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EOR: Emergency Medicine > GI System > Flashcards

GI System Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

9 emergent causes of RUQ Pain

A
  1. Biliary Colic
  2. Acute Cholecystitis
  3. Acute Cholangitis
  4. Sphincter of Oddi Dysfunction
  5. Acute Hepatitis
  6. Perihepatitis (Fitz-Hugh-Curtis Syndrome)
  7. Liver Abscess
  8. Budd-Chiari Syndrome
  9. Portal Vein Thrombosis
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2
Q

9 emergent causes of epigastric pain

A
  1. Acute MI
  2. Acute Pancreatitis
  3. Chronic Pancreatitis
  4. PUD
  5. GERD
  6. Gastritis
  7. Dyspepsia
  8. Gastroparesis
  9. Early appendicitis
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3
Q

4 Emergent Causes of LUQ Pain

A

Splenomegaly
Splenic Infarct
Splenic Abscess
Splenic Rupture

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4
Q

Which sign?

RLQ pain with palpation of LLQ

A

Rovsing

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5
Q

Which sign?

RLQ pain with internal rotation and flexion of the hip

A

obturator sign

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6
Q

Which sign?

RLQ pain with passive hip extension or active flexion against resistance

A

Psoas sign

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7
Q

Imaging of choice for suspected appendicitis…

A

abdominal CT and/or appy ultrasound

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8
Q

Which sign for acute cholelithiasis?

referred right subscapular pain…

A

boas sign

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9
Q

Cholestatic pattern of LFTs…

A

elevated alk phos and conjugated bili

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10
Q

5 Fs of cholecystitis…

A

female, fat, forty, fertile, fair

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11
Q

1st test for acute cholecystitis and gold standard test…

A

1st: US

gold standard: HIDA

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12
Q

3 diagnostic features of acute cholecystitis on US…

A

> 3mm wall thickening

pericholecystic fluid accumulation

stone visualization

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13
Q

Gold standard dx test for choledocolithiasis…

A

ERCP

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14
Q

a 37-year-old male complaining of rapid onset of severe mid-epigastric pain with radiation to the back after eating a large meal.

The pain lessens when she leans forward or lies in the fetal position.

A

Acute pancreatitis

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15
Q

Physical exam shows low-grade fever, epigastric tenderness, diminished bowel sounds, and bruising of the flanks.

An abdominal CT scan shows localized dilation of the upper duodenum and a small collection of fluid in the left pleural cavity.

A

acute pancreatitis

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16
Q

GET SMASHHED mnemonic for acute pancreatitis causes…

A

Gallstones
Ethanol
Trauma

Steroids
Mumps
Autoimmune
Scorpion
Hypercalcemia/lipidemia
ERCP
Drug use
17
Q

Bruising at umbilicus. present in suspected acute pancreatitis.

A

cullen’s sign

18
Q

Flank bruising present in suspected acute pancreatitis

A

grey turner’s sign

19
Q

Tx of acute pancreatitis…

A
  1. admit
  2. IV fluids
  3. pain mgmt
  4. npo
20
Q

1st thought for patient presenting to ED with anorexia…

A

appendicits

21
Q

Typical 4 step migration for appendicitis

A

crampy periumbilical pain –> N/V –> anorexia –> RLQ migration of intense pain

22
Q

5 causes of constipation in the ED…

A 
CRC
obstruction
volvulus
ileus
gastroparesis
23
Q

vomiting, abd. pain, fullness after eating small amounts…

Can occur in DM

A

gastroparesis

24
Q

Belly pain, bloating, nausea, bloody stools and constipation.

X Ray showing colonic distension

A

volvulus

25
Q

Charcot’s triad…

A

Cholangitis:

RUQ Tenderness
Jaundice
Fever

26
Q

Reynold’s pentad:

A

Cholangitis:

RUQ Tenderness
Jaundice
Fever
AMS
Hypotension
27
Q

empiric abx for cholangitis…

A

Cipro + metronidazole

28
Q

Jaundice + Pruritis

a/w IBD, CA

A

Primary Sclerosing Cholangitis

29
Q

Lab testing for constipation… (3)

A

CBC
CMP
TSH
(evaluates for secondary causes)

30
Q

Patient presents with:

  • hx of constipation
  • LLQ Pain/TTP
  • Low fever
  • Midabdominal distension
  • Painless BRBPR
A

diverticulitis

31
Q

Imaging for diverticulitis…

A

CT A/P

32
Q

2 CT findings suggestive of diverticulitis…

A

Fat stranding, bowel wall thickening

33
Q

Tx for diverticulitis…

A

Cipro/Augmentin + Metronidazole

34
Q

Pt. p/w:

  • odynophagia
  • dysphagia
  • retrosternal CP
A

esophagitis

35
Q

Barium swallow shows:

ribbed esophagus

multiple corrugated rings

A

esophagitis

36
Q

Shallow, punched out lesions on EGD…

A

HSV esophagitis

37
Q

large solitary ulcers or erosions on EGD

A

CMV esophagitis

EOR: Emergency Medicine (12 decks)

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