Gastrointestinal Flashcards

1
Q

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

A

Emergent laparotomy to repair a perforated viscus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

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

A

Diverticulosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Diagnostic modality used when ultrasonography is equivocal for cholecystitis

A

Hepatobiliary IminoDiacetic Acid (HIDA) scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Risk factors for cholelithiasis

A

Fat, female, fertile, forty (or older), fair (white)

*First Aid says flatulent instead of fair, not sure where they got that from or what that is supposed to mean.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Inspiratory arrest during palpation of the RUQ. Likely diagnosis?

A

Murphy sign, seen in acute cholecystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The most common cause of small bowel obstruction (SBO) in patients with no history of abdominal surgery? With a history of abdominal surgery?

A

Without surgical hx: hernia

With surgical hx: adhesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Most common bacterial organism causing diarrhea

A

Campylobacter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Organism causing diarrhea associated with recent antibiotic use

A

Clostridium difficile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Organism causing diarrhea associated with camping.

A

Giardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Organism causing diarrhea associated with traveler’s diarrhea

A

Enterotoxigenic E. coli (ETEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Organism causing diarrhea associated with church picnics / mayonnaise

A

Staph aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Organism causing diarrhea associated with uncooked hamburgers

A

E coli. O157:HY (EHEC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Organism causing diarrhea associated with fried rice

A

Bacillus cereus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Organism causing diarrhea associated with poultry/eggs

A

Salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Organisms causing diarrhea associated with raw seafood

A

Vibrio, hepatitis A virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Organisms causing diarrhea associated with AIDS

A

Isospora, Cryptosporidium, Mycobacterium avium complex (MAC)

17
Q

Organisms causing diarrhea associated with pseudoappendicitis.

A

Yersinia, Campylobacter

18
Q

A 25 year-old Jewish man presents with pain and water diarrhea after meals. Examination shows fistulas between the bowel and skin, and nodular lesions on his tibias. Likely diagnosis?

A

Crohn’s disease

19
Q

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

A

Ulcerative colitis (greater risk than Crohn’s)

20
Q

Extraintestinal manifestations of IBD

A

Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, primary sclerosing cholangitis

21
Q

Medical treatment for IBD

A

5-ASA agents and steroids during acute exacerbations

22
Q

A 30 year old man with ulcerative colitis presents with fatigue, jaundice, and pruritis. Likely diagnosis?

A

Primary sclerosing cholangitis

23
Q

Difference between Mallory-Weiss and Boerhaave tears

A

Mallory-Weiss: superficial tear in the esophageal mucosa

Boerhaave: full-thickness esophageal rupture

24
Q

Signs of and condition indicated by Charcot triad?

Reynolds’ pentad?

A

Charcot: RUQ pain, jaundice, and fever/chills. Acute cholangitis.
Reynold’s: Triad plus shock and AMS. Obstructive ascending cholangitis.

25
Q

Medical treatment for hepatic encephalopathy

A

Decreased protein intake, lactulose, rifamixin

26
Q

The first step in the management of a patient with an acute GI bleeding episode

A

ABCs

27
Q

A 4 year old child presents with oliguria, petechiae, and jaundice following an illness with bloodny diarrhea. Most likely diagnosis and cause?

A

Hemolytic-uremic syndrome (HUS) due to E. coli O157:H7 (or alternatively, other E. coli serotypes, Shigella, or Campylobacter)

28
Q

Treatment after exposure to hepatitis B virus?

A

Hepatitis B Immune Globulin (HBIG)

29
Q

Classic causes of drug-induced hepatitis

A

TB medications (isoniazid/INH, rifampin, pyrazinamide), acetaminophen, and tetracycline

30
Q

A 40 year old obese woman with elevated alkaline phosphatase, elevated bilirubin, pruritis, dark urine, and clay-colored stools. Likely diagnosis?

A

Biliary tract obstruction

31
Q

Hernia with highest risk of incarceration: indirect, direct, or femoral?

A

Femoral

32
Q

Severe abdominal pain out of proportion to the examination suggests…?

A

Mesenteric ischemia

33
Q

Diagnosis of ileus

A

Abdominal radiographs (could also perform CT scan)

34
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. Likely diagnosis? Management?

A

Confirm the diagnosis of pancreatitis with elevated amylase and lipase. Make the patient NPO, give IV fluids, oxygen, analgesia, and “tincture of time”

35
Q

Anemia from chronic disease, occult blood loss, vague abdominal pain.

A

Right-sided colon cancer (rarely causes obstruction)

36
Q

Obstructive symptoms and changes in bowel movements

A

Left-sided colon cancer: “apple-core” lesion

37
Q

What presents with watery diarrhea, dehydration, muscle weakness, and flushing? Management?

A

VIPoma. Replace fluids and electrolytes, may need to surgically resect tumor or use octreotide

38
Q

What presents with palpable, nontender gallbladder? Name of sign?

A

Courvoisier sign, suggests pancreatic cancer