cancer in the head of the pancreas
whipple if localized
41
most sensitive and specific lab test for chronic pancreatitis
decreased fecal elastase
42
treatment for chronic pancreatitis
alcohol cessation, enzyme replacement
43
management for patient that comes to ER with abdominal pain and AXR shows free air in abdomen
laparotomy
44
cuban immigrant with malabsorption and megaloblastic anemia
tropical sprue
45
time-frame for post-operative ileus resolution in the different parts of the gut
stomach: 24 hours
small bowel: 2-3 days
large bowel: 3-5 days
46
diagnosis and management: AXR reveals two distinct but sequential portions of bowel in sigmoid colon distended
sigmoid volvulus, colonic decompression, resection as needed
47
most common cause of small bowel obstruction
adhesions or secondly hernias
48
classic characteristic of acute mesenteric ischemia
pain out of proportion to the exam
49
tumors that can cause secretory diarrhea
VIPoma, gastrinoma, carcinoid, and medullary thyroid
50
most likely cause of malabsoprtion in patient with + sudan stain and normal D-xylose test
pancreatic insufficiency
51
treatment for whipple disease
antibiotics (TMP-SMX or ceftriaxone) x 12 months
52
serum antibodies seen in celiac sprue
anti-gliadin, anti-endomysial, anti-transglutaminase
53
serum lab findings distinguishing crohn's from UC
crohn's ASCA positive, UC P-ANCA positive
54
next step in management of patient younger than 50 w/minimal BRBPR
anoscopy looking for hemorrhoids
55
most likely cause of acute pain and swelling of midlien sacrococcygeal skin and subcutaneous tissues
pilonidal cyst
56
most likely cause of recurrent LLQ abdominal pain improving after defecation
diverticulosis
57
patient at risk for acalculous cholecystitis
ICU patient or patient on TPN
58
charcot's triad
fever, RUQ pain, and jaundice
59
reynold's pentad
fever, RUQ pain, jaundice, altered mental status, hypotension
60
next step for patient found to have calcified gallbladder
biopsy
61
treatment of cholecystitis v. cholangitis
cholecystitis go right to cholecystectomy
| cholangitis perform endoscopic drainage followed by delayed cholecystectomy
62
patient with colon cancer has local lymph node involvement without distant mets
stage III
| will require chemotherapy
63
patient undergoes colonoscopy and is found to have 3 small tubular adenomas, when should he undergo his next colonscopy
5 years
64
man tells you his father was diagnosed with colon cancer at age 55, when should his first colonoscopy be
45
65
antibiotic combination to treat diverticulitis as an outpatient
metronidazole + TMP-SMX/augmentin/fluoroquinolone
66
how are anal fissures managed
stool softeners, topical nitroglycerin, anti-spasmotics
| refractory cases may receive partial sphincterotomy (risk of incontinence)
67
most common causes of upper GI bleeds
peptic ulcer disease, esophagitis, variceal bleeds, gastritis, mallory-wise tears
68
most common causes of lower GI bleeds
upper GI bleeds, diverticulosis, AV malformations, colorectal cancer, mesenteric ischemia, meckel's diverticulum
69
how is volume status assessed in patient with GI bleed
blood pressure, heart rate, urine output
70
antibiotic contraindicated in neonates with hyperbilirubinemia
ceftriaxone
71
deep palpation of RUQ causes arrest of inspiration and pain
murphy's sign, cholecystitis
72
RLQ pain on passive extension of hip
psoas sign, appendicitis
73
RLQ pain on passive internal rotation of the flexed hip
obturator sign, appendicitis
74
LUQ pain and referred left shoulder pain
kehr's sign, splenic rupture
75
ecchymosis of the skin overlying the flank
grey-turner sign, pancreatitis
76
ecchymosis of the skin overlying the periumbilical area
cullen's sign, pancreatitis
77
treatment for hepatic encephalopathy
lactulose and rifaximin (or neomycin)
| protein restriction
78
symptoms of budd-chiari syndrome
ascites, hepatomegaly, jaundice
79
most widely used screening test for hemochromatosis
serum ferritin
80
treatment for hemochromatosis
phlebotomy and deferoxamine
81
primary biliary cirrhosis v. primary sclerosing cholangitis
PBC: female, intrahepatic ducts only, anti-mitochondrial antibodies, anti-ANA
PSC: male, intrahepatic and extrahepatic ducts, P-ANCA, ERCP shows beads on a string
82
treatment for primary biliary cirrhosis
urodeoxycholic acid +/- colchicine
| eventual liver transplant
83
most common type of TE fistula
blind upper esophageal pouch, lower esophagus is connected to the trachea
84
hepatitis virus types
```
A: picornavirus, single-stranded RNA
B: hepadnavirus, double-stranded DNA
C: flavivirus, single-stranded RNA
D: delta agent, incomplete single-stranded RNA
E: calicivirus, single-stranded RNA
```
85
statistics for progression to chronic hepatitis
5% adults progress to chronic hepatitis B
90% children progress to chronic hepatitis B
80% adults progress to chronic hepatitis C
86
increased LES pressure, incomplete LES relaxation, decreased peristalsis
achalasia
see "birds beak" sign on CXR
87
management of a duodenal hematoma
most resolve in 1-2 weeks
| treat conservatively with NG tube and TPN
88
polyps that are not pre-malignant
peutz-jaghers, hyperplastic, inflammatory, and juvenile
89
treatment for acute diverticulitis
NPO, IV fluids, antibitoics
| elective surgery for those who have had > 2 attacks
90
treatment for sigmoid volvulus
proctosigmoidoscopic exam, leave rectal tube in
| elective sigmoid resection
91
treatment for pyogenic liver abscess
diagnose with U/S or CT scan
| percutaneous drainage required
92
treatment for amebic liver abscess
seldom require drainage, metronidazole will suffice
93
large, thin, distended gallbladder with obstructive jaundice picture
likely malignancy causing obstruction
94
malignant obstructive jaundice, anemia, blood in stools
cancer of the ampulla bleeding into the lumen
95
severe peptic ulcers, watery diarrhea
zollinger-ellison syndrome (gastrinoma)
| treatment: measure serum gastrin, surgically resect
96
devastating hypoglycemia in newborns that results in 95% pancreatectomy
nesidioblastosis
97
mild diabetes, anemia, glossitis, stomatitis, and severe migratory necrolytic dermatitis
glucagonoma
| treatment: surgically resect, somatostatin or streptozocin for metastatic disease
98
diagnostic method for meconium ileus
gastrografin enema (also therapeutic)
99
management of pyloric stenosis
correct metabolic abnormalities and follow with surgery
100
management of intussusception
barium enema is both diagnostic and therapeutic
