Week 9 Clinical Investigations N / V

Question 1

Gastroenteritis can last how long

Answer 1

Up to 2 weeks

Question 2

Gastroenteritis what do to if pt has volume depletion signs

Answer 2

= serum electrolytes labs (BMP)

= supportive care hydration , bland food,

Question 3

Gastroenteritis TX

Answer 3

= supportive hydration 
= IV hydration (saline, P, Ringers lactate)
= bland food
= bismuth subsalicylate 
= loperamide 
= antiemetic if needed

Question 4

Infectious D

Is what and tx

Answer 4

Dysentery 
= bland diet 
= Pedialyte 
= rehydration 
= anti-D meds
= ABs

Question 5

3 warning sx fro acute D

Answer 5

1. T over 38.5C, ABD pain, bloody D, dehydration, over 6 stools a day
2. Immunocompromied
3. Elderly over 70yo

Question 6

IBD

DX

Answer 6

1. CMP, TSH
2. Vit levels
3. TTG rule our celiac
4. C-reactive P
5. Fecal calprotectin and fat and blood

Question 7

5 causes of metabolic cause of V

Answer 7

1. DKA
2. Uremia
3. Preg
4. Hypothyroidism
5. Parathyroid disease

Question 8

Metabolic cause of D is what

Answer 8

Malabsorption D
Osmotic D : increased stool osmotic gap, improves when not eating
Secretory D : no change with eating or not , normal stool osmotic gap, ZES, cancer, metabolic acidosis from Villous adenoma , IBD

Question 9

Risk of SBO

Answer 9

Surgery
Hernia 
CD (inflammation)
Radiation 
Foreign body ingestion

Question 10

Percussion sound on SBO

Answer 10

Hyperresonance

Question 11

CMP
CBC
ABG
What to do if there is a perforation

Answer 11

CMP : electrolytes and renal and liver function
CBC : blood and infection sign
ABG : acid base problem
Serum lactate and blood cultures

Question 12

Imaging for SBO
Flat
Upright
AP chest

Answer 12

1. Flat : bowel gas can be seen
2. Typical air/fluid levels (gas on top) (more helpful)
3. AP Chest : you can see air under diaphragm is perforated viscous happened (so also should be ordered)

Question 13

LBO risk and looks like what

Answer 13

= no trauma or surgery 
= volvulous
= malignancy 
1. Left : ribbon shaped
2. RIGTH : no change in stool shape
= Diverticular problem

Question 14

LBO imaging

Answer 14

CT** more diagnosistic

Initially = Acute ABD series (3 view)