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GI Flashcards

1
Q

What are the main causes of peptic ulcer disease

A

H. Pylori is 1
NSAIDS, Aspirin, Steroids, Smoker, stress

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2
Q

Are younger patients more likely to have duodenal or gastric ulcers?

A

Duodenal

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3
Q

What are the s/s of peptic ulcer disease?

A

Gnawing pain from the inside out, relief of pain w/ food is duodenal, worse with food is gastric, GIB, melena, hematesis, coffee ground emesis

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4
Q

S/S of bowel perforation

A

Board-like abdomen, quiet bowel sounds, rigidity

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5
Q

Diagnostic testing for peptic ulcer disease

A

Endoscopy

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6
Q

Peptic ulcer disease treatment

A

PPI (watch for rebound GERD), sucrafate

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7
Q

What xray results indicate pneumoperitoneum

A

Free air

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8
Q

What x ray result indicates a bowel perf?

A

Air under the diaphragm

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9
Q

Hep ABC transmission

A

A: Oral fecal
Hep B: blood born
Hep C: Blood IV drug use

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10
Q

Which type of hepatitis can be chronic

A

B and C

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11
Q

General management of Hepatitis infection

A

Supprotive, IVF, avoid alcohol, low to no protein diet, serex, vitamin K, lactulose

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12
Q

Who is diverticulitis more common amungst

A

Women and those with low dietary fiber

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13
Q

S/s of diverticulitis

A

Mild to moderate LLQ aching and pain, constipation or loose stools, N/V, low grade fever

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14
Q

Labs and Diagnostics of Diverticulitis

A

Labs: leukocytosis, ESR, positive heme occult
CT abdomen: colonic diverticula and >4cm wall thickening

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15
Q

Treatment of diverticulitis

A

NPO, bowel rest, IVF, ? Surgery

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16
Q

S/S of cholecystitis

A

Precipitated by a large fatty meal
RUQ/epigastric pain, vomiting, +murphy’s sign, fever, leukocytosis, elevated bili/LDH/Alk phos/AST/ALT/Amylase

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17
Q

What scan can be used to find a gallbladder stone in kidney patients

A

HIDA

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18
Q

What is the treatment for cholecystitis

A

ERCP, IVF, pain management, lap Chole, NPO
ABX: Rocephin and Flagyl

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19
Q

What is Choledocholithiasis

A

Gall stone in the common bile duct

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20
Q

Dx and TX for Choledocholithiasis

A

MRCP/ ERCP, lap Chole, sphinceterotomy
ABX: Unasyn OR Zosyn OR Rocephin if infection

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21
Q

Causes of pancreatitis

A

ETOH, trauma, Chole

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22
Q

S/s of pancreatitis

A

Abrupt onset of epigastric pain with radiation to the back
N/V, pain worse lying flat, tripod positioning, tender to palpation, no rebound pain, fever, tachycardia

23
Q

Pancreatitis work up

A

Elevated amylase and lipase
Hypocalcemia
Elevated CRP
CT ABD

24
Q

What is cullens and grey turners sign

A

Hemorrhagic pancreatitis
Cullens sign: umbilical discoloration
Grey Turners sign: Flank discoloration

25
Pancreatitis treatment
Bedrest, NPO, LR, pain medications
26
Pancreatitis complications
Azotemia Necrotic to MODS Pleural effusion
27
What does a bowel obstruction show on XRay
Dilated bowel loops with air fluid levels \ Called Frame pattern
28
Why does a mesenteric infarct occur
Inadequate blood flow tend ischemia/gangrene of the bowel Arterial venous embolus, smoking, athlerosclerosis, post cardiac/thorasic surgery
29
S/s of mesenteric infarct
Sudden onset of abdominal cramps, colicky abd pain out of proportion to exam, N/V, hyperactive bowel sounds, shock, Afib with post parandial abdominal pain
30
Labs and diagnostics for mesenteric infarct
Leukocytosis CT
31
What are the causes of appendicitis
Undigested food particles or neoplasms that get stuck
32
S/s of appendicitis
Starts as umbilical pain and progresses to RLQ with rebound tenderness N/V Psoas: right thigh extension pain Obturator: pain in the opposite side of the abdomen that is palpated
33
H pylori treatment for patients with NO PCN allergy and have not had a macrolide
ECA: PPI, Clarithromycin, Amoxicillin EBMT: PPI, Bismuth, Metronidazole, Tetracycline ECAM: PPI, clarithromycin, amoxicillin, metronidazole
34
What is the h pylori treatment for a patient who has a PCN allergy and is unable to tolerate bismuth
ECM: PPI, clarithromycin, metronidazole
35
H pylori treatment for patients who are allergic to PCN and previously had a macrolide
EBMT: PPI, Bismuth, Metronidazole, Tetracycline
36
GERD treatment
H2 blocker
37
Hep A serology Active vs Recovered
Active: Anti-HAV, IgM Recovered: Anti-HAV, IgG
38
Hep B Active, Chronic, and Recovered serology (HBsAg, HBeAg, Anti-HBC, Anti HBe, Anti HBs, IgM, IgG)
Active: HBsAg, HBeAg, Anti-HBc, IgM Chronic: HBsAg, Anti-HBC, Anti-HBe, IGM, IgG Recovered: Anti HBc, anti HBs
39
Acute vs Chronic Hep C serology
Acute: Anti-HCV, HCV RNA Chronic: Anti HCV, HVC RNA Need a PCR to determine differences
40
What is the gold standard imaging for cholecystitis
ABD US
41
Major complications of ERCP
Pancreatitis, perforation, hemorrhage, cholangitis
42
What is Ranson’s criteria
Evaluate prognosis of pancreatitis At Admission: George Washington Got Lazy After ->55 yrs old, WBC >16, Glucose >200, LDH > 350, AST> 250 48 hours: He Broke CABE -Hct Drop >10, BUN >5, Ca <8, A O2 <60, Base deficit <4, fluid sequestration >6K 5-6 risk factors= 40% mortality >7= 100% mortality
43
What bowel sounds are present in a bowel obstruction
High pitched tinkling sounds
44
What is the hallmark sign of ulcerative colitis
Bloody diarrhea
45
Treatment of UC
Mesalamine and hydrocortisone suppositories
46
What happens to untreated appendicitis
Gangrene and perf
47
What is Mc burney’s point
Tenderness 1/3 of the way between umbilical and iliac crest indicative of appendicitis
48
What is the Psoas sign
Pain with right thigh extension sign of appendicitis
49
Obturator sign
Pain with internal rotation of flexed right thigh indicative of appendicits
50
What is a Rovsing sign
RLQ pain when LLQ is palpated sign of appendicitis
51
What should not be used to treat diverticulitis
Enemas
52
A patient who is 85 with renal history asks if he should have colorectal cancer screening
No
53
At what age should a patient be offered if they want to or not for colorectal cancer screening
75

Final Exam Prep (19 decks)

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