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AMC MCQ - Key points > Pediatrics > Flashcards

Pediatrics Flashcards

1
Q

Describe the causes of hematemesis mentioned in the content.

A

Causes include peptic ulcer (most common cause), reflux esophagitis, esophageal varices, Mallory-Weis tear, and esophageal and gastric cancer.

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2
Q

What is the first step in fluid resuscitation according to the content?

A

The first step is nfluid resuscitation.

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3
Q

Define Congenital Hypertrophic Pyloric Stenosis (CHPS) based on the content.

A

CHPS is characterized by hypertrophy of the pyloric muscles and typically affects male infants, usually the first born.

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4
Q

How is CHPS diagnosed clinically according to the content?

A

CHPS is diagnosed based on symptoms starting at 6 weeks to 2 months of age, non-bilious vomiting, weight loss, dehydration, and the presence of an olive-like mass on examination.

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5
Q

What is the significance of a positive feeding test in CHPS diagnosis as per the content?

A

If the feeding test is positive, no further tests are needed for CHPS diagnosis.

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6
Q

Describe the first step in treating dehydration and electrolyte disturbance.

A

The first step is to correct dehydration and electrolyte disturbance.

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7
Q

What is the initial treatment for CHPS (Congenital Hypertrophic Pyloric Stenosis) and GERD (Gastroesophageal Reflux Disease)?

A

Resusciation

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8
Q

Differentiate between CHPS and GERD in terms of occurrence time and symptoms.

A

CHPS occurs between 6 weeks to 2 years after birth, associated with severe weight loss and dehydration. GERD can occur at any time and is not necessarily linked to weight loss.

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9
Q

What is the most common cause of acquired pyloric stenosis?

A

A fibrosed peptic ulcer is the most common cause.

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10
Q

What is the important timing of vomiting in cases of recurrent vomiting?

A

Vomiting typically occurs 1 hour after meals.

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11
Q

What is the significant sign seen in cases of dilated stomach on X-ray?

A

A succession splash is an important sign.

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12
Q

How is acquired pyloric stenosis typically treated?
Investigation and treatment

A

 First: Palpation during test feed
 USG
 FBE, electrolytes, ABGs.

 Shock: NS 20 ml/kg
 IV Fluid replacement: 0.45% NS + 5% Dextrose
 Potassium replacement once baby passes urine (KCl)
 Surgery: Refer for Pyloromyotomy
 Good prognosis

.

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13
Q

Describe a peptic ulcer.

A

A peptic ulcer is a sore that forms on the lining of the stomach, small intestine, or esophagus.

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14
Q

What are the risk factors for peptic ulcers?

A

Risk factors include Helicobacter pylori infection (main cause), smoking, alcohol consumption, stress, and the use of NSAIDs.

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15
Q

What are the common symptoms of a peptic ulcer?

A

Common symptoms include epigastric pain, nausea, vomiting, and iron deficiency anemia.

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16
Q

How is a peptic ulcer diagnosed?

A

A peptic ulcer is diagnosed through endoscopy and biopsy.

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17
Q

What is the main cause of peptic ulcers?

A

The main cause of peptic ulcers is Helicobacter pylori infection, accounting for 70% of cases.

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18
Q

What is the treatment for eradicating Helicobacter pylori in peptic ulcers?

A

The treatment for eradicating Helicobacter pylori in peptic ulcers involves a specific regimen of antibiotics and acid-suppressing medications.

PPI+Amoxi+Clarythro. If penicillin allergy: PPI+Metro+Clarythro. - Post-tx you do Urea breath test 4 weeks after starting tx.

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19
Q

Describe the components of triple therapy mentioned in the content.

A

The components are amoxicillin, omeprazole, and metronidazole.

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20
Q

What is the most common cause of failure of triple therapy according to the content?

A

High resistance to metronidazole.

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21
Q

How should a confused patient with a bleeding peptic ulcer be managed according to the content?

A

Intubate first.
inject adrenaline and omeprazole

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22
Q

Define the optimum course of therapy for peptic ulcers as per the content.

