Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PANCE 2024 > GI / Nutrition > Flashcards

GI / Nutrition Flashcards

1
Q

MC mechanism for GERD ; RF

A

Transient LES relaxation

RF =

ETOH, caffeine , obesity, smoking , hiatal hernia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does heartburn occur in GERD

A

30-60 mins after meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Alarm features of GERD [4]

A

Refractory Heartburn

Dysphagia

Unintentional weight loss

GI Bleed/IDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Refractory GERD with negative endoscopy = get what test

A

Amb pH monitoring ; acidity confirming test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Peristaltic abnormalities / or pre op before GERD surgery get what?

A

Manometry ; dysphagia ID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Mild treatment GERD

A

Lifestyle
Tums
H2 blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Persisitant sxs GERD think what TXM

A

PPI once daily for 4-8 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Reflux esophagitis is what two etiologies

A

Mechanical or Functional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Dx for Reflux esophagitsi

A

Endoscopy w/ biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

TXM for reflux esophagitis

A

PPI x2 daily [4-8 weeks]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Barrets makes you at risk for what

A

Adenocarcinoma ; metaplastic columnar epithelium change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Salmon colored mucosa makes you think what

A

Barrett’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Barrets get PPI when ; survelience?

A

For life x2 daily

EGD every 3-5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Infectious esophagitis effects who most

A

HIV DM Chemo therapy patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Infectious esophagitis 3 diff types and what they look like ; TXM

A

CMV = large ulcers ; linear [TXM = IV ganciclovir/foscarnet]

HSV : multi small ulcers less 2cm [TXM = PO acyclovir]

Candidi = white plaques [TXM = PO fluconazole]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How long can pill induced esophagitis last

A

Hours to days after ingestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pill induced esophagitis study of choice

A

Initial double contrast esophagram

Def = upper endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Radiation esophagitis can cause what

A

Impaired peristalsis decreased motility due to edema inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment for trouble swallowing

A

Prokinetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

E o E usually of hx of what

A

Allergies or atropy as a child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

E o E looks like what on endoscopy

A

White exudates ; red furrows ; concentric rings

Bx= + eosinophilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

E o E txm?

A

Budesonide or fluticasone

Swallow instead of inhaling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Peristalsis and LES tone in achalasia

A

Peristalsis is decreased ; LES in increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Dx of choice most sensitive for achalasia

A

Dx = barium swallow

Most sensitive = manometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CREST with Scleroderma

A

Caclicnosis

Raynauds

Esoph dysmotitlity = solids and liquids

Scledorodactyly

Telangiectasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Barium vs manometry on esophageal spasms

A

Corkscrew = Barium swallow

Nutcracker = manometry

MI pain with dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Zenkers outpouch where?

A

Posterior hypopharnyx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Dysphagia coughing regurgitation halitosis

A

Zenkers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

when do surgically treat Zenkers

A

If dysmotility is severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

SCC risk factors in the throat

A

Tobacco and ETOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Peptic stricture is a complication of what 2 things

A

GERD and Esophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Peptic stricture is usually more of a problem of swallowing

A

Solids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Esophageal webs vs schatzkis rings

A

EW = proximal ; solids > liquids ; barium = shelf

Schatzkis = distal ; heartburn solids > liquids ; barium = esophageal narrowing

TXM = dilation and PPI for heartburn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Plummer Vinson syndrome [4]

A

Cervical esophageal webs

IDA

Stomatitis

Glossitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Solid and liquid dysphagia =

A

Motility disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Dysphagia to liquids think what

A

Neurogenic cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Low grade esoph varices presentation

A

Melena + IDA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Pharm therapy for esophageal varices

A

Vit K = abnormal PT

Laculose = encephalopathy

ABX prob = IV FQ or Cef

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

MW tear occurs where

A

GE junction

Self limiting hematemesis

Heavy ETOH after forced RETCHING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Most MW tears heal when

A

48 hours with PPI txm

Refractory = epinephrine or coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Gastritis 4 etiologies

A

NSAIDS
ETOH
Stress
Portal HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What med can coat the stomach and treat pain in gastritis

A

Sucralfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

AIG = auto immune gastritis

A

Pernicious enemies

Dec IF secretion —> B12 def. —> anemia.

