Gastrointestional Flashcards

1
Q

A pt presents w/ sudden onset of severe, diffuse abd pain. Exam reveals peritoneal signs, and AXR reveals free air under the diaphragm. Management?

A

Emergent laparotomy to repair a perforated viscus.

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2
Q

The most likely cause of acute lower GI bleed in pts >40 years of age.

A

Diverticulosis

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3
Q

Diagnostic modality used when U/S is equivocal for cholecystitis

A

HIDA scan

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4
Q

Risk factors for cholelithiasis

A

Fat, female, fertile, forty, flatulent

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5
Q

Inspiratory arrest during palpation of the RUQ

A

Murphy’s sign, seen in acute cholecystitis

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6
Q

The MCC of small bowel obstruction (SBO) in pts w/ no hx of abd surgery

A

Hernia

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7
Q

The MCC of SBO in pts w/ a hx of abd surgery

A

Adhesions

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8
Q

Most common organism causing diarrhea

A

Campylobacter

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9
Q

Diarrhea in recent abx use

A

Clostridium difficile

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10
Q

Diarrhea and camping

A

Giardia

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11
Q

Traveler’s diarrhea

A

ETEC

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12
Q

Diarrhea and church picnics/mayonnaise

A

S aureus

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13
Q

Diarrhea and uncooked hamburgers

A

E coli O157:H7

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14
Q

Diarrhea and Fried rice

A

Bacillus cereus

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15
Q

Diarrhea and poultry/eggs

A

Salmonella

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16
Q

Diarrhea and raw seafood

A

Vibrio, HAV

17
Q

Diarrhea and AIDS

A

Isospora, Cryptosporidium, Mycobacterium avium complex (MAC)

18
Q

Diarrhea and pseudoappendicitis

A

Yersinia

19
Q

A 25 y/o Jewish man presents w/ pain and watery diarrhea after meals. Examination shows fistulas b/w the bowel and skin and nodular lesions on his tibias

A

Crohn’s dz

20
Q

Inflammatory dz of colon w/ an increased risk of colon cancer

A

Ulcerative colitis (greater risk than Crohn’s)

21
Q

Extraintestinal manifestations of IBD

A

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

22
Q

Medical tx for IBD

A

5-ASA agents and steroids during acute exacerbation

23
Q

Difference b/w Mallory-Weiss and Boerhaave tears

A

Mallory-Weiss - superficial tear in the esophageal mucosa; Boerhaave - full thickness esophageal rupture

24
Q

Charcot’s triad

A

RUQ pain, jaundice, and fever/chills - signs of ascending cholangitis

25
Q

Reynolds’ pentad

A

Charcot’s triad plus shock and mental status changes - signs of suppurative ascending cholangitis

26
Q

Medical tx for hepatic encephalopathy

A

Decreased protein intake, lactulose, rifaximin

27
Q

The first step in the management of a pt with an acute GI bleed.

A

Manage ABCs

28
Q

A 4 y/o child presents with oliguria, petechiae, and jaundice following an illness w/ bloody diarrhea. Most likely diagnosis and cause?

A

Hemolytic- uremic syndrome (HUS) due to E coli O157:H7

29
Q

Post-HBV exposure tx

A

HBV immunoglobulin

30
Q

Classic causes of drug-induced hepatitis

A

TB medications (INH, rifampin, pyrazinaminde), acetaminophen, and tetracycline

31
Q

A 40 y/o obese woman with elevated alk phos, elevated bilirubin, pruritus, dark urine, and clay-colored stools

A

Biliary tract obstruction

32
Q

Hernia w/ highest risk of incarceration - indirect, direct or femoral?

A

Femoral hernia

33
Q

A 50 y/o man w/ a hx of alcohol abuse presents w/ boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?

A

Confirm the dx of acute pancreatitis w/ elevated amylase and lipase. Make the patient NPO and give IV fluids, O2, analgesia, and “tincture of time”