A

PPI AMOX CLATH
METRO

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23
Q

What is the first step in managing a perforated peptic ulcer based on the content?

A

Perform an X-ray to check for free air under the diaphragm.

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24
Q

Describe dumping syndrome

A

Dumping syndrome is a complication of gastric surgery characterized by symptoms such as bloating, weakness, and diarrhea occurring within 30 minutes after eating.

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25
Q

What are the symptoms of dumping syndrome following meals?

A

Following meals, symptoms of dumping syndrome include gastrointestinal symptoms like fullness, pain, nausea, and diarrhea, as well as vasomotor symptoms like flushing.

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26
Q

Explain the mechanism of dumping syndrome

A

The mechanism of dumping syndrome involves hypovolemia within the first hour of eating, leading to early dumping, and hypoglycemia 3 hours after eating, resulting in late dumping.

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27
Q

How is dumping syndrome treated?

A

Dumping syndrome is treated by consuming frequent small meals that are rich in protein and fat while being low in carbohydrates.

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28
Q

Describe what a band slip is in the context of gastric band complications.

A

A band slip occurs when the stomach below the band moves up or prolapses through the band, leading to symptoms like heartburn, pain when eating solid food, vomiting, night cough, chest pain, or pressure.

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29
Q

What are some symptoms of a band slip in gastric band complications?

A

Symptoms include severe heartburn or reflux (GERD), pain when eating solid food, vomiting with solid foods, night cough, chest pain, or pressure.

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30
Q

How is a band slip diagnosed in gastric band complications?investigtion

A

A band slip is diagnosed through an investigation like a barium meal, which is considered very important.

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31
Q

What is the definitive management for a band slip in gastric band complications?

A

The definitive management for a band slip is surgery.

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32
Q

What are the steps in managing esophageal varices if not bleeding?

A

If esophageal varices are not bleeding, ligation is performed.

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33
Q

What is the priority in managing esophageal varices with bleeding?

A

In managing esophageal varices with bleeding, fluid resuscitation is a priority.

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34
Q

How can bleeding from esophageal varices be stopped?

A

To stop bleeding from esophageal varices, fresh frozen plasma is used.

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35
Q

What is the intervention for very low hemoglobin levels in the context of esophageal varices?

A

For very low hemoglobin levels, packed red blood cells are administered.

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36
Q

Describe the management of perianal hematoma within the first 24 hours.

A

Simple aspiration under local anesthesia.

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37
Q

What is the recommended management for perianal hematoma between 5 days and 24 hours?

A

Incision under local anesthesia.

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38
Q

How should perianal hematoma be managed if it does not resolve spontaneously after more than 5 days?

A

Surgical intervention.

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39
Q

Define piles and perianal hematoma.

A

Piles are swollen blood vessels in the rectum or anus, while perianal hematoma is a collection of blood outside the blood vessels near the anus.

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40
Q

What are the common causes of piles?

A

Constipation and pregnancy.

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41
Q

What is a key symptom of perianal hematoma?

A

Painful anus.

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42
Q

What is the recommended approach to differentiate between piles and perianal hematoma in images?

A

Look at the clinical scenario for pain; perianal hematoma is painful, while piles are painless.

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43
Q

Describe the management approach for piles.

A

Diet modification and band ligation for mild cases, while severe cases may require surgery.

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44
Q

What diagnostic procedure is recommended for piles in older individuals?

A

Colonoscopy to exclude cancer.

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45
Q

What is a potential complication of piles?

A

Bleeding.

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46
Q

What is the significance of diet in managing piles?

A

It plays a crucial role in the treatment approach.

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47
Q

What is the primary symptom associated with perianal hematoma?

A

Pain in the anal region.

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48
Q

Describe pilonidal sinus.

A

Pilonidal sinus typically presents in young males with dark, dense hair. It is usually asymptomatic or may have discharge.

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49
Q

What is the recommended treatment for pilonidal sinus?

A

Radical excision is the highly important treatment for pilonidal sinus.

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50
Q

Explain anal fistula.

