Term
What is the MATest for Diabetic Gastroperisis but rairly needed?
What is the most common cause of upper GI bleeding?
lower GI bleeding? |
|
Definition
nuclear gastric emptying study
ulcer disease
diverticulosis |
|
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Term
What is the Next best step with a GI bleed?
then
then
then |
|
Definition
replace fluids
then check hematocrit, platelet count and coagulation tests (PT,INR)
Packed red blood cells (if htc is low)
Fresh frozen plasma (if PT or INR is low)
Platelets(if platlets are low
"Give, fluid, blood, plasma, Platelets" |
|
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Term
what is given for variceal bleeds?
what is the treatment for C. diff
What is the treatment for whipple disease |
|
Definition
fluid, blood, platelets and plasma
plus octreotide
Metronidazole
TMP/SMZ |
|
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Term
what is the BITest for celiac disease?
then:
MATest? |
|
Definition
Anti tissue transglutaminase (first
Antiindomysial andtibody, IgA antigliadin antibody
MAT: small bowl biopsy,[essential in celiac disease to exclude lymphoma |
|
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Term
What are the diagnostic tests for Chronic panc.?
MaTest |
|
Definition
Abd xray, Abd CT,
MAT: secretin stimulation testing |
|
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Term
What is the treatment for chronic pancreatitis?
What is the BITest for Carcinoid syndrome?
tx? |
|
Definition
Enzyme replacement
Urinary 5-hydroxyindoleacetic acid
Octreotide |
|
|
Term
describe Irritable bowel syndrome.
describe the pain involved with IBS
does IBS have blood or wbc's in stool? |
|
Definition
pain syndrome that can have diarrhea, constipation or both. no weight loss.
Pain is:
1. Relieved by a bowel movment
2. Less at night
3. Relieved by a change in bowel hapit |
|
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Term
what is the diagnostic test for IBS?
what is the treatment? x5 |
|
Definition
no dx test, dx of exclusion
1. fiber in the diet
2. Antispasmotics: Hyoscyamine,Dicyclomine
3. TCAs
4. Antimotility agents such as loperamide
5. Lubiprostone- chloride channle activator that increases bowel movment |
|
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Term
| What are the S&s of Inflammatory bowel disease? |
|
Definition
diarrhea, blood in stools, weight loss, fever
arthralgias, uveitis iritis, Megacolon, Skin manifestations, Sclerosing cholangitis(more freq in UC) |
|
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Term
What IBD has skipping lesions going down?
What is the MATest for small and large bowel?
If still unclear then what?
what are the markers for the different IBD's |
|
Definition
Crohns
Endoscopy= MAT for Large bowl
Barium= MAT for unreachables
if still unclear: serologic tests
UC=Anca
Crohn's = ASCA |
|
|
Term
What ist he treatment for IBD?
acute:
Chronic: |
|
Definition
Acute: steroids
Chronic:
Asacol(mesalamine)- UC
Pantasa(mesalamine) for Crohns
Rowasa(mesalamine)-UC limited to the rectum |
|
|
Term
What are TNF agens such as infliximab used for in IBD's?
what can be cured with surgery |
|
Definition
Fistulae and severe disease unresponsive to other agents
UC is cured with colonectomy |
|
|
Term
What is the MATest for Diverticulosis?
What are the ass S&S for Diverticulitis? |
|
Definition
Colonoscopy
LLQ pain and Tenderness
Fever, Leukocytosis, Palpable mass
N/C/Bleeding |
|
|
Term
What is the BIT for Diverticulitis?
What is the Treatment for Diverticulitis? |
|
Definition
CT scan
Cipro with Metronidazole
or
Amox/Clavulanate |
|
|
Term
When should HNCC screening be done?
with what family hx
with what start date and intervals
Familial autonomous polyposis(same quesitons) |
|
Definition
HNPCC: three family members, 2 generations, 1 premature(before 50)
screening at age 25 every 1-2yrs.
FAP: abnormal genetic test, Start screening with sigmoidoscopy at age 12 every year |
|
|
Term
What is:
Gardner Syndrome
Turcot syndrome |
|
Definition
GS: Colon cancer with Osteomas( and desmoid tumors, other soft tissue tumors)
TS: Colon cancer with CNS malignancy |
|
|
Term
What is:
Peurtz-Jeghers Syndrome
Juvenile polyposis |
|
Definition
Multipile hamartomatous polyps in ass with Melanotic spots (on the lips) and skin (increase in Breast, gonadal, panc cancer)
colon cancer with ass with Multiple hamartomatous polps |
|
|
Term
What causes over 90% of Acute pancreatitis?
What are the ass S&S of Acute Pancreatitis. |
|
Definition
alcoholism and cholelithiasis
Acute epigastric pain + tenderness+ N/V = Pancreatitis
Pain of panc goes 'like a spear' strait thru the back
in several cases there is hypotention and fever |
|
|
Term
What indicates the worst prognosis for Pancreatitis?
What is the BITest?
What is the Most specific test? |
|
Definition
low calcium
Amylase/Lipase
CT
CBC, Eleveated LDH and AST, |
|
|
Term
What is the treatment for acute Pancreatitis?
what is considered 'extensive necrosis' and what do you do about it |
|
Definition
NPO-no food
IV hydration
Analgesia
PPIs
30% necrosis on CT or MRI add Imipenem or meropenem
is an indication for biopsy for infection |
|
|
Term
When should a Paracentesis be performed?
What is Spontaneous Bacterial peritonitis? |
|
Definition
1. new onset ascities
2. abd pain and tenderness, 3. fever
infection of the peritoneum without perferation |
|
|
Term
What does a SAAG stand for?
What does a value of >1.1 g/dL indicate. x4 |
|
Definition
Serum ascites albumin gradient
Portal HTN
CHF
Hepatic vein thrombosis
Constrictive pericarditis |
|
|
Term
What does a SAAG of less than 1.1 indicate? x3
What is the most common organism that causes Spontaneous Bacterial Peritonitis? |
|
Definition
Infection(except SBP)
Cancer
Nephrotic syndrome
E.coli
Pneumococcus can to |
|
|
Term
What is the Rule for Most accurate test for causes of cirrhosis.
What is the S&S for PB cirrhosis |
|
Definition
All causes of cirrhosis the most accurate test is biopsy
EXCEPT PS cholengitis
woman(40-50s) fatigue and itching
normal bilirubin with elevated alk phos
Xanthelasma/xanthoma, osteoporosis |
|
|
Term
what is the most accurate blood test for PB cirrhosis?
What is the BITest&R for Hemochromatosis? |
|
Definition
antimitochondrial antibody
Iron studies showing increased serum iron and ferritin and decreased iron capacity |
|
|
Term
What is in over 80% ass with Inflamitory bowel diseases?
What is the MATest? |
|
Definition
PS cholangitis
ERCP that shows beading, narrowing, or strictures in the biliary system |
|
|
Term
How doe you treat;
PB cirrhosis
PS cholangitis |
|
Definition
| both treated with cholestyramine or ursodeoxycholic acid |
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