GI/Nutrition Flashcards
(217 cards)
1
Q
sx of hepatitis a
A
fatigue/malaise
n/v
anoreia
fever
RUQ pain
2
Q
transnission of hep A
A
fecal-oral
3
Q
dx for hep A
A
IgM anti HAV
4
Q
hep A vaccination recs
A
routine beginning at 1 yo
5
Q
transmission of hep B
A
sexual
sanguineous
6
Q
vaccine recs for hep b
A
routine for all starting at birth
7
Q
transmission for hep C
A
IVDU
sexual
sanguineous
8
Q
mc route of transmisson for hep C
A
IVDU
9
Q
screening and dx tesst for hep C
A
screening: anti HCV abs
dx: HCV RNA quantitation
10
Q
2 complications of hep C
A
cirrhosis
HCC
11
Q
hep D only occurs in the presence of
A
hep B infxn
12
Q
what makes you suspect hep D
A
severe/worsening hep B infxn
13
Q
dx for hep B
A
HDV abs
14
Q
what pt pop makes you think hep E
A
pregnant, 3rd world countries
15
Q
complication of hep E
A
high infant mortality
16
Q
what is toxic hepatitis
A
APAP toxicity
17
Q
3 rf for NAFLD
A
obesity
HLD
insulin resistance
18
Q
LFT pattern for NAFLD
A
ALT > AST
elevated ALP
19
Q
all pt’s w. suspected NAFLD should get what imaging
A
US
20
Q
US findings of NAFLD
A
steatohepatitis ->
increased echogenicity
coarsened echotexture of liver
21
Q
gs dx for NAFLD
A
liver bx showing macrovesicular fatty infiltrates
22
Q
tx for NAFLD
A
lifestyle
liver transplant
23
Q
what are the 4 serologic tests associated w. Hep B
A
anti HBc IgM
anti HBc IgG
HBsAg
Anti HBs
24
Q
(+) Anti-HBc IgM
(+) HbsAg
A
acute HBV infxn
25
(+) HbsAg
early acute HBV infxn
26
(+) Anti-HBc IgG
(+) Anti-HBs
resolved acute HBV infxn
27
(+) Anti HBs
HBV vaccine/immunity
28
(+) Anti-HBc IgG
(+) HBsAg
chronic HBV infxn
29
two Hep C serology tests
HCV RNA
Anti-HCV
30
(+) HCV RNA
acute HCV infxn
31
(+) anti-HCV
resolved HCV infxn
32
(+) HCV RNA
(+) anti-HCV
chronic HCV infxn
33
2 hep A serology tests
IgM HAV Ab
IGg HAV Ab
34
(+) IgM HAV Ab
acute HAV infxn
35
(+) IgG HAV Ab
past HAV infxn
36
what is this showing
flank ecchymosis -> pancreatitis
37
describe pain w. pancreatitis
abdominal pain radiating to the back
38
mnemonic for causes of pancreatitis
**get smashed**
gallstones
etoh
trauma
steroids
mumps
autoimmune
scorpion
hypercalcemia
ercp
drugs
39
gs dx for pancreatitis
CT
40
most sensitive test for chronic pancreatitis
ERCP
41
what is this showing
periumbilical ecchymosis -> cullen sign
42
ranson's criteria for poor prognosis w. pancreatitis
**at admit:**
ldh > 350
age > 55
bg > 200
wbc > 16,000
ast > 250
**at 48 hr:**
calcium < 8
hct drop > 10%
Po2 < 60
bun rise > 1.8
base deficit > 4
sequestration of fluid > 6L
43
2 complications of pancreatitis
pseudocyst
necrosis
44
chronic pancreatitis triad
pancreatic calcification
steatorrhea
DM
45
tx for pancreatitis
IVF
analgesics
bowel rest
46
anorectal fistulas are a complication of
anorectal abscesses
47
tx for anorectal fistula
surgery
48
tearing rectal pain and bleeding with or shortly after defacation, bright red blood on tp
anal fissure
49
tx for anal fissure
sitz bath
increased fiber/water
stool softeners/laxatives
50
2 hallmark sx of anorectal ca
rectal bleeding
feeling of incomplete bowel emptying (tenesmus)
51
mc type of anorectal ca
adenocarcinoma
52
tx for anorectal ca
surgical excision
xrt
chemo
53
2 hallmark sx of colon ca
painless rectal bleeding
change in bowel habits
54
mc type of colon ca
adenocarcinoma
55
what is this showing
apple core lesion -> colon adenocarcinoma
56
colon ca screening recs for average risk pt's
start at 45
end at 75
57
3 stool tests for colon ca screening and how often they should be done
gFOBT - yearly
FIT - yearly
FIT-DNA - 1-3 years
58
how often should a flexible sigmoidoscopy be performed for colon ca screening
q 5 years
59
imaging for colon ca screening
CT colonography q 5 years
60
tumor marker for colon ca
CEA
61
characteristics of malignant polyp
> 1 cm
sessile
villous
62
characteristics of benign polyp
pedunculated
< 1 cm
tubular
63
tx for colon ca
surgery
chemo
64
mc cause of esophageal ca worldwide vs US
