First Aid GI Flashcards
(39 cards)
etiology of acute cholecystitis?
prolonged blockage of the cystic duct by a gallstone that leads to progressive distention, inflammation, and superinfection.
what is acalculous cholecystitis?
occurs in the absence of cholelithiasis (gallstone) in pts who are chronically debilitated or critically ill
pt suspicious of cholecystitis, you do ultrasound and found nothing, what is the next step?
HIDA scan
what is the positive sign for HIDA scan for cholecystitis?
non-visualization of the gallbladder
treatment for cholecystitis?
IV antibiotics, IV fluids, and cholecystectomy
what is the imaging modality for cholelithiasis and biliary colic?
RUQ ultrasound
4 main risk factors for cholelithiasis (gallstones)?
Female, Fat, Fertile, and Forty
additional risk factors for cholelithiasis?
OCPs, rapid weight loss, chronic hemolysis, small bowel resection, and TPN
what is the treatment for asymptomatic gallstone?
no treatment required
clinical signs for cholelithiasis?
postprandial abdominal pain in RUQ that radiates to Rt. subscapular area or the epigastrium
clinical signs for acute cholecystitis?
RUQ pain, nausea, vomiting, fever, + Murphy’s sign, leukocytosis
what is choledocholithiasis?
gallstones in the common bile duct
clinical signs for choledocholithiasis?
biliary colic, jaundice, fever, pancreatitis
what are the 2 lab hallmarks for choledocholithiasis?
- inc alkaline phosphatase
2. inc total and direct bilirubin
treatment for choledocholithiasis?
ERCP (Endoscopic retrograde cholangiopancreatography) with sphincterotomy followed by cholecystectomy
define cholangitis
acute bacterial infection of the biliary tree that commonly occurs 2’ obstruction usually from gallstones (choledocholithiasis).
unique clinical signs for cholangitis?
- Charcot’s triad - RUQ pain, jaundice, fever/chills
2. Reynold’s pentad: Charcot’s triad plus septic shock and altered mental status
ERCP for cholangitis is both
diagnostic and therapeutic
treatment for acute suppurative cholangitis?
emergent bile duct decompression via ERCP/sphincterotomy
most common cause of acute lower GI bleeding in pts > 40?
diverticulosis
what should be avoided in the initial stages of diverticulitis?
sigmoidoscopy
what is the definitive diagnosis in diverticular dz?
colonoscopy
treatments for diverticulitis?
- bowel rest (NPO)
- NG tube placement
- broad spectrum antibiotics (metronidazole, fluoroquinolone, second/third generation cephalosporin)
most common cause of odynophagia in immunocompromised pts?
candidiasis
