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GPA mini case > GPA - Constipation, Diarrhea, GI bleed, bloody stool > Flashcards

GPA - Constipation, Diarrhea, GI bleed, bloody stool Flashcards

1
Q

Key pe for constipation diarrhea

A

Thyroid endocrine, abdominal and rectal, pelvic

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2
Q 
DDX - Constipation Diarrhea 
67 yo m,
Alternate diarrhea constipation, small caliber
blood in stool x 8 months
Wt loss
low fiber, hx of colon cancer
A 
Colorectal cancer
Irritable bowel syndrome
Diverticulitis
Celiac dz
Parisitic infection
Malabsorption
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3
Q 
Workup - Constipation Diarrhea 
67 yo m,
Alternate diarrhea constipation, small caliber
blood in stool x 8 months
Wt loss
low fiber, hx of colon cancer
A 
CBC: electrolytes
Colonoscopy
Barium enema
CT: Abdonminal 
CMP:
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4
Q

DDX - Constipation Diarrhea
28y Male, Constipation x 3 weeks
eaten junk food x 2 months since mother died

A

Low fiber diet
Hypothyroid
Depression
Irritable bowel syndrome

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5
Q

Workup - Constipation Diarrhea
28y Male, Constipation x 3 weeks
eaten junk food x 2 months since mother died

A

Rectal exam
TSH
PHQ-9

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6
Q 
DDX - Constipation Diarrhea 
30yo F, 
Alternate constipation and diarrhea
abdominal pain releaved by defication
Neg nausea, vomit wt loss or blood in stool
A 
Irritable bowel syndrome
Crohnes
Diverticulitis
Celiac disease
Chronic pancreatitis
malabsorption, lactose
GI parasitic infecttion
Ulcertave colits
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7
Q 
Workup - Constipation Diarrhea 
30yo F, 
Alternate constipation and diarrhea
abdominal pain releaved by defication
Neg nausea, vomit wt loss or blood in stool
A

Rectal exam, occult blood
CBC
Stool: ova parasite
CT abdomen

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8
Q

DDX - Constipation Diarrhea
33yo M, Watery diarrhea, vomiting, diffuse abdomenal pain x 24 hours
coworkers are also ill

A

Infectious diarrhea: gastroenteritis
Food poisoning
Inflammatory bowel disease

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9
Q

Workup - Constipation Diarrhea
33yo M, Watery diarrhea, vomiting, diffuse abdomenal pain x 24 hours
coworkers are also ill

A

Occult blood, rectal
Stool: ova and parasite, leukocytes
CBC, electrolytes
CT abdomen pelvis

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10
Q 
DDX - Constipation Diarrhea 
40yo f
Watery diarrhea
abdominal cramps
antibiotics for UTI last week
A

C.diff: pseudomembranous colitis
Gastroenteritis
food poiiiisoning
IBD

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11
Q 
Workup - Constipation Diarrhea 
40yo f
Watery diarrhea
abdominal cramps
antibiotics for UTI last week
A

Stool Leukosites, culture, occult blood
C diff toxin
CBC electrolytes

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12
Q

DDX - Constipation Diarrhea
25yo M
water diarrhea, abdominal cramps
mexico vacation

A 
travelerrs diarrhea
giardia
amebiasis
food poisoning
Hepatitis A
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13
Q

Workup - Constipation Diarrhea
25yo M
water diarrhea, abdominal cramps
mexico vacation

A 
Stool: ova parasite, leukosides, occult blood 
Antigens: giardia, entamoebia
CBC, electrlytes,
CMP: liver functionn
Viral hepatitis serology
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14
Q

DDX - Constipation Diarrhea
30yo F
watery diarrhea, abdominal cramp, bloating
milk aggrivation, fasting makes better

A 
Lactose intolerance
Gastroenteritis
Malabsorption
Celiac disease
Irritable bowel disease 
Irratable bowel syndrome
Hyper thyroid
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15
Q

Workout - Constipation Diarrhea
30yo F
watery diarrhea, abdominal cramp, bloating
milk aggrivation, fasting makes better

A

Rectal and stool exam
Hydrogen breath test
TSH

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16
Q 
DDX - Constipation Diarrhea 
33yo M
watery diarrhea
diffuse abdomnial pain, wt loss in past 3 weeks
not responded to antibiotics
A 
Crohns disease
celiac disease 
UC
Pseudomembranous colitis
small bowel lymphoma
17
Q 
Workup - Constipation Diarrhea 
33yo M
watery diarrhea
diffuse abdomnial pain, wt loss in past 3 weeks
not responded to antibiotics
A 
Rectal, stool and culture
CBC, electrolytes
TSH
CT abdomen, colonscopy
Small bowel series
Urinary 5-HIAA
18
Q

Key PE for Upper GI bleed

A 
Orthostatic hypothension, 
ENT
Heart and lung
abdominal 
Rectal
19
Q 
DDX - upper GI bleed
4YO F
coffee ground emesis x 3 days
dark tarry stool
hx of epigastric pain releived by antacids and fodo
A

Bleeding peptic ulcer
gastritis
esophageal varices
Gastric cancer

20
Q 
Workup - upper GI bleed
4YO F
coffee ground emesis x 3 days
dark tarry stool
hx of epigastric pain releived by antacids and fodo
A 
CBC
Ferritin, TBIC,
upper endoscopy
Abdominal ultrasound
CMP: AST, ALT, biliruben Alk phos
H pylori
21
Q

DDX - Upper GI bleed
40 yo F
Epigastric pain, coffee ground emesis,
hx of RA treated with aspirin, and alcholic

A 
Gastritis (can be bleeding)
Bleeding peptic ulcer
esophageal varices
Gastric cancer
Malllory weiss tear
22
Q

Workup - Upper GI bleed
40 yo F
Epigastric pain, coffee ground emesis,
hx of RA treated with aspirin, and alcholic

A

CBC, Electrolytes, ast, alt, biliruben alk phos
Endoscopy
barium swallow

23
Q

Key PE for blood in stiool

A

Vitals, orthostatics, and rectal examss

24
Q

ddx - bloody stool
67yo M with blood in stool
wt loss, constipation
Family hx of colon cancer

A 
Colon cancer
Hemorrhoids
anal fissure
Diverticulitis
Lower GI bleed
IBD
25
Q

Workup - bloody stool
67yo M with blood in stool
wt loss, constipation
Family hx of colon cancer

A

Colonoscopy
CBC, electrlytse, AST,ALT, biliruben, ALK phos
CT abdomen
Barium enema

26
Q 
ddx - bloody stool
33 yo R - rectal bleeding
diarrhea x 1 week
lower abdominal pain, 
Tenesmus for several months.
A 
IIrritable bowel disease: Ulcerative colitis, 
Chrones
Anal fissure
hemorrhoids
diverticulosis
dysentery
27
Q 
Workup - bloody stool
33 yo R - rectal bleeding
diarrhea x 1 week
lower abdominal pain, 
Tenesmus for several months.
A 
CBC, PT, PTT
Abdominal x ray
Colonscopy
CT - abdomen and pelvis
barium enema
28
Q 
ddx - bloody stool
58 yo M 
painless bright red blood
chronic constipaiton
low fiber
A 
Diverticulosis
Anal fissure
hemorrhoids
angiodysplasia
colorectol cancer
29
Q 
ddx - bloody stool
58 yo M 
painless bright red blood
chronic constipaiton
low fiber
A 
CBC
PT, PTT
electrolytes
colonscopy
CT, abdomen pelvis

GPA mini case (11 decks)

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