MKSAP-GI Flashcards
Patient with acute abdomen – test?
Supine and upright abdominal radiographs (Although CT scan will be likely be necessary eventually)
Suspect nephrolithiasis – test?
Noncontrast helical abdominal CT
Typical initial symptoms of ruptured AAA? CBC findings?
Sudden, severe pain and near syncope
Leukocytosis and anemia
Clinical criteria for IBS?
Rome III criteria:
- Pain relieved with defecation
- Change in stool frequency
- Change in stool consistency
Also need no alarm indicators (old age, male, nocturnal awakenings, bleeding, weight loss, family history of colon cancer)
Patient with constipation due to IBS – first and second line treatment?
- High-fiber diet
2. Laxative (poly ethylene glycol)
Patient with suspected ischemic colitis – important history? Typical colonoscopy finding?
Atherosclerosis
Thickening of the bowel wall in segmental pattern
Patient with suspected diverticulitis – test?
Contrast enhanced CT scan
Suspected HUS – test? Tx?
Peripheral blood smear; supportive
Suspected radiation proctitis – Sx? test and confirmatory findings?
Diarrhea and tenesmus Six weeks after radiation treatment
Flexible sigmoidoscopy sees mucosal telangiectasia, submucosal fibrosis and arterial Endarteritis
Suspect chronic pancreatitis – test?
Abdominal CT
Marker for celiac disease?
Anti-endomysial antibodies
Symptoms of Clostridium diff?
Diarrhea 10 to 15 times daily, fever, leukocytosis, abdominal pain
Treatment for salmonella gastroenteritis?
Supportive - Antibiotics slow clearance of salmonella from the stool and antidiarrheal agents increase chance of invasion
When to treat salmonella gastroenteritis?
- Age 50
- Patients with severe illness requiring hospitalization
- Patients with atherosclerotic plaques or bone prosthesis (possible seeding)
- Immunocompromised
Hepatocellular injury versus cholestatic injury?
Elevations in AST, ALT, and conjugated bilirubin
Elevation in alkaline phosphatase and small elevations in AST and a penalty
Diseases that can cause a mixed hepatocellular and cholestatic injury?
Hepatitis B and C
Gilbert syndrome a.k.a.?
Constitutional hepatic dysfunction and familial nonhemolytic jaundice
Effect of OCP on liver function?
Conjugated hyperbilirubinemia and elevated alkaline phosphatase
When to use cholecystectomy versus ursodeoxycholic acid?
If previously symptomatic vs if cannot undergo surgery (can only prevent new stone formation)
Acute cholangitis - tx?
Immediate broad spectrum antibiotics followed by ERCP-sphincterotomy
Gallstone pancreatitis - tx?
ERCP
Pt with pancreatitis - general management?
If pancreatic necrosis?
Jegunal Enteral tube feeds > TPN
Imipenem and debridement
GERD - tx? Test if unresponsive? Tx with alarm symptoms?
PPI; esophageal pH monitoring; EGD
Errosive esophagitis - tx?
PPI > H2-blocker
