GI +GU ER Flashcards by cortney davis

What tests do all women need in the ED who present with abdominal or pelvic pain

PRegnancy test

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Basic work up for abdominal pain

U-preg, UA, CBC, CMP, Amylase, lipase

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Do all abdominal pain pts require imaging

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Give me some medications if I am vomiting

IVF and anti-emetics

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Give me some medications if I have diarrhea

IVF

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I have a positive pregnancy test, what next

Where is it?

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What will confirm your suspicion of an ectopic pregnancy

visualization of adenexal mass

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What is the most common surgical emergency of the elderly

Cholecystitis

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What percentage of mesenteric ischemia patients present with diarrhea

31-40%

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What are some comon problems for bariatric patients

Anastomotic leak, bowel obstruction, dumping syndrome, electrolyte disturbances……

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What is the most common cause of travlers diarrhea

E. coli

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What are some treatments for diarrhea

Antimotility (Loperamide), Antibiotics (Cipro, metro), BRAT, fluids

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I am coming to your ED with a chrons exacerbation please treat me

STEROIDS!! Antibiotics(Cipro), liquid diet

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What are the labs to order on a chrons patient

CBC, CMP, UA, and CRP

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I am coming to your ED with a UC exacerbation treat me

PAin meds, cipro 1.0-1.5mg/kg/day and metronidazole 10-20mg/kg/day

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What is a possible complication of UC wher my abdomen is distened tender and tympanic

Toxic megacolon

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What is severe diarrhea

> 10 BM per day

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Treat my hyperkalemia

Amp dextrose, 10 units IV insulin, Amp of calcium gluconate

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I have coffee ground emesis what labs will you get for me

UGIB- CBC. CMP. amylase, lipase, PT/INR, type and screen

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My hemoglobin in 8, do you transfuse me?

Yes- transufse if less than 9

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How do you treat esophageal varacies

Octreotide or vasopressin

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I have guaiac positive stools, what will you start me on while adimiting me

PPI- Peptic ulcer

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What is the # 1 cause of an LGIB

UGIB

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Do diverticular bleeds typically need to be treated

No- 90% resolve spontaneously

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If you are found to have a GI bleed what will you probably have in the near future

Endoscopy/colonoscopy

I bring in my 2 year old who was chocking and gagging earlier- help her

FB- IM or glucagon

I was eating a huge steak and now I cant keep down my food - treat me

Glucagon- 1-2mg then if not passed in 20min give 2 more mg IV

What is the max length a bolus should be allowed to stay in you for

12-24 hours

I have a AP film and the face of the coin is facing you- what tube?

Esophagus

Is pancreatitis dangerous

Yes 20-30% mortality rate

I have pain in my epigastric area radiating to my back- why did I get this and treat me

Pancreatitis- 1) ETOH 2) Admit, NPO,

When would you consider antibiotics for pancreatitis

Necrotic, abcess

How do you assess the severity of pancreatitis

Ransons criteria

What will my labs show with pancreatits

Amylase and lipase tripled

I have RUQ pain radiating to the right shoulder what is the work up

CBC, CMP, UA, amylase, lipase, US

Describe murphys sign

Sudden cessation of deep inspiration due to pain when the infamed gallblader is pressed on

How do you treat my symptomatic gallstones

Cholecystectomy, 3rd gen cephalosporin ad unycin metronidazole

I have fever, jaundice and RUQ pain treat me in the ED

Cholangitis - IVF, broad spectrum antibiotics, consult surgery

Acetaminophen accounts for _____% of liver failure anually

42%

Treat my acetaminophen toxicity

NAC (Mycomyst), admit, follow up tylenol levels, call poison control

AST:ALT ratio greater than 2 is a common finding in....

