GI

Question 1

9 emergency causes of abdominal pain?

Answer 1

1. Ectopic
2. Appy
3. AAA rupture
4. PID
5. Biliary
6. SBO
7. Perferation
8. Mesenteric Ischemia
9. Torsion

Question 2

Ectopic Dx and tx?

Answer 2

DX: no IUP with bHCG >1500
TX: MTX

Question 3

Physical exam in appy with high sens?

high spec?

Answer 3

High sens = RLQ pain

High spec = Ridgid

Question 4

Alvardo score for appy? (6)

Answer 4

Fever
WBC >10,000
anorexia
RLQ tenderness
Pain in RLQ with LLQ palp
Rebound

Question 5

ABX for uncomp and comlicated appy?

Answer 5

uncomp - cipro + metro OR cef

comp —– Impenam OR zosyn

Question 6

Goal BP in ruptured AAA?

Answer 6

90-100

Question 7

Admission criteria for PID? (8)

Answer 7

Intractible vomiting
TOA or Fitz-hugh curtis
IUD in
Peritoneal signs
age

Question 8

Incomplete, complete, and strangulated SBO tx?

Answer 8

incomp = NG + decompression
complete = surgery
Strangulated surgical emergency

Question 9

Perferation symptoms and w/u?

Answer 9

acute local –> Diffuse pain

XR
CBC
CMP

Question 10

Most common cause of Mesenteric ischemia and risk factors?

Answer 10

SMA emboli

• a-fib
• arrhythmia
• post-MI
• Valve disease

Question 11

Worst prognosis for mesenteric ischemia

Answer 11

SMA thrombus

• age
• atherosclerosis

Question 12

Risk factors for mesenteric venous thrombosis?

Answer 12

Hyper-coagulability

Question 13

Causes of non-occlusive mesenteric ischemia?

Answer 13

shock/sepsis

CHF

Question 14

TX for mesenteric

• emboli
• thrombus
• venous thrombosis
• non-occlusive ischemia?

Answer 14

E– TPA or ex-lap
T - Heparin
VT - Surgery
NOI — Surg if peritoneal signs

Question 15

Transfusion indications in GI bleed (6)?

Answer 15

HGB drop of 3 in 2-4hrs
HGB 1000 ml stool in 30 mins
End Organ damage
PLT

Question 16

TX for varices?
PUD?
LGIB?

Answer 16

Octreotide
IV PPI –> clip
Supportive