~Easy Mode GI~ Flashcards
1
Q
contagious for 28 days of incubation, and one week following onset of jaundice
A
Hepatitis A
2
Q
bruising around umbilicus
A
pancreatitis
Cullen’s sign
3
Q
outpatient treatment = ceftriazone + doxycycline
A
Pelvic Inflammatory Disease
4
Q
abrupt onset of RUQ pain, fever/malaise, anorexia, jaundice, hepatomegaly
A
Hepatitis A
5
Q
85% are STI related
A
Pelvic Inflammatory Disease
6
Q
monitor for sepsis- blood cultures x2 before antibiotic treatment
A
Cholangitis
7
Q
complications = obstruction, paralytic ileus, edema, compression of colon
A
diverticulitis
8
Q
typically results from endocarditis or seeding from another site
A
Splenic abscess
9
Q
rigid proctoscopy or flex sig evaluation after treatment
A
rectal foreign body
10
Q
SEVERE pain in anal area
no fever
no findings on DRE
A
perianal abscess
11
Q
splenic artery occluded my embolus, clot, or infection
A
Splenic infarct
12
Q
positive Courvoisier’s sign
A
Choldecholithiasis
13
Q
ascending bacterial infection due to obstruction of the biliary ducts
A
Cholangitis
14
Q
LUQ pain referred pain to the left shoulder
A
Splenic rupture
15
Q
hyperactive bowel sounds/high pitch
A
diverticulitis - obstruction
16
Q
treatment for uncomplicated = monitor + analgesics
treatment for complicated = splenectomy
A
Splenic infarct
17
Q
acute presentation can be a malignant effusion or small bowel obstruction
A
Ovarian cancer
18
Q
can be caused by an infection such as mononucleosis, CMV, HIV
A
Splenic rupture
19
Q
urinary urgency, frequency, dysuria low grade fever change in bowel habits abd distention N/V LLQ pain
A
diverticulitis
20
Q
ultrasound = abscesses, bowel wall thickening, diverticula, fistulas
A
diverticulitis
21
Q
blood cultures x 2 if admitting
A
Pelvic Inflammatory Disease
22
Q
gallstones in the bile or pancreatic duct
A
gall stone pancreatitis
23
Q
anorectal or abdominal pain
blood per rectum
mucus discharge
A
rectal foreign body
24
Q
obstipation
A
small bowel obstruction
25
gallbladder wall thickening, sonographic "murphy's sign", gallstones or sludge, pericholecystic fluid
acute cholecystitis
26
foul smelling vaginal discharge (lochia)
Post-Partum Endometritis
27
d-dimer (GI disorders)
acute mesenteric ischemia
28
IV steroids
Toxic megacolon
29
gallstones within the common bile duct
Choldecholithiasis
30
treatment = anesthetize area, open wound, evacuate pus, irrigate well
no packing
sitz bath
perianal abscess
31
treatment = IV clindamycin + IV gentamycin
Post-Partum Endometritis
32
elevation of serum lipase or amylase to 3 times greater than normal limit
pancreatitis
33
adhesions from prior abdominal/pelvic surgery can cause
small bowel obstruction
34
complications include acute pancreatitis and acute cholangitis
Choldecholithiasis
35
vaginal bleeding with pain, typically 6-8 weeks after last menses
ectopic pregnancy
36
high mortality intestinal emergency
acute mesenteric ischemia
37
left side pain (tender mass) on rectal exam
diverticulitis
38
colicky biliary type pain RUQ
| radiates to epigastric
Choldecholithiasis
39
traumatic and atraumatic etiologies
Splenic rupture
40
```
x-ray = dilated colon
fever > 38 C
HR > 120
neutrophilic leukocytosis > 10500 microliters
anemia
dehydration
altered mental status
electrolyte disturbance
hypotension
```
Toxic megacolon
41
toxic appearing patient, fever
altered mental status
bloody diarrhea
Toxic megacolon
42
cefoxin/cefazolin + metronidazole
| analgesia
appendicitis
43
Shortness of breath and cough especially when lying flat
peptic ulcer disease
44
dark urine + pale stools
Hepatitis A
45
antibiotic triple therapy (ampicillin/gentamycin/metronidazole)
Toxic megacolon
46
hypoactive bowel sounds/ absent (diverticulitis)
peritonitis
47
LLQ deep, steady, constant pain
diverticulitis
48
rebound tenderness
appendicitis
49
free air or dead bowel on x-ray = yes = laparotomy
acute mesenteric ischemia
50
ultrasound with duplex for blood flow
Ovarian torsion
51
inpatient treatment = cefoxitin + doxycycline
Pelvic Inflammatory Disease
52
LUQ pain, fever
+/- splenomegaly
+/- left side pleural effusion
Splenic abscess
53
RLQ pain
N/V, anorexia
fever = late finding
rigidity, guarding, pain on rectal exam
appendicitis
54
CT with contrast = localized bowel thickening, colonic diverticula, abscesses, fistula, dilated loops of bowel
diverticulitis
55
soft uterus +/- excessive uterine bleeding
Post-Partum Endometritis
56
pain increases with fatty food intake
acute cholecystitis
57
leukocytosis with bands, elevated CRP, normal liver labs
acute cholecystitis
58
Grey Turner sign
pancreatitis `
59
severe, constant RUQ pain > 6 hours that radiates to the epigastric and right shoulder
acute cholecystitis
60
RLQ pain - starts periumbilical and migrates
appendicitis
61
consult patient to increase fluids and fiber in diet
hemorrhoid
62
x-ray = dilated loops of bowel with air-fluid levels
small bowel obstruction
63
```
