GASTRO AMC Flashcards
Screening recommendations for members of families with HNPCC
Annual or biennial colonoscopy from the age of 25
Screening recommendations for members of families with FAP
Annual sigmoidoscopy from age 10 then every 3 years from age 35
focal swelling of the tongue base or the upper pharnx along the course of the thyroglossal duct cyst
Lingual ectopic thyroid
Old patient + food regurgitation
Pharyngeal pouch
Lump in throat + absence of physical abnormality
globus phanryngeus syndrome
Shoulder dystocia nerve injury
C5-C6/ porters tip/ Erbs palsy
Klumpke paralysis/ complete claw deformity
C8-T1
Manifestation of Erbs palsy
arm hangs limp in adduction, rotated inetrnally at the shoulder, extended and pronated at the elbow and flexed at the wrist
Rinne positive
AC>BC ; normal
Cocaine intoxication differentiating feature
Fever
IDS: bloody diarrhea + abdominal cramps + systemic symptoms, long incubation; contaminated food (particularly fresh fruits and vegetables washed with contaminated water); dysentery
Ameobiasis/Entamoeba histolytica
watery diarrhea
Enterotoxigenic Escherichia coli (ETEC)
bloody diarrhea, but the incubation period is usually shorter (1-3 days)
Shigella
“Undercooked beef” or “contaminated vegetables”
“Hemolytic uremic syndrome (HUS)”: acute renal failure, thrombocytopenia, microangiopathic hemolytic anemia
“No antibiotics” (due to increased risk of HUS)
EHEC
Salmonella
“Poultry, eggs, reptiles”
“Watery diarrhea”, can be “bloody”
“Typhoid fever” (for Salmonella Typhi): fever, “rose spots” on abdomen, hepatosplenomegaly
Non-typhoidal strains: “gastroenteritis”
Common in immunocompromised and Sickle cell patients (risk for osteomyelitis)
Giardia
“Foul-smelling, greasy stools”
“Steatorrhea”
“Fatty diarrhea” with “bloating” and flatulence
Associated with “drinking contaminated water”, often from streams or wilderness travel (e.g., hikers)
“Cysts in stool” on microscopy
“Chronic diarrhea” in immunocompromised individuals
“Pear-shaped trophozoites” seen on stool examination
Chemoprophylaxis for malaria
Summary of Usage by Region:
Chloroquine-sensitive areas: Use chloroquine or mefloquine.
Chloroquine-resistant areas: Use atovaquone-proguanil, doxycycline, or mefloquine.
P. vivax or P. ovale endemic areas: Use primaquine or tafenoquine (with G6PD testing).
Special Populations:
Pregnant women: Chloroquine and mefloquine are considered safe, while atovaquone-proguanil, doxycycline, and primaquine are not recommended.
Children: Doxycycline is contraindicated in children under 8 years, but mefloquine and atovaquone-proguanil can be used with caution.
Dosing schedule for shingles vaccination
After 50, 0 and then 2-6 monts after
Vaccination schedule for Varicella
Children:
1st dose at 12-15 months.
2nd dose at 4-6 years.
Unvaccinated adolescents/adults:
1st dose at any time.
2nd dose 4-8 weeks later.
Tetanus rules
If you have a dirty wound with incomplete or unknown vaccination OR immunocompromised -> give TIG
If you have completed vaccines + less than 5 years form last dose -> no need to give anything regardless of the type of wound
If you have completed vaccines with last dose 5-10 years prior and a dirty wound –> give vaccine
If completed and more than 10 years, regardless of type of wound –> give vaccine