A

Anal fistula is commonly caused by abscesses. Perianal fistula is associated with Crohn’s disease. Low-lying or multiple fistulae can lead to recurrent malignancy.

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51
Q

What are the clinical manifestations of rectovaginal fistula?

A

Rectovaginal fistula presents with persistent purulent discharge.

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52
Q

What are the main investigations for anal fistula?

A

Proctoscopy and fistulography are the main investigations for anal fistula.

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53
Q

How is anal fistula typically treated?

A

Anal fistula is usually managed with staged operations.

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54
Q

Describe the etiology of anal fissure.

A

Causes of anal fissure include constipation, Crohn’s disease, and multiple other factors.

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55
Q

How is an anal fissure typically diagnosed?

A

An anal fissure is usually diagnosed through inspection, with symptoms like slight bleeding and pain.

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56
Q

What is contraindicated in acute anal fissure examination?

A

Digital rectal examination (DRE) is contraindicated in acute anal fissure.

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57
Q

What are some treatment options for anal fissure?

A

Treatment options include increasing fluid and vegetable intake in the diet, using local anesthesia with corticosteroid cream, applying ointments like Glyceride Trinit, and lateral sphincterectomy in chronic cases.

The treatment options for anal fissure according to RACGP guidelines include:

  1. Conservative Management:
    • Dietary Modification: Increasing dietary fiber intake and ensuring adequate hydration to soften stools and reduce straining.
    • Stool Softeners: Using stool softeners or bulk-forming agents like psyllium to ease bowel movements.
  2. Topical Treatments:
    • Topical Nitrates: Applying nitroglycerin ointment to relax the anal sphincter and improve blood flow to the fissure.
    • Calcium Channel Blockers: Topical diltiazem or nifedipine can also help relax the anal sphincter and promote healing.
    • Local Anesthetics: Using topical anesthetic creams to relieve pain and discomfort.
  3. Botulinum Toxin Injection:
    • Botulinum toxin (Botox) can be injected into the anal sphincter to reduce muscle spasm and pain, facilitating the healing process.
  4. Surgical Options:
    • Lateral Internal Sphincterotomy: This surgical procedure involves cutting a small portion of the internal anal sphincter muscle to reduce spasm and pain, promoting healing.
    • Fissurectomy: Removal of the fissure and surrounding scar tissue, usually considered when other treatments fail.

These treatments aim to alleviate symptoms, promote healing, and prevent recurrence of anal fissures.

For more detailed information, refer to the RACGP guidelines on managing anal fissures. Additional resources and treatment options can be found in the RACGP guidelines.

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58
Q

What is the most common cause of bleeding per rectum in infancy?

A

Anal fissure is the most common cause of bleeding per rectum in infancy.

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59
Q

What is the most common cause of piles and fissure overall?

A

The most common causes of piles (hemorrhoids) and anal fissures are related to bowel habits and diet. For hemorrhoids, the primary cause is constipation, often due to a low-fiber diet and insufficient water intake, leading to straining during bowel movements. For anal fissures, the main cause is trauma to the anal canal, typically from passing hard or large stools, which can result from similar dietary issues or chronic constipation.

For more detailed information, you can refer to the RACGP guidelines on anorectal conditions here.

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60
Q

Describe upper gastrointestinal bleeding.

A

It is a common condition in adults, with the most frequent cause being mentioned.

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61
Q

What is diverticulosis and who does it commonly affect?

A

It is a condition most common in old age.

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62
Q

What is the importance of excluding colon cancer in the elderly?

A

It is crucial to rule out colon cancer in the elderly.

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63
Q

What is the likely diagnosis when there is bleeding per rectum and atrial fibrillation?

A

Ischemic colitis is a possible diagnosis.

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64
Q

What is the initial step in the treatment of upper gastrointestinal bleeding?

A

Fluid resuscitation is the first step.

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65
Q

Define normal saline.

A

It is a type of fluid used in resuscitation.

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66
Q

When blood is needed, what type of blood product is typically given?

A

RH-negative packed red blood cells are usually administered.

