GI Flashcards by Paige LaPointe

What is the difference between Type I and Type II hiatal hernias?
(phys, and difference?)

I: fundus slides into mediastinum, tx like GERD

II: fundus rolls into diaphragm, tx with surgery

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MC type of esophageal cancer

location + cause

scc
upper 1/3 esoph
from smoking, etoh

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what type of esophagus cancer occurs in the lower 1/3

adenocarcinoma

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for barretts esoph how often do you need to repeat EGD

q3y

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what is the gold standard dx study for gastritis

endoscopy

“thick, edematous erosions”

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what is the gastritis tx if + H Pylori

clarithromycin
amoxicillin / flagyl
PPI

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what is the gastritis tx if - H Pylori

PPI
antacids / H2RB
sucralfate

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what 2 signs/symptoms should make you think Z-E Syndrome

recurrent pud

kissing ulcers

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gold standard dx test for z-e syndrome

fasting gastrin level

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gastric cancer:
mc type?
biggest risk?
EGD findings?

MC adenocarcinoma
Biggest risk H Pylori
EGD: “linitus plastica” - diffuse thickening of the stomach wall

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upper GI shows “string sign”

pyloric stenosis

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young woman with new onset RUQ pain, ascites and hepatomegaly - dx?

budd-chiari syndrome

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budd-chiari: best first screening test, and best gold standard test?

first: u/s
gold: venography

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how do you treat budd-chiari

shunts (TIPS)
angioplasty w stent
if acute, no ivc, then anticoags
diuretics for ascites

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dx test of choice for cholelithiasis?

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how do you treat choledocholithiasis

ercp

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patient with sudden onset of RUQ pain, with F/C and jaundice.
what is this called and what is it indicative of

charcot’s triad

dx = cholangitis

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what is reynold’s pentad

charcot’s triad + shock and ams

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what is dx and tx for cholangitis

ercp

+ abx

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what is the test of choice and the gold standard test for cholecystitis

choice: US
gold: HIDA (shows non-visualization of the gb)

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what bili level causes jaundice

> 2.5

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MC cause of jaundice? what causes it?

Gilbert’s syndrome

genetic decrease of UGT enzyme

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MC cause of 1st week of life jaundice?

Crigler Najjar Syndrome

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Prehepatic jaundice:
AKA?
what causes this?
what labs will be elevated?
appearance of urine and stool?

AKA Hemolytic
Cause: RBC hemolysis
Labs: inc. indirect bilirubin
Urine: normal
Stool: dark

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``` Post-hepatic jaundice: AKA? what causes this? what labs will be elevated? appearance of urine and stool? ```

``` AKA Obstructive Cause: cholestasis or tumor Labs: inc. direct bili, ALP, GGT Urine: dark Stool: acholic ```

``` Intrahepatic jaundice: AKA? what causes this? what labs will be elevated? appearance of urine and stool? ```

AKA Hepatocellular Cause: liver damage (etoh, hepatitis) Labs: inc. direct bili, indirect bili, ALT/AST Urine/stool: n/a

when does newborn physiologic jaundice occur and how do you treat

3-5 days p birth | tx with observation and phototherapy

what is the treatment of hepatitis? | what is definitive tx?

1. lactulose 2. neomycin 3. lower protein definitive = transplant

which liver disease is autoimmune in women 40-60yo, with vague liver sx?

primary biliary cirrhosis

what autoimmune lab will be elevated in primary biliary cirrhosis?

anti-mitochondrial Ab

how do you treat primary biliary cirrhosis

ursodeoxycholic acid | cholestyramine + UV light for itching

which liver disease is autoimmune in men 20-40y, usually with IBD and progressive liver symptoms?

primary sclerosing cholangitis

what autoimmune lab will be elevated in primary sclerosing cholangitis?

P-ANCA

gold standard test for primary sclerosing cholangitis? and treatment?

Dx with ERCP | Tx with transplant

what are the sx of meckel's diverticulum? | what can it cause?

sx: asx or painless rectal bleeding | can cause intussusception, volvulus, obstruction, divertic

how to dx meckel's diverticulum?

meckel's scan

symptoms of SBO?

progressive cramping, N/V/D/obstipation

how to treat SBO?

NPO and fluids decompression with NG tube surgery if strangulated

what is it called when the intestinal segment telescopes into the lumen

intussusception

when does intussusception happen in life, what often precedes it

6-18 months | preceded by viral info

"currant jelly stool"

intussusception

"sausage shaped mass in ruq"

intussusception

baby presents with sudden abdominal pain, vomiting, and rectal bleeding. what is dx and tx for this

this is intussusception | barium enema

what presents as a SBO but is caused by twisting of the bowel

volvulus

how do you treat volvulus

endoscopic decompression 1st line | surg 2nd line

what is the official definition of toxic megacolon?

colon dilation > 6cm with systemic toxicity

what is the tx of toxic megacolon

decompression | bowel rest, ng, abx, +/- colostomy

Which IBD? - occurs anywhere - occurs only in rectum/colon

crohns anywhere | UC isolated

which IBD? - pain in LLQ - pain in RLQ

- UC LLQ | - crohns RLQ

which IBD? - assoc with diarrhea and wt loss - assoc with bloody diarrhea and tenesmus

- D + wt loss = crohns | - D bloody + tenesmus = UC

Which IBD? - assoc with "sandpaper appearance" on endo - assoc with "cobblestone appearance" on endo

- sandpaper UC | - cobblestone crohns

which IBD? - string sign (scarring + strictures) on Ba enema - stovepipe sign (loss of haustral markings) on Ba enema

- string = crohns | - stovepipe = UC

which IBD? - + ASCA - + P-ANCA

- asca crohns | - p-anca uc

what is the test of choice for crohns? for UC?

crohns - upper GI with SB follow-thru | UC - flex sig

what test of choice is C/I in UC and why

barium enema C/I | risk of toxic megacolon

what is 1st line tx for IBD?

Mesalamine

which type of polyp is MC and is benign? | which type of polyp is precancerous?

MC benign hyperplastic | precanc adenomatous

what are the 3 types of adenomatous polyps

1 tubulous adenoma (mc) 2 tubulovillous 3 villous adenoma (high risk)

"rice water stools"

vibrio

treatment for vibrio diarrhea

self-limited, fluid replacement

tx for noninvasive E coli diarrhea

FQ BID x 3 days

tx for shigella diarrhea | explosive, mucoid, bloody diarrhea; can cause seizures in kids

Bactrim

tx for yersinia diarrhea | mimics appendicitis

"pea soup stools"

salmonella

typhoid fever: nonspp sx with diarrhea, intractable fever, "rose spots" later on

salmonella

tx for salmonella diarrhea

FQ or ceftriaxone

treatment for invasive enterohemorragic E coli

none | abx can increase risk of HUS in kids

what is the MC bacterial enteritis in US

C Jejuni

"S or Seagull shapes" in stool cx

campylobacter

tx for campylobacter?

erythromycin or FQ

which diarrhea is the MC antecedent in guillain barre

campylobacter

giardiasis tx | frothy, greasy, foul stools

flagyl

amebiasis tx | colitis, dysentery, liver abscess

flagyl

what is the name of the chronic diarrhea in AIDS

cryptosporidium

GI Flashcards

(74 cards)