TXM = B12 r2 and survellience endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

H. Pylori risk factor ;; looks like?

A

Travel and eating different foods

Gram negative spiral shaped bacillus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Dx of H. Pylori

A

Urea breathe test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

TXM H. Pylori

A

14 days of Quad Therapy : PBMT

PPI + Bismuth + Tetracycline + Metronidazole

CLARITHRO less 15% = triple therapy
PPI + amoxicillin + CLARITHROMYCIN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

3 complication of H Pylori

A

Gastric cancer

MALT Lymphome

PUDz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

NSAID // H pylori cause what ulcers

A

NSAIDS = gastric

H pylori = duodenal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

PUD dz

A

Upper endoscopy bx ro r/o H pylori and malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Treatment gastric ulcer vs. duodenal

A

Gastric = PPI x 8 weeks

Duodenal = PPI x 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Gastric neos = MC

A

Adenocarcinoma

[Virchow node// Sister Mary Joseph nodule // krukenberg tumor]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Gastric Lymphoma MC in

A

Non Hodkin B cell lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

ZES is what kind of tumor

A

NE tumor gastric secretin = increased acid production

[MEN-1 Syndrome]

Hella Refractory Ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Gastrin can cause what kind of diarrhea

A

Secretory = normal stool ion gap ; high purge rate ; no response to fasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

ZES for gastrin level over

A

150
PH less 2.0

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Pyloric stenosis Mc cause of what

A

Gastric outlet obstruction in infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Succession splash think what

A

PS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

MC gallstones are what

A

Cholesterol

Think the F’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What two things can prevent gallstones

A

ASA and NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Abdominal pain after fatty meal colicky RUQ pain

A

Cholelithiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Cholecystitis impacted gallstone where

A

Cystic duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What chole sign inhibits inspiration

A

Murphys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Most definitive test of cholecystitis

A

HIDA scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

TXM cholecystitis

A

IV fluids
Bowel Rest
IV ABX : Metro and CIPRO

Pain management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

4 complications of cholecystectomy

A

CBD stone
Bile duct stricture
Bile acid induced diarrhea
Sphincter of oddi dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Chronic Cholecystitis

A

Repeat irritation
RUQ pain vague dull does not go away
Nausea

Fatty meals make it worse ; but does go away

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

CBD stones RF

A

Stones
Biliary stairs s
S/p cholecystectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Large glass tone in the duodenum causing SBO think what

A

Gallstones ILEUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Gold standard for CBD stone

A

ERCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Cholangitis MC organisms

A

E Coli

Klebsiella

Enterococcus

Enterobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Charcots Cholangitis

A

RUQ Fever Jaundice

PENTAD = AMS + Hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What do you give after ERCP to prevent post ERCP pancreatitis

A

Indomethacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

cholangitis ABX of choice

A

Piperzillan / Taxobactam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What type of Hep is common in endemic areas

A

AE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What type of hep is blood borne

A

BC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Aversion to smoking occurs think what

A

Hepatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What type of hep is fecal to oral

A

Hep. A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What type of Hep do we have PEP meds ?

A

A and B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Acute hepatitis

A

IgM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Previous hepatitis infection

A

IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Vaccination are usually [hepatitis]

A

Anti HAVE IgG

Anti -HBs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Hep B previos infection think positive what

A

Core antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Hep A B C treatment

A

A = self limited

B = antivirals [tecavir]

C = monitor for 3 months ; protease inhibitor [simeprevir] NS5B ;

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Needles stick HEp C exposure mangement

A

RNA/LFTs @ 2 wk ; 4 wk ; 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Heb B vaccine is when

A

0 , 1, 6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What type of hep has vaccines

A

A and B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

MC of ALF in the US

A

APAP toxicity and drug rxns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

N acetycystein only given in APA if when

A

Less than 72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Chronic viral hepatitis worry about

A

Progression to cirrhosis or carcinoma of liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Alcoholic Hepatitis think what LFTS

A

AST > ALT

GGT+

elevated ALK phos and Bilirubin

PROLONGED PT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

3 nutritional deficiencies in alcoholic hepatitis

A

Thiamine

Folic Acid

Zinc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Improves circulation prevents hepatorenal syndrome ; treatment in alcoholic hepatitis ?

