Week 3 McGowan CIS Buzzwords Flashcards
ECG
MI
RUQ US
cholelithiasis
ERCP
choledocolithiasis (dx and tx)
- do INR first to check clotting
right renal US
pylonephritis
FOBT
colon cancer screen
urine antigen
strep pneumo
fecal antigen or urea breath test
H. pylori
- MALToma risk factor
subcutaneous emphysema, Hamand’s sign
esophageal perforation
Barrett’s esophagus -> ?
esophageal adenocarcinoma
stone in cystic duct
acute cholecystitis
- positive murphy sign
- acoustic shadowing on RUQ US
- elevated bilirubin, elevated alk phos, leukocytosis
acute cholecystitis
what is a complication of acute cholecystitis?
gangrenous necrosis
stone in common bile duct
- proximal involvement?
- distal involvement?
choledocolithiasis
- proximal: liver and gallbladder
- distal: liver, gallbladder and pancreas!
INR, ECRP, MRCP
choledocolithiasis
what is a complication of choledocolithiasis? what causes it?
primary ascending cholangitis
- caused by UC
rovsings sign
appendicitis
coffee-ground emesis
PUD
courvoisier sign
enlarged, NON-tender gallbladder
NOTE: gallbladder is fine, enlarged pancreas pushes gallbladder forward so you can feel it
what are 2 alarm symptoms for gallstones?
- bariatric surgery
- weight loss
leukocytosis, minorly elevated ast/alt
- elevated total bilirubin
- elevated ALP
- elevated lipase (NOT 3x ul of NL)
gallbladder issue
Ogilvie syndrome
pseudo-obstruction (acute dilation of the colon)
cushing ulcer
intracranial pressure -> ulcer
what is Charcott’s triad?
- jaundice
- fever
- RUQ pain
what is Raynaud’s pentad?
- jaundice
- fever
- RUQ pain
- altered mental status/confusion
- hypotension
decreased trypsinogen level
pancreatic insufficiency
fasting lipid panel
acute pancreatitis -> hyperlipidemia
ammonia level
hepatic encephalopathy
immune related bowel disease with ASCA antibodies
CD
what is the cause and complication of porcelain gallbladder?
- chronic cholecystitis leads to fibrosis and calcification
- is a risk factor for gallbladder cancer
primary sclerosing cholangitis is a risk factor for what
cholangiocarcinoma (bile duct cancer)
“beads on a string” finding on Xray, associated with UC
primary sclerosing cholangitis
HIDA scan with CCK
tests for biliary dyskinesia
- gallbladder should contract with CCK, so all the dye should come out
- low ejection fraction = obstruction
what would you order plain film Xray for?
nephrolithiasis, SBO, porcelain gallbladder
when would you order blood cultures?
bacteremia (ascending cholangitis)
ranson criteria
acute pancreatitis
ROME IV criteria
IBS
Rumack-Matthew nomogram
acetaminophen toxicity
HAPS score
acute pancreatitis
saponification
due to hypocalcemia (acute pancreatitis)
hepatic vein thrombosis
Bud-Chiari syndrome
classic triad:
- abd pain
- ascites
- liver enlargement
tardive dyskinesia
repetitive lip smacking seen with metoclopramide medication (given for gastroparesis)
chloride channel dysfunction
CF
- WBC > 16
- age > 55
- glucose > 200
- AST > 250
- LDH > 350
ranson criteria
- BUN > 25
- impaired mental status
- serous criteria (WBC, tachycardia)
- age > 60
- pleural effusion
BISAP criteria
IV NS at 250 cc/hr
acute pancreatitis -> LOTS of fluids pushed d/t third spacing!
emergent ERCP
ascending cholangitis
pantoprazole 40mg/day IV
PUD
open cholecystectomy
gallbladder cancer (not really done anymore)
SAPE
sentinel acute pancreatic event
- initial episode of pancreatitis
TIGER-O mnemonic
for chronic pancreatitis
- toxic/metabolic
- idiopathic
- genetic
- autoimmune
- recurrent
- obstructive
parietal cell antibodies
autoimmune pancreatitis
panacinar emphysema
a1-AT def
hemoglobin AIC 14%
T2DM
fasting gastrin
ZES
herniation of mucosa in Killian’s triangle
Zenker’s diverticulum
decreased fecal chymotrypsin and fecal elastase
- increased fecal fat
chronic pancreatitis
IV octreotide
for varices, to decrease portal pressure
hematemesis with suspected PUD?
- give IV fluids
2. emergent EGD
air in abdominal cavity
perforated viscus
- elevated total bilirubin
- elevated ALP
- T1DM
- leukocytosis
dark ring around gallbladder on US
emphysematous gallbladder
NOTE: white area around gallbladder would indicated porcelain gallbladder (calcification shows up white, like bone)
ARDS
complication of acute pancreatitis
- third spacing causes fluid backup in lungs!
prolonged PT/INR
liver failure, not enough clotting factors
strep bovis bacteremia
colon cancer
CA 19-9
pancreatic cancer OR cholangiocarcinoma
asterixis
hand flapping seen in liver failure
enlarged left supraclavicular lymph node
Virchow’s node!