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67
Q

What is the purpose of a colonoscopy in this context?

A

It is used for investigation.

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68
Q

How does an isotope scan assist in the assessment of bleeding?

A

It helps determine the site of bleeding.

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69
Q

What is the next step if colonoscopy and endoscopy fail to reveal the source of bleeding in a patient with melena?

A

Capsule endoscopy is the next step.

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70
Q

What is the initial approach when dealing with rectal bleeding in the elderly until colonoscopy confirms otherwise?

A

Assume it is colon cancer until proven otherwise.

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71
Q

What is a common predisposing factor for hernias?

A

Constipation and chronic cough are common predisposing factors.

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72
Q

Describe hernia.

A

It is the protrusion of a viscus through a defect.

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73
Q

What is the note regarding most cases of rectal bleeding in relation to spontaneous cessation?

A

Most cases of rectal bleeding will stop spontaneously by the time of resuscitation.

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74
Q

Describe a femoral hernia.

A

A femoral hernia is a type of hernia that occurs in multiparous females. It is located below the inguinal ligaments, medial to the femoral vessel, and lateral to the pubic tubercle.

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75
Q

What is the most common cause of intestinal obstruction related to hernias?

A

The most common cause of intestinal obstruction related to hernias is femoral hernia.

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76
Q

How can you suspect a complicated hernia?

A

You can suspect a complicated hernia if there is no impulse of cough and if the patient shows symptoms of intestinal obstruction such as vomiting, constipation, and abdominal distention.

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77
Q

What is the imaging modality of choice for investigating intestinal obstruction?

A

X-ray is the imaging modality of choice for investigating intestinal obstruction.

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78
Q

What is the treatment of choice for a complicated hernia?

A

Surgery is the treatment of choice for a complicated hernia.

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79
Q

Describe an incisional hernia.

A

An incisional hernia is a type of hernia caused by an incompletely-healed surgical wound.

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80
Q

What is the most common predisposing factor for incisional hernias?

A

Hematoma is the most common predisposing factor for incisional hernias.

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81
Q

What are the common presenting symptoms of an incisional hernia?

A

Common symptoms include swelling along with a scar.

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82
Q

How should a patient with a suspected incisional hernia be examined?

A

The patient should be examined while standing and asked to cough.

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83
Q

What is the recommended treatment for incisional hernias?

A

Surgery is the recommended treatment for incisional hernias.

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84
Q

What is the management approach for inguinal hernias in pediatric patients with obstruction or strangulation?

A

Immediate surgery is required.

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85
Q

When should surgery be performed for irreducible inguinal hernias in pediatric patients?

A

Surgery should be done as soon as possible.

86
Q

Describe the ‘Rule of 6-2’ for reducible inguinal hernias in pediatric patients based on age.

A

For birth to 6 weeks, surgery should be done in 2 days; for 6 weeks to 6 months, surgery in 2 weeks; for over 6 months, surgery in 2 months.

87
Q

What condition should be excluded in infants with inguinal hernias?

A

Congenital hypothyroidism should be excluded in infants with inguinal hernias.

88
Q

Describe when surgery is recommended for an umbilical hernia.

A

Surgery is recommended for an umbilical hernia in individuals older than 4 years.

89
Q

How can divarication of recti (diastasis recti) be observed?

A

Divarication of recti can be observed by raising up without support.

90
Q

What is the treatment for mild cases of divarication of recti?

A

Physiotherapy is the treatment for mild cases of divarication of recti.

91
Q

What is the treatment for severe cases of divarication of recti?

A

Surgery is the treatment for severe cases of divarication of recti.

92
Q

Describe the first aid management for corrosive injury of the esophagus.

A

Includes avoiding the use of milk, contraindicating gastric lavage, and administering analgesics, cortisone, and antibiotics. Endoscopy is crucial.

93
Q

What is Achalasia and its cause?

A

Achalasia is characterized by the lack of relaxation of the lower esophageal sphincter. It leads to difficulty in swallowing.

94
Q

How is Achalasia diagnosed and what are its common symptoms?

