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Step 2 CK > First Aid GI > Flashcards

First Aid GI Flashcards

1
Q

etiology of acute cholecystitis?

A

prolonged blockage of the cystic duct by a gallstone that leads to progressive distention, inflammation, and superinfection.

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2
Q

what is acalculous cholecystitis?

A

occurs in the absence of cholelithiasis (gallstone) in pts who are chronically debilitated or critically ill

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3
Q

pt suspicious of cholecystitis, you do ultrasound and found nothing, what is the next step?

A

HIDA scan

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4
Q

what is the positive sign for HIDA scan for cholecystitis?

A

non-visualization of the gallbladder

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5
Q

treatment for cholecystitis?

A

IV antibiotics, IV fluids, and cholecystectomy

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6
Q

what is the imaging modality for cholelithiasis and biliary colic?

A

RUQ ultrasound

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7
Q

4 main risk factors for cholelithiasis (gallstones)?

A

Female, Fat, Fertile, and Forty

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8
Q

additional risk factors for cholelithiasis?

A

OCPs, rapid weight loss, chronic hemolysis, small bowel resection, and TPN

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9
Q

what is the treatment for asymptomatic gallstone?

A

no treatment required

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10
Q

clinical signs for cholelithiasis?

A

postprandial abdominal pain in RUQ that radiates to Rt. subscapular area or the epigastrium

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11
Q

clinical signs for acute cholecystitis?

A

RUQ pain, nausea, vomiting, fever, + Murphy’s sign, leukocytosis

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12
Q

what is choledocholithiasis?

A

gallstones in the common bile duct

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13
Q

clinical signs for choledocholithiasis?

A

biliary colic, jaundice, fever, pancreatitis

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14
Q

what are the 2 lab hallmarks for choledocholithiasis?

A
  1. inc alkaline phosphatase

2. inc total and direct bilirubin

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15
Q

treatment for choledocholithiasis?

A

ERCP (Endoscopic retrograde cholangiopancreatography) with sphincterotomy followed by cholecystectomy

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16
Q

define cholangitis

A

acute bacterial infection of the biliary tree that commonly occurs 2’ obstruction usually from gallstones (choledocholithiasis).

17
Q

unique clinical signs for cholangitis?

A
  1. Charcot’s triad - RUQ pain, jaundice, fever/chills

2. Reynold’s pentad: Charcot’s triad plus septic shock and altered mental status

18
Q

ERCP for cholangitis is both

A

diagnostic and therapeutic

19
Q

treatment for acute suppurative cholangitis?

A

emergent bile duct decompression via ERCP/sphincterotomy

20
Q

most common cause of acute lower GI bleeding in pts > 40?

A

diverticulosis

21
Q

what should be avoided in the initial stages of diverticulitis?

A

sigmoidoscopy

22
Q

what is the definitive diagnosis in diverticular dz?

A

colonoscopy

23
Q

treatments for diverticulitis?

A
  1. bowel rest (NPO)
  2. NG tube placement
  3. broad spectrum antibiotics (metronidazole, fluoroquinolone, second/third generation cephalosporin)
24
Q

most common cause of odynophagia in immunocompromised pts?

A

candidiasis

25
Q

definition of oropharyngeal dysphagia?

A

problem with initiation of swallowing

26
Q

what are the 2 types of dysphagia?

A
  1. oropharyngeal dysphagia

2. esophageal dysphagia

27
Q

which dysphagia has more problems with liquids than with solids?

A

oropharyngeal dysphagia

28
Q

causes for oropharyngeal dysphagia?

A

neurologic or muscular

  1. stroke
  2. Parkinson
  3. myasthenia gravis
  4. prolonged intubation
  5. Zenker diverticula
29
Q

causes for esophageal dysphagia?

A
  1. obstructions
    - strictures
    - Schatzki rings
    - webs
    - carcinoma
  2. motility disorder
    - achalasia
    - scleroderma
    - esophageal spasm
30
Q

esophageal web is associated with

A

plummer vinson syndrome (anemia, glossitis)

31
Q

what is the best initial diagnostic tool for oropharyngeal dysphagia?

A

modified barium swallow (video fluoroscopic swallowing exam), occasionally esophagogastroduodenoscopy (EGD)

32
Q

what is the best initial diagnostic tool for esophageal dysphagia?

A

EGD (esophagogastroduodenoscopy)

33
Q

which type of hernia is more common among yound men?

A

indirect

34
Q

best method for diagnosing IBD?

A

colonoscopy

35
Q

1st step of management for oropharyngeal dysphagia?

A

video fluoroscopic swallowing exam = modified barium swallow

36
Q

what is the initial test for achalasia?

A

Barium swallow

37
Q

what is the definitive test for achalasia?

A

Manometry

38
Q

short term treatment for achalasia?

A

nitrates, CCB, endoscopic injection of botulinum toxin

39
Q

long term treatment for achalasia?

A

pneumatic balloon dilation or surgical (Heller) myotomy

Step 2 CK (20 decks)

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