Gastroenterology and Hepatology Flashcards
What is HELLP syndrome?
Hemolysis (microangiopathic), Elevated Liver enzymes, Low Platelets in a
WHo does HELLP syndrome affect?
pregnant women - usu. 3rd trimester - variant of pre-eclampsia
What is the treatment of choice in HELLP syndome?
delivery of the infant
What is tenesmus?
constant feeling of the need to pass stools
What are the “alarm symptoms” that should prompt one to look for IBD in pts w/ abdominal pain? (name 6)
hematochezia, wt loss, family Hx of colon cancer, fever, anemia, or chronic severe diarrhea.
What are physical exam findings should prompt investigation for colon cancer in pts w/ “red flag” Sx?
rectal or abdominal mass, hepatomegaly, abdominal tenderness, or Fe-def anemia
What is the best initial step in the treatment of elderly patients with the clinical picture of diverticulitis?
Broad-spectrum Abx, such as ciprofloxacin or metronidazole.
What should be done if a pt w/ divierticulitis does not respond to Abx therapy (i.e. fever and pain persist after several days)?
CT of abdomen and pelvis to exclude abscess that may need to be drained.
What should be done several weeks after the resolution of an episode of diverticulitis?
colonoscopy to exclude colon cancer
What illness are the following Sx associated with: pain releif w/ defecation, pain w/ onset of loose, frequent stools, abdominal distention, mucus per rectum, and a feeling of incomplete evacuation?
IBS (Manning criteria)
What is the most appropriate Tx for moderate, diarrhea-predominant IBS?
loperamide
What medication may be used in severe, diarrhea-predominant IBS that does not respond to loperamide?
Alosetron
What meds may be used to improve the overall well-being and decrease the pain of IBS sufferers?
SSRIs and tricyclic antidepressants
In Crohn’s disease, pain is often located in the _______.
RLQ
What is Murphy’s sign?
Inspiratory arrest upon palpation of the RUQ
