Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PANCE > GI part 1 > Flashcards

GI part 1 Flashcards

1
Q

What are the 2 main types of esophagitis?

A

Non-infectious (medications, eosinophilic)

Infectious (HSV, CMV, Candidiasis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What medications can cause non-infectious esophagitis in Elderly patients?

A 
*Bisphosphonates (alendronate)
Tetracyclines
NSAID
KCl
teenagers - doxycycline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Patients that have asthma or allergies have a higher possibility of having what type of esophagitis?

A

eosinophilic (check with biopsy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Treatment for eosinophilic esophagitis?

A

diet modification (based on allergy screening), PPI, glucocorticoids, budesonide (topical steroids to reduce inflammation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 2 common viral etiologies of infectious esophagitis?

A

HSV

CMV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fungal esophagitis?

A

Candidiasis

seen in immunocompromised patients - HIV, Cancer, Bone marrow transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What type of esophagitis has small shallow volcano like vesicles and treatment?

A

HSV

Acyclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of esophagitis is common in HIV patients and the ulcer is deeper and wide and treatment?

A

CMV

ganciclovir IV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of esophagitis presents with white mucosal plaque-like lesions with odynophagia (painful swallowing) and whats the treatment?

A

candidiasis
(stain on KOH will show yeast)

fluconazole or ketoconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 8 types of dysphagia?

A 
Achalasia
Esophageal Spasm
Scleroderma
Neurologic Disease
Strictures
Schatzki Ring
Cancer
Esophageal Web
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What dysphagia is sensitive to solids and liquids…..degeneration of Auerbach’s plexus…. bird/parrot beak on barium swallow?

Treatment?

A

achalasia

Tx: muscle relaxants, nifedipine (CCB), botox, myotomy

confirm by manometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What dysphagia is sensitive to solids and liquids… cork screw on barium swallow?

Treatment?

A

Esophageal Spasm

Tx: muscle relaxants, nifedipine, botox, myotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What dysphagia is sensitive to solids and liquids… may manifest in GI tract due to decreased esophageal sphincter tone…

A

scleroderma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What dysphagia is sensitive to solids and liquids… suspect if pt had CVA or parkinson’s or alzheimers?

A

Neurologic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What dysphagia is sensitive to solids…and from the healing process of ulcerative esophagitis (scarring)?

Diagnosis and treatment?

A

Strictures

Get endoscopy with dilatation (treatment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What dysphagia is sensitive to solids and is caused by a muscular band near LES?

A

Schatzki ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What cancerous dysphagia is from a smoker and etoh?

A

squamous cell carcinoma

world wide most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What cancerous dysphagia is from Barrett’s?

A

columnar or adenocarcinoma

US most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What dysphagia is sensitive to solids and iron deficiency anemia and esophageal webs?

A

plummer-vinson

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the most common symptoms for esophageal neoplasm… diagnosis and treatment?

A

progressive dysphagia to solids
wt loss

Endoscopy w/cytology
CT for staging
chemo + surgical resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

linear mucosal tear in the esophagus after forceful vomiting or retching… causing hematemesis?

A

Mallory Weiss Tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do you diagnose and treat a Mallory Weiss Tear?

A

endoscopy

Tx: self limiting
-can use endoscopy with injection and thermal coagulation if bleeding does not resolve on own.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is caused by severe retching and vomiting followed by excruciating retrosternal chest and upper abdominal pain… odynophagia (pain), fever, shock?

A

Boerhaave’s = surgical emergency!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what esophageal disease is caused by dilations of veins due to portal hypertension caused by cirrhosis?

A

Esophageal Varices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Patient presents with painless upper GI bleed, and signs of liver disease (jaundice, palmar erythema)

A

Esophageal varices

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment of esophageal varices?

A

Prevention = BB (nadolol or propranolol)

Endoscopic hematostasis with injection sclerotherapy and variceal band ligation

Correct coagulopathy and transfuse PRN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Symptoms = heartburn, hoarseness, regurgitation of food, atypical chest pain, cough, Barrett’s esophagitis?

A

GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the diagnosis for GERD?

A

pH monitoring = gold standard
Decrease LES pressure
Biopsy for H. Pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Treatment for GERD

A

Lifestyle modifications - smoking, avoid large meals. laying down

Antacids

H2 blockers (cimetidine, famotidine)
PPI (omeprazole)
Nissen Fundoplication
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What medications can worsen GERD?

A 
antibiotics (tetracycline)
bisphosphonates
iron
NSAID
anticholinergic
CCB
narcotics
Benzo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Dyspepsia and abdominal pain…H Pylori/NSAID…may present with GI bleed?

