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1 Inpt > GI > Flashcards

GI Flashcards

1
Q

Gastric malignancy- Eti

A
  • Adenocarcinoma
  • Males > 40
  • H. pylori
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2
Q

Gastric malignancy- Sx

A
  • Wt loss
  • Early satiety
  • Abd pain, fullness
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3
Q

Gastric malignancy- Dx, Tx

A
  • Endoscopy, with bx

- Gastrectomy, chemo, rad

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4
Q

Zollinger ellison syndrome- Eti

A

Gastrinoma

- Gastric neuroendocrine tumor

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5
Q

Zollinger ellison syndrome- Sx

A
  • Peptic “kissing” ulcers
  • Duodenal wall MC
  • Diarrhea
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6
Q

Zollinger ellison syndrome- Dx, Tx

A
  • Secretin and fasting gastrin levels

- Resection, PPIs

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7
Q

Gastritis- Eti

A
  • NSAIDs, ETOH, stress, portal HTN

- H. pylori

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8
Q

Gastritis- Sx

A
  • UGIB

- Asymptomatic

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9
Q

Gastritis- Dx. Tx

A
  • Endoscopy

- PPI, H2

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10
Q

PUD- Eti

A
  • H. pylori = duodenum

- NSAIDs = stomach

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11
Q

PUD- Sx

A
  • Epigastric pain
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12
Q

PUD- Dx, Tx

A
  • PPI trial
  • D/c NSAIDs
  • Test for H. pylori
  • Tx: clarithromycin, amoxacillin, PPI
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13
Q

Sm bowel obstruction- Eti

A
  • Post surgical adhesions MC
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14
Q

Sm bowel obstruction- Sx

A
  • Crampy abd pain
  • Obstipation, vomiting
  • Hyperactive BS
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15
Q

Sm bowel obstruction- Dx

A
  • XR: air fluid levels in step ladder pattern

- Tx: NPO, IV fluids until resolution

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16
Q

Lg bowel obstruction- Eti

A

Malignancy

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17
Q

Lg bowel obstruction- Sx

A
  • Bloating, abd pain

- Progressive change in bowel habits

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18
Q

Lg bowel obstruction- Dx, Tx

A
  • XR: volvulus, coffee-bean sign
  • CT: Best for differentiating
  • Tx: Decompression, fluids, surg
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19
Q

Gastroparesis- Eti

A

DM MC

- scleroderma, lyte abns, meds

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20
Q

Gastroparesis- Sx

A

Nausea, bloating, vomiting

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21
Q

Gastroparesis- Dx

A

Gastric emptying study, EGD

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22
Q

Gastroparesis- Tx

A
  • Underlying dz

- Small portions, pro kinetics, metoclopramide

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23
Q

Diverticulosis

A
  • Small herniations in colon mucosa

- Tx: High fiber diet

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24
Q

Diverticulitis

A
  • Infxn of diverticula, decreased blood supply, micro perks
  • Sx: LLQ abd pain
  • Dx: Abd CT
  • Tx: Clear liquid diet, cipro or metro
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25
Q

C. diff

A
  • Invasion of C. diff spores d/t susceptability
  • Sx: Profuse watery diarrhea, leukocytosis
  • Dx: Stool EIA or PCR
  • Tx: Metro or vanc
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26
Q

Crohns- Sx

A
  • RLQ pain
  • wt loss
  • No blood in diarrhea
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27
Q

Crohns- Dx

A
  • Terminal ilium MC, affects mouth to anus
  • Skip lesions
  • Tx: Corticosteroids for acute flares
28
Q

UC- Sx

A
  • LLQ pain
  • Bloody diarrhea
  • Tenesmus, urgency
29
Q

UC- Dx

A
  • Rectum MC, limited to colon
  • Contiguous spread
  • Corticosteroids for acute flares
30
Q

