FARR Gastrointestinal Flashcards
A patient presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs, and AXR reveals free air under the diaphragm. Management?
Emergent laparotomy to repair perforated viscus.
he most likely cause of acute lower GI bleed in patients > 40 years of age.
Diverticulosis.
Diagnostic modality used when ultrasound is equivocal for cholecystitis.
HIDA scan.
Risk factors for cholelithiasis.
Fat, female, fertile, forty, flatulent.
Inspiratory arrest during palpation of the RUQ.
Murphy’s sign, seen in acute cholecystitis.
The most common cause of SBO in patients with no history of abdominal surgery.
Hernia.
The most common cause of SBO in patients with a history of abdominal surgery.
Adhesions.
Identify key organisms causing diarrhea: ■ Most common organism ■ Recent antibiotic use ■ Camping ■ Traveler’s diarrhea ■ Church picnics/mayonnaise ■ Uncooked hamburgers ■ Fried rice ■ Poultry/eggs ■ Raw seafood ■ AIDS ■ Pseudoappendicitis
Campylobacter Clostridium difficile Giardia ETEC S. aureus E. coli O157:H7 Bacillus cereus Salmonella Vibrio, HAV Isospora, Cryptosporidium, Mycobacterium avium complex (MAC) Yersinia
A 25-year-old Jewish man presents with pain and watery diarrhea after meals. Exam shows fistulas between the bowel and skin and nodular lesions on his tibias.
Crohn’s disease.
Inflammatory disease of the colon with ↑ risk of colon cancer.
Ulcerative colitis (greater risk than Crohn’s).
Extraintestinal manifestations of IBD.
Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, 1° sclerosing cholangitis.
Medical treatment for IBD.
5-ASA agents and steroids during acute exacerbations.
Difference between Mallory-Weiss and Boerhaave tears.
Mallory-Weiss—superficial tear in the esophageal mucosa; Boerhaave—full-thickness esophageal rupture.
Charcot’s triad.
RUQ pain, jaundice, and fever/chills in the setting of ascending cholangitis.
Reynolds’ pentad.
Charcot’s triad plus shock and mental status changes, with suppurative ascending cholangitis.
Medical treatment for hepatic encephalopathy.
↓ protein intake, lactulose, rifaximin.
First step in the management of a patient with an acute GI bleed.
Establish the ABCs.
A four-year-old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
Hemolytic-uremic syndrome (HUS) due to E. coli O157: H7.
Post-HBV exposure treatment.
HBV immunoglobulin.
Classic causes of drug-induced hepatitis.
TB medications (INH, rifampin, pyrazinamide), acetaminophen, and tetracycline.
A 40-year-old obese woman with elevated alkaline phosphatase, elevated bilirubin, pruritus, dark urine, and clay-colored stools.
Biliary tract obstruction.
Hernia with highest risk of incarceration—indirect, direct, or femoral?
Femoral hernia.
A 50-year-old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make the patient NPO and give IV fluids, O2, analgesia, and “tincture of time.”