worldwide: squamous cell
US: adenocarcinoma
65
esophageal adenocarcinoma is mc a complication of
barrett's
66
location of esophageal adenocarcinoma vs squamous cell
adenocarcinoma: distal 1/3
squamous: proximal 2/3
67
screening recs for esophageal adenocarcinoma for pt's w. barrett's
endoscopy q 3-5 years
68
2 rf for sqamous cell esophageal ca
smoking
etoh
69
sx of esophageal squamous cell carcinoma
progressive dysphagia
wt loss
**hoarseness**
70
tx for esophageal ca
surgery
71
2 mc sx of gastric ca
abd pain
unexplained wt loss
72
mc type of gastric ca
adenocarcinoma
73
2 hallmark PE findings for gastric ca
virchow's node (supraclavicular)
sister mary joseph's node (umbilical)
74
dx for gastric ca
upper endoscopy w. bx
75
what is linitis plastica on bx
diffuse thickening of stomach wall d/t ca infiltrtion
76
tx for gastric ca
gastrectomy
xrt
chemo
77
what does dermatitis herpetiformis make you think of
celiac
78
6 conditions associated w. celiac
T1DM
AI hepatitis
thyroid dz
down's syndrome
turner's syndrome
williams syndrome
79
what type of ca is associated w. celiac dz
small bowel lymphoma
80
dx for celiac
IgA anti-endomysial (EMA)
anti tissue transglutaminase (anti-TTG)
**small bowel bx - gs**
81
celiac dz is associated w. what 2 genetic markers
HLA-DQ8
HLA-DQ2
82
infxn of the biliary tract 2/2 obstruction, which leads to biliary stasis and bacterial overgrowth
cholangitis
83
mcc of cholangitis
choledocholithiasis
84
all causes of cholangitis
**choledocholithiasis**
pancreatic ca
biliary neoplasm
post op strictures
ERCP/PTC
choledochal cysts
85
4 organisms associated w. cholangitis
e.coli
enterococcus
klebsiella
enterobacter
86
charcot's triad for cholangitis
fever
jaundice
RUQ pain
87
reynold's pentad for cholangitis
charcot's triad
+
AMS
hypotn
88
imaging for cholangitis: initial vs gs
initial: US
gs: ERCP
89
tx for cholangitis
emergent ERCP w. stent
cipro + metro
IVF
analgesics
post acute cholecystectomy
90
inflammation and fibrosis of intrahepatic and extra hepatic bile ducts
primary sclerosing cholangitis
91
3 hallmark sx of primary sclerosing cholangitis
jaundice
pruritis
hepatosplenomegaly
92
what 4 conditions are associated w. primary sclerosing cholangitis
UC
cholangiocarcinoma
pancreatic ca
colorectal ca
93
only definitive tx for primary sclerosing cholangitis
liver transplant
94
inflammation of the GB mc associated w. gallstones
cholecystitis
95
5 f's of cholecystitis
female
forty
fat
fertile
fair
96
fever, leukocytosis, jaundice
cholecystitis
97
imaging for cholecystitis: initial vs gs
initial: US
gs: HIDA
98
US findings of cholecystitis
gallbladder wall > 3 mm
pericholecystic fluid
gallstones
99
LFT pattern of cholecystitis
elevated ALP and GGP
elevated conjugated bilirubin
100
porcelain gallbladder is a complication of
chronic cholecystitis
101
gs imaging for choledocholithiasis
ERCP
102
tx for cholecystitis
cholecystectomy in 24-48 hr
103
referred right scapular pain from cholelithiasis
boas sign
104
2 mcc of cirrhosis
1. etoh
2. chronic hep B/C
105
tumor marker for HCC
AFP
106
what is budd chiari syndrome
hepatic vein thrombosis - complication of cirrhosis
107
budd chiari triad
abd pain
ascites
hepatomegaly
108
complications of cirrhosis
portal htn
ascites
esophageal varices
hepatorenal syndrome
hepatic encephalopathy
hepatocellular carcinoma
109
4 sx of portal htn
ascites
peripheral edema
splenomgaly
varicosity of veins
110
mcc complication of cirrhosis
ascites
111
work up for ascites
abd US
paracentesis
serum albumin gradient
112
management of ascites
Na restriction
diuretics
paracentesis
113
3 indications for paracentesis w. ascites
tense ascites
SOB
early satiety
114
4 sx of ruptured esophageal varices
retching/dyspepsia
hypovolemia
hypotn
tachycardia
115
pathophys of hepatorenal syndrome w. cirrhosis
progressive ESLD -> vasoconstriction -> decreased renal perfusion -> oliguria, azotemia, hypotn
116
