1 UWorld Flashcards
1st line management to Oglievie’s
NPO, NG decompression, serial abd exams
causes of ogilvie’s
unknown
likely triggered by:
-meds: narcotics, anticholinergics
-electrolyte abnormal: K/Mg/P
-infection
-trauma/recent surgery
-AGE…old people
how to diagnose hepatopulm syndrome
echo
if first line tx for Oglieve’s doesnt work, what is 2nd line?
Neostigmine
3rd line treatment to oglievie’s if 2nd line fails
surgical decompression
severe enterocolitis affecting neutropenic patients think ____
typhlitis aka neutropenic enterocolitis
fulminant Cdiff findings
ileus
toxic megacolon
Shhock
tx for FULminant Cdiff
PO vanc
IV flagyl
urgent surgeon consult
____ cdiff comes after fulminant, and Tx is ___
refractory
colectomy/divert ileostomy, fecal transplant
SAAG formula
Serum albumin - Ascites albumin
> 1.1 SAAG means
cirrhosis (Tprotein<2.5)
CHF (Tprot>2.5)
budd chiari
meaning there is PORTAL HTN
<1.1 SAAG means
nephrotic
malignant
TB
meaning there is NO PORTAL HTN
total protein in cirrhosis and nephrotic tends to be ___
< 2.5
how to diagnose zenker diverticulum
barium NOT EGD which could perf!
how to fix zenker
endoscopically or surgically close
pathophysiology of ___ can happen to lungs in a cirrhotic
intrapul vasculardilations due to portal HTN
overflow fecal incontinence can occur due to fecal ___
impaction
organism invasion into bowel wall in setting of intestinal mucosal injury is called ____ and usually ___ is involved
neutropenic enterocolitis (typhlitis)
cecum
when would you send someone to surgery in neutropneic enterocolitis
bowel perf or uncontrolled bowel bleed
hypoxia in a cirrhosis, consider this diagnosis ____ which can come with ___ vasodilations
hepatopulmoary syndrome
intrapulmonary vasculardilations
clinical features of hepatopulm syndrome
dyspneic with sitting upright
improvement when laying down
MCC of drug induced liver injury
antibiotics
abx for fulminant cdiff
vanc po + iv flagyl
abx for severe Cdiff
po vanc OR fidaxo
difference btwn severe vs fulminant CDiff
SEVERE
abd pain with either:
Cr>1.5 or wbc>15
FULMINANT
severe with either:
ileus/megacolon or Shock/hypoTN
