april 29

Question 1

A patient has suspected pancreatitis, first investigation?

Answer 1

serum amylase or lipase (positive if >3 x greater than upper limit)

Question 2

Criteria for acute pancreatitis?

Answer 2

2+ of the following:

• severe epigastric pain
• serum amylase/lipase >3x upper limit norma
• characteristic findings on imaging

Question 3

how do gouty tophi appear on imaging?

Answer 3

inflammation in bone/surrounding tissue - > bone erosion with overhanging edges

Question 4

A patient has testicular torsion for >12 hours and develops testicular necrosis. What will be seen on ultrasound?

Answer 4

heterogenous echotexture

Question 5

ultrasound of an inguinal hernia would show what?

Answer 5

loops of bowel in the scrotum

Question 6

onset of acute postradiation proctitis?

Answer 6

<8 weeks post radiation

Question 7

onset of chronic postradiation proctitis?

Answer 7

> 3 years after radiation

Question 8

path of acute post radiation proctitis?

Answer 8

direct mucousal damage from radiation

Question 9

path of chronic post radiation proctitis?

Answer 9

• obliterative endarteritis and chronic mucosal ischemia

- submucosal fibrosis

Question 10

clinical manifestations of acute post radiation proctitis?

Answer 10

• diarrhea, mucus discharge, tenesmus

- minimal bleeding

Question 11

clinical manifestations of chronic post radiation proctitis?

Answer 11

• severe bleeding

- strictures + constipation/rectal pain

Question 12

endoscopic appearance of acute post radiation proctitis?

Answer 12

ulcers, erythema, edema

Question 13

endoscopic appearance of chronic post radiation proctistis?

Answer 13

• multiple telangiectasies

- mucosal pallor + friability

Question 14

management of acute post radiation proctitis?

Answer 14

-anti-diarrheals, butyrate enemas

Question 15

management of chronic post radiation proctitis?

Answer 15

• endoscopic thermal coagulation

- sucralfate or glucotcorticote enema

Question 16

management following drainage of a perianal abscess?

Answer 16

systemic antibiotics

Question 17

why are glucocorticoids useful in thyrsoid storm?

Answer 17

-decrease peripheral conversion of T4 to T3

Question 18

You notice a patient has spinal asymmetry. First step?

Answer 18

Spinal imaging

Question 19

Hypocalcemia is more common following blood transfusion in patients with…

Answer 19

liver dysfunction (since the liver normally rapidly metabolizes citrate)