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65 Cards in this Set
- Front
- Back
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most likely cause of non cardiac chest pain
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GERD
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Test of choice in 80 yo pt who complains of dysphagia, liquids > solids, nasal regurgitation
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Videofluoroscopy
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Most common pathophysiologic etiology for GERD
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Transient LES relaxation
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Pathologic finding of replacement of squamous mucosa with columnar mucosa and goblet cells
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Barrett's esophagus
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Optimal treatment in young patient w/ dysphagia. Esophogeal manometry shows aperistalsis and failure of LES relaxation
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Heller myotomy
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2 most common etiologies for PUD
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NSAID
H pylori |
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First line treatment for H pylori
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Omeprazole, Clarithromycin, Amoxicillin for 10-14 d
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Next test to order in patient with gastrin level of 500 who presents with recurrent PUD
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Secretin stimulation test
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Thickened folds in stomach with resultant protein losing enteropathy and associated edema
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Menetrier's Disease
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Diarrhea after eating seafood
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Vibrio
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Stool test result can distinguish between secretory and osmotic diarrhea
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Stool osmolar gap
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Likely dx in patient with stool pH < 5
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Carbohydrate malabsorption - bacterial fermentation of carb
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Renal failure, anemia, thrombocytopenia after receiving antibiotics for bloody diarrhea that started after eating spinahc
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HUS 2/2 E coli
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Diarrhea in pt with AIDS who has a 3 mo history of large volume watery stools, low grade fevers, macrocytic anemia. C diff negative
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Cryptosporidiosis
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Two most common etiologies of acute pancreatitis and most common etiology of chronic
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Acute: Alcohol/gallstones
Chronic: alcohol |
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Most important initial treatment for acute pancreatitis
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IV fluids
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most worrisome cause of painless jaundice in 60 yo male
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Pancreatic cancer
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Most likely etiology of pancreatitis in pt with
normal cbc bun 30, creat 1.2 ast 130, alt 210, bili 1.1 amylase 240, lipase 300 |
gallstone pancreatitis
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70 yo asx pt w/ dilation of pancreatic duct and "fish mouth" with mucin extruding from ampulla on endoscopy
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intraductal papillary mucinous tumor
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sAg negative, cAb positive, sAb+
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Hepatitis b immunity due to clearance of prior infection
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Acute hepatitis C tx
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supportive care
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Chronic heaptitis tx
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PEG-IFN, ribavirin +/- protease inhibitor
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60 yo Caucasian male w/ cirrhosis, arthritis, CHF, diabetes, "great tan"
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hereditary hemochromatosis
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24 yo healthy man who appears yellow after stress
normal Hb, normal AST/ALT, elevated bili, indirect > direct |
Gilbert's disease
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18 yo male with history of "schizophrenia" who presents with fulminant hepatic failure, hemolytic anemia, low alkP
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Wilson's disease
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Transmural involvement of GI tract, inflammatory disease
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Crohn's disease
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first line treatment for mild UC
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5ASA (sulfasalazine, mesalamine)
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UC who has new rise in LFT (cholestatic pattern)
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Primary sclerosing cholangitis
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First line treatment for flare of Crohn's
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Corticosteroids
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infections that can look like IBD flare
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c diff
CMV |
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skip lesions thorughout colon/terminal ileum
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Crohn's
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extra intestinal manifestations of IBD that DO NOT parallel disease course
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pyoderma gangrenosum, uveitis, ankylosing spondylitis, sacroileitis, PSC
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extraintestinal manifestations of IBD that parallel
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erythema nodosum, peripheral arthritis, episcleritis
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Smoking can improve symptoms in this form of IBD
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UC
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steroid sparing agents for IBD
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MTX, azathioprine/6MP, anti-TNF (remiacde, humira, cimzia)
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young pt, 100s of polyps on colonoscopy
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FAP
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Amsterdam criteria for HNPCC
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3 family members with colon cancer
2 generations 1 first degree 1 before the age of 50 |
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Average of starting colon cancer screening
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50
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2 forms of microscopic colitis
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Lymphocytic colitis
Collagenous colitis |
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Most common type of cancer in women with HNPCC after colon cancer
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Endometrial cancer
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Gold standard test to dx celiac sprue
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Small bowel biopsy
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first line tx for 24 yo female with diarrhea, bloating, IDA, pruritic papulovesicular rash on extensor surfaces of arms
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Gluten free diet
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Pt with gastric bypass who presents with significant bloating/diarrhea, incr belching/flatus. Low vitamin B12, high folate
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Small bowel bacterial overgrowth
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Visited Caribbean - came back with diarrhea, wt loss, anorexia. Small bowel biopsy shows flattened villi, tissue transglutaminase is negative
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Tropical sprue
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Diarrhea, fevers, arthralgias, neurologic symptoms. Biopsy shows flattened villi with PAS+, AFB- m0
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Whipple's disease
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Most common cause of upper GI bleeding
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PUD
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2 most common causes of lower GI bleeding
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Internal hemorrhoids, diverticulosis
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Upper GI bleed from ulcer. H pylori + (tx w/ prevpac) -- only method of confirming H pylori eradication on someone who remains on PPI
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Gastric biopsy
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3 IV meds that should be started on admission of cirrhotic pt who presents with hematemesis
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Octreotide gtt, protonix gtt, IV antibx
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Minimum # of PMN needed for dx of SBP
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250
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Medical treatment in PBC has been shown to improve survival
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Ursodeoxycholic acid
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Screening/surveillance for HCC in patients with cirrhosis
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ultrasound, AFP
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Most likely cause for renal failure in pt with cirrhosis who has rapidly rising creatinine, urine Na <10
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Hepatorenal syndrome
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Likely etiology of ascites in pt
alb 3.2, Cr 1.1, bili 1.1 ascitic albumin 1.2, ascitic protein 2.5 |
CHF
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Likely etiology of ascites in pt
alb 3.2, Cr 1.1, bili 1.1 ascitic albumin 1.2, ascitic protein 2.5 |
CHF
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Four Fs for gallstones
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forty, female, fat, fertile
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Four Fs for gallstones
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forty, female, fat, fertile
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Most common cause of liver disease in US
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NAFLD
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Most common cause of liver disease in US
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NAFLD
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Reynold's pentad
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Fever, RUQ, jaundice, MSC, hypotension
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Reynold's pentad
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Fever, RUQ, jaundice, MSC, hypotension
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B12 deficiency causes
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low dietary intake, hypochlorhydria, atrophic gastric, low IF, bacterial overgrowth, ileal disease
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B12 deficiency causes
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low dietary intake, hypochlorhydria, atrophic gastric, low IF, bacterial overgrowth, ileal disease
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2 viral liver disease that have incr mortality in pregnancy
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HSV, Hep E
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2 viral liver disease that have incr mortality in pregnancy
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HSV, Hep E
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