Module 7 - Abdominal Case Studies II Flashcards
40yo female complains of acute right upper quadrant pain radiating to the back and low grade fever. Lab evaluation indicates the presence of urinary bilirubin and an elevation of serum alkaline phosphatase.
Which of the following is the most likely diagnosis?
cholecystitis
- the presence of urinary bilirubin indicating conjugated hyperbilirubinemia coupled with the elevation of serum alkaline phosphatase suggests biliary obstruction that may lead to cholecystitis
wrongs:
- viral hepatitis
- pancreatitis
- duodenal ulcer
62yo pt with arthritis is on daily naproxen therapy.
Which of the following medications is used to protect against GI complications?
misoprostol (cytotec)
- misoprostol is an analog of prostaglandins and used in the treatment of NSAID induced ulcer disease
wrongs:
- diphenoxylate (lomotil)
- sulfasalazine (azulfidine)
- metoclopramide (reglan)
Which medication is considered the mainstay of therapy for mild to moderate inflammatory bowel disease?
prednisone - wrong
sulfasalazine - correct
metronidazole
zathioprine (imuran)
sulfasalazine and other 5-aminosalicylic acid drugs are the cornerstone of therapy in mild to mod inflammatory bowel disease as they have both anti-inflammatory and antibacterial properties. glucocorticoid steroids are used in mod to sev inflammatory bowel disease. Azathioprine is used in severe glucocorticoid dependent inflammatory bowel disease.
The drug of choice in an adult for empirical treatment of an ill-appearing patient with infectious diarrhea who has recently returned from Mexico is…
azithromycin
wrongs:
- amoxicillin
- ceftriaxone
- ciprofloxacin
45yo male presents with abdominal pain and one episode of mild hematemesis, which happened days ago. On PE VS are stable and he is in no acute distress. Hgb and Hct are unremarkable; endoscopy reveals non-bleeding small superficial ulceration of the duodenal bulb. Rapid urease test is positive. Which of the following is the most appropriate treatment at this time?
start omeprazole and antibiotic therapy against h.pylori
Pt presents complaining of periumbilical pain. Which of the following anatomical sites is this finding associated with?
stomach - wrong
bladder
small bowel
pancreas
pain from the small intestine, appendix, or proximal colon causes periumbilical pain. Pain from the stomach, duodenum, or pancreas causes epigastric pain. Pain from the bladder, uterus, or colon causes hypogastric pain
41yo female presents for screening advice. Her 44yo sister passed away recently 18mo after diagnosis of metastatic colon ca. Which of the following is the most appropriate advice for this pt?
- double contrast barium enema now and repeat q 5yrs if normal
- rectal occult blood testing annually until age 50 then sigmoidoscopy q 3 yrs (WRONG)
- rectal occult blood testing annually until age 50 then screening colonoscopy q 5yrs
- screening colonoscopy now and repeat q 3-5yrs if normal
hereditary factors are believed to contribute to up to 30% of colorectal ca. relative risk is 3.8 x if the family members cancer was diagnosed at less than 45yo of the youngest affected first degree relative. Then if negative, q 5 years
which of the following pathophysiological processes is believed to initiate acute appendicitis?
obstruction
hemorrhage
perforation
vascular compromise - wrong
obstruction of the appendiceal lumen by lymphoid hyperplasia, a fecality or foreign body initiates most cases of appendicitis.
which of the following subtypes of viral hepatitis requires the presence of the hepatitis b virus for replication?
hep d
wrongs:
hep a
hep c
hep e
which of the following would be considered for a person who has a successful response to the hep b immunization series
HBsAg negative; anti-HBc negative; anti-HBs positive
wrongs:
- HBsAg positive; anti-HBc positive; anti-HBs negative
- HBsAg negative; anti-HBc positive; anti-HBs positive
- HBsAg negative; anti-HBc negative; anti-HBs negative
there is a feedback too much to type now
