GI Yoni

Question 1

kid with “gallstone” looking presentation

Answer 1

Choledochal cysts

rx: removal

Question 2

acute infection of the gallbladder wall caused by gas-forming organisms

Answer 2

Emphysematous Cholecystitis

Question 3

Hyperactive vs absent bowel sounds

Answer 3

ileus: absent sounds
hyperactive: obstruction

Question 4

Classic volvulus imaging

Answer 4

Parrot sign- comes to a tight point

(the picture that look like a flamingo)

Question 5

Pretty spiral bowel on imaging while supine

Answer 5

SBO

Question 6

RUQ pain in a prego

Answer 6

could be appendicitis (appendix is shifted up)

Question 7

gallbladder wall thickness by age

Answer 7

+1 mm per ten years after 40

Question 8

Ranson criteria on admission

Answer 8

clinical prediction rule for predicting the severity of acute pancreatitis

WBC > 16k
Age > 55
Glucose >200 mg/dL (>10 mmol/L)
AST > 250
LDH > 350

Question 9

Pancreatitis causes

Answer 9

GET SMASHED

gallstone
ETOH
Trauma

squaprian 
mumps
autoimmune
steroid
hyperlipidemia/ Hyper Ca
ERCP
Diabete

Question 10

Ranson criteria after addmission

Answer 10

Within 48 hours:

Serum calcium < < 8.0 mg/dL
Hematocrit fall > 10%
Oxygen (hypoxemia PaO2 < 60 mmHg)
BUN ↑ 1.8 or more mmol/L (5 or more mg/dL) after IV fluid hydration
Base deficit (negative base excess) > 4 mEq/L
Sequestration of fluids > 6 L

Question 11

bisap

Answer 11

↑ BUN
AMS
SIRS
>60 
Pleural Effusion 

3/5 ↑ mortality
5/5 is 1/4 chance of death

Question 12

___________ develop in approximately 10 percent of patients with chronic pancreatitis.

Answer 12

Pseudocysts
can also be acute
Most pseudocysts communicate with the pancreatic ductal system and contain high concentrations of digestive enzymes.

Question 13

a medical sign involving episodes of vessel inflammation due to blood clot which are recurrent or appearing in different locations over time

Answer 13

Trousseau sign of malignancy/ thrombophlebitis migrans or migratory thrombophlebitis

Question 14

Sister mary joe nodule

Answer 14

indicates metastatic cancer spread to peritoneum

“rock in the belly button”

Question 15

the stomach and the section of the esophagus that joins the stomach slide up into the chest through the hiatus.

Answer 15

sliding hiatal hernia

These sliding hiatal hernias are a risk factor for gastroesophageal reflux disease (GERD),

Question 16

paraesophageal hernia

Answer 16

Symptomatic paraesophageal hernias (chest pain, upper abdominal pain, difficulty swallowing), are at ↑ risk for progressing to incarceration or ischemia resulting in the need for emergency surgery.

Question 17

Esophogeal rupture test

Answer 17

water-soluble contrast Upper GI study is best in first 24 hours

Question 18

Anion gap equation

Answer 18

Na- (Cl + HCO3)

Question 19

Non-gap acidosis =

Answer 19

diarrhea, diuretic, RTAs

Question 20

Metabolic Alkalosis with low Cl

Answer 20

Vomiting/NG, antactids, diuretics

Question 21

Metabolic Alkalosis with high Cl

Answer 21

Conn’s, Bartter’s, Gittleman’s.

Question 22

↑volume ↓Na

Answer 22

CHF, nephrotic, cirrotic

Question 23

↓ volume ↓ Na

Answer 23

diuretics or vomiting + free water

Question 24

Nl volume ↓Na

Answer 24

SIADH (also check for lung cancer)
Addisons
hypothyroidism