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Emergency Medicine EOR > EM - GI > Flashcards

EM - GI Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

etiology of appendicitis

A

fecalith

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2
Q

s/s of appendicitis

A

-colicky abdominal pain
-originates in the peri-umbilical region and localizes in the RLQ
-McBurneys point tenderness
-Rosvings
-psoas
-obturator
-heel slap

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3
Q

diagnosis of appendicitis

A

CT

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4
Q

treatment of appendicitis

A

-consult surgery
-cefoxitin or unasyn

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5
Q

etiology of cholecystitis

A

stones

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6
Q

s/s of cholecystitis

A

-RUQ pain
-epigastric or shoulder blade pain
-precipitated by fatty meals
-murphy sign

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7
Q

diagnosis of cholecystitis

A

-US
-HIDA if US in inconclusive

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8
Q

treatment of cholecystitis

A

-lap chole

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9
Q

Roout of transmission for something idk I messed up the card sawy

A

fecal oral route

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10
Q

s/s of hep A

A

-n/v
-mild, constant RUQ pain
-low grade fever
-distaste for smoking
-jaundice

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11
Q

diagnosis of Hep A

A

-anti HAV
-ALT>AST

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12
Q

treatment of Hep A

A

supportive

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13
Q

etiology of Hep B

A

bodily fluids

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14
Q

s/s of hep B

A

-malaise
-mild RUQ pain
-jaundice
-low grade fever
-distaste for smoking

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15
Q

diagnosis of Hep B

A

-serologic markers

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16
Q

first serologic marker to elevate in Hep B

A

HBsAG (surface antigen)

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17
Q

appearance of _____ and decline in ____ indicates recovery of acute infection and non-infectivity

A

anti-HBs; HBsAG

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18
Q

____ indicates a declining acute hep b

A

anti-HBc

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19
Q

t/f IgG anti-HBc persists indefinitely

A

true

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20
Q

_____ indicates viral replication and infectivity

A

HBeAG

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21
Q

treatment of hep B

A

-immune globulin within 7 days
-initiation of vaccine series

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22
Q

etiology of hep c

A

IV drug use

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23
Q

s/s of hep c

A

fatigue
myalgias
jaundice

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24
Q

diagnosis of hep c

A

-anti-HCV
-HCV RNA

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25
Q

____ indicated current infection of hep C

A

HCV RNA

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26
Q

treatment of hep c

A

interferon and ribavirin

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27
Q

Hep D is always a co-infection with _____________.

A

Hep B

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28
Q

diagnosis of Hep D

A

anti-HDV

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29
Q

treatment of hep d

A

supportive

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30
Q

etiology of acute pancreatitis

A

gallstones
alcohol

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31
Q

presentation of acute pancreatitis

A

-epigastric pain radiating to the back
-improves with leaning forward
-n/v
-cullen’s and grey turner sign

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32
Q

diagnosis of acute pancreatitis

A

elevated amylase and lipase
CT with contrast

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33
Q

most sensitive lab for pancreatitis

A

lipase

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34
Q

treatment of pancreatitis

A

-NPO
-fluid
-demerol
-complete bowel rest
Also Oxygen

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35
Q

etiology of anal fissure

A

trauma during defecation

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36
Q

s/s of anal fissure

A

tearing pain with defecation
bleeding

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37
Q

treatment of anal fissure

A

proper toileting

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38
Q

s/s of perianal abscess

A

-throbbing
-pain
-swelling
-fluctuant

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39
Q

treatment of perianal abscess

A

I&D

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40
Q

s/s of perianal fistula

A

purulent discharge that may lead to itching, tenderness, and pain

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41
Q

treatment of perianal fistula

A

surgical excision

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42
Q

etiology of cholangitis

A

EColi obstruction of common bile duct

Cholodocho but with infection

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43
Q

s/s of acute cholangitis

A

-RUQ pain
-fever
-jaundice
(Charcot’s Triad)

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44
Q

diagnosis of cholangitis

A

ERCP

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45
Q

treatment of cholangitis

A

-fluids
-pain control
-NPO
-stone extraction

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46
Q

etiology of cirrhosis

A

alcohol and chronic hep c

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47
Q

s/s of cirrhosis

A

-n/v/abd pain
-esophageal varicies
-spider angiomas
-fatigue
-jaundice
-ascites/peripheral edema
-HSM

48
Q

diagnosis of cirrhosis

A

-first line US
-definitive biopsy

49
Q

treatment of cirrhosis

A

-avoid alcohol
-liver transplant

50
Q

mc location of diverticular disease?