A

Diagnosis involves manometric studies to assess weak peristaltic waves and a dilated esophagus. Symptoms include dysphagia, regurgitation, foul-smelling breath, and a higher risk of aspiration pneumonia.

95
Q

Define the importance of endoscopy in the management of esophageal conditions.

A

Endoscopy is crucial for diagnosing and monitoring esophageal issues, allowing direct visualization of the esophagus and potential abnormalities.

96
Q

What is the significance of timing in performing endoscopy for esophageal conditions?

A

Performing endoscopy within 24 hours of symptom onset is crucial for timely diagnosis and intervention.

97
Q

What are dilators used for in the context of esophageal conditions?

A

Dilators are used for long-term management of conditions like Achalasia to help widen the esophagus and improve swallowing.

98
Q

Describe the characteristics of esophageal manometric studies.

A

Esophageal manometric studies assess the strength of peristaltic waves in the esophagus, helping to diagnose conditions like Achalasia.

99
Q

Explain the role of barium enema in diagnosing esophageal conditions.

A

Barium enema can help identify abnormalities like a dilated esophagus, aiding in the diagnosis and management of esophageal issues.

100
Q

Describe Heller’s operation.

A

Heller’s operation is a surgical procedure used to treat achalasia, a condition where the lower esophageal sphincter fails to relax properly, causing difficulty in swallowing.

101
Q

What are the treatment options for esophageal spasm?

A

Treatment options for esophageal spasm include botulinum toxin injection, use of dilators, and medications like nitroglycerine, calcium channel blockers, and proton pump inhibitors.

102
Q

Define eosinophilic esophagitis.

A

Eosinophilic esophagitis is an allergic inflammatory condition of the esophagus caused by food allergies, characterized by symptoms like swallowing difficulty, food impaction, and heartburn.

103
Q

How is eosinophilic esophagitis diagnosed?

A

Eosinophilic esophagitis is diagnosed through endoscopic examination which may reveal ridges, furrows, or rings in the esophagus.

104
Q

Describe the pathophysiology of eosinophilic esophagitis.

A

The pathophysiology of eosinophilic esophagitis involves infiltration of the esophagus by eosinophils, which are a type of white blood cell associated with allergic reactions.

105
Q

What are some associations of eosinophilic esophagitis?

A

Eosinophilic esophagitis is associated with autoimmune and allergic diseases such as asthma and celiac disease.

106
Q

Describe the treatment options for the condition mentioned in the content.

A

Treatment includes dietary modification to exclude food allergens, corticosteroids, and other anti-inflammatories as first-line medical therapy, and mechanical dilatation in severe cases.

107
Q

What is a common symptom associated with Hiatus Hernia according to the content?

A

Retrosternal discomfort with regurgitation.

108
Q

What diagnostic method is considered the best according to the content for the condition mentioned?

A

24-hour pH monitoring.

109
Q

How is Hiatus Hernia mainly managed according to the content?

A

Mainly conservatively, with a focus on reduction of body weight.

110
Q

Define Hiatus Hernia.

A

It is a condition where a part of the stomach pushes up into the chest cavity through an opening in the diaphragm.

111
Q

What is the first-line medical therapy mentioned for the condition in the content?

A

Corticosteroids and other anti-inflammatories.

112
Q

What is recommended in severe cases of the condition mentioned in the content?

A

Endoscopy.

113
Q

What are some symptoms associated with Hiatus Hernia as per the content?

A

Dysphagia, bleeding, and aspiration.

114
Q

Describe the management strategies for GERD, including elevation of the head of the bed and frequent small meals.

A

Management strategies for GERD include elevating the head of the bed and having frequent small meals.

115
Q

What are the recommended drugs for treating GERD, aside from PPIs?

A

Recommended drugs for treating GERD include H2 blockers and antacids.

116
Q

How is esophageal hernia typically managed in severe cases?

A

Esophageal hernia is typically managed with surgery in severe cases.

117
Q

Define intermittent dysphagia and postprandial pain in the context of esophageal hernia.