A

Pentoxyfilline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Reduces short term mortality in alcoholic hepatitis

A

Methlyprednisolone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Infection complications common in alcoholic hepatitis

A

Aspergillosis - fungal infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

NAFLD Dx

A

Mildly elevated ALK phos , AST , ALT

ALT > AST

Get : U/S ; liver bx = Dx

“Fat in the liver no inflammation”

96
Q

Treatment NAFLD

A

10% body weight loss; lifestyle changes

97
Q

Autoimmune hepatitis mc in who

A

Young middle aged women
Amenorrhea
Straie
Hirsituism
Telangiectasias

+ANA or + Smooth muscle antibody

Liver Bx = Dx

98
Q

A hep treatment

A

Prednisone and Azathioprine

99
Q

Cirrhosis classified as

A

Irreversible fibrosis and nodular regeneration

Compensated
Compensated with varices
Decompensated [ascites, encephalopathy, jaundice]

100
Q

A fibrotic liver in late stage cirrhosis will be what?

A

Smaller and more nodular, firm

101
Q

Cirrhosis dx =

A

Liver biopsy

Low platelets
Low albumin
Leukopenia / anemia

102
Q

How can we treat ascites

A

Salt restriction // fluid restriction

Spironolactone + Furosemide

Paracentesis + Albumin

103
Q

Primary Biliary cirrhosis is destruction where ?

A

Automunimme destruciton of intrahepatic ducts

-cholestasis = jaundice; pruritus

104
Q

What is the positive diagnostic in primary biliary cirrhosis

A

+ antimitochondrial antibodies

Elevated bili, ALK phos, and cholesterol

105
Q

Primary sclerosing cholangitis is what

A

Cholestasis with destruction of intra and extra hepatic bile ducts

Assoc with Ulcerative Colitis

MRCP and ERCP imaging // bx shows periductal fibrosis or “onion skinning”

Screen yearly for malignancy

106
Q

Mc liver neoplasm [benign]

A

Cavernous hemangioma

107
Q

What Mets most common to the liver

A

Lung and breast

108
Q

Exposure to what can predispose someone to Hepatocellular CA

A

Aspergillosis

109
Q

Courvesoier sign =

A

Palpable Nontender gallbladder associated with jaundice

Cholangeiocarcinoma

110
Q

MC liver cancer in children

A

Hepatoblastoma

111
Q

When do you treat liver neos

A

If risk of rupturing hepatic capsule

112
Q

+ Tumor marker for Hepatocellular carcinoma =

A

AFP greater 200 // with U/S every 6 months

Get CT.MRI with Contrast

No needle Bx

113
Q

Pancreatitis is what on exam

A

Steady pain boring
Worse lying down
Between leaning forward
Rads to the back

114
Q

Imaging modality of choice for acute pancreatitis

A

CT scan

115
Q

4 lab values associated with bad acute pancreatic outcomes

A

LDH over 350

AST over 250

Glucose over 200

WBC over 16,000K

116
Q

Treatment for Acute pancreatitis

A

Keep NPO

With AGGRESSIVE FLUID RESCUCITATION

117
Q

When can you advance diet for acute pancreatitis

A

Once pain free

118
Q

MC chronic pancreatitis = due to what?

A

ETOH ; with chronic abdominal pain ; steattorhea

119
Q

Chronic pancreatitis dx

A

ERCP = most sensitive

CT = +calcifications

120
Q

75% of pancreatic cancer occurs where

A

The head

121
Q

What is a sister Mary Joseph nodule

A

Hard Periumbilical nodule

122
Q

Tumor marker for pancreatic neoplasm

A

CA 19-9

123
Q

TTP where for appendicitis

A

McBurney’s Point

124
Q

Psoas vs. OPbturator

A

Psoas = raise leg against resistance

Obturator = right knee bent , Flexion + internal rotation of the right hip

125
Q

Foods for celiac disease [3]

A

Wheat rye and barley

126
Q

High risk groups for celiac

A

1st degree relatives
Type 1 DM
Autoimmune thyroid disorder

127
Q

Initial test vs. confirmatory for celiac

A

Initial = tTG IgA

Confirm = endoscope with small intestine bx

128
Q

70% of celiac disease get what and what else can happen commonly

A

Osteopenia / osteoporosis = 70%

Malignancy = lymphoma or carcinoma

129
Q

Whipple disease is infection of what

A

Trophyeryma whippelii

-affect any system in the body but GI is common.
-dementia ; opthalmoplegia ; myoclonus = TRIAD

“Can’t absorb fats or carbs”

130
Q

Whipple disease picture ; TXM

A

Diarrhea with weight loss fever arthralgia

TXM = Ceftriaxone x 2 weeks then bacttrim for 12 months

131
Q

MC site of Mesenteric ischemia

A

SMA

132
Q

Chronic intestinal ischemia is characteristically what

A

Postpraindal with progressive anorexia

133
Q

Imaging ofr choice for intestinal ischemia

A

CT Angio = pruned tree appearance of distal vascular bed

134
Q

Bowel sounds are what with SBO

A

Hyperactive at first; with progressive absence of sounds

135
Q

Plain film + in SBO + management ?