what is asterixis
flapping tremor w. flexed hands - think hepatic encephalopathy
117
prolonged _ indicates severe cirrhosis
PT/PTT
118
nail findings of cirrhosis
terry's nails -> white nail beds
119
7 skin changes associated w. cirrhosis
spider angiomata
palmar erythema
jaundice
scleral icterus
ecchymoses
caput medusae
hyperpigmentation
120
HCC screening recs
abd US q 6-12 mos
121
which IBD is associated w. aphtous ulcers and polyarthralgia
crohn's
122
mc location for crohn's
terminal ileum
123
cobblestoning, skip lesions, and linear fissures
crohn's
124
which IBD is transmural and which is limited to the mucosa/submucosa
crohn's: transmural
UC: mucosa/submucosa
125
what is this showing
string sign on barium study -> strictures -> **crohn's**
126
4 common complications of crohn's
obstruction
abscess
fistula
sinus tracts
127
best dx test for crohn's
colonoscopy
128
what abs may distinguish crohn's from UC
crohn's: (+) anti-saccharomyces cerevisiae abs (ASCA)
129
management of crohn's
elemental diet
vitamin supplementation
smoking cessation
pharm:
**1. aminosalicylates - first line**
2. steroids
3. immune modifying drugs
4. anti TNF's
130
name 2 aminosalicylates used in crohn's
**mesalamine - preferred/best for maintenance**
sulfasalazine - 2nd line
131
s.e of sulfasalazine
hepatitis
pancreatitis
allergic rxn
fever
132
utility of steroids in crohn's
acute flares
133
t/f: surgery is recommended for crohn's
f!
due to high risk of recurrence
134
painless BRBPR
diverticulitis
135
mc location for diverticulitis
sigmoid colon
136
dx for diverticulitis
CT w. oral/rectal/IV contrast
colonoscopy 1-3 mos after flare up
137
2 CT findings of diverticulitis
fat stranding
bowel wall thickening
138
indications for surgical resection w. diverticulitis
recurrent flareups
perforation
fistula
abscess
139
**gradual/progressive** dysphagia to solids, PMH GERD
esophageal stricture
140
3 types of esophageal stricture
web
plummer-vinson
schatzki ring
141
thin membranes in the mid-upper esophagus - congenital vs acquired
esophageal webs
142
esophageal webs
dysphagia
IDA
plummer vinson
143
diaphragm-like mucosal rink that forms at the esophagogastric junction
schatzki ring
144
dx for esophageal strictures
upper endoscopy
145
management of esophageal strictures
endoscopic dilation
r.o cancer
146
management of esophageal varices
-endoscopic banding vs sclerotherapy vs balloon tamponade
-IV octreotide
-bb for secondary prophylaxis
-TIPS for refractory
147
screening recs for esophageal varices
cirrhosis + portal htn - screen q 2-3 years
monitor small varices q 1-2 years
148
2 types of esophagitis
non-infectious
infectious
149
5 causes of non-infectious esophagitis
reflux
medication-induced
eosinophilic
xrt
corrosive
150
2 meds associated w. errosive esophagitis
NSAIDs
bisphosphonates
151
pt w. asthma sx and GERD not responsive to antacids
eosinophilic esophagitis
152
dx for eosinophilic esophagitis
bx
153
what is this showing
ribbed esophagus w. multiple corrugated rings -> eosinophilic esophagitis
154
4 xrt drugs that cause esophagitis
doxorubicin
bleomycin
cyclophosphamide
cisplatin
155
common cause of corrosive esophagitis
ingestion of alkali or acid from attempted suicide
156
2 hallmark sx's of infectious esophagitis
odynophagia
chest pain
157
what pt pop makes you think of infectious esophagitis
immunocompromised
158
3 mc pathogens associated w. infectious esophagitis
candida albicans
HSV
cytomegalovirus
159
what is this showing
linear yellow-white plaques -> **candida esophagitis**
160
tx for fungal esophagitis
fluconazole
161
4 viral causes of esophagitis
HSV
CMV
EBV
myobacterium
162
what is this showing
shallow punched out lesions on EGD -> **HSV esophagitis**
163
what is this showing
large, solitary ulcers/erosions on EGD -> **CMV esophagitis**
164
tx for CMV esophagitis
ganciclovir
165
dx for infectious esophagitis
endoscopy w. bx/culture
double contrast esophagram
166
