GI

Question 1

High Triglycerides

Answer 1

causes pancreatitis > 500. If > 500 treat with Niacin or Fibrate or Niaspan. If
your patient is already on NIACIN, you can add a fibrate like (LOPID/TRICOR). Apparently, an
insulin infusion works also.

Question 2

Pancreatitis

Answer 2

diagnosed with amylase/lipase draw. Amylase beings 2-12 h. Lipase 4-8 hours. Lipase
however is MORE specific and sensitive to alcoholic pancreatitis. ACUTE: Grey Turner/ Cullen sign.
Abd pain that rates to midback “boring” epigastric pain. Fever, n/v.

Question 3

GERD

Answer 3

Barrett’s “pre ca” chronic cough, acid sour breath, sore throat, thinning tooth enamel. First
line for mild/intermittent lifestyle. BB, CCB, HTN meds increase GERD. FIRST LINE PPI
Never d/c PPI abruptly

Question 4

Pyloric stenosis

Answer 4

4-6 weeks, nonbilious vomiting olive like mass immediately after vomiting.
Diagnosis by ultrasound will see a string. Differential include: GERD, milk protein intol. Intestinal
obstruction. PUNT for surgical correction

Question 5

Intussusception

Answer 5

sausage shaped mass in upper right quad. Currant jelly stool. Ur bowels prolapse into
another part of ur intestine. Barium enema can help to reduce this. Previously healthy then they get
sick. Usually before 2 y/o.

Question 6

Colon CA

Answer 6

Pencil like stool think colon cancer: Descending colon- tenesmus incomplete sensation of
defecation.

Question 7

Encopresis

Answer 7

involuntary soiling of stool in kids < 4 y. Caused by constipation. Treat behavior cuz they
don’t want to shit in public and laxatives to relieve the current constipation

Question 8

Rovsing’s sign

Answer 8

right lower quadrant pain elicited by palpation of the left lower quadrant in acute appendicitis

Question 9

Murphy’s sign

Answer 9

elicited in patients with acute cholecystitis by asking the patient to take in and hold a deep breath while palpating the right subcostal area. If pain occurs on inspiration, when the inflamed gallbladder comes into contact with the examiner’s hand, Murphy’s sign is positive.

Question 10

Blumberg sign

Answer 10

may be indicative of peritonitis. Deep palpation of the viscera over the suspected inflamed appendix followed by sudden release of the pressure causes the severe pain on the site.

Question 11

Psoas sign

Answer 11

elicited by having the patient lie on his or her left side while the right thigh is flexed backward. Pain may indicate an inflamed appendix overlying the psoas muscle.

Question 12

McBurney’s point

Answer 12

located one third of the distance from the right anterior superior iliac spine to the umbilicus (navel).