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GS Medbear > Pre-Pros MEQ prep > Flashcards

Pre-Pros MEQ prep Flashcards

1
Q

Mx of Intestinal Obstruction?

A

Stool culture/C. Diff (if 설사)
Daily AXR
Strict I/O charting
NBM, NGT, Rectal Tube

Treat underlying condition
Review meds
Replace electrolyte problems

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2
Q

1st line invx for acute appendicitis?

A

CTAP

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3
Q

Mx of appendicitis?

A

IV Ceftriaxone + Metronidazole
Symptomatic relief
NBM, IV hydration, electrolytes

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4
Q

Invx for achalasia?

A

Esophageal manometry
OGD

CXR
EUS
CT TAP

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5
Q

Mx of Achalasia?

A

Pneumatic balloon dilatation(1st line non-surgical tx)
Botulinum toxin endoscopic injection (Medical tx)
Heller Esophagomyotomy (Surgical tx)
Lifestyle e.g. Antacid, H2 receptor blockers, eat when sitting up, eat slowly, dont lie down after meals

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6
Q

Invx of GERD?

A

Ambulatory 24hr pH probe (GS)
OGD tro esophagitis, Barrett
Manometry (tro motility disorder)

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7
Q

Mx of GERD?

A

Lifestyle:
- weight loss
- cut 술, 카페인, 매운 맛, fatty foods
- Smoking cessation
- Elevate head when sleeping
- Dont lie down after eating

Meds:
PPIs
Antacids
H2 blockers

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8
Q

Prophylaxis for variceal bleeding?

A

Band ligation 3 weeks
+
Propranolol

If BB contraindicated, go for Isosorbide Mononitrate

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9
Q

Mx of active variceal bleed?

A

Resuscitation
Pharm: Abx, somatostatin, omeprazole, Vit K
Definitive tx is endoscopic variceal band ligation.

Ceftriaxone for abx

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10
Q

Therapeutic mx for active PUD bleeding?

A

Adrenaline injection + Clip/heater probe
through endoscope

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11
Q

Mx of uncomplicated PUD?

A

PPI + Clarithromycin + Metro/Amoxicillin for 10-14 days.
Re-scope in 6 weeks to document healing.

Dont forget lifestyle mx

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12
Q

Invx for ischemic colitis?

A

Endoscopy is GS.
AXR supine
CTAP with contrast (can localize site)

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13
Q

Mx of ischaemic colitis?

A

NBM, Analgesia, fluid hydration, abx
Consider NGT decompression

hydration is to optimize perfusion to ischemic colon

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14
Q

Imaging for Diverticulitis?

A

CTAP

Gold standard to diagnose + stage severity

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15
Q

Mx of uncomplicated diverticulitis?

A

NBM > liquid diet > high fibre low residue diet
Analgesia
IV Ceftriaxone & Metro 10-14d

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15
Q

Invx for Crohn’s disease?

A

Endoscopic + biopsy best
CT/MRI with contrast 2nd line

Look for non-caseating granulomas in colon

16
Q

Invx for ulcerative colitis?

A

flexible sigmoidoscopy + biopsy

Do not scope during acute flare - risk of perforation

17
Q

Mx of haemorrhoids?

A

Grade 1 = Lifestyle modi + stool softeners + daflon
Grade 2 = Above + Rubber band ligation
Grade 3 + 4 = Above + Haemorrhoidectomy

18
Q

Mx of anal fissure?

A

High fibre diet
Bulking agents
Stool softener
Warm sitz baths
Lidocaine jelly
Topical nifeidipine/diltiazem
GTN ointment

19
Q

Mx of anal fistulas?

A

Intersphincteric = Fistulotomy
Suprasphincteric = Fistulotomy / seton cutting
Trans-sphincteric = Seton / endorectal advancement flap / sphincter reconstruction
Extrasphincteric = Endorectal advancement flap / laparotomy

20
Q

Invx for anal fistulas?

A

Endoanal Ultrasound easiest
MRI is gold standard

CT / fistulography in emergency

21
Q

Mx for anal fistulas?

A

High fistula = require seton + endorectal advancement flap
Low fistula = Fistulotomy

Puborectalis is key to future continence

22
Q

Invx for acute pancreatitis?

A

US HBS 1st line
Erect CXR
Supine AXR
CTAP

23
Q

Mx of acute pancreatitis?

A

Fluid resus
Monitoring
Opioid analgesics
Enteral nutrition
IV Ceftriaxone/Metronidazole

NSAIDs banned cuz can worsen pancreatitis + cause renal failure

24
Q

Invx of chronic pancreatitis?

A

MRCP best
CT/MRI/US 2nd choice
Pancreatic Secretin Stimulation Test is GS but invasive

25
Q

Invx for gallstones?

A

US HBS 1st line
MRCP if pt doesnt need therapeutic intervention
ERCP if therapy needed
CTAP tro other differentials
Perc biliary drainage last resort

26
Q

Mx of cholecystitis?

A

Lap chole is definitive tx
Perc cholec

Keep NBM, IV Ceftriaxone + Metronidazole

27
Q

Imaging for choledocholithiasis?

A

US HBS 1st line
MRCP
ERCP
EUS

27
Q

Mx of choledocholithiasis?

A

Lap chole
**ERCP **with sphincterotomy

28
Q

Invx for urolithiasis?

A

CT KUB non contrast 1st line
KUB XR (usu for follow-up/screening)
US kidneys/bladder (evidence of stone/comp)

29
Q

Mx of urolithiasis?

A

<5mm can wash out.
Tamsulosin to relax ureter tone
Lower protein and salt intake
Surgical = Perc nephrolithotomy (PCNL) 1st line

ESWL not commonly done cuz too pain, and success rate not high

30
Q

Invx for prostatic cancer?

A

Prostate-specific Antigen
Trans-rectal Ultrasound with biopsy (TRUS)
MRI to stage

CT or MRI to stage? pls check

30
Q

Invx for testicular tumour?

A

Ultrasound scrotum to diagnose.
CT TAP for staging

Seminoma shows hypoechoic intratesticular mass.

Non-seminoma shows inhomogenous lesion e.g. teratoma

31
Q

Invx for hernia?

A

Dynamic Ultrasound if clinically inconclusive
AXR supine if suspect IO

GS Medbear (14 decks)

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