GI
What are the 4 core functions of the GI tract?
What are motility, secretion, digestion, and absorption?
This medication, used to treat acute gout flares, commonly causes gastrointestinal adverse effects, including diarrhea, nausea, and vomiting.
What is colchicine?
The liver receives its blood supply from 2 sources. One of these sources is the ___, which is a vessel network that delivers blood ___ in nutrients but ___ low in oxygen.
What is hepatic portal vein, high, low?
~50% of HRS episodes have no identifiable precipitant; when present, precipitants either __ effective arterial blood volume or __ inflammation
What is reduce and amplify?
What are the most common etiologies for chronic pancreatitis “TIGAR-O”?
What are toxic metabolite, idiopathic, genetic, autoimmune, recurrent & severe AP, and obstructive?
Ultrasonography, computed tomography, Radionuclide imaging, Magnetic resonance imaging, and Arteriography describe what type of radiologic studies?
What are computer-assisted?
What is the recommended goal of uric acid levels for a patient receiving treatment for hyperuricemia?
What is <6 mg/dL?
The nurse is caring for a male patient w cirrhosis. Which assessment findings indicate that patient has deficient Vitamin K absorption or stores caused by this hepatic disease?
What is purpura (easily bruised/bleeding)?
What are the KDIGO criteria for acute HRS-AKI?
Increase in SCr of __ mg/dL in 48 hours or a __% SCr increase in 7 days
What is an increase in SCr of ≥0.3 mg/dL in 48 hours or a ≥50% SCr increase in 7 days?
Which CYP is most glucocorticoids a substrate for?
What is CYP3A4?
Patient CL with a history of peptic duodenal ulcers presents with hematemesis and melena. What type of GI bleeding is this?
What is overt UGIB?
What are appropriate therapies for an acute gout attack for a 24-year-old man with no other medical history?
What are NSAIDs, colchicine, and glucocorticoids?
A drug of choice for the primary prevention of variceal bleeding is:
What is carvedilol?
What is the most effective treatment for HRS-AKI?
What is liver transplant?
Cortisol exerts negative feedback on both the hypothalamus and anterior pituitary to prevent excessive cortisol production. In what disease state is there an oversecretion of cortisol caused by hypersecretion of ACTH?
What is Cushing’s Disease?
Patient CL has a history of peptic duodenal ulcers. Endoscopic findings show active bleeding. What is the appropriate medical therapy?
What is high-dose PPI for 3 days? (80 mg IV bolus followed by 8 mg/h infusion, or 40 mg IV/PO BID-QID)
What is an appropriate colchicine dosing regimen for initial treatment of acute gout assuming normal renal function?
What is two 0.6 mg tabs (total 1.2 mg) followed by one tab (0.6 mg) in one hour; dose can be repeated in 3 days?
The lab abnormality of AST > ALT is indicative of?
What is chronic hepatitis progressing to cirrhosis?
This combination of pharmacologic therapies is used to treat HRS-AKI by causing splanchnic vasoconstriction and expanding intravascular volume.
What are vasoconstrictors (e.g., terlipressin, norepinephrine, octreotide) plus IV albumin?
A 65-year-old patient with a history of heavy alcohol use presents with severe epigastric pain radiating to the back, nausea, and vomiting. Lab results show significantly elevated serum lipase. Imaging reveals pancreatic inflammation with absence of organ failure or systemic complications. Identify the type of pancreatitis affecting this patient.
What is mild acute pancreatitis?
A 47 year old patient presents to the ED with chest pain. It does not radiate anywhere and is mildly relieved when the patient drinks water. They mention having a large steak dinner the night before to celebrate their work promotion.
Name the four parts of an abdominal examination in sequential order, along with one example of what each step could determine.
You later perform a radiologic study and discover gallstones in their gallbladder. What radiologic study is best for evaluating deeper structures and finding gallstones?
What is:
Inspection (scars, hernias, bulges, and peristalsis)
Auscultation (bowel sounds and bruits)
Percussion (tympany, visceral organ size, and ascites)
Palpation (tenderness, rigidity, masses, and hernias)
What is ultrasonography?
A 58-year-old man presents for follow-up after experiencing several episodes of acute gout over the past year. His medical history includes stage 3 chronic kidney disease and a previous uric acid kidney stone. Physical exam reveals a nodule near his elbow consistent with a tophus. His most recent serum uric acid level is 8.9 mg/dL.
The provider is considering initiating long-term urate-lowering therapy. Identify the clinical indications in this patient that support initiating therapy and the target serum uric acid concentration.
What are:
- History of kidney stones?
- Presence of at least one tophus?
- CKD stage 2 or greater?
- Two or more gout attacks per year?
- Target serum uric acid below 6 mg/dL?
What is the standard of care for secondary prophylaxis of recurrent esophageal variceal hemorrhage?
What is endoscopic variceal ligation (EVL - Q1-4wk until eradication of varices) PLUS BB (carvedilol preferred)?
A 62-year-old patient with decompensated cirrhosis is being evaluated for worsening renal function.
- Patient A: Serum creatinine has increased by 55% over the past 30 days.
- Patient B: eGFR has remained below 60 mL/min/1.73 m² for the past 120 days.
Based on the duration and degree of renal dysfunction, classify each patient's hepatorenal syndrome as HRS-AKD (subacute) or HRS-CKD (chronic).
Patient A: What is HRS-AKD?
Patient B: What is HRS-CKD?
A patient taking prednisone 10 mg daily for over 2 weeks undergoes a cosyntropin stimulation test. Baseline cortisol is 6 mcg/dL and stimulated cortisol is 15 mcg/dL.
Identify the prednisone dosing category and determine whether the patient has HPA axis suppression.
What are supraphysiologic dosing (10-20 mg) and HPA axis suppression(<18 mcg/dL = suppressed)?