GI and Nutrition

Question 1

what is the most common cause of small bowel obstruction

Answer 1

post op adhesions
hernias
cancer
IBD
volvulus
itussusception (MCC in kids)

Question 2

what is the tx of SBO`

Answer 2

decompression with NGT
surgery if a mechanical obstuction

Question 3

what are the most common causes of LBO

Answer 3

cancer
strictures
hernias
volvulus
fecal impaction

Question 4

what is sseen on KUB with LBO

Answer 4

dilated colon
air fluid levels in the colon
haustra that do not transverse bowel

Question 5

what is the treatment of LBO

Answer 5

bowel rest
NG tube placement
surgery as directed by underlying cause

Question 6

what is cholelithiasis

Answer 6

stones within the GB causing pain secndary to contraction of gall against obstructed cystic duct

Question 7

what is Boas sign

Answer 7

referred right subscapular pain

Question 8

what is the tx of cholelithasis

Answer 8

asymptomatic - none
elective cholecystectomy if recurrent bouts

Question 9

what is cholecystitis

Answer 9

inflammation of GB caused by gallstones blocking the cystic duct

Question 10

what is the typical presentation of cholecystitis

Answer 10

5Fs: female, fat, forty, fertile and fair

Question 11

what is a positive murphys sign and what is it indicative of

Answer 11

RUQ pain with GB palpation on inspiration
- cholecystitis

Question 12

what is the gold standard test for cholecystitis

Answer 12

HIDA

Question 13

what is cholecdocholithiasis

Answer 13

stones in common bile duct

Question 14

how is choledocholithiasis diagnosed

Answer 14

ERCP

Question 15

what is the most common cause of cirrhosis

Answer 15

alcoholic liver disease

Question 16

what is Budd Chiari syndrome (hepatic vein thrombosis)

Answer 16

triad of abdominal pain, ascites and hepatomegaly

Question 17

what presents with an accumulations of ammonia that reaches the brain causing a decrease in mental function, confusion and poor concentrations

Answer 17

hepatic encephalopathy

Question 18

what is asterixis

Answer 18

flapping tremor
associated with hepatic encephalopathy

Question 19

what tumor marker is used fro colorectal cancer

Answer 19

CEA

Question 20

what is the treatment of ecoli diarrea

Answer 20

ciprofloxacin 500mg BID x 1-3 days and Loperamide

Question 21

what are the two common acute viral gastroenterities

Answer 21

diarrhea in daycare setting - rotavirus
diarrhea on cruise ship - norovirus

Question 22

what are the common etiologiest of salmonella

Answer 22

poulty, pork or raw eggs

Question 23

what is the treatment for salmonella

Answer 23

fluoroquinolones or azithro in immunocompromized or enteric fever

Question 24

whos is commonly affected by shigella

Answer 24

children - especially daycare settings

Question 25

what is the presentation of shigella

Answer 25

abdominal pian, inflammatory diarrhea, frequent mucous and bloody stool

Question 26

what is tenesmus

Answer 26

feeling of constatnly needing to pass stools

Question 27

what is the treament of choice for shigella

Answer 27

TMP-SMX can use cipro or fluoroquinolone

Question 28

what causes life-threatening rice water diarrhea

Answer 28

cholera

Question 29

what is the treatment of cholera

Answer 29

glucose and Na rich electolyte fluids doxycycline, azithro, TMP /SMX or cipro

Question 30

what are three causes of gastritis

Answer 30

infection - h. pylori inflammation - NSAIDs and alcohol autoimmune/hypersensitivity rxn

Question 31

what is the presentation of pin worm

Answer 31

perianal pruritis that is worse at night

Question 32

what is the treatment of pinworm

Answer 32

mebendazole or pyrantel pamoate

Question 33

what is the presentation of tapeworm

Answer 33

GI symptoms and weight loss - also associted wtih B12 deficiency

Question 34

what is the presentation of hookworm

Answer 34

cough, weight loss, anemia with reent travel

Question 35

what is the presentation of roundworm

Answer 35

pancreatic duct, common bile duct and bowel obstruction

Question 36

what is the treatment of UC

Answer 36

colectomy = curative meds: prednisone an dmesalamine

Question 37

what is the treatment for crohns

Answer 37

flares: prednisone +/- mesalamine +/- metronidazole or cipro Maintenance: mesalamine

Question 38

what is the presentation of acute pancreatitis

Answer 38

epigastric pain radiating to the back with nausea and vomiting and elevated lipase levels

Question 39

what is grey turners sign and what is it associated wtih

Answer 39

flank bruising - pancreatitis

Question 40

what is cullens sign

Answer 40

brusing near umbilicus associated with pancreatitis