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CDM2 - Final > GI/Renal Cases > Flashcards

GI/Renal Cases Flashcards

(60 cards)

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1
Q

what renal/GI conditions is a KUB useful in diagnosing (6)

A

SBO
constipation
calcification
perforated viscous
+/- nephrolithiasis > 5mm
+/- gallstones (in ~20% of people)

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2
Q

mc cause of perforated viscous

A

gastric ulcer

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3
Q

t/f: all cholangitis patients need US prior to ERCP

A

t!
no surgeon will touch them without imaging

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4
Q

what type of gallstones are visible on US

A

all! regardless of composition

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5
Q

what imaging do you need to evaluate the extent of pancreatitis

A

CT

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6
Q

2 complications of pancreatitis

A

necrosis
abscess

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7
Q

besides US, what test do cholangitis pt’s need prior to ERCP

A

EKG

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8
Q

what labs would you order for a pt with suspected gallstone pancreatitis (3)

A

CMP
Ca
lipids

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9
Q

what is cholecystitis

A

inflammation of the gallbladder

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10
Q

what is cholelithiasis

A

gallstones

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11
Q

what is cholangitis

A

redness and swelling/inflammation of the bile duct system

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12
Q

what is choledocholithiasis

A

gallstones w.in CBD

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13
Q

difference between cholecystitis and cholangitis

A

cholangitis presents w. RUQ pain, fever, leukocytosis, or jaundice

cholecystitis presents w. RUQ pain and less e.o infxn

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14
Q

meds for pain control for pancreatitis

A

IV opioids:
IV morphine
vs
Fentanyl
vs
Dilaudid

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15
Q

gs choice for nausea control in pancreatitis

A

zofran 4 mg

if EKG shows QT prolongation -> compazine or raglan

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16
Q

fluids for pancreatitis pt

A

normal saline TKO

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17
Q

are abx needed for pancreatitis

A

per GI consult

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18
Q

what is Charcot’s triad

A

fever
jaundice
RUQ pain

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19
Q

what does elevated direct (conjugated) bilirubin indicate

A

liver pathology

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20
Q

what does elevated indirect (unconjugated) bilirubin indicate

A

pathology outside of liver -> ex hemolytic anemia

body is not clearing RBC

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21
Q

what is Reynold’s pentad

A

fever
jaundice
RUQ pain
confusion
shock

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22
Q

which is more sensitive for pancreatitis: amylase or lipase

A

lipase

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23
Q

how elevated is lipase in pancreatitis

A

> 3 x nl

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24
Q

what are the 4 f’s of cholelithiasis

A

fat
forty
female
fertile

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25
mc cause of pancreatitis
gallstone pancreatitis
26
what LFT abnormalities suggest a cholestatic pattern
elevated alk phos direct bilirubin
27
what LFT abnormality suggests alcohol related pathology
elevated AST
28
what is functional rectal retention
constipation in peds
29
what imaging is best for eval of constipation
KUB
30
what lab may be useful in constipation work up
UA
31
med for pediatric constipation
miralax 0.4-0.8 g/kg/day max: 17 g/day
32
what antidiarrheal meds are safe for peds
dicyclomine 10 mg po TID-QID loperamide 2 mg PO x 1 after each loose stool
33
your patient has a BUN:Cr ratio > 30 - are you thinking upper GIB or lower GIB
upper GIB
34
gs test for h.pylori
urea breath
35
if urea breath test is positive for h.pylori, what is you next step
start PPI
36
2nd line test for h.pylori if urea breath is not available
serum
37
PPI can affect which h.pylori test
urea breath do test before starting PPI
38
do you need to endoscopy a pt w. PUD who tests positive for h.pylori
not necessarily can just do PPI trial
39
what med can cause false positive on FOBT
pesto bismol tell pt to take tums instead
40
2 tx for arthritis if pt can not take NSAIDs
PT votaren gel
41
5 causes of lower GI bleeds
malignancy hemorrhoids polyps fissures diverticulitis
42
causes of upper GI bleeds
gastric ulcer other stomach pathology
43
what do you suspect when you see elevated BUN w. nl Cr
GI bleed
44
which type of ulcer is improved with food
duodenal
45
which type of ulcer is worse with food
gastric
46
what med do you give a pt with a confirmed and actively bleeding ulcer
H2 blocker: famotidine cimetidine
47
what med is best for chronic management of ulcers
PPI
48
presentation of upper GI bleed
hematemesis and/or melena (black/tarry stool) BUN:Cr > 30
49
presentation of lower GI bleed
hematochezia (BRBPR)
50
rf for neonatal jaundice
jaundice w.in 1st 24 hr of life a sibling w. jaundice as neonate unrecognized hemolysis non-optimal sucking/nursing deficiency of g6pd infxn cephalohematoma/bruising (birth trauma) east asian/north indian
51
management of breast milk jaundice
-reassurance -education that jaundice is commonly seen in neonates 2-3 weeks old -sclera can take a while to go back to normal -let baby eat!! increases liver activity -repeat vitals/weight
52
breast milk jaundice is due to ___ production in some breast milk jaundice
beta-glucoronidase
53
__% of babies develop breast milk jaundice
60
54
what labs are helpful in work up of neonatal jaundice
TSB (total serum biluribin) direct serum bilirubin CBC reticulocyte count DAT (direct antiglobulin) if concern for Rh incompatibility serum albumin BMP G6PD
55
big do not miss with neonatal jaundice
kernicterus
56
sx of kernicterus
AMS floppy baby poor feeding
57
first sign of neonatal jaundice
icterus of sclera
58
sclera icterus occurs around __ mg/dL bilirubin
3
59
2 deadly genetic conditions related to neonatal jaundice
criggler-najaar dubin-johnson
60
what anatomic feature separates upper GI from lower GI
ligament of treitz

CDM2 - Final (9 decks)

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