EM - GI Flashcards
1
Q
etiology of appendicitis
A
fecalith
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
3
Q
diagnosis of appendicitis
A
CT
4
Q
treatment of appendicitis
A
-consult surgery
-cefoxitin or unasyn
5
Q
etiology of cholecystitis
A
stones
6
Q
s/s of cholecystitis
A
-RUQ pain
-epigastric or shoulder blade pain
-precipitated by fatty meals
-murphy sign
7
Q
diagnosis of cholecystitis
A
-US
-HIDA if US in inconclusive
8
Q
treatment of cholecystitis
A
-lap chole
9
Q
Roout of transmission for something idk I messed up the card sawy
A
fecal oral route
10
Q
s/s of hep A
A
-n/v
-mild, constant RUQ pain
-low grade fever
-distaste for smoking
-jaundice
11
Q
diagnosis of Hep A
A
-anti HAV
-ALT>AST
12
Q
treatment of Hep A
A
supportive
13
Q
etiology of Hep B
A
bodily fluids
14
Q
s/s of hep B
A
-malaise
-mild RUQ pain
-jaundice
-low grade fever
-distaste for smoking
15
Q
diagnosis of Hep B
A
-serologic markers
16
Q
first serologic marker to elevate in Hep B
A
HBsAG (surface antigen)
17
Q
appearance of _____ and decline in ____ indicates recovery of acute infection and non-infectivity
A
anti-HBs; HBsAG
18
Q
____ indicates a declining acute hep b
A
anti-HBc
19
Q
t/f IgG anti-HBc persists indefinitely
A
true
20
Q
_____ indicates viral replication and infectivity
A
HBeAG
21
Q
treatment of hep B
A
-immune globulin within 7 days
-initiation of vaccine series
22
Q
etiology of hep c
A
IV drug use
23
Q
s/s of hep c
A
fatigue
myalgias
jaundice
24
Q
diagnosis of hep c
A
-anti-HCV
-HCV RNA
25
____ indicated current infection of hep C
HCV RNA
26
treatment of hep c
interferon and ribavirin
27
Hep D is always a co-infection with _____________.
Hep B
28
diagnosis of Hep D
anti-HDV
29
treatment of hep d
supportive
30
etiology of acute pancreatitis
gallstones
alcohol
31
presentation of acute pancreatitis
-epigastric pain radiating to the back
-*improves with leaning forward*
-n/v
-*cullen's and grey turner sign*
32
diagnosis of acute pancreatitis
elevated amylase and lipase
CT with contrast
33
most sensitive lab for pancreatitis
lipase
34
treatment of pancreatitis
-NPO
-fluid
-demerol
-complete bowel rest
Also Oxygen
35
etiology of anal fissure
trauma during defecation
36
s/s of anal fissure
tearing pain with defecation
bleeding
37
treatment of anal fissure
proper toileting
38
s/s of perianal abscess
-throbbing
-pain
-swelling
-fluctuant
39
treatment of perianal abscess
I&D
40
s/s of perianal fistula
purulent discharge that may lead to itching, tenderness, and pain
41
treatment of perianal fistula
surgical excision
42
etiology of cholangitis
EColi obstruction of common *bile duct*
Cholodocho but with infection
43
s/s of acute cholangitis
-RUQ pain
-fever
-jaundice
(Charcot's Triad)
44
diagnosis of cholangitis
ERCP
45
treatment of cholangitis
-fluids
-pain control
-NPO
-stone extraction
46
etiology of cirrhosis
alcohol and chronic hep c
47
s/s of cirrhosis
-n/v/abd pain
-esophageal varicies
-spider angiomas
-fatigue
-jaundice
-ascites/peripheral edema
-HSM
48
diagnosis of cirrhosis
-first line US
-definitive biopsy
49
treatment of cirrhosis
-avoid alcohol
-liver transplant
50
mc location of diverticular disease?
