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GI Flashcards

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1
Q

treatment of idiopathic thrombocytopenia purpura if asymptomatic with platelets >30,000 vs symptomatic and <30,000

A

asymp: expectant management
symp: steroids (splenectomy if real bad)

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2
Q

indication for appendix cancer

A

right hemicolectomy

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3
Q

initial management of achalasia

A

meds (CCBS, nitrates), endoscopic dilatiioin, botox

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4
Q

safest and most effective treatment of achalasia

A

surgical esophagomotomy- Heller myotomy

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5
Q

definitive treatment for UC

A

total proctocolectomy with ileal puch anal astomosis and diverting ileostomy

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6
Q

treatment for pancreatic pseudocyst

A

abx and drainage

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7
Q

most serious complication of colostomy

A

parastomal hernia- when colostomy put lateral to rather than through rectus muscle

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8
Q

painless jaundice with weight loss is suspicious for

A

pancreatic cancer- head or uncinate

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9
Q

best study to evaluate pancreatic mass

A

helical contrast enhanced CT

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10
Q

which test useful for bowel perf or obstruction

A

acute abdominal series

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11
Q

which test useful in evaluating obstructive jaundice without a detectable mass on CT?

A

ERCP

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12
Q

procedure of choice for perforated duodenal ulcer?

A

simple closure with omental patch

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13
Q

dumping syndrome

A

following surgery of stomach/pyloric sphincter removal/alteration

GI symtpoms (bloating, cramp, diarrhea)
vasomotor symp (weak flushing palpitations, sweat dizzy)

after ingestion of meal, for 3 months

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14
Q

early vs late dumping syndrome timing

A

early: within 20-30 min of eating
late: 2-3 hrs after- resemble hypoglycemic shock

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15
Q

dumping syndrome management

A

reassurance- 3 mo

frequent small meals, avoid sugars, separate fluids and solids

octreotide but costly

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16
Q

what meds can decrease splanchnic blood flow during variceal bleed

A

octreotide, vasopressin

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17
Q

best option for long term management of recurring esophageal varices from poorly compensated liver disease, and what if well-compensated liver dz

A

transjugular intraheaptic portosystemic shunting (TIPS)- poor

well compensated: portosystemic shunt

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18
Q

treatment for persistent gastric ulcer

A

distal gastrectomy with gastroduodenostomy (billroth I reconstruction)

or with gastrojejunostomy (billroth II)

to rule out malignancy

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19
Q

which hernia is in the cremaster muscle

A

indirect inguinal

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20
Q

findings of air in the biliary tree of a nonseptic patient is diagnostic of

A

biliary enteric fistula –> small bowel obstruction from stone

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21
Q

which syndrome: intestinal polyposis (hamartomas) and melanin spots of oral mucosa

A

peutz jeghers

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22
Q

treatment for gallstone ileus –> small bowel obstruction

A

ileotomy
stone removal
cholecystectomy if possible

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23
Q

indications for surgical intervention (hartmann) for diverticular dz

A

hemorrhage sexondary to diverticulosis

recurrent diverticultiis

intractable to meds

complicated diverticulitis- perf w/ or w/o abscess,fistula

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24
Q

eval of choice if RUQ pain and fatty food intolerance but no evidence of gallstones and nl liver

A

CCK-HIDA scan for biliary dyskinesia`

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25
hematoma of rectus sheath presentation
elderly, history of trauma, sudden muscular exertion, anticoagulation sudden onset, sharp pain abdominal mass, doesnt change with contraction of muscles
26
hematoma of rectus sheath diagnosis and management
CT, US conservative unless severe or bleeding-surgery
27
what is important imaging before surgery for GERD/hiatal hernia
endoscopy
28
should you electively repair femoral hernias, even if asymptomatic?
yes, fear of strangulation
29
painful fluctuant mass in midline between gluteal folds
pilonidal abscess
30
CABG stands for
coronary artery bypass graft
31
ischemic colitis presentation
hematochezia, fever, abdominal pain
32
management of ischemic colitis
expectant with supportive care surgery only if: full thickness necrosis, perf, refractory bleeding
33
are there long term changes with sigmoidectomy?
no because reserve for water absorption in colon is greater than requirement and right colon absorbs more water than left
34
hepatic adenomas associated with
OCPs
35
treatment of focal nodular hyperplasia of liver?
nothing unless symptomatic
36
what provides the most info on T staging for an esophogeal tumor
endoscopic US
37
how to confirm Zollinger ellison?
measure gastrin at baseline then add secretin measure gastrin post at dif times
38
gastrinomas are usually located where
junction of 2nd and 3rd part duodenum, pancreas, cystic and bile duct
39
nigro protocol
combined radiation plus chemo (flurouracil and mitomycin)
40
"air filled kidney bean shaped structure in LUQ post-abdominal surgery." think...
volvolus
41
how to treat above volvolus
right hemicolectomy
42
definitive treatment of echinoccous cysts
surgical resection or evaucation
43
most common nonobstetric surgical disease of the abdomen during pregnancy
appendicitis
44
ogilvie syndrome
colon dilatation without mechanical obstruction
45
1st line therapy for major hemobilia
transarterial embolization (TAE)
46
crpt abscesses and superficial ulcerations are common in UC or crohns
UC
47
therapy of choice for paraesophageal hernias
surgery
48
therapy of choice for pancreatic tumors around critical peripancreatic arteries
unresectable- chemo and radiation
49
most common cause of small intestinal bleeding in patients under 30 yo
Meckel diverticulum
50
diagnostic modality for meckel diverticulum
99mTc pertechnetate scan
51
findings on endoscopy for stress gastritis
multiple shallow lesions with erythema, hemorrhage in fundus
52
what to do if antibiotic refractory cholangitis
ERCP- endoscopic drainage of obstructed common bile duct if that doesn't work or PTBD, then do surgery- place T tube into duct
53
Charcot triad
cholangitis- fever , jaundice, RUQ pain
54
how can cholecystitis be treated if you want to avoid general surgery (high comorbidities)
tube cholecystectomy- with local anesthetic or percutaneous
55
how do you manage pancreatic pseudocysts
typically self resolved within 6 weeks
56
Dieulafoy lesion
abnormally large submucosal artery that protrudes thru small mucosal defect typically 6 cm distal to gastroesophageal junction
57
carcinoid tumors on the appendix should be treated with right hemicolectomy (versus appendectomy) when they are bigger than how many cm?
1 cm
58
polypoid gall bladder lesion features
30s-50s y/o small, dont show shadow on US 90% benign, but can be malignant surgery if symptomatic
59
management for asymptomatic hepatic hemangiomas
observation
60
CEA elevated in which cancer recurrences
colon, pancreatic, gyn, gastric, lung
61
indications for surgery for UC
high grade dysplasia or carcinoma toxic megacolon massic colonic bleeding med-refratory
62
surgery of choice for UC
proctocolectomy with either: - end ileostomy - ileoanal J pouch anastomosis
63
toxic megacolon symptoms
fever abdominal pain marked dilatation of large bowel
64
what surgery do you do for distal anal cancers with fecal incontinence
APR (because sphincter-sparing surgery contraindicated)

Surgery (22 decks)

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