A

Dilated bowel loops with positive air fluid levels

Get CT to define transition points

GET NGT , IV fluids , pain control , antiemetics

136
Q

Invagination of what = intussusception

A

Proximal bowel into distal segment

137
Q

Kids vs. Adults intussusception treatment

A

Kids = barium enema

Adults = surgery because likely a mass is provoking it.

138
Q

Constipation red flags [ 5 ]

A

Age over 50

IDA

Weight Loss

FH of Colon Cancer or IBD

+FOBT or +FIT test

139
Q

Osmotic laxatives are indicated when? How do they work? Examples?

A

—> good start medication

Increase secretion of water into the lumen

Mag Hydroxide ; PEG ; Sorbitol ; Lactulose

140
Q

Stimulant laxatives are indicated when? How do they work? Examples?

A

Short term step up from osmotics

Stimulate fluid secretion and colonic contraction

Bisacodyl ; senna ; cascara

141
Q

Chloride secretory agent laxatives are indicated when? How do they work? Examples?

A

Longer term use without building a tolerance
Increase intestinal fluid and accelerate colonic transit

Lubiprostone ; linaclotide ; plecanatide

142
Q

Serotonin 5 HT receptor agonist

A

Prucalopride

143
Q

Opioid receptor antagonists

A

Block peripheral opioid receptors without affecting central anesthesia

Methlynaltrexone ; naloxegol

144
Q

Mangement for fecal impaction

A

Saline mineral oil enema
Digital disimpaction
Maintain soft stool // regular BM
REFERAL for PFT ; Colonscopy ; Surgery

145
Q

MC diverticulosis MC site

A

Sigmoidoscopy colon

146
Q

What should you not get for diverticulitis

A

Barium study

147
Q

Mild uncomplicated diverticulitis treatment

A

PO ABX x 7-10 days

Metro + Cipro or Bactrim

Augmentin

Clear liquid diet ASTolerated

148
Q

Severe diverticulitis treatment

A

Admit + IV ABX

1st line = cefoxitin / pipe/tazo

149
Q

Abscess formation can occur in diverticulitis greater than how large

A

4 cm

150
Q

Ciggarettes help what and make what worse

A

Help UC . Make Crohns worse

151
Q

What ethnicity is commonly effected by IBD

A

Jews

152
Q

Crohn’s think what [4]

A

Mouth to anus
Transmural
NEGATIVE IN THE RECTUM
Non caseating Granulomas on Bx

+strictures ; fistula ; malabsorption*

153
Q

UC [4]

A

Gradual onset rectum to proximal segment
Bloody diarrhea
Tenesmus
Severe Fever def ; Toxi mega ; perforation

Colon CA

154
Q

MC extra intestinal IBD

A

Joints

155
Q

Crohn’s mild mod severe/ Mx treatment

A

Mild / moderate = PO 5 ASA

Severe = PO or IV Steriods

Mx = 5 ASA ; Immunomodulators ; Biologics

156
Q

UC distal ; above sigmoid ; severe treatment

A

Distal = topical 5 Asa or steriods

Above sigmoid = PO 5 ASA

Severe = PO or IV Steriods

Mx - 5 ASA ; Immunomodulators Biologics

157
Q

In UC surgery =

A

Curative

158
Q

2 types of microscopic colitis

A

Lymphocytic
Collagenous

159
Q

How do elevated levels of estrogen // progesterone effect the gallbladder [ pregnancy ]

A

Estrogen = increase cholesterol excretion into the bowel

Progesterone = decrease gallbladder motility and emptying

Pregnant women are increased risk for Gallbladder Dz
* Both elevated E and P can lead to decreased LES tone*

160
Q

Are pregnant women good candidates for cholecystectomy

A

No usually delayed until postpartum

161
Q

What is the most sensitive initial test for malabsorptive conditions ?