A

Intermittent dysphagia refers to occasional difficulty swallowing, while postprandial pain occurs after eating.

118
Q

What are the common symptoms associated with pressure on the heart in esophageal hernia?

A

Common symptoms of pressure on the heart in esophageal hernia include cardiac symptoms.

119
Q

What is the most common type of esophageal hernia?

A

The most common type of esophageal hernia is sliding hernia.

120
Q

Describe the main treatment approach for sliding hernia.

A

The main treatment approach for sliding hernia is conservative management.

121
Q

How is paraesophageal hernia typically treated?

A

Paraesophageal hernia is typically treated with surgery.

122
Q

What is the best treatment for GERD?

A

The best treatment for GERD is PPI (Proton Pump Inhibitors).

123
Q

What is the best medical treatment for sliding hernia?

A

The best medical treatment for sliding hernia is PPI (Proton Pump Inhibitors).

124
Q

Describe the characteristics of esophageal stricture in individuals with a history of prolonged GERD syndrome.

A

Esophageal stricture in individuals with a history of prolonged GERD syndrome presents with dysphagia but no longer GERD symptoms.

125
Q

Describe the importance of Barrett’s esophagus in the provided content.

A

Barrett’s esophagus is highlighted as very important due to its association with long-standing GERD and the increased risk of developing adenocarcinoma of the esophagus.

126
Q

What is recommended if metaplasia is found during biopsy in Barrett’s esophagus?

A

If metaplasia is found during biopsy, it is recommended to repeat endoscopy every 6 months.

127
Q

What is the suggested course of action if low-grade dysplasia is detected in Barrett’s esophagus?

A

If low-grade dysplasia is detected, ablation or surgery may be considered.

128
Q

What is the management strategy for high-grade dysplasia in Barrett’s esophagus?

A

For high-grade dysplasia, ablation or surgery is highly recommended.

129
Q

Define the role of PPIs in the context of Barrett’s esophagus.

A

Proton pump inhibitors (PPIs) are crucial for managing Barrett’s esophagus and are considered the best treatment option.

130
Q

Describe the most common type of malignancy in the esophagus.

A

Squamous cell carcinoma (SCC) is the most common type of malignancy in the esophagus.

131
Q

What are the risk factors associated with esophageal cancer, particularly squamous cell carcinoma (SCC)?

A

Smoking and alcohol consumption are the primary risk factors for SCC of the esophagus.

132
Q

Define Mallory-Weiss syndrome.

A

Mallory-Weiss syndrome is characterized by partial tears or lacerations in the esophagus, often caused by severe vomiting or retching.

133
Q

How is Boerhaave syndrome characterized?

A

Boerhaave syndrome involves a full-thickness tear or rupture of the esophageal wall, typically caused by severe vomiting or retching.

134
Q

What is the definitive diagnostic method for esophageal cancer?

A

Endoscopy is the definitive diagnostic method for esophageal cancer.

135
Q

What are the common symptoms associated with esophageal cancer?

A

Symptoms may include dysphagia (difficulty swallowing), weight loss, and vomiting blood.

136
Q

Describe the treatment approach for esophageal cancer.

A

Treatment may involve supportive care, cauterization, or injection of epinephrine to stop bleeding.

137
Q

What is the location of squamous cell carcinoma (SCC) in the esophagus typically found?

A

SCC is commonly found in the middle third of the esophagus.

138
Q

How is palliative treatment typically approached in early cases of esophageal cancer?

A

In early cases, palliative treatment may involve surgery.

139
Q

What are some common causes of esophageal lacerations or tears?

A

Causes may include severe vomiting, coughing, retching, and alcoholism.

140
Q

Describe Familial Polyposis Coli-1

A

An autosomal dominant genetic condition where the colon and rectum are filled with polyps, with a 100% risk of developing cancer.

141
Q

What is the fate of individuals with Familial Polyposis Coli-1?

A

Individuals with this condition usually develop cancer by the age of 10-15 years.

142
Q

How is Familial Polyposis Coli-1 treated?

A

Surgery is the recommended treatment once polyps start to appear.

