GI Flashcards
Schatzki rings are almost always associated with what other upper gastrointestinal pathology?
hiatal hernia
MC postop complication related to general anesthesia
N/V
What 5 meds can be used to tx postop N/V from general anesthesia
transdermal scopolamine
dexamethasone
ondansetron
prochlorperazine
droperidol
does SMOKING increase or decrease chances of postop N/V?
smoking= decreases chances
serum marker for pancreatic cancer
CA 19-9
what preop abx is given in acute appy w/o perforation/abscess
single dose of cefotetan 2 g intravenously
describe the tremor seen in hyperthyroidism
high frequency, low amplitude tremor
present with action
At what age should individuals with Lynch syndrome begin colorectal cancer screening via colonoscopy?
Q 1-2years beginning at age 20 to 25 years
or
2-5yrs prior to the earliest age of colorectal cancer diagnosis in the family
(whichever comes first)
What dx test would be the initial biochemical test performed for a patient who is considered high risk for a pheochromocytoma (family history, familial tumor syndrome, history of previously resected pheochromocytoma, or presence of adrenal mass found incidentally).
Plasma fractionated metanephrines
initial test for pt considered to be LOW risk for pheochromocytoma
24-hour urine fractionated metanephrines and catecholamines
respiratory alkalosis results in what electrolyte disturbance?
alkalosis= HYPOkalemia
acidocis= HYPERkalemia
(Intracellular K is exchanged for H+)
what pre-op study should be ordered for a COPD patient w/ increasing respiratory symptoms, decreasing exercise tolerance, or new lung auscultation findings on exam
CXR
(to rule out an active infection and heart failure)
3 tumor markers seen in testicular cancer
AFP
HCG
LDH
TIA tx?
- Symptomatic carotid stenosis of 70-99% + life expectancy >5yrs (perioperative M&M <6%)= ASA** + **carotid endarterectomy
- If carotid lesion not suitable for surgical access, radiation induced stenosis or clinically significant coronary, pulmonary or other dz that increases risk of anesthesia/surgery–> Carotid artery stenting preferred
- Symptomatic carotid stenosis <50%–> antithrombotics
TIA tx:
when is carotid stenting preferred over carotid endarterectomy?
- Symptomatic carotid stenosis of 70-99% + life expectancy >5yrs= ASA** + **carotid endarterectomy
- If carotid lesion not suitable for surgical access, radiation induced stenosis or clinically significant coronary, pulmonary or other dz that increases risk of anesthesia/surgery–> Carotid artery stenting preferred
Cardio functional status: what is poor, moderate and excellent?
- Poor functional capacity (<4 METS)= Self-care, the ability to complete activities of daily living (ADLs), vacuuming, walking 2 mph, and writing
- Mod functional capacity (4-10 METS)= The ability to walk up a flight of stairs, walk 4 mph, walking a golf course, doing yard work, and cycling
- Excellent functional capacity (>10 METS)= Jogging, playing singles tennis, swimming, and skiing
walking 2 flights of stairs or 4 blocks= good sign
Risk factors for small bowel carcinoma
- Diet: salt-cured foods, refined sugar, red meat, smoked foods
- alcohol
- genetic: lynch, peutz-jeghers, familial adenomatous polyposis
- IBD (Chrons)
MC location of small bowel carcinoma
ileum
tx for melanoma that is <1mm thick? >1mm thick?
- < 1mm** thick= Wide excision w/ **1cm margins
- > 1mm** thick= wide excision w/ **2cm margins
Indications for emergent craniotomy in pt with epidural hematoma
- hematoma volume > 30 cm3, regardless of Glasgow Coma Scale,
- acute epidural hematoma with a GCS score < 9 in the presence of anisocoria.
*
when can a pt with an epidural hematomy be treated medically
- Patients with stable and small epidural hematoma with mild symptoms who have :
- epidural hematoma volume < 30 cm3
- clot thickness < 15 mm on head CT
- midline shift of < 5 mm
- no coma (GCS score > 8)
- no neurological deficits can be managed nonoperatively.
1st line tx for outpatient pediatric pneumonia
Amoxicillin
Which of the following medications helps prevent cerebral vasospasm in patients with spontaneous subarachnoid hemorrhage?
Oral Nimodipine
what are classic imaging findings of MS
The classic brain noncontrast MRI findings:
multiple T2 hyperintensities found most commonly in the periventricular white matter, brainstem, cerebellum and spinal cord.
What is Lofgren Syndrome?
Acute form of Sarcoidosis:
- Hilar lymphadenopathy
- Erythema nodosum
- Polyarthralgia
What is seen in CSF of patient with West Nile Encephalitis? What is an expected lab abnormality
elevated lymphocytes, glucose, protein
expected lab abnormality: lymphopenia