A

Stool fat testing

162
Q

4 risk factors for C diff

A

Recent ABx

Gastric acid suppression

IBD

Chem/rads / AGE

163
Q

How do patients present with FOB in the esophagus vs down to the bronchus?

A

Esophagus = usually a witnessed swallow but patient as no sxs ; no drooling ; NML breathe sounds

Bronchus = sudden onset respiratory distress and asmx breathe sounds

164
Q

3 risk factors for emphysematous cholecystitis

A

Immune suppression
DM
Vascular Compromise

165
Q

What age size umbilical hernia gets surgical management

A

Age = over 5 years old

Size = over 1.5 cm

166
Q

Achalasia discomfort is better in what position

A

Sitting up right and leaning forward

167
Q

What type of IBS do you need to make sure you screen for celiac disease?

A

IBS-D because sxs can be similar

-loose with freq stools-

168
Q

What is the treatment algorithm for pregnant patients with N/V

A

lifestyle changes —> B6 & H1[doxylamine] AH —> oral dopamine and serotonin antagonists —> IV Fluid and IV Antiemetics —> CC —> TPN

169
Q

SBO looks like what on plain film

A

Multiple loops of dilated bowel

170
Q

What is the typical chronic pancreatitis supplementation

A

Lipase , protease , amylase

171
Q

What does the imaging look like in chronic pancreatitis

A

Pancreatic atrophy with calcifications

172
Q

What are two protective factors for RF for colon cancer?

A

High fiber diet
NSAID / ASA use

173
Q

Acalcaulous cholecystitis can lead to what complications

A

Cholestasis
Gallbladder ischemia
Gallbladder edema and necrosis [from secondary infection]

174
Q

IBS at least 1 day per week assoc with greater than 2 what

A

ABD pain relieved to defecation
Change in stool frequency
Assoc with change in stool appearance

175
Q

Peppermint oil can do what

A

Antispasmodic but caution because it relaxes the LES

176
Q

IBS c med treatment

A

Lubiprostone linaclotide plecantide proclamation

177
Q

What type of IBS benefits from TCA

A

IBSD

178
Q

After long run LLQ + hematochezia think

A

Ischemic colitis

Get CT / def = Colonscopy

179
Q

MC location for ischemic colitis

A

Inferior Mesenteric Artery

180
Q

What type of colon polyp has most risk for malignancy

A

ADENOMATOUS

181
Q

If family history what is the Colonscopy screening

A

Every 5 years + family history
And 10 years before onset of family cancer
Or age 40

182
Q

What age should the avg adult start Colonscopy screening

A

Age 45

183
Q

Tumor marker for colon cancer

A

CEA

184
Q

MC cause of LBO

A

Neoplasm

185
Q

What is a good motility activator for LBO

A

Neostigmine ; decompress the bowel

If volvulus = Colonscopy

186
Q

What will x ray for LBO

A

Free Air

Coffee bean or Birds Beak

get a CT scan to confirm

187
Q

2 etiologies for Toxic megacolon

A

C diff

Or

UC

***new onset fever; shock, hypovolemia

188
Q

MC place for anal fissure

A

Posterior midline

189
Q

Treatment for anal fissure

A

Fiber

Sitz bath

Topical lidocaine ; diltiazem

190
Q

Perinatal abscess think what etiology

A

Crohn’s ; also can develop fistulas into the mucosa

191
Q

Where are pilonidal cysts commonly

A

Sacrococcygeal cleft

192
Q

How do you know internal vs external hemorrhoids

A

Internal = painless BRPR

External = below the dentate line ; painful

193
Q

Management vs. grade hemorrhoids

A

1 = bleed ; no prolapse —> rubber band ligation ; sclerotherapy

2 = prolapse but Spont reduce —> rubber band ligation ; sclerotherapy

3 = prolapse but req manual reduction —> rubber band ligation ; sclerotherotherapy, surgery

4 = chronic prolapse ; STRANGULATION risk —> urgent surgery ; hemorroidectomy

194
Q

MC anal cancer

A

80% HPV squamous cell carcinoma

195
Q

Less than what size = conservative txm for anal cancer? ; what treatment for anal cancer

