GI Notes

Question 1

Rovsings sign?

Answer 1

pain referred to point of maximum tenderness when palpating adjacent qudrant, sign of peritonitis

Question 2

When US for differentials?

Answer 2

AAA if not reupture. also for pelvic pathology.. gallbladder.

Question 3

When use CT with contrast of abdomen or pelvis?

Answer 3

fluid filled. like abscess, infection, or inflammatio of unknown cause.

Question 4

When use nonconstrast CT?

Answer 4

free air. renal colic, ruptured AAA, bowel obstruction?

Question 5

labs when suspect GERD?

Answer 5

1. can epirically treat. step up or step down.
2. lifestyle changes
3. CBC, h pylori testing (stool antigen) or endoscopy, FOBT to rule out bleeding r/t ulcer

Question 6

what is definitive test for PUD?

Answer 6

EGD or upper barium study

Question 7

Tx PUD?

Answer 7

PPI or H2RA

antimicrobials option???

Question 8

Murphys sign?

Answer 8

inhale with palpation on live rborder. hault breathing. + cholecystitis.

Question 9

icterus definition?

Answer 9

jaundice

Question 10

polycthemia definition?

Answer 10

abnormal increased concentration of hgb in blood . linked to respiratory or circulatory disorder ot cancer. ELEVATED RBC.

Question 11

barretts esophagus is what change in cells?

Answer 11

esophageal epithelium replaces by metaplastic columnar cells. damage from prolgoned GERD. signs are acid regurg and dysphagia. EGD for diagnosis and biopsy. monitor with endoscopic US. survellinece at 3 month intervals ntil 2 consecutive clears.

Question 12

what complications of GERD do aenmia, hematamesis or tarry stools indicate

Answer 12

erosive esophagitis, ulceration.

Question 13

when follow up for PUD?

Answer 13

1 month rechecl.

Question 14

when does pain of cholecystitis start and end?

Answer 14

starts 1-3 hours after meals ans subsides 2-3 hours.

Question 15

pancreatitis worsens with what?

Answer 15

alcohol and fatty foods.

Question 16

tx of CHRONIC pancreatitis?

Answer 16

low fat diet, pain control (may need narcotis) short course opiates, low dose amitriptyline, NSAID, small meals, H@ blockers, avoid smoking, inuslin might be needed.