143
Q

Define Gardner syndrome

A

A variant of Familial Polyposis Coli-1 characterized by desmoid tumors, osteomas, and epidermoid cysts.

144
Q

Describe Peutz Jegher’s syndrome

A

A condition characterized by mucocutaneous pigmentation and an increased future risk of colon cancer.

145
Q

What is the risk associated with Juvenile Polyposis?

A

Solitary polyps pose no risk of cancer but may lead to bleeding.

146
Q

Describe the risk of cancer associated with having multiple polyps greater than 5.

A

Having multiple polyps greater than 5 carries a 10% risk of cancer.

147
Q

What are some risk factors for colon cancer according to the content?

A

Risk factors include Ulcerative Colitis, Familial Adenomatous Polyposis, Colonic Adenomas, and a low-fiber diet.

148
Q

What are some common symptoms of colon cancer mentioned in the content?

A

Common symptoms include iron deficiency anemia, altered bowel habits, complete bowel obstruction, bleeding, dyspepsia, abdominal mass, abdominal pain, rectal bleeding, tenesmus, and fatigue.

149
Q

Define villous adenoma and tubular adenoma in the context of malignant potential.

A

Villous adenomas have a higher malignant potential compared to tubular adenomas.

150
Q

How does the risk of colon cancer vary between males and females according to the content?

A

The risk of colon cancer is higher in males compared to females.

151
Q

What is the most common symptom of cancer in the cecum according to the content?

A

Bleeding is the most common symptom of cancer in the cecum.

152
Q

What is the most common symptom of cancer in the rectum according to the content?

A

Rectal bleeding is the most common symptom of cancer in the rectum.

153
Q

Describe the most common symptom of colon cancer in the left colon.

A

Alteration in bowel habits.

154
Q

What is the apple core appearance seen in X-ray indicative of?

A

Colon cancer.

155
Q

What is the investigation of choice for colon cancer?

A

Colonoscopy.

156
Q

What is the first step if a Fecal Occult Blood Test (FOBT) is positive?

A

Colonoscopy.

157
Q

If a patient above 50 presents with iron deficiency anemia, what should be suspected until proven otherwise?

A

Colon cancer.

158
Q

What is the recommended screening frequency for colon cancer recurrence after surgery?

A

Every year.

159
Q

What is the preferred treatment before surgery for colon cancer?

A

Preoperative chemo and radiotherapy.

160
Q

What treatment is recommended after surgery for colon cancer?

A

Postoperative chemotherapy only.

161
Q

How should colonoscopy be initiated in high-risk individuals for colon cancer?

A

From the beginning.

162
Q

What should be given in case of colon cancer?

A

Chemotherapy and radiotherapy.

163
Q

What is the abbreviation for Fecal Occult Blood Test?

A

FOBT.

164
Q

What does CEA stand for in the context of colon cancer?

A

Carcinoembryonic antigen.

165
Q

What is the significance of CEA in colon cancer monitoring?

A

Screening for recurrence.

166
Q

Describe the location commonly affected by diverticular disease.

A

Diverticular disease typically affects the sigmoid colon.

167
Q

What is a key characteristic of diverticular disease in relation to the rectum?

A

The rectum is never affected by diverticular disease.

168
Q

Define the term ‘premalignant’ in the context of diverticular disease.

A

Diverticular disease is not premalignant.

169
Q

What are some common symptoms of diverticular disease in the acute stage?

A

Symptoms may include fever, pain in the left iliac fossa, and bleeding.

170
Q

What is a potential complication of diverticular disease involving the rectum?

A

A mass may develop in the left iliac fossa in chronic cases.

171
Q

How is diverticular disease typically diagnosed in the acute stage?

A

Barium enema is considered the best diagnostic test, while CT scans are also used.

172
Q

What is the recommended treatment for diverticular disease?

A

High fiber diet and laxatives are often prescribed as conservative treatment.

173
Q

What is the course of action if perforation occurs in diverticular disease?

A

Surgery is usually required if perforation occurs.

