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Flashcards in GI Deck (80):
1

s/s of acute pancreatitis

fever, N/V, epigastric abd pain that radiates to the back

2

clinical signs of pancreatitis

Cullen's sign (bluish discoloration around umbilicus) and Grey-Turner sign (blue around flank)

3

s/s of diverticulitis

fever, N/V, anorexia, LLQ abd pain, positive Rovsing sign, boardlike abd

4

s/s of appendicitis

periumbilical pain --> RLQ pain --> anorexia, vomiting, fever

5

s/s of cholecystitis

severe RUQ or epigastric pain that occur within 1 hour after eating a fatty meal; may radiate to right shoulder; N/V, anorexia

6

risk factors for colon cx

age greater than 40, hx of multiple polyps, IBD, consumption of red meat, obesity, smoking, alcohol

7

A gastrinoma located in the pancreas or stomach that secretes gastrin and high levels of acid causing ulcers

Zollinger-Ellison Syndrome

8

s/s of Zollinger-Ellison Syndrome

epigastric abd pain, tarry stools

9

labs for Zollinger-Ellison Syndrome

serum fasting gastrin level

10

s/s of Crohn's disease

intermittent RLQ pain that occurs 1 hour after eating; diarrhea with mucus, fever, malaise

11

s/s of Cdiff

watery diarrhea 10-15 times a day with lower abd pain and cramping; fever

12

causes of Cdiff

abtx, PPI

13

route of food from mouth

esophagus --> stomach --> duodenum --> jejunum --> ileum --> colon --> cecum --> rectum --> anus

14

organs in LUQ

stomach, pancreas, descending colon, left kidney

15

organs in RUQ

liver, gallbladder, ascending colon, right kidney

16

organs in LLQ

sigmoid colon

17

organs in RLQ

appendix, ileum, cecum

18

psoas sign

patient is supine, bend knee 90 degrees and ask patient to push against hand to straighten leg

19

obturator sign

patient lies supine, rotate right hip, positive if pain

20

rovsing's sign

deep palpation on LLQ causes pain in RLQ

21

Markle (Heel Jar) test

ask patient to jump in place

22

Murphy's sign

pressing into the RUQ during inspiration causes the patient to gasp for air

23

associated with acidic or sour odor to breath

GERD

24

gold standard for diagnosing GERD

esophageal motility study

25

trial of PPI for GERD

omeprazole x 4-6 weeks

26

untreated GERD can lead to

Barrett's esophagus (precancerous)

27

Barrett's esophagus is diagnosed by

upper endoscopy with biopsy

28

avoid these foods in GERD

mints, alcohol, caffeine

29

s/s of IBS

cramping, bloating, gas, relief after pooping

30

cause of duodenal and gastric ulcers

H. pylori, chronic NSAIDs, biphosphonates

31

s/s of duodenal ulcer

burning epigastric pain relieved by foods; pain occurs mostly at night

32

s/s of gastric ulcer

N/V, pain worse with eating, weight loss

33

quad therapy trx for H. pylori ulcers

Bismuth tab 600 mg QID + metronidazole 250 mg QID + tetracycline 500 mg QID x 2 weeks + PPI daily x 4-6 weeks

34

trx for diverticulitis

cipro 500 mg bid + metronidazole 500 mg tid x 10-14 days

35

diagnostics for acute pancreatitis

amylase, lipase, trypsin; AST/ALT; CBC; abd US

36

trx for nonsevere C.diff

metronidazole tid x 10-14 days; avoid antimotility agents

37

IgG Anti-HAV positive means

the patient is immune to hep A

38

IgM Anti-HAV positive means

acute infection with Hep A; patient is contagious

39

Anti-HCV

screening test for Hep C

40

If a patient is positive Anti-HCV, next step is

order HCV RIBA; if positive then patient has Hep C

41

If a patient is positive Anti-HCV and has negative RIBA, then

it is a false positive.

42

Hepatitis D requires the presence of

Hep B

43

this liver enzyme is present in liver, heart, skeletal, kidney, and lung

AST

44

this liver enzyme is liver specific

ALT

45

AST/ALT ratio may be indicative of alcohol abuse

greater than 2.0

46

sensitive indicator of alcohol abuse

serum GGT

47

an enzyme derived from bone, liver, gallbladder, kidney, GI tract, and placenta

alkaline phosphatase

48

High levels of this during growth spurts in children and teens

alkaline phosphatase

49

transmission of Hep A

fecal/oral route

50

transmission of Hep B

sexual, blood

51

transmission of Hep C

IV drug use, blood, sex

52

Anti-HAV means

the patient has antibodies to Hep A; the patient had a previous hep A infection or received vaccination

53

HbsAg positive means

the patient has a current Hep A infeciton

54

this type of hepatitis has highest risk of cirrhosis and liver cancer

Hep C

55

olive shaped mass in RUQ

pyloric stenosis

56

most children with fecal incontinence have

underlying constipation

57

a chronic inflammatory condition characterized by relapsing and remitting episodes of inflammation limited to the mucosal layer of the colon

Ulcerative colitis

58

characterized by transmural inflammation and by skip lesions.

Crohn's disease

59

IBD that mostly involves the rectum

ulcerative colitis

60

IBD that may involve the whole colon

Crohn's disease

61

s/s of pyloric stenosis

projectile vomiting

62

imaging for pyloric stenosis

US

63

trx for pyloric stenosis

pyloromyotomy

64

what medication may worsen symptoms of GERD?

amlodipine

65

Risk of long term PPI use

decreases absorption of vitamins and iron (anemia, B12 deficiency)

66

diarrhea alarm symptoms

rectal bleeding, weight loss, nocturnal abd pain, anemia

67

recommended screening for colorectal cancer

colonoscopy every 10 years, flex sigmoidoscopy every 5 years, barium enema every 5 years, FOBT annually

68

When ALT is greater than AST, think

viral hepatitis

69

When AST is greater than ALT, think

acetaminophen, statins, tequila

70

anti-HAV IgG

immunity to Hep A

71

anti-HAV IgM

current Hep A infection

72

HBsAg is

antigen = infection

73

Anti-HBs is

antibody = immunity

74

Rule for Hep B surface markers

can either have surface antigen or antibody, not both.

75

+Anti-HBs, + Anti-HBc IgG means

patient is immune through previous infection

76

+Anti-HBs, - Anti-HBc IgG means

patient immune through vaccine

77

imaging study of choice for cholecystitis

US of RUQ

78

s/s of bowel obstruction

dilated loop of bowel, tinkling bowel sounds, abd pain

79

Elevated bilirubin but normal LFTs

Gilbert's disease

80

painful bleeding with BMs

anal fissure