A

sigmoid colon

51
Q

s/s of diverticulosis

A

-asymptomatic
-may see mild LLQ pain

52
Q

treatment of diverticulosis

A

high fiber diet

53
Q

s/s of diverticulitis

A

-LLQ pain
-palpable mass
-low grade fever
-bowel changes

54
Q

diagnosis of diverticulitis

A

CT

55
Q

treatment of diverticulitis outpatient

A

-clear liquid diet
-cipro + flagyl or augmentin

56
Q

treatment of diverticulitis inpatient

A

-NPO with IV fluids
-pip/taz

57
Q

treatment of diverticular bleed

A

-may resolve on own
-colonoscopy with cauterization of bleed

58
Q

etiologies of erosive gastritis

A

-meds
-alcohol
-stress

59
Q

s/s of gastritis

A

-anorexia
-epigastric pain
-n/v
-hematemesis

60
Q

diagnosis of gastritis

A

EGD

61
Q

treatment of gastritis

A

PPI

62
Q

treatment of h.pylori

A

-clarithromycin
-omeprazole
-amoxicillin

63
Q

diagnosis of hpylori

A

-urea breath test
-EGD

64
Q

s/s of viral gastroenteritis

A

watery stool
no blood or mucus
dehydration

65
Q

management of viral gastroenteritis

A

oral fluid challenge
zofran
antidiarrheal

66
Q

presentation of bacterial gastroenteritis

A

-bloody mucopurulent diarrhea
-cramping
-fever

67
Q

management of bacterial gastroenteritis

A

-fluids
-can use pepto bismol if needed
-empiric abx in adults only

68
Q

presentation of GI bleed

A

-hematemesis
-melena
-hematochezia

69
Q

PE of GI bleed

A

-hyperactive bowel sounds (UGI)
-tenderness

70
Q

-hyperactive bowel sounds (UGI)
-tenderness

A

-stable: consult surgery for endoscopy
-unstable: fluids, transfusion if needed, reverse anticoagulation if needed, PPI

71
Q

management of GI bleed if variceal

A

octreotide

72
Q

presentation of giardiasis

A

-watery diarrhea
-dehydration
-no vomiting
-afebrile

73
Q

diagnosis of giardiasis

A

stool sample

74
Q

treatment of giardiasis

A

-azole

75
Q

etiology of GERD

A

-relaxation of lower esophageal sphincter

76
Q

s/s of GERD

A

-heartburn
-worse after meals
-regurgitation
-dysphagia

77
Q

diagnosis of GERD

A

-clinical for mild
-EGD

78
Q

treatment of GERD

A

-lifestyle modification
-H2 blockers
-antacids
-PPI

79
Q

etiology of hemorrhoids

A

increase in venous pressure

80
Q

s/s of hemorrhoids

A

-mostly asx
-may have bleeding or prolapse

81
Q

diagnosis of hemorrhoids

A

inspection via DRE

82
Q

treatment of hemorrhoids

A

-proper toileting
-banding
-hemorrhoidectomy

83
Q

management of external thrombosed hemorrhoid

A

evacuation of clot

84
Q

presentation of incarcerated/strangulated hernia

A

-firm
-tender
-redness or discoloration of overlying skin

85
Q

treatment of hernia

A

surgery

86
Q

mc area of chrons disease

A

terminal ileum

87
Q

s/s of chrons disease

A

-RLQ pain
-non-bloody diarrhea
-steatorrhea
-erythema nodosum
-pyoderma gangrenosum

88
Q

diagnosis of chrons disease

A

-cobblestoning on colonoscopy
-skip lesions

89
Q

management of chrons disease

A

-steroids
-TNF blockers + azathioprine

90
Q

mc area for ulcerative colitis

A

rectum and sigmoid colon

91
Q

s/s of ulcerative colitis

A

-bloody diarrhea
-crampy abdominal pain

92
Q

diagnosis of ulcerative colitis

A

sigmoidoscopy

93
Q

management of ulcerative colitis

A

mesalamine
steroids
curative: total proctocolectomy

94
Q

S/S of toxic megacolon

A

-severe bloody diarrhea
-abd pain and distention
-vomtiing

95
Q

in which IBD is toxic megacolon seen?

A

ulcerative colitis

96
Q

diagnosis of toxic megacolon

A

CT

97
Q

treatment of toxic megacolon

A

-steroids
-surgical consult

98
Q

S/S of mesenteric ischemia

A

-abd pain out of proportion to PE
-mild distention
-absent bowel sounds
-occult blood in stool

99
Q

diagnosis of mesenteric ischemia

A

mesenteric arteriography

100
Q

treatment of mesenteric ischemia

A

pain control
-abx
-anticoagulation
-NTG

101
Q

cause of jaundice

A

accumulation of bilirubin

102
Q

pre-hepatic vs hepatic vs post-hepatic jaundice

A

-prehepatic: unconjugated bilirubin
-hepatic: conjugated and unconjugated
-posthepatic: conjugated

103
Q

clinical findings associated with unconjugated hyperbilirubinermia

A

-normal stool and urine
-mild jaundice

104
Q

clinical findings associated with conjugated hyperbilirubinermia

A

-light colored stools
-dark urine
-hepatomegaly
-jaundice

105
Q

etiology of mallory weiss tear

A

retching, vomiting, or lifting

106
Q

s/s of mallory weiss tear

A

-hematemesis
-epigastric pain
-hx of vomiting

107
Q

diagnosis of mallory weiss tear

A

egd

108
Q

treatment of mallory weiss tear

A

-fluids and blood
-stop bleeding
-PPI

109
Q

mc type of volvulus

A

sigmoid

110
Q

pathophys of volvulus

A

sigmoid colon twists around the mesentery

111
Q

s/s of volvulus

A

-slow onset of abd pain
-nausea
-distention
-constipation
-tympanic

112
Q

diagnosis of sigmoid volvulus

A

CT (whirl pattern)

113
Q

management of sigmoid volvulus

A

-endoscopic decompression with rigid sigmoidoscope

114
Q

diagnosis of cecal volvulus

A

-radiography (coffee bean sign, comma sign)
-CT (whirl pattern)

115
Q

management of cecal volvulus

A

-stable without compromise: open surgical detorsion and ileocecal resection
-unstable without compromise: cecopexy
-stable with compromise: ileocecal resection and right colectomy
-unstable with compromise: resection of compromised bowel and ileostomy

116
Q

treatment of bowel obstruction

A

NG suction

117
Q

Diagnosis of bowel obstruction

A

Xray, CT

Emergency Medicine EOR (12 decks)

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