174
Q

What demographic is most commonly affected by diverticular disease in terms of causing rectal bleeding?

A

The elderly are the most common demographic affected by diverticular disease causing rectal bleeding.

175
Q

Describe intestinal fistula causes

A

Mainly post-operative, others include Crohn’s disease

176
Q

What are the complications of intestinal fistula?

A

Electrolyte disturbances and skin irritation

177
Q

How is intestinal fistula mainly treated?

A

Surgery, rarely conservative management

178
Q

Describe irritable bowel syndrome characteristics

A

More common in young people, associated with stress, chronic abdominal pain, alternating constipation and diarrhea, ribbon-shaped stool

179
Q

What is the main line of treatment for irritable bowel syndrome?

A

High fiber diet

180
Q

What are some treatment options for irritable bowel syndrome symptoms?

A

Laxatives, spasmolytics for pain relief, SSRI (takes 2-4 weeks to work)

181
Q

Define dyspepsia

A

Functional pain with no organic lesion, characterized by abdominal discomfort, epigastric pain, fullness, bloating, heartburn, and nausea

182
Q

Describe the most common cause of bloody diarrhea

A

Campylobacter

183
Q

What is the second most common cause of bloody diarrhea?

A

Shigella

184
Q

What is the most common cause of traveler’s diarrhea?

A

E. coli

185
Q

What is the most common cause of diarrhea in pediatrics?

A

Viral infections

186
Q

What is the most common virus causing diarrhea in kids?

A

Rotavirus

187
Q

What condition is characterized by diarrhea followed by weakness and areflexia?

A

Guillain-Barre Syndrome (GBS)

188
Q

What condition is characterized by diarrhea followed by renal impairment?

A

Hemolytic Uremic Syndrome (HUS)

189
Q

What causes bloody diarrhea followed by right upper quadrant pain?

A

Ameba

190
Q

What parasite causes diarrhea after camping?

A

Giardia

191
Q

What condition presents with chronic bloody diarrhea in young males?

A

Irritable Bowel Syndrome (IBS)

192
Q

What is a common cause of diarrhea after long-term antibiotic use?

A

Clostridium difficile

193
Q

What antibiotic is known to cause Clostridium difficile infection?

A

Clindamycin

194
Q

How is Clostridium difficile infection treated?

A

Metronidazole or vancomycin

195
Q

What pathogen causes diarrhea after consuming eggs or chicken?

A

Salmonella

196
Q

What causes diarrhea shortly after a meal?

A

Staphylococcal toxin

197
Q

What condition presents with diarrhea in bedridden patients with constipation?

A

Fecal impaction

198
Q

What is the main treatment for diarrhea?

A

Fluid replacement

199
Q

How is traveler’s diarrhea typically treated?

A

Fluid replacement only

200
Q

How is Staphylococcal toxin-induced diarrhea treated?

A

Fluid replacement only

201
Q

How are Shigella or Campylobacter infections typically treated?

A

Antibiotics

202
Q

How are Ameba or Giardia infections typically treated?

A

Metronidazole

203
Q

Describe the organism responsible for Pseudomembranous colitis

A

Clostridium difficile

204
Q

What is the key factor in the development of Pseudomembranous colitis?

A

Prolonged use of antibiotics

205
Q

What is the most common antibiotic associated with Pseudomembranous colitis?

A

Clindamycin

206
Q

What are the signs and symptoms of Clostridium difficile infection?

A

Range from mild diarrhea to severe, life-threatening symptoms

207
Q

What type of analysis is typically done for diagnosing Clostridium difficile infection?

A

Stool analysis

208
Q

How are mild cases of Clostridium difficile infection usually managed?

A

No treatment

209
Q

Describe the use of metronidazole in treating Clostridium difficile infection.

A

Metronidazole is the initial drug of choice for mild to moderate disease.

210
Q

Describe the use of oral vancomycin in treating Clostridium difficile infection.

A

Oral vancomycin is preferred for more severe disease or if diarrhea persists after a course of metronidazole.

AMC MCQ - Key points (49 decks)

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