GI CIS Flashcards
What are some protective factors against Gallstones?
Low carb diet, physical activity, caffeine, high fiber diet, statins, NSAIDs/ASA
What are the most common gram - bacteria found in ascending cholangitis?
E. Coli
K. Pneumoniae
Enterobacter
What are the most common gram + bacteria found in ascending cholangitis?
Enterococcus species
What is the Tx for ascending cholangitis?
Urgent ERCP
What is Charcot’s triad and what is it associated with?
Jaundice, Fever, RUQ pain
Ascending cholangitis
What is Reynold’s pentad and what is it associated with?
Charcot’s triad + mental status change
Ascending cholangitis
What do Gallstones show on US?
Acoustic shadow
What is first line Tx for cholangitis?
ß-lactam + ß-lactamase (-illin + -actam)
OR
Ceftriaxone + Metronidazole
What is an alternative Tx for cholangitis?
Fluoroquinolone + Metronidazole
What is Mirizzi syndrome?
Common hepatic duct obstruction due to extrinsic compression from an impacted stone in the cystic duct
What is Grey Turner sign?
Flank ecchymosis 2˚ to hemorrhage
What is Cullen sign?
Periumbilical ecchymosis 2˚ to hemorrhage
What is Rovsing’s sign?
Pain in RLQ during left-sided pressure
What is Courvoisier’s sign?
Enlarged, non-tender gallbladder 2˚ to pancreatic disease or cancer
A + iliopsoas muscle test is indicative of what?
Appendicitis
A + obturator muscle test is indicative of what?
Appendicitis
+ CVAT is associated with what?
Kidney abscess
Pyelonephritis
Renal stone
A + heel strike test is indicative of what?
Appendicitis
Why are opioid’s contraindicated in pts with biliary disorders?
Opioids increase sphincter of Oddi pressure worsening the pain Sx’s
What are the SNS levels for the esophagus?
T2-8
What are the SNS levels for the stomach?
T5-9
What are the SNS levels for the liver?
T6-9
What are the SNS levels for the gallbladder?
T6-9
What are the SNS levels for the SI?
T9-11
What are the SNS levels for the colon?
T10-L2
What are the SNS levels for the pancreas?
T5-11
What are the SNS levels for the appendix?
T12
What are the Sx’s of Systemic Inflammatory Response Syndrome (SIRS)?
Temp > 38˚C or < 36˚C
HR > 90
Resp > 20 or PaCO2 < 32 mmHg
WBC count > 12k or < 4k