ToL EM GI/Nutrition Flashcards

1
Q

Name 4 physical exam signs that may be seen in acute appendicitis.

A

Mcburney’s sign
Rovsing’s sign
Obturator sign
Iliopsoas sign

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2
Q

What is the initial imaging for suspected appedicitis?

A

U

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3
Q

What is the confirmatory imaging for acute appendicitis?

A

Contrast CT

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4
Q

What bacteria is most commonly implicated in cholescystitis?

A

E. coli

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5
Q

What can precipitate RUQ pain in cholecystitis?

A

Fatty foods or large meals

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6
Q

What physical exam special tests would you expect to be positive in cholecystitis?

A

Murphy’s sign

Boas sign

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7
Q

What is the initial diagnostic test of chouce for cholecystitis?

A

US

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8
Q

What US findings are consistent with cholecystitis?

A

Thickened GB, distended GB, gal sludge, gallstones, pericholecystic fluid, sonographic murphys sign.

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9
Q

What is the gold standard diagnostic test for cholecystitis?

A

HIDA( heptoiminodiacetic acid) scan

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10
Q

What is concerning about a porcelain gallbladder?

A

It is a premalignant condition

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11
Q

What analgesic is preferred for treatment of cholecysitis?

A

Meperidine, because morphine is associated with sphincter of oddi spasms

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12
Q

What are the risk factors for cholelithiasis?

A

Fat, Fair, Female, Forty, Fertile

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13
Q

What is the first line diagnostic tool for choledocolithiasis?

A

MRCP

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14
Q

What is the treatment for choledocolithiasis?

A

Stone extraction via ERCP

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15
Q

What is the name of the rare condition causing autoimmune progressive cholestasis with fibrosis of intrahepatic and extrahepatic ducts?

A

Primary sclerosing cholangitis

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16
Q

What is the most common comorbid condition with primary schlerosing cholangitis?

A

inflammatory bowel disease.

17
Q

What is Charcot’s triad, and what is it a sign of?

A

Charcot’s triad: Fever/chills, RUQ pain, Jaundice/elevated liver enzymes
It indicates ascending cholangitis

18
Q

What is Reynold’s pentad, and what does it indicate?

A

Reynold’s pentad = Charcot’s triad + shock and AMS

It indicates severe ascending cholangitis

19
Q

What is the treatment of ascending cholangitis?

A

PCN + aminoglycoside

Decompression of biliary tree via ERCP stone extraction

20
Q

What two types of hepatitis are fecal-orally transmitted?

A

Hep A and E

21
Q

What type of hepatitis can only occur with hepatitis B coninfection?

A

Hepatitis D

22
Q

What is the most common cause of pancreatitis?

A

Cholelithiasis

23
Q

What is the second most common cause of pancreatitis?

A

Alcohol abuse

24
Q

What cause of pancreatitis might you find in routine lab work?

A

Hypertriglyceridemia

25
Q

What two physical exam findings are associated with hemorrhagic pancreatitis?

A

Grey turner sign (flank bruising) and Cullen sign (periumbilical bruising)

26
Q

What lab finding is most sensitive for pancreatitis?

A

Lipase 3x greater than upper limit of normal

27
Q

What is the diagnostic test of choice for pancreatitis?

A

CT abdomen

28
Q

What is the treatment for pancreatitis?

A

90% recover with fluid resuscitation, NPO, and supportive measures

29
Q

What is the most common location for an anal fissure?

A

Posterior midline

30
Q

What is the first line treatment for anal fissures?.

A

Analgesics, sitz bath, bulking agents and increased fluids to avoid straining

31
Q

What is the most common cause of cirrhosis?

A

Chronic hepatitis

32
Q

What is the second most common cause of chirrhosis?

A

Alcohol

33
Q

What physical exam finding in cirrhosis patients is characterized by a flapping like motion of the hands when arms are abducted?

A

Asterixis

34
Q

What diagnosis should you consider in a cirrhosis patient with fever and abdominal pain?

A

Spontaneous bacterial peritonitis

35
Q

What is the treatment spontaneous bacterial peritonitis?

A

Ceftriaxone or cefotaxime

36
Q

What is the prophylactic treatment for spontaneous bacterial peritonitis?

A

Norfloxacin or bactrim