Gastrointestinal Flashcards
Now Gastrointestinal
Pt presents with sudden onset of severe, diffuse abdominal pain. Exam reveals peritoneal signs, and AXR reveals free air under the diaphram. Management?
Emergent laparotomy to repair perforated viscus.
The most likely cause of acute lower GI bleed in pt >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 pt with no history of abdominal surgery
Hernia
The most common cause of SBO in pt with a history of abdominal surgery
Adhesions
Identify Key Organisms causing Diarrhea:
Most common organism
- Campylobacter
Identify Key Organisms causing Diarrhea:
Recent antibiotic use
Clostridium difficile
Identify Key Organisms causing Diarrhea:
Camping
Giardia
Identify Key Organisms causing Diarrhea:
Traveler’s Diarrhea
ETEC
Identify Key Organisms causing Diarrhea:
Church Picnics / Mayonnaise
S. Aureus
Identify Key Organisms causing Diarrhea:
Uncooked Hamburger
E.-Coli 0157-H7
Identify Key Organisms causing Diarrhea:
Fried Rice
B. Cereus
Identify Key Organisms causing Diarrhea:
Poultry / Eggs
Salmonella
Identify Key Organisms causing Diarrhea:
Raw Seafood
Vibrio
HAV
Identify Key Organisms causing Diarrhea:
AIDS
Cryptosporidium
Mycobacterium Avium Complex (MAC)
Identify Key Organisms causing Diarrhea:
Pseudoappendicitis
Yersinia
25 y/o 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 the increase risk of colon cancer
Ulcerative colitis
Extraintestinal manifestations of IBD
Uveitis Ankylosing Spondylitis Pyoderma Gangrenosum Erythema Nodosum 1 Sclerosing cholangitis
Medical treatment for IBD
5-ASA
Steroids during acute exacerbations
Difference between Mallory-Weiss and Boerhaave Tears
Mallory Weiss- Superficial tear in esophgeal mucosa
Boehaave- Full thickness esophageal rupture
Charcot’s Triad
RUQ Pain
Jaundice
Fever / Chills
in setting of Adscending Cholangitis
Reynold’s Pentad
Charcot’s Triad plus
Shock
Mental Status Change
Medical Treatment for Hepatic Encephalopathy
Decrease protein intake
Lactulose
Rifaximin
First step in the management of patient with an acute GI bleed
Establish the ABCs
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 0157-H7
Post HBV exposure treatment
HBV Immunoglobulin
Classic Causes of drug induced hepatitis
TB Meds (INH, Rifampin, Pyrazinamide)
Acetaminophen
Tetracycline
40 year old obese women with elevated alkaline phosphatase, elevated bilirubin, pruritus, dark urine, and clay coloured stool
Biliary tract obstruction
Hernia with highest risk of incarceration
- indirect, direct or femoral
Femoral
50 y/o man with hx of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?
Confirm Acute Pancreatitis with elevated Amylase and Lipase
Make pt- NPO and give fluids, 02, analgesia and Tincture of time
