GI Flashcards
(27 cards)
Additional test to complete after diagnosis with celiac disease
DEXA at time of diagnosis regardless of age or menopausal status as increased risk of bone loss
Reasons to go straight to an EGD when evaluating new onset dyspepsia
age >60 OR <60 with alarm features (family history of gastric cancer, unintended weight loss, dysphagia, GI bleeding, iron deficient anemia)
Timing of ERCP and Cholecystectomy in gallstone pancreatitis
ERCP within first 24 hours, cholecystectomy after recovery to reduce risk of recurrence
Two conditions more commonly associated with arteriovenous malformation lower GI bleeding
Elderly patients with ESRD and aortic stenosis
Decreased arterial saturation >5% from supine to upright
Orthodeoxia
Increased dypsnea when sitting upright, relieve when supine
Platypnea
Triad of liver disease, hypoxemia and intrapulmonary vascular dilatations
Hepatopulmonary syndrome
Best diagnostic test to diagnose hepatopulmonary syndrome
Contrast echocardiography
Best next step if jaundice and abdominal pain with elevated alk phos and bili, but no gallstones on US
CT scan to look for pancreatic malignancy with extrahepatic obstruction
Watery nonbloody diarrhea; fecal urgency and incontinence, abdominal pain, fatigue, weight loss. Colonoscopy on biopsy can demonstrate thickened subepithelial collagen band or high levels of intraepithelial lymphocytes
Microscopic colitis
Microscopic colitis triggers
NSAIDs and smoking
Diarreha, steatorrhea, abdominal cramps and bloating, weight loss despite good intake
Indicative of malabsorption. Need to first evaluate for infectious causes such as giardia
Next steps in patients with dyspepsia without GERD symptoms
if < 60 - stool or breath test for H. Pylori. If > 60, EGD
Persistently elevated lipase with abdominal fullness or early statiety 4-6 weeks afteer an episode of acute pancreatitis
Pacnreatic pseudocyst
Treatment of locally advanced rectal cancer
preoperative chemoradiation –> surgery –> postop chemotherapy
Present > 60 years old with months to years of transient oropharyngeal dysphagia, halitosis, gurgling in the throat, food regurgitation, apeparance of a neck mass and weight loss
Zenker’s diverticulum
Preferred diagnostic modality for Zenker’s diverticulum
Barium esophogram
Treatment of anorectal fistulas in patients with Crohn’s.
If asymptomatic - observation and heals on own, if mildly symptomatic - cipro/flagyl for prolonged course, if moderately symptomatic - immunomudulator therapy with TNF inhibitors. Surgery if fails medical therapy or have recurrent fistulas
Effects of low carb diets
Produce rapid initial weight loss, but long term the weight loss is similar to other diets. They are associated with increased incidence of GI Side effects
What should you consider in patients with typical symptoms of achalasia, but are elderly +/- a fast (< 6 months of symptoms) onset?
Pseudoachalasia - should do an EGD to evaluate for a tumor and the LES
What is relatively common in women with PBC and needs to be monitored for?
About 50% of women will develop osteopenia or osteoporosis
First step in diagnosing gastroparesis?
Need to first rule out causes of gastric outlet obstruction with EGD +/- CT/MRI abdomen. THEN can move on to gastric emptying study
Watery diarrhea that can occur at night with associated episodes of fecal incontinence in a diabetic
Diabetic diarrhea - combination of autonomic neuropathy, bacterial overgrowth, and anorectal dysfucntion
Most concerning complication of pituitary apoplexy?
Acute adrenal insufficiency - when pituitary apoplexy is suspected should give IV glucocorticoids