A

PUD (peptic ulcer disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is diagnosis for PUD?

A

Upper GI endoscopy

Biopsy for H. pylori (breath test)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What disease is pain with food?

A

peptic ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What disease is pain after food?

A

duodenal ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Treatment for H. Pylori PUD?

A

PPI, amoxicillin, clarithromycin x 7-14 days
or

PPI, clarithromycin + metronidazole
or

PPI, bismuth subsalicylate + tetracycline, metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are causes of gastritis?

A

NSAID
Alcohol
H. pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is delayed gastric emptying?

A

Gastroparesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the causes of gastroparesis?

A

Myopathic diseases of smooth muscles and neurological dysfunction

-diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Treatment for gastroparesis? (Delayed gastric emptying)

A

Pro kinetic meds = cisapride and metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the 4 gastric neoplasms?

A

Zollinger-Ellison syndrome
Gastric adenocarcinoma
Carcinoid tumor
Gastric lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What happens in Zollinger-Ellison syndrome?

A

A gastrin secreting tumor (gastrinoma) causes hypergastrinemia = which results in refractory PUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What test do you order for suspecting Zollinger-Ellison syndrome?

A

Fasting gastrin >150
Secretin test
Endoscopy/CT/MRI localize tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Treatment for gastrinoma?

A

PPI

Surgical resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What gastric cancer is associated with h pylori and cigarette smoking?

A

Gastric adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Patient is >40, dyspepsia, wt loss, iron deficiency anemia, occult GI bleeding

A

Order endoscopy with cytology (anyone over 40 with dyspepsia), then CT to see extent of disease

Gastric adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Treatment for gastric adenocarcinoma?

A

Curative or palliative resection

Chemo or radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is Virchow node vs sister Mary Joseph nodule?

A

Virchow = left supra ventricular lymphadenopathy

Sister Mary Joseph = umbilical nodule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

The risk of gastric lymphoma is greater by 6 fold if ______ is present?

A

H pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

S/S of gastroparesis?

A

post prandial hypoglycemia despite eating, post prandial n/v

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Which gastric cancer is the most common site of extra-nodal site of non-Hodgkin’s lymphoma?

A

gastric lymphoma, <2% of gastric cancers

Tx: same as adenocarcinoma = surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are the primary sites of gastric cancer metastasis?

A

liver
peritoneum
lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what are the 4 diseases of the biliary tract (gallbladder)?

A

Cholelithiasis
acute cholecystitis
cholangitis
cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are some risk factors for cholelithiasis?

A
  • increasing age, pregnancy, estrogen, obesity
  • cirrhosis
  • clofibrate
  • ceftriaxone
  • sickle cell disease, Crohn’s
  • hereditary spherocytosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Pain is episodic, after fatty meals in RUQ, may have some n/v, normal exam between episodes?

A

cholelithiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are the 5 F’s for cholelithiasis?

A

female, fat, forty, fertile, flatulent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is Murphy’s sign?

A

acute cholecystitis

-severe pain when breathing in and palpating RUQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Patient has Murphy’s sign, n/v, fever, chills, anorexia, elevated WBC and LFT?

A

acute cholecystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

First step in diagnosing acute cholecystitis?

A

Ultrasound = stones/sludge; wall thickening +/- pericholecystic fluid

Biliary Scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Treatment for acute cholecystitis?

A

ERCP = biliary obstruction/choledocholithiasis

Surgery = ABX therapy (laparoscopy vs open cholecystectomy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is a HIDA scan?

A

nuclear scan of gall bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is Fitz-Hugh-Curtis?

A

gonococcal infection causing perihepatitis that looks like cholecystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is Charcot Triad?

A

Cholangitis

-fever, jaundice, RUQ pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is Reynold’s pentad?

A

Cholangitis

-fever, jaundice RUQ pain
+ confusion and hypotension (acute obstructive)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is cholangitis?

A

obstruction of common bile duct with ascending infection (typically e coli)

65
Q

How do you diagnose cholangitis?

A

RUQ US = biliary dilation or stones

leukocytosis with left shift, increases transaminase levels

ERCP = diagnosis and treatment

66
Q

Treatment for cholangitis?

A
  1. ABX
    - fluoroquinolone (cipro)
    - cephalosporin
    - ampicillin
    - gentamicin + metronidazole
  2. ERCP and remove stone
  3. cholecystectomy when acute syndrome is resolved
67
Q

primary sclerosing cholangitis is associated with what?

A

cholangiocarcinoma

68
Q

What do you think of with wt loss +/- non-painful RUQ palpable mass, jaundice and pruritus?

