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Step III
Step III - GI 1
| Question | Answer |
|---|---|
| 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
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