Boards Gi

Front 1

Cholycystitis Tx (besides cholecystectomy)

Back 1

– Pre-op ERCP or intraop cholangiogram
– IV Abx and fluids
– if medical problems, wait 4-6 weeks

Front 2

Choledocolithiasis Tx

Back 2

– ERCP w/ sphincterotomy then remove gallbladder

Front 3

Cholangitis Tx

Back 3

– ICU w/ IV abx
– will need to immediate decompression
– can do ERCP w/ sphincterotomy, a tube, or open decompression

Front 4

Campylobactur special stuff and Tx

Back 4

– r/o appendicitis and IBD
– Erythromycin

Front 5

Entamoeba special stuff and Tx

Back 5

– can incubate up to 3 months
– mimicks IBD
– give metro and avoid steroids (can cause perf)

Front 6

E coli diarrhea special stuff and Tx

Back 6

– Avoid Abx!

Front 7

Salmonella special stuff and Tx

Back 7

– sepsis is common and only fecal WBCs
– TMP-SMX if bacteremia or at risk

Front 8

Shigella special stuff and Tx

Back 8

– Seizures
– TMP/SMX

Front 9

When do you do surgery w/ SBO?

Back 9

– complete, necrotic, or Sx > 3 days

Front 10

Who is at increased risk for diverticular disease?

Back 10

– CT disorders like Ehlers danlos or marfans

Front 11

Diverticulitis Tx

Back 11

– bowel rest w/ metro and quinolone or 2nd/3rd gen ceph

Front 12

Colon cancer, colon lesions Tx

Back 12

– 3-5 cm margins
– get lympatics and mesentary
– radiation doesn’t work
– chemo if + nodes

Front 13

Colon cancer, rectal lesions Tx

Back 13

– APR if < 10 cm from verge (will need colostomy)
– LAR if > 10 cm (can do anastamosis)
– chemo if + nodes or radiation

Front 14

What studies do you do for Oropharyngeal dysphasia, esophageal dysphasia, and odyonophasia

Back 14

– Cine-esophogram
– Barium swallow then endoscopy (unless you suspect obstructive)
– endoscopy

Front 15

Chronic gastiris types

Back 15

– Type A is fundus and from antibodies
– type B is antrum and from H pylori and NSAIDS and all that stuff

Front 16

Gastric cancer types

Back 16

– intestinal type is metaplasia of gastric mucosa cells (normal type)
– diffuse is poorly differentiated and we don’t know RFs

Front 17

Posterior ulcers vs. anterior ulcers

Back 17

– bleeding (gastroduodenal artery) and perforation

Front 18

Direct hernias where are they contained?

Back 18

– aponeurosis of external oblique

Front 19

UC things to remember

Back 19

– mucosa only
– Sulfasalazie or 5-ASA (mesalamine)

Front 20

Crohn’s things to remember

Back 20

– transmural
– creeping fat
– do sulfasalazie and steroids (if no improvement)

Front 21

What drugs can cause hepatitis?

Back 21

– INH, methyldopa, and Tylenol

Front 22

Autoimmune hepatitis Antibodies and Tx

Back 22

– smooth muscle, mitochondrial, and ANA
– steroids and azathioprine

Front 23

Chronic HBV vs. HCV Tx

Back 23

– IFN-a, lamivudine, and adefovir
– peginterferon and ribavirin

Front 24

SAAG > 1.1 and < 1.1

Back 24

– hydrostatic imbalance (chronic liver disease, massive hepatic mets, and CHF)
– protein leakage (nephrotic syndrome, TB, and malignancy like ovarian cancer)

Front 25

SBP dx and tx

Back 25

– > 350 PMNs and > 500 WBCs
– 3rd gen ceph for both gram negative and +

Front 26

Hemocromatosis genetics, associations, Sx, Dx

Back 26

– AR, C282Y mutation
– increased in alcoholics (EtOH increases iron secretion)
– get MCP arthirits
– dx w/ fasting transferring sat (>45%)
– C282Y mutation

Front 27

Wilsons genetics, Sx, and Tx

Back 27

– AR, chromosome 13
– hemolytic anemia
– avoid shellfish, liver, and legumes)
– penicillamine (copper chelator) w/ B6 and oral zinc (increase fecal excretion)