A

Gallbladder cancer

69
Q

Diagnosis for gallbladder cancer?

A

porcelain gallbladder = radiopaque from calcification

70
Q

Treatment for gallbladder cancer?

A

surgery

71
Q

What is the only Viral Hepatitis that is DNA?

A

Hepatitis B

-all others are RNA

72
Q

Which 2 viral hepatitis occur together?

A

Hepatitis B and D

73
Q

Hepatitis + _____ = _____

A

hepatitis + pregnancy = fetal demise

74
Q

What is the most common cause of Hepatitis?

A

VIRAL (A-E)

toxins (alcohol) = 2nd

75
Q

Which 2 viral hepatitis are transmitted by fecal-oral contamination?

A

hepatitis A and E

76
Q

What 3 viral hepatitis are transmitted parenterally or by mucous membrane contact?

A

hepatitis B,C,D

77
Q

Which viral hepatitis is most likely to progress to serious liver disease?

A

hepatitis C

78
Q

What is Hepatitis A screening assay and antibody?

A

Screening assay = anti-HAV IgM (indicates resolved hepatitis A = gold standard for diagnosis)

Antibody = ANTI-HAV

79
Q

What is Hepatitis B screening assay and antibody?

A

Screen assay = HBsAg (ongoing infection), Anti-HBc Ig

Antibody = HBeAg (active infection), Anti-Hbe

80
Q

What are symptoms of viral hepatitis?

A

fatigue, malaise, anorexia, nausea, tea-colored urine, vague abdominal discomfort….jaundice

elevated LFT (AST/ALT)

81
Q

Hepatitis A

A

fecal-oral
anti-HAV IgM
hepatomegaly + jaundice
GIVE VACCINE

82
Q

Hepatits B

A

DNA

Blood borne: needles, sex, mom to child, close contact

Flu symptoms + jaundice

can lead to cirrhosis and liver failure

associated with hep D

83
Q

Hepatitis C

A

needles, blood contact

almost always converts to chronic (cirrhosis/liver failure)

84
Q

Hepatitis D

A

clotting factors and drug users

only occurs with hep B

85
Q

Hepatitis E

A

fecal oral
self limiting
high infant mortality rate in pregnant women

86
Q

Causes of Toxic Hepatitis?

A

ALCOHOL

acetaminophen, carbon tetrachloride, isoniazid,halthane, phenytoin

87
Q

What do you use for acetaminophen toxicity?

A

acetylcysteine

88
Q

What does chronic hepatitis result in?

A

cirrhosis and end-stage liver disease

caused by hep B,C,D, autoimmune/drug induced, hemochromatosis and Wilson’s disease

89
Q

Treatment for viral causes of chronic hepatitis?

A

pegylated interferon-alpha

Hep B = HBsAg
Hep C = Anti-HCV
Hep D = Anti-HDV

90
Q

treatment for autoimmune causes of chronic hepatitis?

A

corticosteroids

screening test = ANA

91
Q

treatment for drug-induced chronic hepatitis?

A

remove offending agent

screening test = get history

92
Q

Wilson’s Disease?

A

Tx: copper chelation (penicillamine)

screening = decreased ceruloplasmin

Diagnosis = kayser-fleischer ring on corneal-scleral junction, altered mental status

93
Q

Treatment for hemochromatosis for chronic hepatitis?

A

phlebotomy and deferoxamine chelation

94
Q

3 Benign Liver Neoplasm?

A
  • cavernous hemangioma
  • hepatocellular adenoma
  • infantile hemangio-endothelioma
95
Q

What are 3 symptoms concerning for liver cancer?

A
  • abdominal pain
  • palpable abdominal mass (hepatomegaly/splenomegaly)
  • weight loss
  • jaundice
  • hepatic bruit
  • ascites

(have increased alpha-fetoprotein)

96
Q

Liver Cancer Risk factors?

A
  • Hep B/C
  • cirrhosis
  • diabetes
  • NAFLD
  • ETOH
  • aflatoxin exposure
97
Q

What is cirrhosis?

A

irreversible fibrosis and nodular regeneration throughout the liver

-liver is unable to regenerate due to large amounts of scar tissue

98
Q

Common cause of cirrhosis?

A

ETOH

hep B/C

99
Q

Describe exam for cirrhosis?

A

skin telangiectasias
spider hemangioma
ruddy face/nose
caput medusae (big belly veins)

100
Q

What are cirrhosis complications?

