May 5 Flashcards
Trousseau syndrome =
migratory superficial thrombophlebitis
Trousseau syndrome is associated with..
cancer (esp pancreatic)
path of migratory superficial thrombophlebitis in the setting of pancreatic cancer?
the tumour likely releases mucins that react with platelets and form platelet rich microthrombi
a patient with mgiratory superficial thrombophlbeitis requires work up for what?
Occult malignancy - perform abdominal CT
should you manage a patient with COMPLETE bowel obstruction conservatively?
no (you can do that for partial though)
which cardiac pathology can lead to destruction of vWF?
aortic stenosis - damages vWF multimers as they flow through the valve
What commonly causes small bowel bleeding?
vascular malformations such as angiodysplasias
where is vWF primarily produced?
the endothelium
presentation of a postbariatric anastomotic leak?
abdominal pain, fever, tachypnea, tacchycardia
what investigation should be performed in patients with a suspected anastomic leak ?
oral enhanced contrast abdominal CT
treatment of a postbariatric anastomotic leak?
urgent surgery
what type of diarrhoea is bile acid diarrhoea?
secretory
why may cholecystectomy lead to bile acid diarrhea?
bile acids enter the bowel rapidly when produced (no longer stoled and released in a controlled manner)
clinical features of bile acid diarrhea?
- secretory diarrhea (diarrhea regardless of eating)
- bloating/cramps
- unremarkable test results
treatment of bile acid diarrhea?
bile acid resins
what are the bile acid resins?
cholestyramine, colestipol, colesevelam
how do bile acid resins prevent bile acid diarrhea?
bind to the bile acids and prevent colonic irritation
presentation of ovarian cancer?
bloating, lower abdominal pain, early satiety, constipation
how can acute diverticulitis cause a positive leukocyte esterase in the bladder?
it may cause bladder irritation due to adjacent sigmoid colon inflammation
where is the narrowest section of the bowel?
the ileum
presentation of esophageal perforation?
severe chest/back pain, fever, widened mediastinum
diagnosis of esophageal perforation?
water-soluble esophagography
how do you treat septic arthritis in a small joint (MCP)?
surgical irrigation and debridement
