GI

Question 1

Indications for Emergent Endoscopy in FB?

Answer 1

> 5 cm x 2 cm

Button battery

Causing obstruction

Question 2

Cecal Volvulus v. Sigmoid Volvulus

Answer 2

Sigmoid Volvulus = old/bedridden/chronic constipation, dilated loops on LEFT side X-ray, treat with rectal tube first –> surgery

Cecal Volvulus = young/healthy/ embryologic, dilated loops on RIGHT side X-ray, treat with surgery first

Question 3

How do you treat necrotizing enterocolitis?

Answer 3

IVF, abx, surgery consult

Question 4

Components of Ranson’s Criteria

Answer 4

PANCREATITIS PROGNOSIS

glucose>200,
LDH >350
AST > 250
WBC > 16
age > 55

Question 5

Toxic Megacolon (presentation, radiology, tx)

Answer 5

Sx - fever, ab pain, shock

Plain film - > 6 cm dilated colon, loss of haustra, “Thumbprinting” from bowel wall edema

Tx - fluids, steroids (ask GI), surgery?

Question 6

Posterior v. Lateral Anal Fissures

Answer 6

Posterior midline - 2/2 constipation, anal sex, diarrhea
Tx - fiber, stool softeners, topical analgesia, nitroglycerin

Lateral - look for systemic dx such as Chron’s, HIV, Tb, syphilis, malignancy, leukemia