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Flashcards in GI Deck (34):
1

How is visceral pain described?

Deep, dull, crampy, poorly localized

2

How is parietal pain described?

sharp, localized

3

What does rebound tenderness suggest?

Peritoneal inflammation

4

What does vascular pain look like?

Severe, ripping, radiating to back

5

Lead poisoning pain?

Poorly localized, wandering pain, rigid abdomen

6

What are some causes of referred pain to abdomen?

MI, pneumonia, ovarian problems, urinary tract problems

7

What medication can worsen GERD?

CCB, progestin, estrogens

8

Red flags for Gerd?

Dysphagia, odynophagia, globus, asthma, GI bleeding, weight loss, anemia, gastric cancer, palpable mass, jaundice

9

What's an important differential diagnoisis for GERD?

Hiatal hernia

10

Step therapy for GERD?

1. Lifestyle modifications, tums, malox, mylanta, cimetidine, rinatidine
2. Prescription medications
3. Increase PPI for 8-12 weeks, possible referral
4. Refferal and possible surgical intervention

11

What's an important complication of GERD?

Barret's esophagus, 40x increased risk for esophageal cancer, EGD every 3-5 years to look for cancer

12

Factors for PUD?

NSAIDS, alcohol, tobacco, glucocorticoids, anticoagulants, H. Pylori

13

Differential for PUD from gastric to duodenal?

1. Duodenal is woken up at night, relieved by food.
2. Gastric is worsened by food

14

When do you do endoscopy for PUD?

for alarm signs, including hx of gastric cancer, weight loss, bleeding, anemia, abdominal mass, hematemesis, early saiety

15

Treatments for PUD?

PPIs, H2 blockers, antacids, cytotec, COX-2 inhibitors, Carafate, H.Pylori eradication

16

What is triple and quad therapy for H. Pylori

Triple- Ciprofloxacin, amoxicillin or flagyl, PPI
Quad- Bismuth, PPI, Flagyl + tetracycline

17

What is a side effect of Bismuth?

Hypoglycemia and turning stools black

18

When should you refer for PUD?

> 2 weeks, suspect gastric ulcer, treatment failure, endoscopy

19

Risk factors for gallstones

1. Fat
2. female
3. 40
4. flatulet,
5. fertile
6. fat intolerant
Rapid weight loss

20

Assessment sign for gallstones and cholecystitis?

Murphy's Sign

21

Labs suggestive of cholecystitis?

Increase alkaline phosphatase and billiruben, U/S, WBC up to 15K

22

Symptoms of IBS/ Rome Criteria?

1. painless diarrhea
2. Abdominal pain with altered bowel habits
3. Abdominal pain with relief with dedication, mucus in stool

23

Physical exam of IBS?

may have tender sigmoid colon and discomfort on rectal exam

24

Treatment of IBS?

Fiber, antispasmodics (bentyl), antidiarrhea, reglan, antidepressants, probiotics

25

When do you refer IBS?

Patient's >50y.o. organic disease, treatment failures

26

Important risk factors for colon cancer?

Advanced age, family history, etcetera

27

Main symptom for colon cancer?

Change in BM

28

Systemic signs of Ulcerative Colitis and Crohn Disease?

1. Central Arthropothies- ankylosing spondylitis and sacroiliitis
2. Peripheral arthritis
3. Osteoporosis
4. Erythema nudism
5. Pyoderma gangrenosum
6. Aphthous ulcers
7. Episcleritis
8. Uveitis
9Gallstones/Primary Sclerosing cholangitis

29

Describe diverticular disease

Greater than 40 y.o., LLQ pain, possible firm mass, CT with oral contrast is best test

30

Assessment findings for pancreatitis?

Relieved by sitting up, worse when laying down

31

Risk factors for bowel obstruction? x4

Hernia, adhesions, cancer, diverticulitis

32

Mediations for diverticulitis?

Flagyl and clindamycin

33

Difference between UC and CD

1. UC is more common in men, continuous, and situated rectum
2. CD is more common in women, can have skip lesions, anywhere in the GI system.

34

What disease can be surgically cured and why? CD or UC?

UC because it's only limited to the small bowel. Total colectomy is curative.