UGIB- Eti

A
  • PUD MC

- Varices, mallory weiss tear

31
Q

UGIB- Sx

A
  • Hematemesis, coffee ground emesis
  • Melena
  • Epigastric pain
32
Q

UGIB- Dx

A
  • Hct + Hb decrease, H &P to determine eti

- EGD

33
Q

LGIB- Eti

A

Diverticular hemorrhage MC

- CA, colitis, hemorrhoids

34
Q

LGIB- Sx

A
  • Diarrhea with tenses
  • BRBPR
  • Hematochezia
35
Q

Variceal bleed- Eti

A
  • Cirrhosis, portal vein HTN
36
Q

Variceal bleed- Sx

A

Hematemesis, melena, hx of hepatitis

37
Q

Variceal bleed- Dx, Tx

A
  • EGD- red wale markings, cherry red spots

- Endoscopic ligation, octreotide drip

38
Q

SBP- Eti

A
  • Gram - rods
  • E. coli & klebsiella
  • 20% cirrhotics
39
Q

SBP- Sx

A
  • Asterixis

- Abd pain, fever, encephalopathy

40
Q

SBP- Dx, Tx

A
  • Paracentesis, PMNs > 250

- Cefotaxamine or amox/ clav

41
Q

Ascites-

A
  • Portal HTN
  • Shifting dullness, + fluid wave
  • Tx: Na, fluid restriction, diuretics
42
Q

Acute liver failure- Eti

A
  • Liver failure w/in 8 wks of injury
  • Rapid liver failure + encephalopathy + coagulopathy
  • Reye’s syndrome w/ asa usage
  • Acetamenophen MC cause
  • Viral hep- A, E
43
Q

Acute liver failure- Dx

A
  • Increased serum ammonia
  • PT/ INR > 1.5
  • Hypoglycemia
44
Q

Chronic liver failure

A
  • > 8 wks liver injury

- Jaundice, variceal bleeding, encephalopathy & ascites

45
Q

Cirrhosis- Labs

A
  • Increased: bili, PT/INR, AST & ALT

- Decreased: albumin, Hct, Hb, throbocytopenia

46
Q

Hepatorenal syndrome- Patho

A
  • Renal vasoconstriction, decreased renal blood flow in response to splanchnic arterial vasodilation
47
Q

Hepatorenal syndrome- Dx

A
  • Cr > 1.5, rapid increase over 2 weeks
  • Cr doesn’t improve after d/c diuretic, volume expansion
  • Low Na excretion
48
Q

Hepatorenal syndrome- Tx

A
  • Albumin, midodrine (pressor)
49
Q

Hepatic encephalopathy

A
  • Increased ammonia from protein breakdown
  • Confusion, lethargy, asterixis
  • Increased ammonia
  • Lactulose, neomycin, rifaxamin, low protein diet
50
Q

Acute pancreatitis- Eti

A
  • ETOH, gallstones
51
Q

Acute pancreatitis- Sx

A
  • Epigastric abd pain, radiates to back

- Constant, relieved by sitting forward, fetal position

52
Q

Acute pancreatitis- Dx

A
  • Abd CT
  • Increased lipase most specific
  • Increased amylase, ALT, triglycerides
53
Q

Acute pancreatitis- Tx

A
  • NPO, IV fluids, pancreas rest
54
Q

Ranson criteria

A
  • Glucose > 200
  • Age >55
  • LDH >350
  • AST >250
  • WBC >16,000
55
Q

Chronic pancreatitis- Eti

A
  • Chronic inflammation, loss of exocrine fun
  • ETOH MC, CF in children
  • Gallstones do not play role
56
Q

Chronic pancreatitis- Sx

A
  • Triad: Calcifications, steatorrhea, DM
57
Q

Chronic pancreatitis- Dx

A

Abd XR: Calcified pancreas

- Amylase, lipase WNL

58
Q

Chronic pancreatitis- Tx

A

Oral enzyme replacement

59
Q

Pancreatic carcinoma- Eti

A
  • Smoking, > 60 y
  • DDT exposure
  • ETOH, DM, males
  • Adenocarcinoma MC
60
Q

Pancreatic carcinoma- Sx

A
  • Painless jaundice, wt loss
  • Abd, back pain
  • Pruritis
  • Courvoisier sign- palpable, non-tender distended GB
61
Q

Pancreatic carcinoma- Dx

A
  • CT scan

- Tumor markers: CEA, CA 19-9

62
Q

Pancreatic carcinoma- Tx

A

Whipple procedure- pancreaticoduodenal resection

- ERCP with stent

63
Q

Pancreatic pseudocyst- Eti

A
  • Encapsulated collection of pancreatic fluid

- d/t severe pancreatitis

64
Q

Pancreatic pseudocyst- Sx

A
  • Epigastric pain, mass
  • Fever, leukocytosis
  • Failure to recover from acute pancreatitis
65
Q

Pancreatic pseudocyst- Dx, Tx

A
  • CT scan

- Symptom mgmt, drain in > 12 wks

1 Inpt (12 decks)

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