tx for infectious esophagitis based on cause
candida: fluconazole
HSV: acyclovir
CMV: ganciclovir
corrosive: steroid
eosinophilic: topical steroids, SABA
167
3 causes of gatritis to know
1. **h.pylori - mc**
2. NSAIDs/etoh
3. autoimmune/hypersensitivity
168
location of gastritis w. h pylori infxn
antrum
body
169
2 dx tests for h pylori
urea breath test
fecal antigen
170
why do NSAIDs cause gastritis
diminish local prostaglandin production in stomach/duodenum
171
what does autoimmune gastritis make you think of
pernicious anemia
172
what test is positive in pernicious anemia
schilling
173
location of autoimmune/hypersensitivity gastritis
body of the fundus
174
management of gastritis
stop offending agent
PPI x 4-8 weeks
abx if h pylori
UGI endo
US
175
triple therapy for h pylori
clarithromycin
amoxicillin
PPI
176
quadruple therapy for h pylori
tetracycline
omeprazole
metro
bismuth
177
gs dx test for GERD
24 hr pH monitoring
178
7 indications for endoscopy w. GERD
dysphagia
recurrent vomiting
wt loss
hematemesis
anemia
melena
age > 50
179
management of GERD (4)
H2 blockers
PPI
lifestyle
nissen fundoplication
180
varicose veins of the anus/rectum
hemorrhoids
181
6 rf for hemorrhoids
constipation/straining
pregnancy
portal HTN
obesity
prolonged sitting or standing
anal intercourse
182
hallmark sx of hemorrhoids
painless BRBPR
183
indications for anoscopy w. hemorrhoids
BRBPR
suspected thrombosis
184
2 types of hemorrhoids
internal
external
185
indication for excision of hemorrhoid
external thrombosed
186
3 indications for rubber band ligation of hemorrhoid
protrudes w. defacation
enlargement
intermittent bleeding
187
indication for closed hemorrhoidectomy
permanently prolapsed
188
2 mcc of hepatic ca
1. cirrhosis
2. chronic hep C
189
protrusion of stomach thru the esophageal hiatus
hiatal hernia
190
2 types of hiatal hernia
type 1 - sliding - **mc**
type 2 - rolling
191
GE junction and stomach slie into the mediastinum
type 1/sliding hiatal hernia
192
fundus of the stomach protrudes thru diaphragm w. GE junction
type 2/rolling hiatal hernia
193
which type of hiatal hernia requires surgical intervention
type 2/rolling
194
5 sx of hiatal hernia
epigastric pain
substernal regurgitation
dysphagia
chest palpitations
SOB
195
gs dx for hiatal hernia
US
196
definition of IBS according to rome IV criteria
recurrent abd pain on average at least one day per week in the last 3 mos associated w. 2 or more:
-related to defecation
-associated w. change in stool frequency
-associated w. change in stool form/appearance
197
management of IBS
loperamide vs colace/psyllium
tegaserod maleate
rifamixin (diarrhea)
exercise
198
where do mallory weiss tears occur
GEJ
199
common presentation of mallory weiss tear
etoh intake -> forceful vomiting -> hematemesis
200
upper endoscopy findings of mallory weiss tear
superficial longitudinal mucosal erosions
201
management of mallory weiss tear
supportive
cauterize vs epi
202
3 causes of PUD
**h pylori**
NSAIDs
zollinger ellison
203
which type of ulcer is improved w. food
duodenal
204
gs dx for PUD
endoscopy
205
gs dx for h pylori
endoscopy w bx
206
what h pylori test should be used to confirm eradication after tx
stool antigen
207
which h pylori test can confirm infxn but should not be used to cofirm eradication
serologic abs
208
management of PUD
**ppi - most effective**
h2 blockers
abx if h pylori
surgery for refractory
209
3 hallmark sx of UC
hematochezia
pus filled diarrhea
tenesmus
210
mc location for UC
rectum
211
imaging findings of UC
loss of haustral markings
lumen narrowing
212
what dx test should be used for UC if you are concerned for colon perf
flex sigmoidoscopy
213
what is this showing
lead pipe apperance -> **UC**
214
which IBD is associated w. toxic megacolon
UC
215
definitive tx for UC
colectomy
216
pharm management of UC
prednisone
mesalamine
217
abs assocaited w. UC
antineutrophil cytoplasmic abs (pANCA)