A
  • ascites
  • variceal bleeding (itchy/brusing)
  • gynecomastia
  • obstructive jaundice
  • spontaneous bacterial peritonitis (fever/ab pain = give ABX)
  • hepatic encephalopathy) - give lactulose
  • hepatocellular carcinoma (monitor AFP)
  • hepatic vein thrombosis (Budd Chiaria = abdominal pain, ascites, hepatomegaly)
101
Q

Treatment for Cirrhosis?

A
  • avoid NSAID
  • reduce salt intake
  • spironolactone and furosemide
  • paracentesis
  • liver transplant
102
Q

Primary Sclerosing Cholangitis?

A

symptoms: pruritus, steatorrhea, fat soluble vitamin deficiency (ADEK), metabolic bone disease
- associated with ulcerative colitis
- order contrast cholangiography = beaded bile duct

103
Q

Primary Biliary Cirrhosis?

A

Symptoms = fatigue, pruritus, kon-jaundic skin hyperpigment “slate colored”, hepatomegaly

diagnosis = elevated alk phos, cholesterol, bilirubin

get liver biopsy (+ anti-mitochondrial antibodies)

104
Q

Non-alcoholic Steatohepatitis?

A

fat builds up in the liver and causes scar tissue

risk factor = DM, metabolic syndrome, obesity, CAD, steroid use

US = infiltration suggestive, biopsy

105
Q

Hereditary Hemochromatosis?

A

FHx of cirrhosis, skin hyper pigmentation, DM, pseudo gout

transferrin and ferritin = elevated

genetics = HFE mutation

TX = phlebotomy, deferoxamine chelation therapy

106
Q

Most common cause of acute pancreatitis?

A

alcohol

gallstones

107
Q

Other causes of acute pancreatitis?

A
  • hyperlipidemia (hypertriglyceridemia),
  • trauma (blunt)
  • drugs (thiazides, furosemide, tetracycline, metronidazole, sulphasalazine, salicylate, valproic acid, estrogen, calcium)
  • hypercalcemia,
  • penetrating PUD
108
Q

Patient presents with epigastric pain that radiates to the back, n/v, pain is relieved when patient leans forward (boring pain)

A

acute pancreatitis

109
Q

Grey Turner Sign?

A

acute pancreatitis

-hemorrhagic pancreatitis may cause bleeding into the flanks

110
Q

Cullen Sign?

A

hemorrhagic pancreatitis bleeding into umbilical area

111
Q

What Criteria is used for acute pancreatitis?

A

RANSON CRITERIA

on admission = >55, elevated WBC, serum glucose, LDH, AST, lactate dehydrogenase

within 48 hours = drop in hematocrit, increased BUN, low calcium, low O2, base deficit increased

112
Q

What would labs look like for acute pancreatitis?

A 
increased = WBC, LFT, amylase/lipase, glucose. 
decreased = calcium
113
Q

Xray findings for acute pancreatitis?

A

sentinel loop

US (may help to look for gallstones)

114
Q

Acute Pancreatitis Treatment?

A
  • NPO (bowel rest)
  • maintain fluid balance
  • ABX
  • Pain control = opioid
  • monitor for complications
115
Q

Causes of CHRONIC pancreatitis?

A

alcohol abuse (90%)

other causes = cholelithiasis, PUD< hyperparathyroidism, hyperlipidemia

116
Q

Classic triad for chronic pancreatitis?

A
  • pancreatic calcification
  • steatorrhea
  • DM
117
Q

Diagnosis for Chronic pancreatitis?

A
  • amylase/lipase
  • 72 hr fecal analysis
  • cholecystokinin
  • xray pancreatic calcification
  • US
  • ERCP = most sensitive
118
Q

Treatment for Chronic Pancreatitis?

A
  • same as acute
  • low-fat diet
  • treat underlying cause = which is usually alcohol
119
Q

What and where is the most common for pancreatic cancer?

A

ductal adenocarcinoma

-at head of pancreas

120
Q

Risk factors for pancreatic cancer?

A

smoking, age, obesity, chronic pancreatitis, FHx

121
Q

painless jaundice, non-tender palpable gallbladder, epigastric abdominal pain, wt loss?

A

pancreatic cancer

122
Q

What is Courvoisier’s sign?

A

non-tender palpable gallbladder (pancreatic cancer)

123
Q

What is Virchow’s node?

A

left supraclavicular “sentinel node” (pancreatic and GI cancers)

124
Q

Diagnosis for pancreatic cancer?

A

CT scan = look for metastases

CA 19-9

125
Q

Treatment for pancreatic cancer?

A

Surgical = whipple procedure
chemo/radiation
poor prognosis

126
Q

What is the most common cause of appendicitis?

