Gastroenterology & General Surgery - Mnemotechnics & Key points

Question 1

Gastroenterology

Causes of Abdominal Distention

Answer 1

6 F’s

• Fat
• Feces
• Fetus
• Flatus
• Fluid
• Fatal Growth

Question 1

Gastroenterology

Approach to Peptic Ulcer Disease

Answer 1

1. Stop NSAIDs
2. Acid neutralization
3. H. pylori eradication
4. Quit smoking

Question 2

Gastroenterology

Infectious Causes of Inflammatory Diarrhea

Answer 2

“Your Shit Smells Extremely Crappy”

Y Yersinia
S Shigella
S Salmonella
E E. coli, E. histolytica
C Campylobacter, C. difficile

Question 3

Gastroenterology

Fat soluble Vitamins

Answer 3

ADEK

Question 4

Gastroenterology

Vitamin K dependent coagulation factors

Answer 4

“1972 Canada vs. Soviet”
X, IX, VII, II protein C and S

*Vitamin K antagonists (e.g. warfarin) affect function of these factors

Question 5

Gastroenterology

Where is found Gluten

Answer 5

Gluten found in “BROW”

B Barley (Cebada)
R Rye (Centeno)
O Oats (controversial) (Avena)
W Wheat (Trigo)

Question 6

Gastroenterology

Causes of Constipation

Answer 6

-DOPED-

D Drugs
O Obstruction
P Pain
E Endocrine dysfunction
D Depression

Question 7

Gastroenterology

Lower Gl Bleed Etiology

Answer 7

-CHAND-

C Colitis [radiation, infectious, ischemic, IBD (UC > CD)]
H Hemorrhoids/fissure
A Angiodysplasia
N Neoplastic
D Diverticular disease

Question 8

Gastroenterology

Portal Hypertension Signs and Management

Answer 8

A. Signs
Esophageal varices
Melena
Splenomegaly
Ascites
Hemorrhoids

B. Management
β-blockers
Nitrates
Shunts [e.g. transjugular intrahepatic portosystemic shunt (TIPS)]

Question 9

Gastroenterology

Precipitating Factors for Hepatic Encephalopathy

Answer 9

-HEPATICS-

H Hemorrhage in Gl tract / Hypokalemia
E Excess dietary protein
P Paracentesis
A Alkalosis/Anemia
T Trauma
I Infection
C Colon surgery
S Sedatives

Question 10

Gastroenterology

Charcot’s Triad

Answer 10

For Acute Cholangitis or Multiple Sclerosis
• RUQ pain
• Fever
• Jaundice

Question 11

Gastroenterology

Reynold’s Pentad

Answer 11

For Ascending Cholangitis
• Charcot’s triad
• Hypotension
• Confusion

Question 12

Gastroenterology

Pancreatic Enzymes

Answer 12

• Amylase
• Lipase
• Trypsin
• Chymotrypsin

Question 13

General Surgery

Indications for Urgent Operation

Answer 13

-HIPO-

H Hemorrhage
I Ischemia
P Perforation
O Obstruction

Question 14

General Surgery

Biochemical Signs for Deferentiating Jaundice

Answer 14

Hepatocellular: ↑ Billiruben + ↑ ALT/AST
Cholestatic: ↑ Billiruben +↑ ALP/GGT ± duct dillitation upon biliary USG
Hemolysis: ↑ Haptoglobin + LDH

Question 15

General Surgery

Top 3 Causes of Small Bowel Obstruction

Answer 15

-ABC- (in order)

A Adhesions
B Bulge (hernias)
C Cancer (neoplasms)

Question 16

General Surgery

Top 3 Causes of Large Bowel Obstruction

Answer 16

(in order)

1. Cancer
2. Diverticulitis
3. Volvulus

Question 17

General Surgery

Where is the McBurney’s Sign?

Answer 17

Tenderness 1/3 the distance from the

Anterior superior iliac spine to the umbilicus on the right side

Question 18

General Surgery

Crohn’s Disease 3 Major Patterns

Answer 18

• Ileocecal 40% (RLQ pain, fever, weight loss)
• Small intestine 30% (especially terminal ileum)
• Colon 25% (diarrhea)

Question 19

General Surgery

AXR findings in Cecal Volvulus

Answer 19

AXR: Central cleft of “coffee bean” sign points to RLQ.

Question 20

General Surgery

AXR findings in Sigmoid Volvulus

Answer 20

AXR: Central cleft of “coffee bean” sign points to LLQ.

Barium enema: “ace of spades” or “birds beak” sign.

Question 21

General Surgery

Signs for Gastric Volvulus

Answer 21

Brochardt’s Triad

1. Epigastric distention
2. Failure to pass NG tube
3. Emesis followed by inability to vomit

Question 22

General Surgery

Risk factors for cholesterol stones

Answer 22

4F’s

Fat
Female
Fertile
Forties

Question 23

General Surgery

Common Bacteria in Biliary Tract

Answer 23

-KEEPS-

K Klebsiella
E Enterococcus
E E. Coli, Enterobacter
P Proteus, Pseudomonas
S Serratia