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#4 EOR General Surgery > PANCE Pearls > Flashcards

PANCE Pearls Flashcards

1
Q

Anti-motility drug tx types:

A

1-Bismuth subsalicylates:
2-Opioid Agonists:
3-Anticholinergics:

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2
Q

Bismuth subsalicylates: 2

A

1- PEPTO-BISMOL

2-KAOPECTATE

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3
Q

Opioid Agonists: 2

A

1- IMMODIUM
• Loperamide
• Inhibits peristalsis and increases anal sphincter tone
• Avoid in acute dysentery (bloody stools, fever)
2- LOMOTIL
• Diphenoxylate/atropine
• Inhibits peristalsis

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4
Q

Anticholinergics: 1

A

DONNATOL
• Phenobarbital/atropine/hyoscyamine/scopolamine
—Antispasmodic and slows down GI motility

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5
Q

Anti-emetic drug tx types:

A

1-Block Serotonin (5-HT3)- PNS & CNS

2-Block Dopamine- CNS only

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6
Q

Serotonin Receptor Antagonists: 3

A

Ondansetron (Zofran)
Granisetron
Dolasetron

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7
Q

Dopamine Receptor Antagonists: 3

A

1- Prochlorperazine (compazine)
2- Promethazine (phenergan)
3- Metoclopramide (reglan)
Also, Prokinetic

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8
Q

S. Aureus food sources: (4)

A
  • eggs
  • mayo
  • dairy products
  • meats
  • short incubation period: ~6 hr
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9
Q

Bacillus cereus food sources:

A
  • fried rice

* short incubation period: ~6 hr

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10
Q

Raw shellfish ingested from the gulf of mexico should make you consider these organisms in gastroenteritis etiology: 2

A

V. parahemolyticus and V. vulnificus

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11
Q

V. vulnificus SXS MC:

A

bacteremia and cellulitis

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12
Q

MC non-foodborne bacterial cause of gastroenteritis in U.S.

A

C. jejuni (2/2 GBS w. undercooked poultry)

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13
Q

MC cause on foodborne, bacterial gastroenteritis in U.S.

A

Salmonella

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14
Q

avoid these drugs in enterohemorrhagic e. coli due to this complication:

A

abx; HUS

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15
Q

these diarrheal syndromes may have sxs that mimic acute apendicitis: 2

A 
C. jejuni
Yersinia enterocolitica (also mesenteric adenitis and gaurding)
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16
Q

salmonella MC sources: 2

A
  • poultry (dairy, meat, eggs)

- exotic animals (reptiles– turtle)

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17
Q

blanching rose spots, intractable fever, pea soups stools and bradycardia are characteristic of this diarrheal dz:

A

Typhoid (enteric) fever 2/2 S. typhi

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18
Q

DX Sigmoidoscopy in shigella reveals:

A

punctate areas of ulcerations

also, WBC >50k

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19
Q

what is the main complication in Shigella enteritis in children that HCP should monitor for?

A

febrile SZ

20
Q

enterohemorrhagic e. coli MC sources: 4

A
  • undercooked ground beef
  • unpasteurized milk/apple cider
  • contaminated water
  • daycare centers
21
Q

frothy, greasy and foul diarrhea is seen with this organism:

A

G. lamblia

22
Q

G. lamblia tx in adults and kids:

A

adults: metro
kids: furazolidone

23
Q

MC cause of chronic diarrhea in pts with AIDS:

A

Cryptosporidium

24
Q

How do you dx Whipple’s dz?

A

duodenal bx and periodic acid-schiff testiing- positive macrophages, non-acid fast bacilli, dilated lacteals

25
Q

How do you tx Whipple’s dz?

A

penicillin* or tetracycline 1-2 yrs

26
Q

Foods high in phenylalanine: 9

A 
1- aspartame (diet sodas)
2- chicken
3- cheese
4- eggs
5- fish
6- legumes
7- meats
8- milk
9- nuts
27
Q

chronic anal fissures can reveal this on PE:

A

skin tags

28
Q

anal fissures MC occur at this site:

A

posterior midline

29
Q

anal fissures tx:

A

1- supportive: WASH (mc resolve spontaneously)

2- ntg topically/nifedipine ointment

30
Q

obturator hernia RF: 2

A
  • multiparous women

- women with significant weight loss

31
Q

CRC factors ass. with worse prognosis: 2

A

preop CEA >5

ulcerative patterns

32
Q

MC cause of LBO in adults

A

CRC

33
Q

MC CRC mets site

A

Liver (then lungs, lymph nodes)

34
Q

screening recommendations for CRC: avg risk vs first degree relative

A

avg risk–> initiate screening @ 50 y.o w. annual FOB and q10 yrs colonoscopy
CRC in first degree relative with dx >60 y.o.–>
annual FOB at 40 yo and q10 yr colonoscopy
CRC in first degree relative with dx <60 y.o.–>
annual FOB at 40 yo and q5 yr colonoscopy

35
Q

Crohn dx test of choice in acute dz:

A

upper GI serious with small bowel follow through

36
Q

UC dx test of choice in acute dz:

A

Flex sig (colonoscopy CI in acute dysentery 2/2 perforation risk and BE CI acute colitis 2/2 TM risk)

37
Q

IBD MC affects this population and age:

A

caucasians, 15-35 yo

38
Q

MC etiology of AMI:

A

occlusive: emboli (a. fib/MI) or thrombus (atherosclerosis)

39
Q

MC etiology of SBO

A 
1- post surgical adhesions (60%)
2- incarcerated hernias
3- crohns
4- cancer
5- intussception
40
Q

MC etiology of LBO

A

malignancy

41
Q

TX nonstrangulated SBO:

A

NPO, IVF, and bowel decompression (NG tube)

42
Q

TX strangulated SBO:

A

surgical intervention

43
Q

Celiac Dz (Sprue) MC affects:

A

females of european descent (finnish/irish)

44
Q

PE in a pt with celiac dz may show:

A

GI: diarrhea, malabsorption, bloating, steatorrhea, abd pain
Skin: dermatitis herpetiformis– itchy rash on extensor surfaces (neck, trunk, and scalp)

45
Q

celiac dz dx:

A
  • endomysial IgA* Ab and transglutaminase Ab*

- Definitive DX: small bowel bx

46
Q

celiac dz tx: 3

A

1- gluten free diet– no wheat, rye, barley (oats, rice and corn okay)
2- vitamin supplements
3- steroids if refractory

#4 EOR General Surgery (6 decks)

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