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S4M2 > Gold Standards > Flashcards

Gold Standards Flashcards

1
Q

Dysphagia Dx

A

Barium swallow or fluoroscopy

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2
Q

Barrett’s Esophagus Dx:

A

Upper Endoscopy (EGD) + Biopsy (MUST HAVE GOBLET CELLS)

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3
Q

Ulcerative Colitis: Dx

A

Sigmoidoscopy + Biopsy + Barium Enema (diff UC & CD)

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4
Q

Peptic Ulcer Dx

A

Upper Endoscopy (EGD)

  • All non-healing gastric ulcers must be biopsied for malignancy
  • Duodenal ulcers are rarely malignant– do NOT biopsy
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5
Q

Esophageal Varices Dx

A

Upper Endoscopy (EGD)

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6
Q

Esophageal Varices rupture– Tx?

A

Endoscopic Band Ligation
Balloon tamponade
Octreotide/terlipressin
TIPS

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7
Q

Late stage gastric cancer Dx & Tx

A

Biopsy

Tx: radical surgery w/chemo/radiotherapy

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8
Q

Tracheoesophageal Fistula: Dx

A

Esophageal Catherter & Esophagogram
Do NOT use standard barium!!!! (aspiration)

Prenatal sonography + polyhydramnios can detect Esophageal Atresia

Must be corrected.

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9
Q

Esophageal Atresia vs TEF: Dx

A

EA w/o TEF: catheter will hit blocked end @ mid chest
EA w/TEF: Catheter hits blocked end & X-ray will show gas in stomach
TEF ONLY: Esophagogram (NON-barium)

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10
Q

TEF associations & Dx

A 
VACTRL:
Vertebral (x-ray)
Anal
Cardiac (ECHO)
TEF (Esophagogram)
Renal (US)
Limbs (x-ray)
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11
Q

Pyloric Stenosis Dx

A

US

H&P usually sufficient (projectile vomiting)

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12
Q

FAP Dx

A

Colonoscopy
Must rule out Upper GI polyps
Resection of entire colon/rectum necessary

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13
Q

Celiac Disease Dx

A

Endoscopic small bowel biopsy (shows villous atrophy, crypt hyperplasia, increased lymphocytes & serum anti-gliadin or anti-transglutaminase)

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14
Q

Colorectal cancer Dx & Tx

A

Colonoscopy
Occult blood test useful but may have false (+)
Tx: radical surgery

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15
Q

Necrotizing Enterocolitis Dx

A

Clinical suspicion

Imaging shows penumatosis intestinalis or pneumoperitoneum (gasss)

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16
Q

Meckel’s Diverticulum: Dx, Tx

A 
99mTc scan (Meckel scan)-- detects gastric mucosa
NOT visualized by contrast or CT

Tx: resection required if symptomatic
DO NOT remove with incidental finding

17
Q

Intussusceptin Dx

A

Child with colicky abdominal pain followed by vomiting + currant jelly stool

18
Q

Cystic fibrosis: Dx

A

Every state in US routinely screens newborns

19
Q

Hereditary Spherocytosis: Dx, Tx

A

Osmotic Fragility
Blood smear

Tx: splenectomy after 6y

20
Q

Acute Abdomen: Dx

A

Dx: PAIN
Abdominal x-ray inconclusive (except for intestinal obstruction, perforative peritonitis)
CT & abdominal US– good for preop

21
Q

Appendicitis Dx

A

Clinical: vague epigastric pain intesnsifies & localizes to RLQ, rebound tenderness (peritonitis), guarding
MUST HAVE MUCOSAL INVOLVEMENT (with neutrophils)

22
Q

Acute Cholecystitis: Dx

A

ERCP
Pain in RUP that radiates to scapula + (+)Murphy sign
Charcot’s triad = pain + jaundice + fever

23
Q

Perforated peptic ulcer Dx, Tx

A

Chest X-ray for FREE GAS UNDER DIAPRHAGM

SURGERY NECESSARY

24
Q

Acute Pancreatitis: Dx

A

Triple phase abdominal CT + abdominal US
CT diff mild acute pancreatitis & severe necrotic pancreatitis
(DONT use ERCP– can cause acute pancreatitis)

S/S: Epigastric pain radiating to back, worse in supine, after eating
Grey Turner (flank bruising) + Cullen (umbilical bruising)
Lipase more specific for dx

25
Q

Diverticular disease: dx

A

Barium enema

26
Q

Acute Diverticulitis: Dx

A

CT abdomen & pelvis w/ oral & IV contrast

DO NOT GIVE BARIUM ENEMA OR COLONOSCOPY FOR RISK OF PERFORATION!!!!

27
Q

Liver Enzymes (AST:ALT)

A

Alcohol Hepatitis: AST:ALT > 2, AST < 300

Viral Hepatitis: AST:ALT < 1

Acetominophen Toxicity: AST:ALT > 2, AST > 1000

Cirrhosis: 2 > AST:ALT > 1

28
Q

Pancreatic Cancer: Dx

A

Biopsy
Serum CA19-9
Courvoisier Law: Non-tender, enlarged gallbladder + mild jaundice + old age

29
Q

Acute HBV: Dx

A

HBsAg- FIRST antigen to appear, but bound to HBsAg IgM during window period (false neg)
During window period: Anti-HBcAg IgM
HBeAg measures viral replication
ABcAg degrades quickly- not detectable

30
Q

Resolution HBV: Dx

A

HBsAg NEGATIVE, IgG for surface + core antigen

31
Q

Immunity vs Resolution

A

Vaccination given for HBsAg- so there will be only IgG for surface protein, but NOT core (NOT anti-HBcAg IgG)

32
Q

Chronic HBV: Dx

A

After 6 mo infection, if HBsAg remains with no IgM

33
Q

C. dificile: Dx

A

In vitro cytotoxin assay

S4M2 (10 decks)

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