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CB Internal Medicine > GI > Flashcards

GI 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.

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2
Q

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

A

Diverticulosis

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3
Q

Diagnostic modality used when ultrasonography is equivocal for cholecystitis.

A

HIDA scan (hepatobiliary iminodiacetic acid)

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4
Q

Risk factors for cholelithiasis

A

Fs

Fat, female, fertile, forty, flatulent

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5
Q

Inspiratory arrest during palpation of the RUQ

A

Murphy sign, acute cholecystitis

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6
Q

The most common cause of small bowel obstruction in patients with no hx of abdominal surgery

A

Hernia

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7
Q

The most common cause of SBO in patients with a hx of abdominal surgery

A

Adhesions

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8
Q

Key organism causing diarrhea:

Most common bacterial organism

A

Campylobacter

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9
Q

Key organism causing diarrhea:

Recent antibiotic use

A

Clostridium difficile

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10
Q

Key organism causing diarrhea:

Camping

A

Giardia

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11
Q

Key organism causing diarrhea:

Traveler’s diarrhea

A

ETEC - enterotoxigenic escherichia coli

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12
Q

Key organism causing diarrhea:

Church picnics/ mayonnaise

A

S aureus

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13
Q

Key organism causing diarrhea:

Uncooked hamburgers

A

E coli O157:H7

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14
Q

Key organism causing diarrhea:

Fried rice

A

Bacillus cereus

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15
Q

Key organism causing diarrhea:

Poulty/eggs

A

Salmonella

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16
Q

Key organism causing diarrhea:

Raw seafood

A

Vibrio, hepatitis A virus (HAV)

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17
Q

Key organism causing diarrhea:

AIDS

A

Isospora, cryptosporidium, mycobacterium avid complex (MAC)

18
Q

Key organism causing diarrhea:

Pseudoappendicitis

A

Yersinia, Campylobacter

19
Q

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

A

Crohns Disease

20
Q

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

A

Ulcerative colitis (greater risk than Crohns)

21
Q

Extra intestinal manifestation of IBD

A

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

22
Q

Medical treatment for IBD

A

5-ASA agents and stereos during acute exacerbations

23
Q

A 30-year old man with ulcerative colitis presents with fatigue, jaundice, pruritus

A

Primary sclerosing cholangitis

24
Q

Difference between Mallory-Weiss and Boerhaave tears

A

Mallory-Weiss is superficial tear in esophageal mucosa

Boerhaave - full thickness esophageal rupture

25
Q

Charcot triad

A

RUQ pain, jaundice, and fever/chills

26
Q

Reynolds pentad

A

Charcot triad (RUQ pain, jaundice, fever/chills) + shock + mental status change

27
Q

Medical treatment for hepatic encephalopathy

A

Decreased protein intake, lactulose, rifaximin

28
Q

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

A

ABCs

29
Q

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

A

HUS due to E Coli O157:H7

30
Q

Treatment after exposure to Hep B virus

A

HBV immunoglobulin

31
Q

Classic cause of drug-induced hepatitis

A

TB medications (INH, rifampin, pytazinamide), acetaminophen, and tetracyclin

32
Q

A 40-year old obese women with elevated alk phase, bill, pruritus, dark urine, and clay coloured stools

A

Biliary tract obstruction

33
Q

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

A

Femoral hernia

34
Q

Sever abdominal pain out of proportion to the examination

A

Mesenteric ischemia

35
Q

Diagnosis of ileus

A

Abdominal radiographs (or CT scan)

36
Q

A 50 year old man with a hx of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward.
Management?

A

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

37
Q

Colon cancer region based on symptoms:

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

A

Right sided: rare to have obstruction

38
Q

Colon cancer region based on symptoms:

Obstructive symptoms, change in bowel mvmts

A

Left sided: “apple-core” lesion

39
Q

Presents with watery diarrhea, dehydration, muscle weakness, and flushing

A

VIPipoma (replace fluids and electrolytes, may need surgical resection of tumor, use octreotide)

40
Q

Presents with palpable, contender gallbladder

A

Courvoisier sign (suggests pancreatic cancer)

CB Internal Medicine (12 decks)

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