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COMLEX 3 > GI > Flashcards

GI Flashcards

(63 cards)

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1
Q

GI bleed –> brisk bleeding –> EGD negative –> next step?

A

angiogram

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2
Q

GI bleed –> slow bleeding –> EGD negative –> next step?

A

tagged RBC

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3
Q

what medication helps shrink esophageal varices?

A

propranolol low dose

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4
Q

what is potential adverse effect of TIPS procedure for esophageal varices?

A

worsening hepatic encephalopathy

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5
Q

suspect boerhaave syndrome –> how diagnose?

A

gastrografin swallow

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6
Q

GI bleed –> bleeding stopped –> EGD negative –> next step?

A

colonoscopy

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7
Q

suspect boerhaave syndrome –> gastrografin swallow normal –> next step to diagnose?

A

barium swallow

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8
Q

suspect boerhaave syndrome –> gastrografin and barium swallows normal –> next step to diagnose?

A

EGD

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9
Q

AVMs are associated with what dz/condition?

A

aortic stenosis

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10
Q

how does octreotide help with esophageal variceal bleeding?

A

reduces portal pressure –> slow bleeding

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11
Q

what is charcot’s triad?

A
  • RUQ pain
  • jaundice
  • fever
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12
Q

what condition does charcot’s triad indicate?

A

ascending cholangitis

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13
Q

what is Reynold’s pentad?

A

charcot’s triad + hypotension + AMS

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14
Q

plummer-vinson syndrome –> presentation

A
  • F
  • esophageal webs –> dysphagia, esophageal CA
  • IDA
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15
Q

traveler’s diarrhea –> ppx tx?

A

cipro

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16
Q

fecal impaction –> tx?

A

high fiber diet

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17
Q

fecal impaction –> type of laxative?

A

bulking agent (psyllium)

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18
Q

laxative –> docusate sodium –> MOA?

A

incorporate water & fat into stool –> soften stool

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19
Q

osmotic laxative –> MOA?

A

osmotically retain fluid in bowel

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20
Q

osmotic laxative –> examples?

A
  • Mg hydroxide
  • Na phosphate
  • lactulose
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21
Q

laxative –> senna –> MOA?

A

peristaltic stimulant

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22
Q

ulcerative colitis –> extraintestinal manifestations (4)

A
  • erythema nodosum
  • uveitis
  • autoimmune hemolytic anemia
  • sclerosing cholangitis
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23
Q

primary biliary cirrhosis –> pathophys

A

autoimmune –> granulomatous destruction of intrahepatic bile ducts –> spare extrahepatic ducts

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24
Q

primary biliary cirrhosis –> tx

A
  • ursodeoxycholic acid

- cholestyramine, diphenhydramine

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25
primary biliary cirrhosis --> trt w ursodeoxycholic acid --> goal of tx
slow progression of dz
26
primary biliary cirrhosis --> trt w cholestyramine, diphenhydramine --> goal of tx
relieve pruritis
27
89M --> abd distension, decreased bowel sounds --> labs show moderate hypoCa and severe hypoK --> dx?
colonic pseudo-obstruction (Ogilvie's synd)
28
what is colonic pseudo-obstruction (Ogilvie's synd)
severely ill patient --> dilated colon --> looks obstructed --> but absence of mechanical obstruction
29
what is colonic pseudo-obstruction (Ogilvie's synd) --> MCC (2)
- meds | - electrolyte abnormality
30
obstructive jaundice --> classic finding on imaging
dilated intrahep ducts
31
ascending cholangitis --> most definitive tx
bile duct decompression
32
primary sclerosing cholangitis --> gold standard for dx
MRCP
33
primary sclerosing cholangitis --> imaging findings
intra- and extra-hepatic ducts --> strictures & dilations (beads on a string)
34
56F --> dull epigastric pain, 12lb weight loss, painful leg swelling --> h/o smoke, alcohol --> exam shows nontender palpable gallbladder dx?
pancreatic CA
35
pancreatic CA --> presentation
- mid-epigastric pain - wt loss - anorexia - palpable, nontender gallbladder
36
pancreatic CA --> palpable, nontender gallbladder what is this sign called?
Courvoisier's sign
37
black M --> weight loss, abd pain, migratory thrombophlebitis dx?
pancreatic CA
38
pancreatic CA --> migratory thrombophlebitis what is this sign called?
Trousseau's synd
39
pancreatic CA --> MC environmental RF
smoking
40
Wilson's dz --> pathophys
AR --> liver cannot synthesize ceruloplasmin --> cannot excrete copper
41
non-obese patient --> acanthosis nigricans what condition?
GI malignancy
42
colon CA --> what tumor marker can be used to monitor recurrence?
carcinoembryonic antigen (CEA)
43
59M being treated for acute pancreatitis --> sudden AMS, BP 80/40, HR 114, T 102 --> pitting edema, decreased bibasilar breath sounds --> WBC 16, Hct 60%, BUN 42, Cr 2.1 what condition? why?
acute pancreatitis --> assoc w increased microvascular permeability --> large volume loss of intravascular fluid into tissue --> hypovolemic shock --> decreased perfusion to lungs, kidneys, other organs
44
acute pancreatitis --> erythematous skin nodules --> what is it?
subcutaneous fat necrosis
45
celiac disease --> extra-intestinal manifestations (6)
- anemia: impaired absorption of iron or folate - bleeding diathesis: impaired absorption of vitK - osteopenia/osteoporosis: impaired absorption of vitD, Ca - neuro ssx: from hypoCa - skin disorder ie dermatitis herpetiformis - hormonal disorders: amenorrhea, infertility
46
what is sister mary joseph nodule
bulging mass at umbilicus (mets from GI cancer) --> ulcerate, ooze
47
pancreatic cancer --> how dx?
ERCP
48
primary biliary cirrhosis --> risk for what complication?
cholangiocarcinoma
49
obstructive jaundice + hemoccult positive dx?
ampullary cancer
50
hemochromatosis --> most sensitive dx test
fasting transferrin saturation level
51
hemochromatosis --> tx
phlebotomy
52
hemochromatosis --> when trted w deferoxaxmine
when not candidate for phlebotomy
53
cirrhosis + COPD --> what condition?
alpha 1 antitrypsin def
54
anal cancer --> tx
nigro protocol: chemo + rad
55
lactose intolerance --> how to dx?
hydrogen breath test
56
being trted for acute pancreatitis --> develop dyspnea, hypotension, tachypnea dx?
ARDS
57
8moF --> episodic "spitting up" following meals --> no projectile vomiting --> 13th percentile on growth chart --> was 30th percentile at last visit dx?
GERD
58
GERD --> gold standard for dx
24hr esophageal pH monitoring
59
infant --> GERD --> tx
- thicken formula w small amt of baby cereal | - position upright after meals
60
infant --> GERD --> fail conservative tx --> next step
PPI
61
19F --> obese, sex active, smoke, alcohol --> c/o sudden RUQ pain --> febrile, RUQ tender, leukocytosis, elevated ESR, normal liver enzymes --> had abx for dysuria 2 days ago dx?
perihepatitis from ascending infection (Fitz-Hugh-Curtis synd from PID)
62
Fitz-Hugh-Curtis synd --> what organism?
Chlamydia (more common than Neisseria gonorrhea)
63
what is Rovsing sign? indicates what?
palpate LLQ --> pain at RLQ ==> appendicitis

COMLEX 3 (17 decks)

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