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MOHD Keystone Exam 3 > GI > Flashcards

Flashcards in GI Deck (73)
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1

What are foods to avoid in dietary modification of GERD patients?

fatty foods
chocolate
peppermint
alcohol

2

What is the surgical treatment for GERD?

fundoplication

3

What medical therapies can treat GERD?

PPIs
H2 blockers
antacids

4

Associated with allergic rhinitis, asthma, food allergies --> shows 'trachealization' of esophagus on endoscopy

Eosinophilic esophagitis

--> Overlap with GERD, can treat with PPI or topical steroids

5

Misoprostol is

Prostaglandin analog --> treat gastric ulcers (opposite of COX inhibition)

SE: diarrhea!

6

What are the options for diagnosing H. pylori infection?

Urease breath test
Stool antigen test
Serology (igG anti-Hp ab)
Gastric biopsy

* all except serology influenced by PPI use

7

Causes of gastroparesis

Diabetic gastropathy
Nerve damage (vagal, spinal)
Post-viral
Scleroderma

8

Diagnosing gastroparesis

succussion splash
UGI showing dilated stomach
scintigraphy for rate of gastric emptying

9

Probiotics, Antibiotics, tegaserod treat _______ in IBS patients

Bloat

10

PPIs or H2 blockers can treat _________ in IBS patients

dyspepsia

11

Priobiotics and Antibiotics can treat these in the IBS patient

Bloat, diarrhea

12

Tegaserod can treat these in the IBS patient

Bloating, abdominal pain/discomfort, constipation

13

Medications to treat acute infectious diarrhea

antibiotics
NSAIDs
metformin
Beta blockers
SSRI
PPI

14

Who is at high risk for diarrhea?

Travelers/outdoor activity
Immunocompromised
Daycare
Healthcare facilities
Antibiotic use
New medications
Food exposures

15

diarrhea that resolves with fasting, with steatorrhea, weight loss

malabsorptive or maldigestive diarrhea

16

Causes of osmotic diarrhea

Magnesium (laxatives, antacids, supplements)
Carbohydrate malabsorption

17

Stool osmotic gap >125 suggests

osmotic diarrhea

18

watery large volume stools without gross blood, nocturnal diarrhea, continues with fasting, recurrent dehydration

secretory diarrhea

19

Associations with secretory diarrhea

toxins, inflammation, medications, NET, bile acids, villous adenoma

20

Diarrhea that resolves with fasting

osmotic diarrhea
malabsorptive, maldigestive diarrhea

21

Na, K less than 50 and no osmotic gap suggests

secretory diarrhea

22

Examples of malaborptive diarrhea

exocrine insufficiency, bacterial overgrowth, bariatric surgery, IBD, celiac, CF, PPIs

23

Risk factors for malabsorptive diarrhea

alcoholism, celiac disease, cystic fibrosis, chronic infections

24

Celiac disease, IBD, microscopic colitis, NSAID enteritis are examples of

Inflammatory diarrhea

25

Signs/symptoms include abdominal pain, blood in stool, weight loss, urgency/tenesmus, +/- fever

Inflammatory diarrhea

26

Example of functional diarrhea

Irritable bowel syndrome (disturbed intestinal/colonic motor/sensory responses)

27

Ways to test for inflammatory diarrhea

Stool leukocytes (WBC/lactoferrin/calprotectin/occult blood)
Serum TTG IgA, total IgA
Upper endoscopy + SI biopsy
Colonoscopy

28

Indications of GI inflammation

WBC
PLT
ESR
CRP

29

Common causes of osmotic diarrhea

Magnesium (laxatives, antacids, supplements)

Carbohydrate malabsorption (lactase/disaccharide deficiency, monosaccharide/fructose overload, non-absorbable sugars/lactulose-sorbitol)

Other diseases with malabsorbed carbs (SI bacterial overgrowth, celiac disease, Crohn's disease, pancreatic insufficiency, gastric/intestinal resection)

30

BUN/creatinine > 20 favors this source of bleeding

Upper GI bleed

--> result of decreased renal perfusion