Front 28

Grey Turner sign and Cullens sign

Back 28

– in pancreatitis w/ flank discoloration and periumbilical discoloration

Front 29

Chronic pancreatitis

Back 29

– chain of lakes on CT
– give exogenous lipase/trypsin and medium chain fatty acids

Front 30

Ranson’s criteria

Back 30

– glucose > 200
– age > 55
– LDH > 350
– AST > 250
– CA < 8
– Hematocrit decreased > 10%
- PaO2 < 60
– base excess > 4
– Bun increase > 5
– Sequestered fulid > 6 L

Front 31

Pancreatic cancer chemo

Back 31

– 5-FU and gemcitabine

Front 32

Intrahepatic cholestasis of pregnancy

Back 32

– increased total bili and pruritis

Front 33

Acute fatty liver of preganancy

Back 33

– occurs with pre-eclampsia

Front 34

1o biliary cirrhosis

Back 34

– anit-mitochondrial Ab
– big increase in AP and cholesterol w/ intense pruritis

Front 35

Where does mesenteric ischemia usually occur

Back 35

– at splenic flexure

Front 36

Conjugated hyperbili Dx

Back 36

– always from some obstruction
– first do abdominal u/s
– then try ERCP or PCT

Front 37

Cirrhotic ascites

Back 37

– treat with spironolactone
– can augment with lasix

Front 38

Angiodysplasia

Back 38

– aka vascular ectasia
– associated w/ AS
– will not have colonoscopy findings

Front 39

Scleroderma esophagus

Back 39

– absent peristalsis in lower 2/3 and decrease in LES tone (unlike achalasia)

Front 40

When do you go straight to upper endoscopy?

Back 40

– wt loss, N and V, >1-2 years of Sx, and no response to PPIs

Front 41

Reye’s syndrome histo

Back 41

– fulminant failure w/ extensive vacuolization of the liver

Front 42

Amebic abscess

Back 42

– draws back anchovy paste
– don’t aspirate, give metro

Front 43

Viral hepatitis and Isoniazid liver histo

Back 43

– panlobular w/ monocytes and necrosis

Front 44

Zenker’s diverticulum

Back 44

– can lead to aspiration pneumonia
– will have nck mass and dysphasia
– get esophogram (why you always get this before endoscopy)

Front 45

What else can go along w/ Hep C

Back 45

– B cell lymphoma
– plasmacytomas
– auto immune (sjogrens and thyroiditis)
– Lichen Planus
– porphyria cutanea tarda
– ITP

Front 46

ZES Dx

Back 46

– serum gastrin (> 1000 is dx)
– if not dx, can try secretin stimulation (should decrease gastrin)

Front 47

Hepatorenal syndrome tx

Back 47

– careful volume loading and stop lasix and spironolactone
– may need dialysis

Front 48

What is the best way to dx acute diverticulitis

Back 48

– CT

Front 49

Carcinoid location frequency

Back 49

– more in appendix, but you if you have Sx, more likely in SI

Front 50

Rotor’s syndrome

Back 50

– like Gilbert’s but conjugated
– there will also be bili in urine b/c only conjugated gets into urine

Front 51

Cirrhosis Screening

Back 51

– endoscopy for varices

Front 52

Tropical Sprue histo

Back 52

– villi blunting and inflammatory cells

Front 53

When should you suspect giradiasis and give metro

Back 53

– anyone from a developing country or the rockey mountains w/ diarrhea

Front 54

Malabsorption after abdominal surgery is likely?

Back 54

– bacterial overgrowth

Front 55

Primary sclerosing cholagitis

Back 55

– increased AP and bili
– normal LFTs
– sometimes p-ANCA

Front 56

Lactose intolerance Dx

Back 56

– hydrogen breath tests
– clinitest for reducing substances
– increased osmotic gap

Front 57

Most common causes of cirrhosis

Back 57

– EtOH then Hep C
– dx hep c with HCV RNA

Front 58

Blood transfusion and hepatitis

Back 58

– before 1992 is Hep C
– before 1986 is Hep B

Front 59

Dig tox

Back 59

– w/ verapimil
– mainly abdominal Sx