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Step 3 > OME - Day 17 > Flashcards

OME - Day 17 Flashcards

1
Q

40 year old man with ulcerative colitis and jaundice, diagnosis?

A

Primary Sclerosing Cholangitis, get an MRCP

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2
Q

40 year old woman with jaundice and no alcohol or viruses, diagnosis?

A

Primary Biliary Cirrhosis

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3
Q

Beads on a string on MRCP, diagnosis?

A

Primary Sclerosing Cholangitis

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4
Q

Cirrhosis and COPD, diagnosis?

A

Alpha-1 Anti-Trypsin Deficiency

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5
Q

Diabetes, Diastolic CHF, Hyperpigmentation, and Cirrhosis, diagnosis and next step?

A

Hemochromatosis, get a ferritin

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6
Q

Fatty liver on ultrasound but no alcohol or viral hepatitis, diagnosis?

A

NASH, NAFL

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7
Q

See a picture of someone’s eye and the vignette is about cirrhosis, diagnosis and next step?

A

Wilson’s disease, get a urinary copper

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8
Q

Serology associated with Primary Sclerosing Cholangitis, diagnosis?

A

p-ANCA

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9
Q

Treatment for Hemochromatosis (before cirrhosis)

A

Phlebotomy or Deferoxamine/Deferasirox

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10
Q

What is the diagnostic step for primary biliary cirrhosis?

A

Biopsy only (Microductal intrahepatic disease)

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11
Q

Flapping tremor, altered mental status, cirrhosis, diagnosis and next step?

A

Hepatic Encephalopathy, asterixis, give lactulose

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12
Q

How do you diagnose Hepatocellular Carcinoma?

A

Triple Phase CT Scan (NOT a biopsy)

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13
Q

How do you treat Spontaneous Bacterial Peritonitis?

A

Ceftriaxone

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14
Q

Paracentesis is done and there are 1000 white cells, 75% white blood cells, what is it?

A

Spontaneous bacterial peritonitis

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15
Q

Prophylaxis for Spontaneous bacterial peritonitis?

A

Fluoroquinolone

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16
Q

Screening for Hepatocellular Carcinoma?

A

Ultrasound and AFP q6 months

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17
Q

You do a large volume paracentesis, what should you do immediately after?

A

IV albumin

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18
Q

First step in a GI Bleed?

A

2 large bore IVs - manage the ABCs

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19
Q

Superficial mucosal tear, self limiting GI bleed, diagnosis?

A

Mallory-Weiss

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20
Q

There is a GI bleed not seen on endoscopy, and they require transfusions every 3 hours, diagnosis and treatment?

A

Brisk bleed, arteriogram

21
Q

There was a GI bleed last week and it stopped, EGD was negative, next step?

A

Colonoscopy

22
Q

There was a GI bleed two weeks ago, both the EGD and colonoscopy were negative, next step?

A

Pill-cam endoscopy

23
Q

Transmural tear, mediastinitis, diagnosis?

A

Boerhaave’s

24
Q

What do you add to the usual 5 things in gi bleed if they are cirrhotic?

A

Octreotide (for varices) and Ceftriaxone (for SBP prophylaxis)

25
Q

What FIVE things do you do for someone with a GI bleed?

A

2 large bore IVs, IV fluids, type and cross, call GI, IV PPI

26
Q

What is the treatment of a peptic ulcer disease causing bleeding?

A

PPI

27
Q

You suspect Boerhaave’s, what’s the first step?

A

Gastrografin (usually it is barium)

28
Q

Currant jelly diarrhea in a child, pain relieved by knee-to-chest position. What’s the diagnosis?

A

Intussusception

29
Q

What is the treatment for Intussusception?

A

Air-enema

30
Q

What three things should you look for in a patient with necrotizing enterocolitis?

A

Intraventricular hemorrhage (ultrasound with Doppler), Retinopathy of prematurity (Ophtho exam), Bronchopulmonary Dysplasia

31
Q

X-ray findings in Necrotizing Enterocolitis?

A

Pneumatosis Intestinalis, air in the wall of the bowel

32
Q

Diagnostic step for a Meckel’s Diverticulum?

A

Technetium-99 scan (it won’t be called a Meckel’s scan)

33
Q

Painful bloody bowel movement in a child, relieved by knee-chest position - diagnosis?

A

Intussusception

34
Q

Sausage-shaped mass and currant-jelly diarrhea - diagnosis?

A

Intussusception

35
Q

What do you do about an anal fissure in a child?

A

Treat constipation if present. Check for IBD if older child.

36
Q

What do you get if you’re worried about a GI bleed in a healthy term neonate right after delivery?

A

Apt Test

37
Q

What test do you do to investigate Intussusception?

A

Air Enema

38
Q

What are the imaging keywords you’re looking for to diagnose necrotizing enterocolitis?

A

Pneumatosis Intestinalis (air in the wall of the bowel)

39
Q

You’re worried about a GI bleed in a premature neonate, what do you get?

A

X-ray

40
Q

Epigastric pain boring to the back, better with leaning forward, diagnosis?

A

Pancreatitis

41
Q

Flank ecchymosis and pancreatitis, diagnosis?

A

Grey-Turner Sign

42
Q

How do you diagnose acute pancreatitis?

A

Lipase

43
Q

How do you manage a pancreatic pseudocyst?

A

6cm and 6 weeks, if > drain, if < watch

44
Q

How do you treat Pancreatitis?

A

NPO, IVF, Pain control

45
Q

Two most common causes of pancreatitis?

A

Alcohol and Gallstones

46
Q

Umbilical ecchymosis and pancreatitis, look for what sign?

A

Cullen’s

47
Q

What is the treatment of gallstone pancreatitis?

A

ERCP

48
Q

When do you get a CT scan in pancreatitis?

A

When you’re really sure it is pancreatitis, but Lipase is normal

49
Q

When do you give antibiotics to pancreatitis?

A

Meropenem if an FNA / Biopsy grows an organism

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