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HJ S2RR > Gastro > Flashcards

Gastro Flashcards

1
Q

A patient presents with sudden onset of severe, diffuse abdominal pain. Examination reveals peritoneal signs, and abdominal radiograph reveals free at under the diaphragm.
Management?

A

Emergency laparotomy to repair a perforated viscus

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2
Q

The most likely cause of acute lower GI bleeding in patients >40 years of age

A

Diverticulosis

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3
Q

Diagnosis modality used when USS is equivocal for cholecystitis

A

Hepatobiliary iminodiacetic acid (HIDA) scan

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4
Q

Risk factors for cholelithiasis

A

Fat, female, fertile, forty, flatulent

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5
Q

Inspiratory arrest during palpation of the RUQ

A

Murphy sign, seen in acute cholecystitis

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6
Q

Most common cause of small bowel obstruction in patients with no history of abdominal surgery

A

Hernia

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7
Q

Most common cause of small bowel obstruction in patients with a history of abdominal surgery

A

Adhesions

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8
Q

Most common organism causing diarrhoea

A

Campylobacter

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9
Q

Diarrhoea caused by recent antibiotic use?

A

C.diff

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10
Q

Diarrhoea from recent camping

A

Giardia

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11
Q

Travellers diarrhoea

A

Enterotoxigenic E.coli (ETEC)

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12
Q

Diarrhoea from church picnics/ mayonnaise

A

Staph aureus

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13
Q

Diarrhoea from uncooked hamburgers?

A

E.coli O157:H7

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14
Q

Diarrhoea from fried rice

A

Bacillus cereus

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15
Q

Diarrhoea from poultry/eggs

A

Salmonella

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16
Q

Diarrhoea from raw seafood

A

Vibrio cholerae or hepatitis A virus (HAV)

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17
Q

Diarrhoea in AIDS

A

Isospora; cryptosporidium; mycobacterium avium complex (MAC)

18
Q

Diarrhoea as pseudoappendicitis?

A

Yersinia; campylobacter

19
Q

A 25 year old Jewish man presents with pain and watery diarrhoea after meals. Examination shows fistula between the bowel and skin and nodular lesions on his tibias

A

Crohn’s disease

20
Q

Inflammatory disease of the colon with an increased risk of colon cancer

A

Ulcerative colitis (greater risk than Crohns)

21
Q

Extraintestinal manifestations of IBD

A

Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, PSC

22
Q

Medical treatment for IBD

A

5-ASA agents and steroids during acute exacerbation

23
Q

A 30 year old man with UC presents with fatigue, jaundice and pruritus

A

Primary sclerosing cholangitis (PSC)

24
Q

Difference between Mallory-Weiss and Boerhaave tears?

A

MW: superficial tear in oesophageal mucosa

Boerhaave: full thickness oesophageal rupture

25
Q

Charcot triad

A

RUQ pain, jaundice, fever/rigors

26
Q

Reynolds Pentad

A

Charcots triad + shock + mental state changes

27
Q

Medical treatment for hepatic encephalopathy

A

Reduce protein intake, lactulose, rifaximin

28
Q

First step in management of a patient with an acute GI bleeding episode

A

Management ABCs

29
Q

A 4 year old child presents with oliguria, petechia, and jaundice following an illness with bloody diarrhoea. Most likely Dx & cause?

A

HUS

Due to E.coli O157:H7

30
Q

Treatment after exposure to hepatitis B virus (HBV)

A

HBV immunoglobulin

31
Q

Classic causes of drug induced hepatitis

A

TB meds (INH, rifampicin, pyrazinamide); acetaminophen; tetracycline

32
Q

A 40 year old obese woman with elevated ALP, bilirubin, pruritus, dark urine, and clay-coloured stools

A

Biliary tract obstruction

33
Q

Hernia with greatest risk of incarceration - indirect, direct or femoral?

A

Femoral hernia

34
Q

Severe abdominal pain or of proportion to the examination?

A

Mesenteric ischaemia

35
Q

Diagnostic test for ileus

A

Abdo XR (could also do CT)

36
Q

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?

A

Confirm the diagnosis of acute pancreatitis with raised amylase and lipase

Make the patient nil per oral (NBM) and give IV fluids, O2, analgesia, and ‘tincture of time’

37
Q

Colon cancer region based on anaemia of chronic disease, occult blood loss, vague abdo pain?

A

R sided: rare to have an obstruction

38
Q

Colon cancer region based on obstructive symptx, change in bowel habits?

A

L sided: ‘apple core lesion’

39
Q

Presents with watery diarrhoea, dehydration, muscle weakness & flushing

A

VIPoma (replace fluids and electrolytes, may need to surgically resect tumour, or use octreotide)

40
Q

Presents with palpable, non tender gallbladder

A

Courvoisier sign (jaundice not due to gallstones - suggests pancreatic cancer)

HJ S2RR (16 decks)

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