Surgery-GI Flashcards
Abd pain after trauma- X-ray, gas-filled loops of both small and large intestines and gastric dilation
Paralytic (dynamic) ileus
Migratory pain, N/V, fever, leukocytosis, McBurney point tenderness, and Rovsing sign. NSIM?
<p>Immediate appendectomy; no imaging needed for classic presentation</p>
Evidence of pancreatitis ( Midepigastric pain, N/V, elevated Amylase & Lipase) with ALT >150; gallstones on US, diagnosis? NSIM?
<p>Gallstone pancreatitis; Laparoscopic Cholecystectomy
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<p>The most common cause of SBO</p>
<p>Adhesions</p>
<p>N/V, abd bloating, high-pitched hyperactive bowel sounds, dilated loops of bowel on x-ray</p>
<p>complete SBO</p>
<p>Easily satiety, Nausea, non bilious vomiting, wt loss, hx of acid ingestion</p>
<p>Gastric outlet obstruction- pyloric stricture </p>
<p>acute-onset severe abd pain, fever, tachycardia, sign of peritonitis (guarding, rigidity, reduced bowel sound, rebound tenderness) is? NSIM?</p>
<p>Perforated viscus, upright x-ray of chest &amp; abd</p>
Recurrent episodes of mild jaundice precipitated by stressors (eg. infection, fasting, vigorous exercise, surgery)
Gilbert syndrome
cholestatsis and gallbladder ischemia leading to secondary infection by enteric organisms and resultant edema and necrosis of the gallbladder is? Tx?
Acalculous cholecystitis; Abx, percutaneous cholecystostomy, followed by cholecystectomy after pt is stable
Left-sided and pain with radiation to the shoulder, fever, and vomiting
spleen infarct
Hypotension, free intraperitoneal fluid, RUQ pain and bruising, and R shoulder pain
Hepatic laceration
treatment for anal fissures
fiber, fluid intake, stool softeners, sitz baths, and topical anesthetics and vasodilators (Nifedipine, nitroglycerin, lidocaine)
what is the differential diagnosis of an inguinal hernia
Lymphadenopathy, psoas abscess, ectopic testis, hydrocele of the cord, saphenous varix, lipoma, varicocele, testicular torsion, femoral artery aneurysm, abscess
Gallstone that has passed through a biliary-enteric fistula is called? caused by?TX?
Gallstone ileum results from small bowel obstruction, Surgical removal of stone and cholecystectomy
The 3 peritoneal signs
- rebound tenderness
- involuntary guarding
- Abdominal rigidity
RLQ pain with extension of right thigh is called? Dx?
Psoas sign, abscess adjacent to posts or retrocecal appendix
RLQ pain with internal rotation of R thigh called? Dx?
Obturator sign, pelvic appendix or abscess
RLQ pain with LLQ palpation and retropulsion of colonic contents is called? Dx?
Rovsing’s sign, acute appendicitis
Right pelvic pain during rectal examination, especially with pressure on right rectal wall
Rectal tenderness, pelvic appendix or abscess
The most likely cause of abd pain, tachycardia, left chest wall and shoulder pain in blunt abd trauma is? NSIM?
Splenic injury; FAST examination
Fever, RUQ pain, N/V, crepitus in abd wall adjacent to gallbladder, air-fluid levels in gallbladder. Dx? Tx?
Empheysematous cholecystitis; emergent cholecystectomy with broad-spectrum antibiotics with clostridium coverage (Amp-Sulbactam)
25M, obese, with sedentary lifestyle, fluctuant mass cephalad to the anus (near the tip of the coccyx) in the intergluteal region with mucoid, purulent or bloody drainage, painful. Dx?
Pilonidal disease
Colicky abd pain, vomiting, no flatus or stool, hyperactive to absent bowel sounds, distended and tympanitic abd. DX? NSIM?
SBO; bowel rest, NG suction, IVF and complicated needs urgent surgical exploration
67M, N/V increasing abd pain over 3hrs. Post MI, DM 2, PUD, HTN & hypercholesterolemia. Dx?
Acute mesenteric ischemia
