GI

Question 1

post op antibiotics for prophylaxis should be continued for how long?

Answer 1

24 hours, unless see signs of infxn or sepsis

Question 2

Tx acute pancreatitis caused by ______ eventually with PO gemfibrozil

Answer 2

high triglycerides

Question 3

dilaudid is for _______

Answer 3

pain control

Question 4

anorectal fistulas in crowns disease should be treated with _________

Answer 4

metronidazole

Question 5

cholangitis presents with Charcot’s triad which is

Answer 5

fever, jaundice, abdominal pain

Question 6

what treatment offers the best chance of curing liver mestases from colorectal cancer (imagine 3 masses in liver)

Answer 6

surgical resection

Question 7

biggest risk factor for acute pancreatitis according to ranson’s criteria is _____

Answer 7

age

Question 8

best diagnostic test for diverticulitis

Answer 8

CT (fever, LLQ pain w/ guarding, older age)

Question 9

Pancreatic pseudocyst management

Answer 9

• if low/minimal symptoms: NPO and expectant management

- if severe sx(abdominal pain, vomiting): endoscopic drainage

Question 10

_______ injury is one of the most common solid organ injuries in blunt abdominal trauma. How does it manifest

Answer 10

hepatic

-hypotension, free intraperitoneal fluid, RUQ pain, bruising, right shoulder pain

Question 11

What does the HIDA scan do?

Answer 11

hepatobiliary iminodiacetic acid (HIDA) uses a nuclear tracer that is excreted in bile so when not in gallbladder, suggests obstruction
-use when ultrasound is indeterminate

Question 12

______ can lead to free air on CXR and manage how if have sx?

Answer 12

peptic ulcer disease, urgent exploratory laporotomy

Question 13

______ can present with severe abdominal pain, fever, tachycardia, signs of peritonitis (rigidity, dec bowel sounds, rebound tenderness) and is often associated with NSAID and alcohol use. How do you confirm diagnosis

Answer 13

perforated viscus, upright CXR of chest and abdomen showing intraperitoneal free air under the diaphragm

Question 14

_____ presents as an abdominal mass that doesn’t change with contraction of rectus muscles, are more common in the elderly and have a sudden muscular exertion

Answer 14

hematomas of rectus sheath

Question 15

mesenteric ischemia affects the ______ intestine and requires _______ intervention

Answer 15

small, emergent

Question 16

_________ presents as fever, hematochezia, abdominal pain and ________ intervention

Answer 16

ischemic colitis, rarely requires surgical unless you have full thickness necrosis/perforation/ refractory bleeding

Question 17

Patients who undergo major colon resections suffer ______ long term change in their bowel habits following operation

Answer 17

little, b/c the reserve capacity of the colon for water absorption greatly exceeds the normal requirements for maintaining stable bowel function

Question 18

_________ commonly presents as subacute fever and lower abdominal or flank pain radiating to the groin

Answer 18

psoas abscess

• previously have a skin infection (furunculosis: pus filled bumps)
• see psoas sign: abd pain with hip extension