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Long case > GI > Flashcards

GI Flashcards

1
Q

Investigations biliary colic

A

US abdo

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2
Q

Tx biliary colic

A

Analgesia
IV fluids
Cholecystectomy

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3
Q

Acute cholecystitis

A

RUQ pain going to back/ shoulder
Nausea
Vomiting
Fever

Murphys sign

JAUNDICE- NO—> mirizzi

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4
Q

Investigations acute cholecystitis

A

Labs
Micro
US – wall thickening, distended, air in GB wall, peri cholecysto fluid

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5
Q

Complications of GS

A 
Biliary colic
Acute cholecystitis 
Ascending cholangitis
Obstructive jaundice 
Acute pancreatitis
Chronic cholecystitis
GB Ca
Perforated GB
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6
Q

Complications of acute cholecystitis

A

Necrotizing inflammation with perforation

  • empyema
  • mucocele
  • peri cholecystitic abscess
  • generalized biliary peritonitis

Adhesions– gallstone ileus = cholecystoduodenal fistula

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7
Q

Tx of acute cholecystitis

A

Pre-op
ERCP
Cholecystectomy

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8
Q

Ascending cholangitis

A

Fever
Jaundice
RUQ pain
(Charcot)

Shock
Encephalopathy
(Reynolds)

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9
Q

Investigations ascending cholangitis

A

Labs
Blood cultures
US

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10
Q

Tx ascending cholangitis

A

Sepsis 6

ERCP emergency decompressive

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11
Q

Sepsis 6

A

Give

  • oxygen
  • antibiotics
  • IV fluids

Take

  • blood
  • LDH and Hb
  • urine output hourly
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12
Q

Acute pancreatitis drugs that cause it

A

Thiazides
Azathioprine
HAART
steroids

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13
Q

Acute pancreatitis

A 
KNIFE LIKE PAIN in epigastric--back
Nausea / Vomiting / fever 
HypoCa
Hypoxia
Hypovolaemic shock
DIC

Grey turner
Cullen’s sign

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14
Q

Complications of acute pancreatitis

A 
Necrotic
Chronic
Abscess 
Pseudocyst
Haemorrhage
Transverse colon necrosis
ATN
ARDS
Intra abdominal sepsis
Death
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15
Q

Investigations of acute pancreatitis

A

Labs- urinary> serum amylase
- lipase, calcium, triglycerides, glucose, LDH, AST, albumin
AbGs

Imaging- PFA, CXR, US, dynamic CT

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16
Q

Treatment acute pancreatitis

A 
Sepsis 6
Necrosectomy
Distal pancratecomy
Whipples
Cholecystectomy
Drain any abscesses
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17
Q

Scoring for acute pancreatitis

A

Glasgow
Ranson
APACHE

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18
Q

PUD

A 
Coffee ground vomit
Malaena 
Anaemia 
Epi pain- worse/ better
Dyspepsia/ belch and bloat
Early saiety

RUPTURE

  • -> sepsis
  • -> hypovolaemic shock
19
Q

Risk factors for PUD

A 
N- BASSS
NSAIDs
Bile reflux 
Alcohol
Smoking
Stress
Steroids
20
Q

Staging gastric ulcers

A

Johnson classification

21
Q

Risk for acute upper GI bleed

A 
Rockall score 
ABCDS
Age
Bleeding
Comorbidities 
Diagnosis 
Shock
22
Q

Dx PUD

A

Labs

H pylori testing- urease breathe test, CLONtest, stool antigen

Endoscopy

Radiography– perforation

Angiography

23
Q

Treatment of PUD

A

Stabilize haematogenously

Triple therapy- PPI, amoxicillin, clarithromycin

24
Q

Appendicitis

25
Dx appendicitis
Labs CT- oral or rectal gastrografin enema US- kids
26
Mgmt appendicitis
Sepsis 6 Pare eternal analgesia Appendectomy
27
Blumberg sign
Rebound tenderness McBurny
28
Rovsing
RLQ pain with PALPATION of LLQ
29
Psoas sign
Pain with Extension thigh
30
Obturator sign
IR-ER pain
31
Dunphy
Pain with coughing in RLQ
32
Markle sign
Pain going from toes to heels
33
Diverticulitis
``` Diarrhea Constipation- bloating, flatulence Haematochezia LLQ pain Peritonitis signs Nausea vomiting ``` Purulent vaginal discharge Air in urine UTI symptoms
34
Complications of diverticulitis
``` Strictures Diverticulitis PR bleed Fistulae Peritonitis ```
35
Dx diverticular disease
Labs | CT abdomen
36
Tx diverticular disease
``` Fluid diet Antibiotics Bowel rest IV fluids Hartmanns ```
37
Hinchey classification diverticular disease
1: diverticulitis with phlegmon and pericolic abscess 2: diverticulitis with abscess= pelvic, retroperitoneal, intra abdominal 3: perforated-- generalized peritonitis 4: ruptured-- fecal peritonitis
38
Biliary colic
RUQ pain going to back/ shoulder Restless Wax and wane After meals OR night. NO- fever
39
Ischaemic colitis
Sudden onset bloody diarrhea | Pain with eating
40
IBD UC
``` Bloody mucus diarrhea LLQ pain Weight loss Anaemia Cramps Tenesmus Malaise ```
41
IBD CD
``` Aphthous ulcers Anaemia B12 Intermittent diarrhea RLQ pain Kidney stones ``` Extra intestinal
42
Mgmt IBD
``` Aminosalicylates Antibiotics Corticosteroids Immuno modulators -- MAC Infliximab and Adalimumab antiTNF ```
43
Colon cancer
``` Change in bowel habit Tenesmus Anaemia Abdo pain Onstruction Cachexia ```
44
Tx colon cancer
R and L hemicolectomy Upper 1/3 rectum- colonic anastomosis Lower and middle 2/3: APR Total mesorectal excision High litigation pedicle vessels

Long case (4 decks)

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