Gastrointestinal and Nutrition

Question 1

Esophageal Perforation clinical presentation

Answer 1

Chest/back/epigastric pain
Crepitus
Pleural effusion with atypical fluid (green)

Question 2

Esophageal perforation management

Answer 2

NPO, IV antibiotics, PPI

Emergency surgical consultation

Question 3

Esophageal perforation diagnosis

Answer 3

Esophagoraphy with water soluble contrast: leak from perforation
CXR: widened mediastinum, pneumomediastinum, pneumothorax, pleural effusion
CT: esophageal wall thickening, mediastinal fluid collection

Question 4

Zollinger-Ellison features

Answer 4

Duodenal/jejunal ulcers

Refractory to PPI

Gastrin producing tumor induce high amounts of HCl, leading to inactivation of pancratic enzymes and injury to the mucal brush border

Question 5

Copper deficiency

Answer 5

Skin Depigmentation
Anemia
Osteoporosis
Brittle Hair
Neurologic manifestations

Question 6

Selenium dficiency

Answer 6

Thyroid dysfunction
Cardiomyopathy
Immune dysfunction

Question 7

Zinc deficiency

Answer 7

Alopecia
Pustular skin rash
Impaired taste
Impaired wound healing
Hypogonadism
Immune dysfunction

Question 8

Parenteral Nutrition and Central Line Associated Bloodstream infection

Answer 8

Ppor patient hygine
Severity of Illness
Duration of PN

Question 8

Parenteral Nutrition and Central Line Associated Bloodstream infection

Answer 8

Ppor patient hygine
Severity of Illness
Duration of PN

Question 9

Vitamin A deficiency

Answer 9

Impaired night vision that can lead to night blindness

dry conjuntiva

bitot spots (conjuntiva hyperkeratosis)

dry cornea

Question 10

B2 deficiendy (riboflavin)

Answer 10

Angular Cheilosis

Stomatitis

Glossitis

Normocytic Anemia

Seborrheic dermatitis

Question 11

B3 deficiency (niacin)

Answer 11

Pellagra: dermatitis, diarrhea, dementia

glossitis