A

3cm = local excision

Larger = surgery/chemo

196
Q

What is a richter hernia

A

Part of the bowel wall becomes incarcerated not the whole LOOP

197
Q

Hiatal hernia are due to what

A

GERD

198
Q

Direct vs Indirect Hernia location

A

Direct = MC Acquired ! Through the abdominal wall

Indirect = through inguinal canal

199
Q

what are the components of the hesselbach triangle

A

Inguinal ligament ; inferior epigastric vessels ; lateral border of the rectus muscle

200
Q

Acute diarrhea vs Chronic diarrhea

A

Acute = less than 2 weeks

Chronic = longer than 3 weeks

201
Q

How do you describe febrile bloody or pus in stool diarrhea

A

Inflammatory

202
Q

Pregnant women are at risk for what bloody diarrheal agent

A

Listeria

203
Q

Campylobacter think what [3]

A

Rare poultry

Fever bloody diarrhea

FQ treatment

204
Q

Entoemeba [3]

A

Tropical regions poor sanitation

Hepatomegaly

Metronidazole TXM

205
Q

salmonella [3]

A

Eggs poultry unpastrerized milk

Bloody diarrhea

FQ TXM

206
Q

Shigella [3]

A

Food water in human feces

Fever pain diarrhea + blood

FQ or Bactrim TXM

207
Q

Yersenia E. [3]

A

Undercooked pork ; contaminated water

Bloody appendix like pain + poly arthritis in children or erythema nodosum

Tetracycline or FQ if severe TXM

208
Q

With metronidazole txm avoid what

A

ETOH for disulfiram reaction

209
Q

Greasy malodorous diarrhea ? And what TXM

A

Giardia ; FQ

210
Q

Rice water stool ? And TXM?

A

Vibrio Cholerea

Tetracycline or Azithromycin TXM

211
Q

What diet is good in diarrhea

A

BRAT

212
Q

Osmotic diarrhea resolves with what

A

Fasting

secretory does not change with eating

213
Q

Secretory diarrhea has a normal what

A

Osmotic gap

214
Q

Vitamin A deficiency causes what

A

Vision changes ; at night
Dry scaly skin
Hair loss
Hip fractures

215
Q

Vitamin D deficiency think what

A

Rickets

Hypercalcemia
Renal stones

216
Q

Vitamin E deficiency think what

A

Cellular aging and vascular integrity changes

Areflexia gait disturbance loss of vibratory sense

GI discomfort

217
Q

Vitamin K deficiency think what

A

Bleeding issues anemia jaundice

218
Q

Vitamin B12 deficient think what

A

Megaloblastic anemia
Parenthesias
Confusion

219
Q

Vitamin B1 deficiency thin what

A

Thiamine

Lethargy ataxia

Wernickes encephalopathy

220
Q

Vitamin B6 deficiency think what

A

Dermatitis / cheilossis

Photosensitivity
Peripheral neuropathy

221
Q

Vitamin B2 deficiency think what

A

Glossitis leukopenia anemia

Oxidation reduction function

222
Q

Niacin defiency think what

A

Diarrhea
Dermatitis
Dementia

223
Q

Vitamin C deficiency think what

A

Swollen gums

“Scurvy”

Atraumatic hermarthrosis

224
Q

Risk factors for phentermine / topiramate

A

Tachycardia

Contraindicated in pregnancy

225
Q

What is an injectable obesity medication

A

Liraglutide

226
Q

FOB with cough worry about what

A

Aspiration

227
Q

When do you barium swallow for FOB

A

If highly suspect but negative X-RAY

228
Q

What substances a can cause hyperthermia [4]

A

Amphetamines

Anticholinergic

Cocaine

Salicylates

229
Q

Arsenic ;; methadone ;; citalopram can cause what arrhythmia

A

QT prolongation

230
Q

APAP toxicity affects what organ

A

The liver

231
Q

G6PD is what type of deficiency

A

X lined recessive

232
Q

What is the osteoid formation in Piaget disease

Affects what body area first

A

Disorganized

Affects long bones first

233
Q

Increased hat size think what disease

A

Pagets

Elevated ALK phos

234
Q

Treatment and complication of Paget’s disease

A

Bisphosphonates = TXM

Complication = osteosarcoma

235
Q

‘PKU is what genetic defect

A

Autosomal recessive

236
Q

Reduce intake of what in PKU

A

Dairy
Meat
Fish
Eggs
Nuts/Legumes

PANCE 2024 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions