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Flashcards in Gastrointestional Deck (33):
1

A pt presents w/ sudden onset of severe, diffuse abd pain. Exam reveals peritoneal signs, and AXR reveals free air under the diaphragm. Management?

Emergent laparotomy to repair a perforated viscus.

2

The most likely cause of acute lower GI bleed in pts >40 years of age.

Diverticulosis

3

Diagnostic modality used when U/S is equivocal for cholecystitis

HIDA scan

4

Risk factors for cholelithiasis

Fat, female, fertile, forty, flatulent

5

Inspiratory arrest during palpation of the RUQ

Murphy's sign, seen in acute cholecystitis

6

The MCC of small bowel obstruction (SBO) in pts w/ no hx of abd surgery

Hernia

7

The MCC of SBO in pts w/ a hx of abd surgery

Adhesions

8

Most common organism causing diarrhea

Campylobacter

9

Diarrhea in recent abx use

Clostridium difficile

10

Diarrhea and camping

Giardia

11

Traveler's diarrhea

ETEC

12

Diarrhea and church picnics/mayonnaise

S aureus

13

Diarrhea and uncooked hamburgers

E coli O157:H7

14

Diarrhea and Fried rice

Bacillus cereus

15

Diarrhea and poultry/eggs

Salmonella

16

Diarrhea and raw seafood

Vibrio, HAV

17

Diarrhea and AIDS

Isospora, Cryptosporidium, Mycobacterium avium complex (MAC)

18

Diarrhea and pseudoappendicitis

Yersinia

19

A 25 y/o Jewish man presents w/ pain and watery diarrhea after meals. Examination shows fistulas b/w the bowel and skin and nodular lesions on his tibias

Crohn's dz

20

Inflammatory dz of colon w/ an increased risk of colon cancer

Ulcerative colitis (greater risk than Crohn's)

21

Extraintestinal manifestations of IBD

Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, primary sclerosing cholangitis

22

Medical tx for IBD

5-ASA agents and steroids during acute exacerbation

23

Difference b/w Mallory-Weiss and Boerhaave tears

Mallory-Weiss - superficial tear in the esophageal mucosa; Boerhaave - full thickness esophageal rupture

24

Charcot's triad

RUQ pain, jaundice, and fever/chills - signs of ascending cholangitis

25

Reynolds' pentad

Charcot's triad plus shock and mental status changes - signs of suppurative ascending cholangitis

26

Medical tx for hepatic encephalopathy

Decreased protein intake, lactulose, rifaximin

27

The first step in the management of a pt with an acute GI bleed.

Manage ABCs

28

A 4 y/o child presents with oliguria, petechiae, and jaundice following an illness w/ bloody diarrhea. Most likely diagnosis and cause?

Hemolytic- uremic syndrome (HUS) due to E coli O157:H7

29

Post-HBV exposure tx

HBV immunoglobulin

30

Classic causes of drug-induced hepatitis

TB medications (INH, rifampin, pyrazinaminde), acetaminophen, and tetracycline

31

A 40 y/o obese woman with elevated alk phos, elevated bilirubin, pruritus, dark urine, and clay-colored stools

Biliary tract obstruction

32

Hernia w/ highest risk of incarceration - indirect, direct or femoral?

Femoral hernia

33

A 50 y/o man w/ a hx of alcohol abuse presents w/ boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?

Confirm the dx of acute pancreatitis w/ elevated amylase and lipase. Make the patient NPO and give IV fluids, O2, analgesia, and "tincture of time"