GI CIS Flashcards
(29 cards)
how is smoking related to UC?
-stopping smoking is a risk factor for developing UC
What is the BUN:Cr ratios in an upper HIB?
30:1
What is the AST:ALT ratio in an alcoholic?
2:1
What is the anatomical division of an upper GIB vs a lower GIB?
ligament of Treitz
What can abruptly stopping a beta blocker lead to?
rebound tachycardia
What skin condition do ppl with IBD present with sometimes?
Erythema nodosum
What do you need to obtain before a blood transfusion?
iron studies
-they could be inaccurate after the transfusion
What IBD is associated with Pigmented galltone formation for some reason?
Crohn disease
How fast can potassium chloride be given through a peripheral IV?
10 mEq per hour (otherwise it is irritating to the vein)
How many g/dL would you expect the hemoglobin to raise from 1 unit of packed RBC’s?
giving 1 unit of PRBC’s should increase the Hgb by 1 g/dL
-it’s 1 to 1
During an acute IBD flare, what is the primary treatment?
-Corticosteroids (IV or PO)
How often do people get a colonoscopy?
every 10 years
Which patients might refuse blood products?
Jehova’s witnesses
What are some risk factor for gallstone formation?
female old indians obesity rapid weight loss DM Crohn disease (pigmented gallstones) -oral contraceptives
What are some protective things for gallstone formation
Low carb diet physical activity cardiorespiratory fitness consumption of caffeinated coffee high intake of Mg and good fats high fiber diet ASA and NSAIDs
What is ascending cholangitis
infection of the biliary tract secondary to bile duct obstruction or bile stasis
What are some lab changes with ascending cholangitis?
hyperbilirubinemia,
leukocytosis
transaminitis,
alk phos elevation
What are some causes of Ascending cholangitis?
- choledocholithiasis
- pancreatic/biliary neoplasm, postoperative strictures, choledocal cysts
What organisms are involved with ascending cholangitis?
E. coli, klebsiella, enterobacter (gram -)
- Enterococcus (gram +)
- anaerobes: Bacteroides fragilis, clostridia
What is Charcot’s triad?
- Jaundice
- RUQ pain
- Fever
What is Reynold’s pentad?
Charcot’s triad plus confusion and hypotension
-associated with significant morbidity and mortality
What is the tx of ascending cholangitis?
urgent ERCP (within 12-24 hrs)
abx geared towards colonic bacteria
-supportive care like IVF
What are some antibiotic options for treating cholangitis?
monotherapy with a “bactam” or
-or ceftriaxone plus metranidazole
What labs should be ordered and followed for ascending cholangitis?
AST/ALT, alk phos, fractionated bilirubin, amylase/lipase
- pre procedure INR
- follow up on the blood cultures and bile cultures that were ordered and are pending