sigmoid colon
51
s/s of diverticulosis
-asymptomatic
-may see mild LLQ pain
52
treatment of diverticulosis
high fiber diet
53
s/s of diverticulitis
-LLQ pain
-palpable mass
-low grade fever
-bowel changes
54
diagnosis of diverticulitis
CT
55
treatment of diverticulitis outpatient
-clear liquid diet
-cipro + flagyl or augmentin
56
treatment of diverticulitis inpatient
-NPO with IV fluids
-pip/taz
57
treatment of diverticular bleed
-may resolve on own
-colonoscopy with cauterization of bleed
58
etiologies of erosive gastritis
-meds
-alcohol
-stress
59
s/s of gastritis
-anorexia
-epigastric pain
-n/v
-hematemesis
60
diagnosis of gastritis
EGD
61
treatment of gastritis
PPI
62
treatment of h.pylori
-clarithromycin
-omeprazole
-amoxicillin
63
diagnosis of hpylori
-urea breath test
-EGD
64
s/s of viral gastroenteritis
watery stool
no blood or mucus
dehydration
65
management of viral gastroenteritis
oral fluid challenge
zofran
antidiarrheal
66
presentation of bacterial gastroenteritis
-bloody mucopurulent diarrhea
-cramping
-fever
67
management of bacterial gastroenteritis
-fluids
-can use pepto bismol if needed
-empiric abx in adults only
68
presentation of GI bleed
-hematemesis
-melena
-hematochezia
69
PE of GI bleed
-hyperactive bowel sounds (UGI)
-tenderness
70
-hyperactive bowel sounds (UGI)
-tenderness
-stable: consult surgery for endoscopy
-unstable: fluids, transfusion if needed, reverse anticoagulation if needed, PPI
71
management of GI bleed if variceal
octreotide
72
presentation of giardiasis
-watery diarrhea
-dehydration
-no vomiting
-afebrile
73
diagnosis of giardiasis
stool sample
74
treatment of giardiasis
-azole
75
etiology of GERD
-relaxation of lower esophageal sphincter
76
s/s of GERD
-heartburn
-worse after meals
-regurgitation
-dysphagia
77
diagnosis of GERD
-clinical for mild
-EGD
78
treatment of GERD
-lifestyle modification
-H2 blockers
-antacids
-PPI
79
etiology of hemorrhoids
increase in venous pressure
80
s/s of hemorrhoids
-mostly asx
-may have bleeding or prolapse
81
diagnosis of hemorrhoids
inspection via DRE
82
treatment of hemorrhoids
-proper toileting
-banding
-hemorrhoidectomy
83
management of external thrombosed hemorrhoid
evacuation of clot
84
presentation of incarcerated/strangulated hernia
-firm
-tender
-redness or discoloration of overlying skin
85
treatment of hernia
surgery
86
mc area of chrons disease
terminal ileum
87
s/s of chrons disease
-RLQ pain
-non-bloody diarrhea
-steatorrhea
-erythema nodosum
-pyoderma gangrenosum
88
diagnosis of chrons disease
-cobblestoning on colonoscopy
-skip lesions
89
management of chrons disease
-steroids
-TNF blockers + azathioprine
90
mc area for ulcerative colitis
rectum and sigmoid colon
91
s/s of ulcerative colitis
-bloody diarrhea
-crampy abdominal pain
92
diagnosis of ulcerative colitis
sigmoidoscopy
93
management of ulcerative colitis
mesalamine
steroids
curative: total proctocolectomy
94
S/S of toxic megacolon
-severe bloody diarrhea
-abd pain and distention
-vomtiing
95
in which IBD is toxic megacolon seen?
ulcerative colitis
96
diagnosis of toxic megacolon
CT
97
treatment of toxic megacolon
-steroids
-surgical consult
98
S/S of mesenteric ischemia
-abd pain out of proportion to PE
-mild distention
-absent bowel sounds
-occult blood in stool
99
diagnosis of mesenteric ischemia
mesenteric arteriography
100
treatment of mesenteric ischemia
pain control
-abx
-anticoagulation
-NTG
101
cause of jaundice
accumulation of bilirubin
102
pre-hepatic vs hepatic vs post-hepatic jaundice
-prehepatic: unconjugated bilirubin
-hepatic: conjugated and unconjugated
-posthepatic: conjugated
103
clinical findings associated with unconjugated hyperbilirubinermia
-normal stool and urine
-mild jaundice
104
clinical findings associated with conjugated hyperbilirubinermia
-light colored stools
-dark urine
-hepatomegaly
-jaundice
105
etiology of mallory weiss tear
retching, vomiting, or lifting
106
s/s of mallory weiss tear
-hematemesis
-epigastric pain
-hx of vomiting
107
diagnosis of mallory weiss tear
egd
108
treatment of mallory weiss tear
-fluids and blood
-stop bleeding
-PPI
109
mc type of volvulus
sigmoid
110
pathophys of volvulus
sigmoid colon twists around the mesentery
111
s/s of volvulus
-slow onset of abd pain
-nausea
-distention
-constipation
-tympanic
112
diagnosis of sigmoid volvulus
CT (whirl pattern)
113
management of sigmoid volvulus
-endoscopic decompression with rigid sigmoidoscope
114
diagnosis of cecal volvulus
-radiography (coffee bean sign, comma sign)
-CT (whirl pattern)
115
management of cecal volvulus
-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
treatment of bowel obstruction
NG suction
117
Diagnosis of bowel obstruction
Xray, CT
