OME - Day 12 Flashcards
Colicky right upper quadrant abdominal pain: what’s the diagnosis and next step?
Gallstones, cholelithiasis, get an ultrasound
Gallstones and dilated common bile duct on ultrasound, diagnosis?
Choledocholithiasis
Inspiratory arrest on palpation of the gallbladder shows what?
Murphy’s sign, positive for cholecystitis
Right upper quadrant pain, jaundice, and fever is what diagnosis?
Ascending Cholangitis, Charcot’s Triad
Right upper quadrant pain, jaundice, fever, altered mental status and hypotension; what do you do?
ERCP (first) and antibiotics (at the same time), Ascending Cholangitis (Reynold’s pentad)
What antibiotics for Ascending Cholangitis?
Cipro + Metronidazole or Ampicillin + Gentamycin + Metronidazole
What are the risk factors for gallstones?
Female, Fat, Forty, Fertile, and Native American
What are the ultrasound findings for a cholecystitis?
Pericholecystic fluid, thickening of gallbladder wall, gallstones
You get an ultrasound and you aren’t sure if it is cholecystitis - what do you get?
HIDA scan
Biopsy of esophagus reveals 30 eosinophils per high power field, what is the next step?
PPI (not oral steroids? treat eosinophilic esophagitis as GERD first)
Guy tries to kill himself by drinking battery acid. What do you do?
Protect airway, EGD, maintain NPO
How do you treat candida esophagitis?
Oral fluconazole
How do you treat HSV esophagitis?
Valaciclovir or Acyclovir
Odynophagia and a white cottage cheese on the mouth that can be removed, what’s the diagnosis?
Candida esophagitis
Old lady on oral antibiotics in a nursing home complains of odynophagia, what’s the diagnosis?
Pill-induced esophagitis