Alcoholic hepatitis

I have know ascitis with abdomial pain and fever, what special test do I need

Paracentesis with fluid analysis - Spontaneous bacterial peritonitis

Will a retrocecal appendix have peritonitis signs

No- will not cause peritoneal irritation

What is the test used to diagnose appendicitis

CT abd and pelvis with IV and PO contrast

What are the preop antibiotics for appendicitis

IV Unasyn 3grams

I have LLQ pain, fever and leukocystosis work me up

Diverticulitis- CBC, CMP, UA, CT with IV and PO contrast

What antibiotics do yo give me if I have diverticulitis and you are discharging me

Metronidazole 500mg PO Q8h and Cipro 500mg Q12h

What antibiotics do yo give me if I have diverticulitis and you are admiting me

Unacyn 3grams IV Q6hr, cipro, or metronidazole

DO you need to treat adynamic ileus

No- self limiting

MCC of SBO

Adhesion

MCC of LBO

neoplasms

You see a step ladder appearance on uprigh x ray- why

SBO

What is the diagnostic method of choice for diagnosing a bowel obstruction

CT with oral and IV contrast

Treat my obstruction

Surgical intervention, NG tube, IV fluid replacement, antibiotics,

Do hernias hurt

Not unless there is a problem

Work up for a possible hernia

CT with IV and PO contrast

I have a hernia that has popped out and isnt going back in help me

Push it back in as long as not necrotic

I have a very tender hernia and it looks black treat me

Surgical emergency - broad spectrum IV antibiotics

I have ainless red lumps near my anus what do you do to treat me

Internal- Push them back in

What is the MCC of rectal bleeding

External hemorrhoids

I have blue and black purple that are painful treat me

Sits bath, tucks, proctofoam,

I have acute sharp cutting pain while defecating can you treat me

Anal fissures- Clean area, sitz baths, stool softeners

I am a middle aged male and now I have a very painful rectal exam and painful defecation what is my treatment

Isolated- I/D in ER | The rest- Drain in OR

I have itching burning, painful lesions on my anus treat me

Acyclovir

My rectum has prolapsed when should you nor reduce it manually

If it looks necrotic or strangulated

I stuck a bottle up my ass treat me

If I can feel it I will and pull it out. If I can't we need to go to surgery

It's summer and I am a truck driver and now my lower back/ butt hurts treat me

Pilonidal cyst- I&D

I have clear fishy discharge with clue cells treat me

BV - PO metroidazole

I have white curd, itchy diacharge treat me

Diflucane, fluconazole topical or PO

I have frothy malodorus discharge, puritis and irritation treat me

Flagyl and partner needs treatment

What other GU infection should you consider treating me for if I have Trich

Gonorrhea and chlamydia

MCC of PID

Chlamydia

Treat me outpatient for PID

Doxy- 100mg PO BID for 14 days OR Azithromycin 1 gram weekly for 2 weeks

Tx me if I have a tuboovarian abcess

Clinda 450 mg POQID or metronidazole with doxy

I had PID and now I have RUQ pain

Fitz-Hugh- Curtis syndrome

Work up for Renal failure in the ED

CBC, CMP (Bun/Cr), UA,

MCC of rhabdomyolysis

Alcohol/drugs, statins, elderly who have fallen

I have dark urine what lab value of mine will be distinctive

How do you treat my rhabd

IVF!!

I am a healthy young female coming in complaining on burning with urination, urgency and frequency treat me

Uncomplicated- Bactrim DS for 3 days, macrobid, cipro

Can pyelonephritis go home

Yes- if normal BUN/Cr and able to take PO

MCC of hematuria

Infection

Work up for hematuria

UA, UC, CBC, CMP, PT/INR

MCC of urinary retention

BPH

Treat my urinary retention

Foley, admit if older, dishcharge if younger and healthy

Who gets fourniers gangrene

diabetics, obese and alcoholics

tx my fourniers gangrene

IV Imepnim and vancomycin

What diagnostic tests are needed for fourniers gangrene

CTpelvis with IV contrast

I am a young male with acute severe pain in my testicle what test is 99% sensitive to diagnose me

absence of cremasteric reflex

Treat my testicular torsion

Can open like a book or call urology

I have right flank pain radiating down with hematuria work me up

UA dry CT of abd+pelvis

GI +GU ER Flashcards

(91 cards)