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Gi Review for Awesome People > Lab Medicine Stuff > Flashcards

Lab Medicine Stuff Flashcards

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1
Q

dx for abdominal pain before vomiting or abdominal pain with nausea or vomiting

A

Appendicitis

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2
Q

Dx for abdominal pain with nausea or abdominal pain with vomiting

A

Acute cholecysitis

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3
Q

Dx for dyspepsia with vomiting or dyspepsia with water brush (regur of sour or tasteless fluid)

A

Peptic ulcer dz

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4
Q

Dx for N/V associated with diarrhea, headache and myalgias

A

viral gastroenteritis

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5
Q

Dx for bilious vomiting and study you should get

A

Small bowel obstruction

gastric emptying study

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6
Q

Dx for continuous vomiting and study to get

A

Conversion disorders

get electrolyte levels

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7
Q

Dx for delayed vomiting (more than one hour after meals)

A

gastric obstruction

gastroparesis

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8
Q

Study to get for suspected obstruction

A

abdominal x-ray

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9
Q

study to get for potential gastroparesis

A

gastric emptying study

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10
Q

dx for feculent or foul odor to vomitus

A

intestinal obstruction

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11
Q

dx for habitual postprandial, irregular vomiting

A

major depression

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12
Q

Dx for insidious onset N/V

A 
GERD
gastroparesis
medication related effect
metabolic disorder
pregnancy
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13
Q

Labs to get for metabolic disorder

A

pulse ox
ABGs
serum chemistries
chest x-ray

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14
Q

Dx for projectile vomiting, may not be preceded by nausea

A

intracranial disorders, increased intracranial pressure (or could be normal emesis)

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15
Q

dx for regurgitation of undigested food

A

Achalasia
esophageal stricture
zenker diverticulum

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16
Q

Dx for vomiting before breakfast

A

alcohol ingestion
increased ICP
pregnancy
uremia

17
Q

Studies for uremia

A

Renal function testing

electrolyte levels

18
Q

Dx for vomiting during or soon after meals

A

anorexia

bulimia

19
Q

Dx for vomiting partly digested food or chyme several hours after meals

A

Gastric outlet obstruction, gastroparesis

20
Q

man with stage 4 colon cancer and metastasis, AAA repair. Hx of HTN, hyperlipidemia. Has been constipated x 2 weeks.
elevated urea nitrogen, glucose, WBC
low calcium, RBC, hemoglobin, crit
CT- AAA had gas in it

A

aortic-enteric fistula

21
Q

most common cause of periaortic ectopic gas in a patient with repaiared AAA

A

stent graph infection

aortic-enteric fistula

22
Q

common complication of AAA. Gas is uncommon

A

endoleak

23
Q

CT can see this. Infection from staph aureus.

A

stent graph infection

24
Q

often due to exaggerated local inflammatory infection due to aortic arteriosclerosis. Usually no gas on CT, has more symptoms than the patient did

A

retroperitoneal fibrosis

25
Q

CT sign is gas, common complication AAA

Gi bleeding, abdominal pain, pulsatile abdominal mass

A

aortic-enteric fistula

26
Q

most common sign/ symptom of aortic-enteric fistula in order of occurrence

A

GI bleeding
sepsis (predominant clinical manifestations)
abdominal pain
back pain

27
Q

tests for aortic-enteric fisultas

A

upper GI endoscopy

CT

28
Q

where do aortic-enteric fistulas occur most commonly

A

duodenum

29
Q

how do you treat an aortic enteric fistula?

A

surgery

30
Q

35 year old male with fever and abdominal pain
crampy, intermittent, not associated with BMs in RLQ. Has loose, non-bloody stools. Acute promyelocytic leukemia and last chemo was 10 days ago. PE shows 38.4 C 108/56 BP R-20. Port doesn’t appear infected. Moderate tenderness to RLQ palpation. No lesions in perianal area.
Low hemoglobin, platelets slightly low
extremely low leukocyte (0.1), low neutrophils.
low alkaline phosphatase.

A

typhlitis (neutropenic entercolitis)

31
Q

most important initial medical therapy in patient with fever and neutropenia?

A

antipseudomonal beta lactam+ vanco (skin/ catheter)+ metronidazole (c. Diff) within 60 minutes of presentation

32
Q

persist with neutropenic fever after 4-7 day of antimicrobial therapy what should you ad?

A

Anti-fungal therapy

33
Q

least appropriate test for evaluating symptoms in the 35 year old male.

A

colonoscopy

34
Q

what labs should you get on the 35 year old male

A

blood cultures from peripheral and port
stool sample for C. Diff
CBC
Ultrasound

35
Q

why should the 35 year old male not get a colonoscopy or barium enema?

A

Bacteremia or perf

36
Q

most appropriate management of typhlitis

A

broad spectrum antibiotics, bowel rest, G-CSF (granulocyte site stimulating colony therapy)
surgery indicated with ileus

consider floroquinolone prophlaxis in future

37
Q

what is the Nadir

A

after 7-14 days of chemo

lowest neutrophil count

Gi Review for Awesome People (4 decks)

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