10: Adult Misc GI

Question 1

Where is the pain located in diverticulitis?

Answer 1

LLQ

Question 2

If you wanted to r/o obstruction or ischemia in appendicitis, what test would you order?

Answer 2

Flat plate XR or KUB (will show bowel gas pattern)

Question 3

Where is diverticulosis common?

Answer 3

• Industrialized, Western cultures
• Increased prevalence with aging

Question 4

What is the pharm treatment for diverticulitis?

Answer 4

• Cipro 500 mg PO BID

+

• Metronidazole 500 mg PO TID

x 7-10 days

Question 5

Etiology of diverticulosis is unknown, but thought to be related to _____ and _____.

Answer 5

Etiology of diverticulosis is unknown, but thought to be related to decrease in peristalsis over time and lack of dietary fiber and fluids.

Question 6

If you wanted to r/o gallstones, pancreatitis, abdominal aorta, or liver issues in appendicitis, what test would you order?

Answer 6

Abd U/S

Question 7

T/F Early appendicitis has pain that is not well localized.

Answer 7

True. Pain eventually localizes to the RLQ. Pregnant women and pts with dislocated appendix are exceptions.

Question 8

Formation of pouches in the colon.

Answer 8

Diverticulosis

Question 9

If you wanted to r/o diverticulitis, abscess, mass, ischemia, pseudocyst, or pancreatitis in appendicitis, what test would you order?

Answer 9

Abd CT (assesses bowel fx)

Question 10

An infection in a pouch in the colon.

Answer 10

Diverticulitis

Question 11

When do you treat empirically with diverticulitis?

Answer 11

• With a known disease, can treat empirically if symptoms are classic.
• First time episode needs to be transferred to ED for evaluation to determine cause.