GI med Flashcards

1
Q

most serious complication of Barrett esophagus

A

adenocarcinoma

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2
Q

lower esophageal mucosal ring is a sign of what?

A

hiatal hernia

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3
Q

most common cause solid food dysphagia in adults

A

lower esophageal mucosal ring

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4
Q

how does esophageal squamous cell carcinoma appear on imaging?

A

focal, irregular narrowing with abrupt upper and lower margins

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5
Q

hematochezia life-threatening indication

A

massive upper GI bleed

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6
Q

most common presentation for upper GI bleed

A

melena or hematemesis

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7
Q

list the major sources of acute upper GI bleeding

A

PUD, portal HTN, mallory-weiss tears, vascular anomalies, gastric neoplasms, erosive gastritis, erosive esophagitis, others (aortoenteric fistula, hemobilia, pancreatic malignancy, pseudoaneurysm)

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8
Q

what is a barium swallow helpful to diagnose??

A

stricture, hiatal hernia, swallowing problems

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9
Q

contraindication of barium swallow

A

unable to visualize or biopsy

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10
Q

what is important to remember when analyzing GI illness?

A

PYSCHOSOCIAL aspect!

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11
Q

on what imagining would you see an apple core lesion?

A

barium swallow

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12
Q

what is an apple core lesion?

A

mass or constriction pushing on esophagus & not allowing it to expand

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13
Q

gold standard for GERD

A

24-hr pH probe

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14
Q

when is an esophageal manometry helpful?

A

to diagnose motility disorders bc it measures esophageal fxn by using pressure readings of muscle contractions

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15
Q

what is an ultrasound helpful to diagnose?

A

cholecystitis/cholelithiasis, cholangitis, abscesses, diverticulitis, SB inflammation. Basically when you want to visualize an organ but don’t need to see inside of it. much cheaper, less invasive

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16
Q

gold standard for colon

A

colonoscopy

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17
Q

treatment of choice for symptomatic gallbladder disease

A

laparoscopic cholecystectomy

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18
Q

risk factors for gallstones

A

the four F’s! female, fat, forty, fertile (estrogen exposure/multiple pregnancies)

19
Q

symptoms of cholelithiasis

A

usu. asymptomatic! or infrequent episodic severe pain in epigastrium or RUQ w/ radiation to right scapula

20
Q

cholelithiasis gold standard

A

ultrasound

21
Q

alternative tx to cholecystectomy

A

ursodeoxycholic acid

22
Q

most common cause gallbladder disease

A

stones

23
Q

differential dx acute cholecystitis

A

definite localization of pain and tenderness in RUQ with radiation to right infrascapular area = definite. Diff: perforated peptic ulcer, acute pancreatitis, appendicitis, hepatitis, pneumonia w/ pleurisy, MI

24
Q

elevated amylase indicates

A

pancreatitis

25
Q

ultrasound findings in acute cholecystitis

A

gallstones, thickened gallbladder wall, sonographic murphy’s sign; if nothing, go on to HIDA scan

26
Q

most common cause small bowel obstruction

A

post-op adhesions

27
Q

complication of reflux esophagitis

A

peptic stricture

28
Q

how does baby’s weight change within one year

A

should TRIPLE

29
Q

what’s a bowel risk for newborns?

A

necrotizing enterocolitis (NEC)

30
Q

what are internal hemorrhoids ABOVE?

A

dentate line

31
Q

how do you conservatively treat hemorrhoids?

A

decrease straining with defecation, avoid prolonged sitting, symptomatic tx for pruritis/irritation (steroid creams, suppositories, analgesics, sitz baths)

32
Q

presents with blood on surface of stool & is painful (esp. w/ defecation)

A

anal fissure

33
Q

how would you treat an anal fissure?

A

topical analgesics, stool softener; if doesn’t respond, consider surgery

34
Q

what do you do for an anorectal abscess?

A

NOT A DRE! Broad spectrum antibiotics and referral to surgery for I&D

35
Q

treatment for giardia in adults vs kids?

A

adults=metronidazole, kids=furazolidone

36
Q

what can cause HUS in kids?

A

treating e coli 0157:h7 w/ abx in kids

37
Q

do you treat e coli 0157:h7 in kids?

A

no! can lead to HUS

38
Q

treatment for shigella diarrhea

A

TMP-SMX

39
Q

nonbilous vomiting, think..

A

pyloric stenosis

40
Q

what is zollinger ellison syndrome

A

gastrinoma-> multiple peptic ulcers

41
Q

tx for h pylori

A

CAP! clarithromycin, amoxicillin, PPI

42
Q

when is esophageal manometry diagnostic test of choice?

A

achalasia

43
Q

bird beak appearance of LES

A

achalasia