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PANCE Review > PANCE - GI review > Flashcards

PANCE - GI review Flashcards

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1
Q

what antibiotic is a major cause of biliary sludge

A

ceftriaxone

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2
Q

boas sign

A

referred right subscapular pain of biliary colic

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3
Q

patho of cholangitis

A

ascending infxn due to an obstruction in the common bile duct

MC organism: E. coli

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4
Q

charcot’s triad

A
  • RUQ pain
  • fever
  • jaundice
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5
Q

reynold’s pentad

A
  • hypotension
  • AMS
  • RUQ pain
  • fever
  • jaundice
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6
Q

tx of cholangitis

A

ERCP + cipro + metronidazole

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7
Q

patho or primary sclerosing cholangitis

A

chronic liver dz characterized by inflammation and fibrosis of intrahepatic and extrahepatic bile ducts

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8
Q

primary sclerosing cholangitis is assoc with

A

UC

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9
Q

dx of primary sclerosing cholangitis

A

cholangiography
- fibrosis of bile ducts w dilation between strictures

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10
Q

tx of primary sclerosing cholangitis

A

liver transplant

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11
Q

primary sclerosing cholangitis presentation

A

pruritus + jaundice

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12
Q

anal fissure patho

A

develop secondary to local ischemia caused by hypertonia of internal sphincter

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13
Q

dx anal fissure

A

hx & visual inspection w anoscopy

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14
Q

tx of anal fissure

A

combo of supportive care AND topical vasodilator
- nifedipine or nitroglycerin

2nd line:
- topical CCB (diltiazem 2%)
- botox

failure of conservative tx & symptoms > 8 weeks
- lateral internal sphincterotomy

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15
Q

dx of anorectal fistula

A

anoscopy

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16
Q

tx of anorectal fistula

A

SURGERY
- fistulotomy w or w/out marsupialization

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17
Q

where does bleeding occur in diverticulosis

A

MCC of LOWER GI bleed

bleeding distal to the ligament of Treitz

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18
Q

MC location of diverticulosis

A

sigmoid (descending) colon

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19
Q

diverticulitis triad

A
  • LLQ pain
  • fever
  • leukocytosis
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20
Q

how to dx diverticulitis

A

CT w oral and IV contrast
- fat stranding
- bowel wall thickening >4mm

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21
Q

clinical prediction rule for diverticulitis

A
  • absence of vomiting
  • CRP > 5 mg/dL
  • LLQ pain

all 3 = positive result

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22
Q

diverticulitis complications

A
  • abscess formation
  • fistula formation
    *bladder –> colon
  • SBO
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23
Q

MCC of rectal bleeding in pts < 50

24
Q

internal hemorrhoids arise from

Study These Flashcards
A

superior hemorrhoidal cushion

above dentate line and covered by columnar cells

25
how to dx internal hemorrhoids
anoscopy
26
internal hemorrhoid tx
symptomatic care: - stool softeners - warm sitz bath - lidocaine ointment or witch hazel bleeding internal hemorrhoid: - sclerotherapy injection prolapsed: - rubber band ligation grade IV hem: - hemorrhoidectomy
27
inflammatory bowel diseases are MC in which population
Ashkenazi Jewish population
28
smoking in IBD
INCREASED risk of Crohn's disease in smokers *C for Cigarettes DECREASES flares in UC
29
transmural inflammation meaning
affects ALL layers of intestinal mucosa crohn's affects ANY part of GI tract *mouth to anus
30
what is spared in crohn's
rectum!!!
31
crohn's presentation
- RLQ pain - NON-bloody diarrhea* - aphthous ulcers* - fistula - B12 & iron def anemia - weight loss due to malabsorption
32
colonoscopy findings for crohns
skip lesions (cobblestone appearance) - NON-continuous areas of inflammation creeping fat - pathognomonic - mesenteric fat that migrates to the bowel
33
biopsy findings for crohn's
- transmural inflammation - granuloma!!!
34
rectum is ALWAYS affected in what dz
UC!
35
Rome IV Criteria
- related to defecation - change in freq of stool - change in form of stool abd pain at least once a wk for 3 consecutive months
36
tx for IBS-C
polyethylene glycol lactulose linaclotide lubiprostone
37
tx for IBS-D
loperamide cholestyramine eluxadoline
38
tx for abd pain / bloating in IBS
dicyclomine hyoscyamine
39
radiographic features of button battery
halo or double ring around the circular object - seen on anteroposterior view
40
tx of button battery ingestion
emergency endoscopic removal
41
when to screen patients with UC for colon cancer
start screening 8-10 years AFTER dx colonoscopy q 1-3 yrs
42
colon CA screening in patients with a positive 1st degree relative
colonoscopy at age 40 OR 10 years prior to age of diagnosis of FDR, whichever comes 1st repeat q 5 years
43
colon CA screening
screen adults 45-75 OR at age 40 OR 10 years prior to age of diagnosis of FDR, whichever comes 1st
44
MC type of colon CA
adenocarcinoma patho: - progression of adenomatous polyps into adenocarcinoma of colon or rectum
45
RIGHT sided (ascending) colon CA symptoms
- iron def anemia - occult blood loss - melena (upper GI bleed)
46
LEFT sided (descending) colon CA symptoms
- changes in bowel habits - hematochezia (lower GI bleed) - SBO *left sided colon CA in MC than right sided
47
colon CA screening methods: when to repeat a FIT
q year - antibodies are detected in blood
48
colon CA screening methods: when to repeat a FIT-DNA
q 1-3 years
49
colon CA screening methods: when to repeat a flexible sigmoidoscopy
q 5 years only examines distal 3rd of colon
50
colon CA screening methods: when to repeat a CT colonography
q 5 years
51
patho of phenylketouria (PKU)
absent phenylalanine hydroxylase (PAH) enzyme activity phenylalanine accumulates in CNS leading to mental retardation & mvmt d/o
52
PKU presentation
- blonde, blue eyed w fair skin - mousy, musty odor - wide spaced teeth
53
dx of PKU
newborn screen 24-48 hrs after 1st feed - plasma phenylalanine levels > 20 mg/dL
54
tx of PKU
dietary phenylalanine restriction & increased dietary tyrosine intake
55

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