- gastric cancer
hyper-pigmented macules on lips and buccal mucosa
Peutz-Jegher syndrome
inability to swallow or control own saliva
food impaction (eosinophilic esophagitis)
McMurray sign
meniscus sign
angioectasia
common cause of occult blood
Dieulafoy lesion
submucosal vascular anomaly of the stomach wall that comes and goes intermittently
- large tortuous arteriole that erodes and bleeds
fecal DNA testing
colon cancer
ASCA testing
CD
therapeutic phlebotomy
hemchromatosis (Yersinia)
DEXA scan
any malabsorptive condition (celiacs, CD)
Lynch syndrome
YOUNG cancer
- aka hereditary non-polyposis colorectal cancer
- associated with endometrial, colon, ovarian, hepatobiliary, urinary tract cancer
rectal prolaspe
cystic fibrosis (sometime first sign) - chloride channel mutation can lead to constipation -> hard to pass stools -> rectal prolapse
APC gene mutation
FAP
CEA
colon cancer tumor marker (NOT dx), but can following during treatment
abrupt appearance of multiple seborrhoeic keratoses that rapidly increase in size and number
sign of lesser trelat
- can indicate colon cancer
decreased fecal elastase and chemotrypsin
pancreatic insufficiency
chronic diarrhea
- KUB Xray shows calcifications
- greasy foul smelling stool (steatorrhea)
- decreased fecal elastase and chemotrypsin
porcelain gallbladder -> chronic pancreatitis
what vitamin deficiency is associated with pernicious anemia, and various neuropathies (numbness, tingling, weakness)
B12
papulovesicular rash
dermatitis herpetiformis -> celiac!
ankylosing spondylitis
IBD
edema, joint pain, fever, swollen lymph nodes, heart murmur
- gram positive bacillis with PAS positive macrophages
Whipple dz
sigmoid dilation of esophagus
achalasia
grey turner sign
acute pancreatitis (retroperitoneal bleed)
pANCA positive
UC
thousands of polyps on colonoscopy
FAP
widened mediastinum on CXR
aortic dissection
subcutaneous emphysema
Boerhaave’s
dilated common bile duct
choledocolithiasis
smokes 1 pack per day, drinks 3 beers every night
- worsening dysphagia (now includes solids)
most likely dx?
what diagnostic study?
- dx: esophageal SCC
- workup: EGD with biopsy
52 y/o obese WM with Barrett’s esophagus, takes omeprazole daily
- worsening dysphagia, weight loss, fatigue
most likely dx?
how is this treated?
- dx: esophageal adenocarcinoma
- tx: EGD with ablation
- painless jaundice
- new onset T2Dm
- courvoisier sign
- male >60
- drinking/smoking
pancreatic cancer
elevated AFP and hepatocellular mass?
- hx of non-alcoholic fatty liver disease and Hep C
hepatocellular carcinoma
“beads on a string”
primary sclerosis cholangitis
- risk for cholangiocarcinoma
polyp >10mm can lead to what?
gallbladder cancer
intranasal drug use?
Hep C
GERD -> barretts -> ?
adenocarcinoma
alcohol abuse
- low WBC, low Hg, low platelet
hyper spleen-ism
- suppressed bone marrow
HFE gene mutation
hemachromatosis d/t Yersinia
CFTR gene mutation: CF is risk factor for what cancer?
pancreatic cancer
stool toxin, watery diarrhea
C. diff
stool antigen, watery malodorous diarrhea
Giardia
- kite/pear shaped
- 4 flagella, 2 nuclei
blood culture
Listeria
bloody diarrhea and pharyngitis
- can have RLQ pain that mimics appendicitis
Yersinia
NGT to suction
SBO
is a bowel perforation an surgical emergency?
yes!
occlusion of the hepatic veins
- hepatomegaly
- abdominal pain
- ascites
Budd-Chiari syndrome
- contrast-enhanced Doppler US is gold standard
liver biopsy
nutmeg liver
men aged 65-75 that have smoked need to be screened for what?
AAA
all patients over the age of 18 need to be screened for what, at least once?
Hep C, HIV
when would a transvaginal US be used in diagnosis?
ovarian torsion
acute colonic pseudo-obstruction (ACPO)
- massive colonic distention without mechanical obstruction
Ogilvie’s syndrome
- usually seen in “super sick” ICU patients
what is tx of Ogilvie’s syndrome?
supportive, with serial Xrays
areas of edema and bleeding that resemble thumb prints on Xray?
mesenteric ischemia
air fluid levels, with dilated loops of small bowel on CT
SBO
hyperechoic densities in ureter
nephrolithiasis
radiating pain below right scapula
Boas sign
- indicative of cholecystitis
what is the tx of diverticulosis?
abx, NPO (clear liquids) to give bowels a rest
overcrowded swimming pools
cryptosporidium
Gullian Barre syndrome
campylobacter
colon perforation is a potential complication
C. diff associated TOXIC MEGACOLON
human T-cell lymphotrophic virus-1 (HTLV-1) is a risk factor
strongyloides