Abdomen

Question 1

Risk factors for acalculous cholecystitis

Answer 1

• critically ill patient, trauma or major surgery
• elderly patient with pre existing vascular disease
• DM
• HIV
• long term parenteral nutrition

Question 2

Headlines for upper GI bleed ( details could be added)

Answer 2

1-resuscitation:
a-airway and breathing: RSI if required, O2 if hypoxic
b-circulation: large bore IVC x 2,
Hypotensive resuscitation
Minimize crystalloids,
Blood transfusion if HD unstable or Hb<70
MTP if required
2-supportive:
a-reversal of anticoagulation if any
b-antibiotic ceftriaxone 1 g IV especially if liver disease
c-prokinetic agent for better visualization on endoscopy, erythromycin 250 iv or metoclopromide 10 mg iv

3-specific:
a-pantoprazole 80 mg iv bolus then 8mg/hr ivi
b-octreotide for oesophageal varices 50 mcg iv bolus then 25-50 mcg/hr ivi

4-definitive:depends on pathology
a-gastroscopy
b-surgery

5-temporary measures, sengstaken or Minnesota tube