A

fecalith

other causes = infection, collagen vascular disease,e inflammatory bowel disease

127
Q

patient presents with periumbilical/epigastric pain with localization to RLQ, n/v, fever, chills, anorexia

leukocytosis

A

Appendicitis

128
Q

Describe McBurney sign?

A

appendicitis

+pain upon palpation in RLQ

129
Q

Describe Rovsing sign?

A

appendicitis

+RLQ pain upon palpation of LLQ

130
Q

Describe Obturator sign?

A

appendicitis

+RLQ pain upon flexion and internal rotation of Right LE

131
Q

Describe Iliopsoas sign?

A

appendicitis

RLQ pain with R hip extension

132
Q

Test of choice for appendicitis?

A

CT

133
Q

Treatment for appendicitis?

A
  • empiric ABX = piperacillin-tazobactam

- SURGERY

134
Q

What is a hernia?

A

protrusion of an organ or structure through the wall that normally contains it

135
Q

What are several types of hernias? (5)

A
  • umbilical
  • diaphragmatic or hiatal
  • incisional
  • inguinal (indirect - most common)
  • ventral
136
Q

What are the two types of hiatal hernia and Tx?

A

-sliding: due to decreased resting pressures of LES
(reflux)
Tx: medical (antacids), surgical if no improvement (Nissen)

-paraesophageal: stomach herniates into thorax
(asymptomatic)
Tx: surgical repair

137
Q

Describe ventral hernia?

A

occurs when there is a weakening in the anterior abdominal wall (incisional or umbilical)

138
Q

Risk factors for ventral hernia?

A

previous abdominal surgery, obesity, age, wound infection, previous placement of drain

(notice abdominal mass at site of previous incision)

139
Q

Treatment for ventral hernia?

A

observation - if no pain or sign of strangulation

-surgical - if strangulation or at risk of strangulation

140
Q

Risk factors for umbilical hernia?

A

multiple pregnancy, obesity, intra-abdominal tumor

notice mass at umbilicus

141
Q

Treatment for umbilical hernia?

A
  • surgical to avoid incarceration and strangulation

- if <12 months = will resolve on own

142
Q

Describe Indirect inguinal Hernia…

A

-congenital and present before age 1
-patent tunical vaginalis
-exam: hernia descends into scrotum and is not easily reducible
(tip of finger)
-pass through internal inguinal ring

143
Q

Describe direct inguinal hernia…

A
  • weakness of the transversalis fascia in Hesselbach’s triangle
  • present when pt stands and disappears/reducible when supine
  • side of finger
144
Q

What is Hesselbach’s triangle?

A

medial border: rectus abdominus

Superior border: inferior epigastric artery

Lateral border: inguinal ligament

(direct inguinal hernia- pass through)

145
Q

urine has mouse like odor.

mental retardation. seizures. movement disorders

A

phenylketonuria

(autosomal recessive disorder with decreased activity of phenylalanine hydroxylase - increases in brain and causes damage)

146
Q

How do you diagnose phenylketonuria?

A

through infancy screening between 24 hours and 3 weeks

147
Q

Treatment for phenylketonuria?

A

limit diet intake of phenylalanine

(breast milk is low in phenylalanine, special formulas)

may need strict control of protein intake for life

148
Q

projectile vomiting, immediate postprandial, non-bilious

olive like mass

between 4-6 weeks old

A

pyloric stenosis

149
Q

How do you diagnose pyloric stenosis?

A

US - double tract

Barium studies - string sign/shoulder sign (delayed emptying)

150
Q

Treat pyloric stenosis?

A

surgery

151
Q

xray: double bubble sign

first day of life - bilious vomiting w/o abdominal distension

A

duodenal atresia

often in down syndrome and polyhydramnios

152
Q

treatment for duodenal atresia?

A
  • decompression and IVF rehydration

- surgery

153
Q

newborn with excessive saliva and choking/coughing with feeding attempts.

inability to pass nasogastric tube

A

esophageal atresia

(associated with tracheoesophageal fistula)

Tx: surgical

154
Q

immediate respiratory distress in newborn because lung is compromised by abdominal contents?

A

diaphragmatic hernia

155
Q

Treatment for diaphragmatic hernia?

A

immediate intubation and ventilation

156
Q

Diagnosis for diaphragmatic hernia?

A
  • bowel sounds in chest
  • radiography - loops of bowel in involved hemithorax, heart and mediastinal structures displaced

Tx: surgery

157
Q

congenital megacolon

A

hirschsprung disease

congenital absence of Meissner and Auerbach autonomic plexus

158
Q

symptoms of hirschsprung disease and treatment?

A

constipation, obstipation, vomiting, Failure to thrive

Tx: surgical resection of affected bowel

PANCE (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions