Rapid Review Flashcards
Patient presents with sudden onset of severe, diffuse abdominal pain. Exam shows peritoneal signs and AXR shows free air under diaphragm. Management?
Emergent laparotomy to repair a perforated viscus
Most likely cause of acute lower GI bleed in patients older than 40?
Diverticulosis
Diagnostic modality used when US is equivocal for cholecystitis?
HIDA scan
Risk factors for cholelithiasis
Fat, female, fertile, forty, flatulent
Inspiratory arrest during palpation of the RUQ
Murphy’s sign, seen in acute cholecystitis
The most common cause of SBO in patients with no history of abdominal surgery?
Hernia
Most common cause of SBO in patients with a history of abdominal surgery?
Adhesions
11 scenarios involving organisms causing diarrhea
1) Most common organism - campylobacter
2) Recent antibiotic use - C. Dif
3) Cramping - Giardia
4) Traveler’s diarrhea - ETEC
5) Church picnics/mayo - S aureus
6) Uncooked hamburgers - E Coli O157:H7
7) Fried rice - B cereus
8) Poultry/eggs - Salmonella
9) Raw seafood - vibrio, HAV
10) AIDS - Isospora, Cryptosporidium, M avium complex (MAC)
11) Pseudoappendicitis - Yersinia
25 year old jewish man presents with pain and watery diarrhea after meals. Exam shows fistulas btw bowel and skin and nodular lesions on his tibias
Crohn’s disease
Inflammatory disease of the colon with an increased risk of colon cancer
UC (greater risk than Crohn’s)
Extraintestinal manifestations of IBD
Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, primary sclerosing cholangitis
Medical treatment of IBD
5-ASA agents and steroids during acute exacerbations
Difference between Mallory-Weiss and Boerhaave tears
MW - superficial tear in esophageal mucosa
BH - full thickness esophageal rupture
Charcot’s triad
RUQ pain
Jaundice
Fever/chills
Signs of ascending cholangitis
Reynold’s pentad
Charcot’s triad plus shock and AMS - signs of suppurative ascending cholangitis
Medical treatment for hepatic encephalopathy
Lower protein intake
Lactulose
Rifaximin
First step in the management of a patient with an acute GI bleed
Manage ABCs
A 4 year old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
HUS due to E Coli O157H7
Post-HBV exposure tx
HBV immunoglobulin
Classic causes of drug-induced hepatitis
TB meds (INH, rifampin, pyrazinamide)
Acetaminophen
Tetracycline
40 year old obese woman with elevated alkaline phosphatase, elevated bilirubin, pruritus, dark urine, and clay-colored stools.
Biliary tract obstruction
Hernia with highest risk of incarceration - indirect, direct or femoral?
Femoral
50 year old man with history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?
Confirm dx of pancreatitis with elevated amylase and lipase. Make the patient NPO and give IVFs, O2, analgesia, and “tincture of time”
