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Step III

Step III - GI 1

QuestionAnswer
What do the labs show in acute pancreatitis ↑ lipase , ↑/nl amylase, ↑ ALT
Epigastric pain, abrupt, worse w/ supine + after eating, radiates to back. Better w/ leaning forward. Dx Acute pancreatitis
Most accurate Diagnostic study for acute pancrx CT
Tx for acute pancreatx analgesia, IVF, bowel rest, ERCP, sphincterotomy; If necrx add Abx + debridement
MCC of acute pancreatitis gallstones > EtOH
MCC acute pancrx in children trauma
MCC of CHR. Pancrx EtOH
LLQ pain, Tenderness, Fever, Leukocytosis. Dx Diverticulitis
Diagnostic study for diverticulx CT
Tx for diverticulx IVF, IV Abx, bowel rest
Tx for RECURRENT diverticulx bowel resection
Alcoholic coughing up blood. Dx Acute bleeding esophageal varices
Most effective tx for Acute bleeding esophageal varices sclerotherapy
Most effective non-invasive tx for Acute bleeding esophageal varices Somatostatin/octreotide
If sclerotherapy and Rx tx fails for Acute bleeding esophageal varices then what is the next tx TIPS
HypoTN + tach = dehydrated, N/V, ↑ WBC. Dx Small bowel obstruction
Initial Diagnostic study for SBO X-Ray
Tx for SBO IVF, IV Abx, NG-tube
If exam shows guarding or signs of acute abdomen then what is the next step go to OR
MCC of SBO adhesions > hernia
MCC of SBO in kids Hernia
LLQ pain, Painless bleeding @ rectum. Dx Diverticulosis
Most accurate diagnostic study for Diverticulosis colonoscopy
Tx for Diverticulosis Increase fiber intake
LLQ pain, Diarrhea/constipation, +/- Fever, ↑ WBC, Distended ab. Dx Diverticulitis
BEST Diagnostic study for Diverticulitis/-osis CT w/
Rx Tx for Diverticulitis Antibx (-) GNR eg quinolone/ceph + anti-aerobes eg metro
If recurrence of Diverticulitis then tx Lap resection of segment
Bleeding, (+) FOBT. Dx Gastric + esophageal varices
Tx for Gastric + esophageal varices β (-) + banding
If actively bleeding Gastric + esophageal varices then rx tx octreotide/vasopressin
Cause of Gastric + esophageal varices portal hypertension/cirrhosis
New murmur (restrictive cardio), Tan skin, Joint pain, Infertility. Dx Hemochromatosis
Most accurate Diagnostic study for Hemochromatosis Liver bx -OR-MRI + genetic test for HFe gene mutx
Labs seen in Hemochromatosis Pancreatic damage: ↑ glucose; ↑ Fe, ferritin,  TIBC; Panhypopitituitary Hepatoma: ↑ LFTs
Tx for Hemochromatosis phlebotomy
Foul smelling stool, Steatorhea, Diarrhea,Weight loss, Dermatx herpeti = vesicular skin lesions (not mucosal). Dx Celiac
most accurate Diagnostic study for Celiac Small bowel biopsy
Initial Tx for Celiac Eliminate gluten
What Abs are made in Celiac dz IgA Abs: -gliadin, -endomyseal, -transglutaminase
What kind of anemia is seen in Celiac dz Macro OR micro anemia
What is elements are not absorbed in Celiac dz folate + Fe + Ca
What disease shows abnL D-xylose testing celiac
Asymptomatic or S/S of GERD. Dx Paraesophageal hernia
Initial Diagnostic study for Paraesophageal hernia XR
Tx for Paraesophageal hernia Surgery regardless of +/- symptoms
Pt c/o abdominal pain that is worse w/ food. Dx Gastric PUD
Pt c/o abdominal pain that is better w/ food. Dx duodenal PUD
What blood type is associated with gastric and duodenal PUD respectively Type A; Type O
What is the limitation of serology testing in pts w/ PUD Can’t tell you if new or prior infection
What diagnostic test can tell you the difference b/t a new vs prior infection in PUD Stool Ag + breath test
Initial rx tx for PUD Amox + clarithro + PPI
If primary rx tx for PUD fails then what is the next tx Metro + tetra + PPI
If both Rx tx for PUD fail then what other dz should you look for ZE
What is the MCC of PUD H. pylori
What is the MC type of gastric PUD and location Type I – ulcer along lesser curve stomach
Where are gastric PUD types II – V located II – gastr + duo ulcer; III – prepyloric ulcer; IV – prox GE ulcer; V – body/anywhere
(+)ASCA (saccharomyces cervesiae) is a lab marker found in which type of IBD Crohn’s
(+) ANCA) is a lab marker found in which type of IBD UC
RUQ pain, Itching, Jaundice, Fatigue. Dx Primary biliary cirrhosis
Anti-mitochondrial Abs are found in what disease Primary biliary cirrhosis
What is being destroyed by immune system in Primary biliary cirrhosis intrahepatic bile ducts
RUQ pain, Itching, Jaundice, Fatigue, Weight loss, Fever. Dx Primary sclerosing cholangitis
best initial test for acute pancreatitis? lipase >> amylase
Created by: DrINFJ