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ED > GI +GU ER > Flashcards

GI +GU ER Flashcards

1
Q

What tests do all women need in the ED who present with abdominal or pelvic pain

A

PRegnancy test

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2
Q

Basic work up for abdominal pain

A

U-preg, UA, CBC, CMP, Amylase, lipase

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3
Q

Do all abdominal pain pts require imaging

A

No

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4
Q

Give me some medications if I am vomiting

A

IVF and anti-emetics

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5
Q

Give me some medications if I have diarrhea

A

IVF

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6
Q

I have a positive pregnancy test, what next

A

Where is it?

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7
Q

What will confirm your suspicion of an ectopic pregnancy

A

visualization of adenexal mass

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8
Q

What is the most common surgical emergency of the elderly

A

Cholecystitis

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9
Q

What percentage of mesenteric ischemia patients present with diarrhea

A

31-40%

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10
Q

What are some comon problems for bariatric patients

A

Anastomotic leak, bowel obstruction, dumping syndrome, electrolyte disturbances……

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11
Q

What is the most common cause of travlers diarrhea

A

E. coli

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12
Q

What are some treatments for diarrhea

A

Antimotility (Loperamide), Antibiotics (Cipro, metro), BRAT, fluids

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13
Q

I am coming to your ED with a chrons exacerbation please treat me

A

STEROIDS!! Antibiotics(Cipro), liquid diet

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14
Q

What are the labs to order on a chrons patient

A

CBC, CMP, UA, and CRP

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15
Q

I am coming to your ED with a UC exacerbation treat me

A

PAin meds, cipro 1.0-1.5mg/kg/day and metronidazole 10-20mg/kg/day

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16
Q

What is a possible complication of UC wher my abdomen is distened tender and tympanic

A

Toxic megacolon

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17
Q

What is severe diarrhea

A

> 10 BM per day

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18
Q

Treat my hyperkalemia

A

Amp dextrose, 10 units IV insulin, Amp of calcium gluconate

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19
Q

I have coffee ground emesis what labs will you get for me

A

UGIB- CBC. CMP. amylase, lipase, PT/INR, type and screen

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20
Q

My hemoglobin in 8, do you transfuse me?

A

Yes- transufse if less than 9

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21
Q

How do you treat esophageal varacies

A

Octreotide or vasopressin

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22
Q

I have guaiac positive stools, what will you start me on while adimiting me

A

PPI- Peptic ulcer

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23
Q

What is the # 1 cause of an LGIB

A

UGIB

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24
Q

Do diverticular bleeds typically need to be treated

A

No- 90% resolve spontaneously

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25
Q

If you are found to have a GI bleed what will you probably have in the near future

A

Endoscopy/colonoscopy

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26
Q

I bring in my 2 year old who was chocking and gagging earlier- help her

A

FB- IM or glucagon

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27
Q

I was eating a huge steak and now I cant keep down my food - treat me

A

Glucagon- 1-2mg then if not passed in 20min give 2 more mg IV

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28
Q

What is the max length a bolus should be allowed to stay in you for

A

12-24 hours

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29
Q

I have a AP film and the face of the coin is facing you- what tube?

A

Esophagus

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30
Q

Is pancreatitis dangerous

A

Yes 20-30% mortality rate

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31
Q

I have pain in my epigastric area radiating to my back- why did I get this and treat me

A

Pancreatitis- 1) ETOH 2) Admit, NPO,

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32
Q

When would you consider antibiotics for pancreatitis

A

Necrotic, abcess

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33
Q

How do you assess the severity of pancreatitis

A

Ransons criteria

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34
Q

What will my labs show with pancreatits

A

Amylase and lipase tripled

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35
Q

I have RUQ pain radiating to the right shoulder what is the work up

A

CBC, CMP, UA, amylase, lipase, US

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36
Q

Describe murphys sign

A

Sudden cessation of deep inspiration due to pain when the infamed gallblader is pressed on

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37
Q

How do you treat my symptomatic gallstones

A

Cholecystectomy, 3rd gen cephalosporin ad unycin metronidazole

38
Q

I have fever, jaundice and RUQ pain treat me in the ED

A

Cholangitis - IVF, broad spectrum antibiotics, consult surgery

39
Q

Acetaminophen accounts for _____% of liver failure anually

A

42%

40
Q

Treat my acetaminophen toxicity

A

NAC (Mycomyst), admit, follow up tylenol levels, call poison control

41
Q

AST:ALT ratio greater than 2 is a common finding in….

