Flashcards in Gastrointestional Deck (33):
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.
The most likely cause of acute lower GI bleed in pts >40 years of age.
Diagnostic modality used when U/S is equivocal for cholecystitis
Risk factors for cholelithiasis
Fat, female, fertile, forty, flatulent
Inspiratory arrest during palpation of the RUQ
Murphy's sign, seen in acute cholecystitis
The MCC of small bowel obstruction (SBO) in pts w/ no hx of abd surgery
The MCC of SBO in pts w/ a hx of abd surgery
Most common organism causing diarrhea
Diarrhea in recent abx use
Diarrhea and camping
Diarrhea and church picnics/mayonnaise
Diarrhea and uncooked hamburgers
E coli O157:H7
Diarrhea and Fried rice
Diarrhea and poultry/eggs
Diarrhea and raw seafood
Diarrhea and AIDS
Isospora, Cryptosporidium, Mycobacterium avium complex (MAC)
Diarrhea and pseudoappendicitis
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
Inflammatory dz of colon w/ an increased risk of colon cancer
Ulcerative colitis (greater risk than Crohn's)
Extraintestinal manifestations of IBD
Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, primary sclerosing cholangitis
Medical tx for IBD
5-ASA agents and steroids during acute exacerbation
Difference b/w Mallory-Weiss and Boerhaave tears
Mallory-Weiss - superficial tear in the esophageal mucosa; Boerhaave - full thickness esophageal rupture
RUQ pain, jaundice, and fever/chills - signs of ascending cholangitis
Charcot's triad plus shock and mental status changes - signs of suppurative ascending cholangitis
Medical tx for hepatic encephalopathy
Decreased protein intake, lactulose, rifaximin
The first step in the management of a pt with an acute GI bleed.
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
Post-HBV exposure tx
Classic causes of drug-induced hepatitis
TB medications (INH, rifampin, pyrazinaminde), acetaminophen, and tetracycline
A 40 y/o obese woman with elevated alk phos, elevated bilirubin, pruritus, dark urine, and clay-colored stools
Biliary tract obstruction
Hernia w/ highest risk of incarceration - indirect, direct or femoral?