Rapid Review: Gastrointestinal Flashcards
A patient presents with sudden onsent of severe, diffuse abdominal pain. Examination reveals peritoneal signs, and AXR reveals free air under the diaphragm. Management?
Emergent laparotomy to repair a perforated viscus
The most likely cause of acute lower GI bleed in patients >40 years of age
Diverticulosis
Diagnostic modality used when ultrasound 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 who no history of abdominal surgery
Hernia
The most common cause of SBO in patients with a history of abdominal surgery
Adhesions
Identify key organisms causing diarrhea:
- Most common
- Recent antibiotic use
- Camping
- Traveler’s
- Church picnics/mayonnaise
- Uncooked hamburgers
- Fried rice
- Poultry/eggs
- Raw seafood
- AIDS
- Pseudoappendicitis
- Campylobacter
- Clostridium difficle
- Giardia
- ETEC
- Staph aureus
- E coli O157:H7
- Bacillus cereus
- Salmonella
- Vibrio, HAV
- Isospora, Cryptosporidium, Mycobacterium avium complex (MAC)
- Yersinia
A 25 year old Jewish man presents with pain and watery diarrhea after meals. Examination shows fistulas between the bowel and skin and nodular lesions on his tibias
Crohn’s disease
Inflammatory disease of the colon with an increased risk of colon cancer
Ulcerative colitis (greater risk than Crohn’s)
Extraintestinal manifestations of IBD
Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, primary sclerosing cholangitis
Medical treatment for IBD
5-ASA agents and steroids during acute exacerbations
Difference between Mallory-Weiss and Boerhaave tears
Mallory-Weiss: superficial tear in the esophageal mucosa
Boerhaave: Full-thickness esophageal rupture
Charcot’s triad
RUQ pain, jaundice, and fever/chills–signs of ascending cholangitis
Reynolds’ Pentad
Charcot’s triad plus shock and mental status changes—signs of suppurative ascending cholangitis
Medical treatment for hepatic encephalopathy
Decreased protein intake, lactulose, rifaximin
The first step in the management of a patient with an acute GI bleed
ABCs
A 4 year old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?
Hemolytic uremic syndrome due to E coli O157:H7
Post-HBV exposure treatment
HBV immunoglubulin
Classic causes of drug induced hepatitis
TB medications, acetaminophen, and tetracycline
A 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?
Femoral
A 50 year old man with a history of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?
Confirm the diagnosis of acute pancreatitis with elevated amylase and lipase. Make the patient NPO and give IV fluids, O2, analgesia, and “tincture of time”