fever/ chills
mucopurulent vaginal discharge
intermenstrual bleeding
cervical friability
pelvic TTP
```
Pelvic Inflammatory Disease
64
treatment = methotrexate
ectopic pregnancy
65
CT with contrast shows inflammation, fat stranding, fluid collection
appendicitis
66
anal pruritus, prolapse
hemorrhoid
67
percutaneous drainage
acute cholecystitis - unstable patient
68
RUQ pain relieved by leaning forward, hypoactive bowel sounds, fever, tachypnea, hypotension, N/V, bloating
pancreatitis
69
defect in gastric of duodenal mucosa
peptic ulcer disease
70
IV contrast CT is very important, oral not as important for detecting ischemia associated with
small bowel obstruction
71
early satiety, dyspepsia, "heart burn"
peptic ulcer disease
72
Rovsings
appendicitis
73
ecchymotic discoloration due to retroperitoneal bleeding
pancreatitis
grey turner sign
74
treatment is splenectomy and blood transfusion
Splenic rupture
75
leukocytosis with elevated liver labs (alk phos, GGT, bilirubin, transaminases) +/- elevated amylase with pancreatic involvement
Cholangitis
76
ALT > AST
Hepatitis A
77
tumor markers CA 125
Ovarian cancer
78
fever/chills + uterine tenderness
Post-Partum Endometritis
79
treatment = transanal removal with IV sedation or surgical removal
rectal foreign body
80
ceftriaxone + metronidazole
| +/- systemic anticoagulation
acute mesenteric ischemia
81
no anti-motility medications or opioids
Toxic megacolon
82
WBCs on saline microscopy
| elevated ESR and CRP
Pelvic Inflammatory Disease
83
Most commonly caused by Choldecholithiasis
Cholangitis
84
x-ray = transverse/ right colon dilated up to 15 cm +/- air fluid levels
Toxic megacolon
85
elevated LDH, leukocytosis
Splenic infarct
86
Appears ill, lies still, + positive murphy's sign
acute cholecystitis
87
RUQ pain, slower progression, persistent, severe, boring acute pain, radiates to back
pancreatitis
| non-gallstone because slower progression
88
fever/ chills, RUQ pain, jaundice
Cholangitis (Charcot's triad)
89
NG tube + antiemetics
small bowel obstruction
90
severe, bloody diarrhea
Toxic megacolon
91
decreased of no perfusion to section of colon- obstructive arterial or venous process
acute mesenteric ischemia
92
fever/ chills, RUQ pain, jaundice, altered mental status, hypotension
Cholangitis (Reynold's pentad)
93
```
+/- leukocytosis
+/- metabolic acidosis
hemoconcentration (third spacing)
increased lactate
increased LDH
```
acute mesenteric ischemia
94
Splenic emergency that is diagnosed by ultra sound and not CT with contrast like the other splenic emergencies
Splenic rupture
95
epigastric pain that radiates to the mid thoracic region
peptic ulcer disease
96
LUQ pain and FULLNESS
Splenic rupture
97
lead point of the bowel is pulled forward by normal peristalsis, telescoping or prolapsing the affected segment of bowel into another segment of bowel
intussusception
98
high risk patients = ERCP then elective cholecystectomy
| low risk = cholecystectomy
Choldecholithiasis
99
if thrombosed, incise overlying skin, evacuate clot = immediate relief
hemorrhoid
100
Cullen's sign
pancreatitis
101
bright red, copious rectal bleeding
hemorrhoid
102
order a KUB and CXR to check for free air
peptic ulcer disease
103
acute perianal pain, "lump" due to thrombosis
hemorrhoid
104
usually caused by enterococci
Cholangitis
105
free air of dead bowel on x-ray = no = abdominal CT angiography with IV contrast
acute mesenteric ischemia
106
localized pain to the RUQ, RAPID ONSET****, radiates to back
gall stone pancreatitis
107
treatment = salpingo-oophrectomy
Ovarian torsion - post-menopausal
108
partial or complete rotation of ovary, often results in ischemia
Ovarian torsion
109
"possible forceful bowel evacuation"
| post-prandial pain
acute mesenteric ischemia
110
air-filled loop of the sigmoid colon twists about its mesentery
volvulus
111
blockage of appendix with stool, appendicolith, tumor with secondary infection
appendicitis
112
+ obturator sign
pelvic appendicitis
113
rapid onset, severe periumbilical pain out of proportion to physical exam
acute mesenteric ischemia
114
UA = pyuria
diverticulitis
115
inflammation due to microperforation of a diverticulum
diverticulitis
116
+ psoas sign
retroceccal appendicitis
117
can be caused by a neoplasm from leukemia or lymphoma
Splenic rupture
118
acute onset of pain
N/V
adnexal mass
pain radiates to back/flank/groin
Ovarian torsion
119
treatment for uncomplicated = cipro + metronidazole at home
diverticulitis
120
treatment if suspected tubal rupture or hemodynamically unstable = oophorectomy
ectopic pregnancy
121
treatment = laproscopic detorsion
Ovarian torsion - pre-menopausal
122
LIFE-THREATENING hemorrhage is ruptured
ectopic pregnancy
123
cramping***, abdominal pain, periumbilical
small bowel obstruction
124
```
adnexal mass
abd distention
bloating
early satiety
weight loss
```
Ovarian cancer
125
positive stool guaiac
diverticulitis
