Rapid Fire Flashcards
Diagnosis & Treatment for Choldocholithiasis
ERCP
Diagnostic Test for Cholelithialiasis
Ultrasound
Charcot’s Triad (Fever, Jaundice, RUQ Pain)
Acute Cholangitis
Best test for Acute Cholecystitis
HIDA Scan (but usually NOT necessary)
Where do Gallbladder D/O radiate to?
Right Shoulder/Scapula
Charcot’s Triad + Altered Mental Status + Hypotension
Reynold’s Pentad
MCC = fecalith
Appendicitis
+ Psoas sign, +Obturator Sign; + Leukocytosis (10-20K)
Appendicitis
Lipase vs. Amylase… which is more sensitive for Pancreatitis?
Lipase
2 Most Common Causes of Acute Pancreatitis
Gallstones & Alcohol
Where does Pancreatic pain radiate to?
The back
Cullen’s Sign & Grey Turner’s Sign
Hemorrhagic Pancreatitis
MCC of Chronic Pancreatitis
Alcohol
Examination Feature Pathognomonic for Chronic Pancreatitis
Plain radiographs:
Show pancreatic calcification in 25-59% of patients
Ranson Criteria
Acute Pancreatitis:
Higher score = More severe disease & increased chance of death
ALT >150 suggests
Gallstone Pancreatitis
Imaging of Choice for Pancreatitis
CT Scan
Do Gallstones cause Chronic Pancreatitis?
NO!
PE: Palpable Gallbladder (Courvoisier Sign)
Txt: Whipple procedure
Pancreatic Neoplasm/CA
CA19-9
Pancreas
Secretin Stimulation Test
Gold Standard test of pancreatic function in early diagnosis of Chronic Pancreatitis
Most Specific Test to Dx Celiacs
Intestinal Biopsy
Pellagra
Niacin deficiency
Pellagra = diarrhea, dementia, dermatitis
Dermatitis Herpetiformis
Celiac Dz
AST > ALT (2:1)
Alcoholic Hepatitis
Hemorrhoids.. painful? painless?
Both - Internal = painless; External = painful
Painless Jaundice until proven otherwise =’s
Pancreatic CA
Virchow’s Nodes & Trouseau’s Sign
Pancreatic CA
4th Leading cause of CA Death
Most Common Cause of Painful Rectal Bleeding
Anal Fissure
How do you determine if there’s a fistula involved w/ an anorectal abscess?
CT Scan
Goodsall’s Rule for anal fistulas
Posterior Fistula = curved tracts; Anterior fistula = straight tracts
Most common anorectal problems in adults >50yo
Hemorrhoids
What Stage(s) of Internal Hemorrhoids are candidates for Surgery?
3rd + 4th
Villous Adenomas vs. Tubular Adenomas… which has higher risk of Colon CA?
Villous Adenomas (sessile)
TOXIC MEGACOLON & Bowel Sounds
Loss of Bowel Sounds!!
A child presents with tearing pain during bowel movements & bright red blood on toilet paper?
Anal Fissure
Anorectal Fistula – How do you want it to heal?
Secondary Intention
Best Diagnostic Tool for PUD
Endoscopy - EGD
*Able to visualize & Biopsy
2 Good noninvasive H. pylori tests
Fecal Antigen Test
C-urea breath test
Major difference between GU & DU
Gastric Ulcers may be malignant
Preferred Rx for PUD
PPIs
Triple Drug Rx for H. pylori
Omeprazole, Clarithromycin, Amoxicillin
Quadruple Drug Rx for H. pylori
Tetracycline, Omeprazole, Metronidazole, Bismuth