A

Alcoholic hepatitis

42
Q

I have know ascitis with abdomial pain and fever, what special test do I need

A

Paracentesis with fluid analysis - Spontaneous bacterial peritonitis

43
Q

Will a retrocecal appendix have peritonitis signs

A

No- will not cause peritoneal irritation

44
Q

What is the test used to diagnose appendicitis

A

CT abd and pelvis with IV and PO contrast

45
Q

What are the preop antibiotics for appendicitis

A

IV Unasyn 3grams

46
Q

I have LLQ pain, fever and leukocystosis work me up

A

Diverticulitis- CBC, CMP, UA, CT with IV and PO contrast

47
Q

What antibiotics do yo give me if I have diverticulitis and you are discharging me

A

Metronidazole 500mg PO Q8h and Cipro 500mg Q12h

48
Q

What antibiotics do yo give me if I have diverticulitis and you are admiting me

A

Unacyn 3grams IV Q6hr, cipro, or metronidazole

49
Q

DO you need to treat adynamic ileus

A

No- self limiting

50
Q

MCC of SBO

A

Adhesion

51
Q

MCC of LBO

A

neoplasms

52
Q

You see a step ladder appearance on uprigh x ray- why

A

SBO

53
Q

What is the diagnostic method of choice for diagnosing a bowel obstruction

A

CT with oral and IV contrast

54
Q

Treat my obstruction

A

Surgical intervention, NG tube, IV fluid replacement, antibiotics,

55
Q

Do hernias hurt

A

Not unless there is a problem

56
Q

Work up for a possible hernia

A

CT with IV and PO contrast

57
Q

I have a hernia that has popped out and isnt going back in help me

A

Push it back in as long as not necrotic

58
Q

I have a very tender hernia and it looks black treat me

A

Surgical emergency - broad spectrum IV antibiotics

59
Q

I have ainless red lumps near my anus what do you do to treat me

A

Internal- Push them back in

60
Q

What is the MCC of rectal bleeding

A

External hemorrhoids

61
Q

I have blue and black purple that are painful treat me

A

Sits bath, tucks, proctofoam,

62
Q

I have acute sharp cutting pain while defecating can you treat me

A

Anal fissures- Clean area, sitz baths, stool softeners

63
Q

I am a middle aged male and now I have a very painful rectal exam and painful defecation what is my treatment

A

Isolated- I/D in ER

The rest- Drain in OR

64
Q

I have itching burning, painful lesions on my anus treat me

A

Acyclovir

65
Q

My rectum has prolapsed when should you nor reduce it manually

A

If it looks necrotic or strangulated

66
Q

I stuck a bottle up my ass treat me

A

If I can feel it I will and pull it out. If I can’t we need to go to surgery

67
Q

It’s summer and I am a truck driver and now my lower back/ butt hurts treat me

A

Pilonidal cyst- I&D

68
Q

I have clear fishy discharge with clue cells treat me

A

BV - PO metroidazole

69
Q

I have white curd, itchy diacharge treat me

A

Diflucane, fluconazole topical or PO

70
Q

I have frothy malodorus discharge, puritis and irritation treat me

A

Flagyl and partner needs treatment

71
Q

What other GU infection should you consider treating me for if I have Trich

A

Gonorrhea and chlamydia

72
Q

MCC of PID

A

Chlamydia

73
Q

Treat me outpatient for PID

A

Doxy- 100mg PO BID for 14 days OR Azithromycin 1 gram weekly for 2 weeks

74
Q

Tx me if I have a tuboovarian abcess

A

Clinda 450 mg POQID or metronidazole with doxy

75
Q

I had PID and now I have RUQ pain

A

Fitz-Hugh- Curtis syndrome

76
Q

Work up for Renal failure in the ED

A

CBC, CMP (Bun/Cr), UA,

77
Q

MCC of rhabdomyolysis

A

Alcohol/drugs, statins, elderly who have fallen

78
Q

I have dark urine what lab value of mine will be distinctive

A

CK

79
Q

How do you treat my rhabd

A

IVF!!

80
Q

I am a healthy young female coming in complaining on burning with urination, urgency and frequency treat me

A

Uncomplicated- Bactrim DS for 3 days, macrobid, cipro

81
Q

Can pyelonephritis go home

A

Yes- if normal BUN/Cr and able to take PO

82
Q

MCC of hematuria

A

Infection

83
Q

Work up for hematuria

A

UA, UC, CBC, CMP, PT/INR

84
Q

MCC of urinary retention

A

BPH

85
Q

Treat my urinary retention

A

Foley, admit if older, dishcharge if younger and healthy

86
Q

Who gets fourniers gangrene

A

diabetics, obese and alcoholics

87
Q

tx my fourniers gangrene

A

IV Imepnim and vancomycin

88
Q

What diagnostic tests are needed for fourniers gangrene

A

CTpelvis with IV contrast

89
Q

I am a young male with acute severe pain in my testicle what test is 99% sensitive to diagnose me

A

absence of cremasteric reflex

90
Q

Treat my testicular torsion

A

Can open like a book or call urology

91
Q

I have right flank pain radiating down with hematuria work me up

A

UA dry CT of abd+pelvis

ED (7 decks)

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