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(24 cards)
recommended test for h pylori eradication
urea breath test
Investigation of choice for acute mesenteric ischemia
HR CT non contrast
Management of acute mesenteric ischaemia
Laparotomy to restore flow, remove necrotic bowel, prevent cx
When is thrombolysis considered for acute mesenteric ischemia
Early ischemia without signs of peritonitis or sepsi
What radiologic finding are you likely to see on abdominal x-ray for small bowel obstruction?
Valvulae conniventes - complete circular folds that extend across entire diameter of small bowel
Expected lab findings in biliary colic
No fever
Normal LFTs and inflamm markers
Lab findings for cholecystitis
Norm ALP, GGT, AST, ALT
Raised CRP
Expected lab findings in obstructive biliary tree conditions - choledocholithiasis, ca
Raised ALP, GGT
Norm AST, ALT, CRP (or raised)
Lab findings for mixed cholestatic and hepatocellular picture
Raised ALP, GGT, AST, ALT, CRP
Reddening and thickening of the Apple and areolar
Pagets
How does pagets disease differ from eczema of the nipple
Pagets - involves the nipple primarily and then spreads to areolar. Eczema is opposite
Next step in women with breast ca and no palpable lymphadenopathy
If preop axillary US is negative, then sential node bx to assess burden
Management of acute anal fissure
Stool softners
Lubricants before defectation
Topical anasthetics
Management of chronic anal fissure
Topical GTN
if not effective after 8 weeks, then referal for sphincterotomy
Period of hypotension followed by renal impairment with urinary casts??
Acute tubular necrosis
Clin f of acute interstitial nephritis
Fever rash eiosniphilla
Clin f of glomerulonephritis
Haematuria, proteinuria, htn
Red casts
Preceding strep inf - URTI
Diverticulitis vs Diverticula vs diverticulosis
Diverticulitis - inf of diverticulum = out pouching of the intestinal mucosa
Presence of diverticula = diverticulosis – when this causes symptoms = diverticular disease
Clin f of acute diverticulitis
Acute onset of :
Severe LLQ pain
N/v
Change in bowel habit -usually constipation
Urinary frequency, urgency, dysuria
PR bleeding
Low grade pyrexia
Tachycardia
Tender LIF
Ix for suspected diverticulitis
CT abdo and pelvis with contrast - bowel wall thickening, periodic fat stranding, presence of diverticula +/- abscess or perforation
Management off acute sigmoid volvulous - non cx
Sigmoidoscopic/colonoscopic decompression
What is most suspicious of sigmoid infarction
Area of localised tenderness in LLQ
What findingon abdominal examination is very Suggestive off an underlying peritonitis
Localised tenderness
