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Step 3 > Inservice Deck 2 - GI > Flashcards

Inservice Deck 2 - GI Flashcards

(53 cards)

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1
Q

Most sensitive symptom for appy?

A

RLQ pain

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2
Q

20 year old with constipation has BRPBR and painful BM. Pain lasts 1-2 hours after BM. What is the diagnosis and tx?

A

anal fissure
- not hemorrhoid, pain continues after BM

Tx - WASH
warm soaks, analgesics, stool softener, high fiber diet

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3
Q

Name a possible appropriate tx for esophageal foreign body?

A

IV glucagon

nitro/nifedipine or CO2 may also work

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4
Q

dx of patient with history of AAA repair with pain and massive hematemsis?

A

aorto enteric fistula

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5
Q

Kehr’s sign, hemolysis, and leuk may indicate?

A

splenic rupture

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6
Q

diagnostic criteria for spontaneous bacterial peritonitis?

A

ascites with PMN > 250
- diagnostic with 93% sens
WBC > 1000
- diagnostic less sens

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7
Q

abx coverage for SBP should include what main organisms?

A

gram neg (enterobacteria/enterococci) and strep pneumo

tx - 3rd gen cephalosporin or amp/sulbactam

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8
Q

most common cause of acute hepatic encephalopathy in cirrhotic?

A

GI bleed

LIVER
L - librium (or sedatives)
I - infection/sepsis
V - volume loss
E - electrolytes (hypoK, hypo Na
R - RBCs in stool (GI bleed is #1 cause
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9
Q

60 year old patient presents with AMS, exam reveals gynecomastia and spider angioma. What medication is indicated?

A

lactulose

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10
Q

Most common area of esophageal foreign body in child? In adult?

A

cricopharyngeus

lower esophageal sphincter

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11
Q

type of incision should be made when excising a thrombosed hemorrhoid?

A

elliptical

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12
Q

Risk factors associated qwith coffee bean shaped bowel on abd XR?

A

sigmoid volvulus

  • elderly, bed ridden patients or patients of any age with neuro illness with history of severe chronic constipation
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13
Q

most common type of hernia in adults?

A

indirect inguinal

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14
Q

test used to diagnose pinworm?

A

scotch tape test

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15
Q

abd pain in the elderly is more often a medical or surgical emergency?

A

surgical

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16
Q

construction worker with painless lower GI bleed and normal external exam most likely has what?

A

internal hemorrhoids

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17
Q

name a medication indicated for intractible hiccups?

A

chlorpromazine

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18
Q

What are the markerds of acute infection in hep B?

A

HbSAg and HbcAb (IgM)

core ab is seen in window period with acute infection

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19
Q

healthcare worker who has had hep B vaccine gets needlestick from HepB positive patient. What should be done next?

A

test worker for anti-HBs (antibody to HbsAg) if adequate do not treat. If inadequate administer HBIG and vaccine booster

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20
Q

Test done in ED for patient with cirrhosis, painful abd fluid wave,a nd fever?

A

paracentesis

  • fluid for WBC and diff, glucose, and protein, GM stain and cx
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21
Q

lab marker indicates poor prognosis in alcoholic hepatitis?

A

PT (> 8 sec)

indicates failing not just injured liver

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22
Q

alcoholic with vomiting, now streaked with blood has what dx? where do most of the tears occur?

Study These Flashcards
A

mallory weiss tear

GE junction

23
Q

pt has epigastric pain that awakens him at night and is relieved by food. Dx?

Study These Flashcards
A

duodenal ulcer

gastric ulcer worse with food

24
Q

most common presenting sx of gi angiodysplasia (AVM)

Study These Flashcards
A

painless lower GI bleed

U - upper gi bleed
D - diverticulosis
R - rectal causes, hemorrhoids, fissures
A - AVM, aorto-enteric fistula
I - infection, IBD
N - neoplam
25
tx for child who began vomiting 4 hours after eating at a picnic?
hydration, antiemetic NO abx - likely staph
26
patient presents with vomiting and diarrhea after eating oysters. Etiology?
vibrio cholera (or vulnificus)
27
6 week old presents with bloody diarrhea tinged with mucus, generalized seizure in the ED. Possible etiology?
shigella
28
patient develops vomiting and diarrhea one wk after being tx for pneumonia. Most likely etiology?
c difficile - diagnose by stool toxin not culture
29
patient with rectal pain, surrounding induration, and fever may have?
rectal abscess
30
40 year old presents with severe vomiting, now with increasing pain. CXR is unrevealing. What is the next test to rule out esophageal rupture?
gastrograffin before endo
31
50 year old has intermittent difficulty initiating swallowing of solids. Most likely cause?
achalasia mech sx - difficulty swallowing solids and liquids vs obstructive cause - difficulty swallowing solids, then liquids later (tumor)
32
patient with caustic ingestion requires what diagnostic evaluating study?
endoscopy
33
source of melenal is where, with relationship to the ligament of treitz
prox to it
34
GI study that can localize bleeding at rate of 0.1 ml/min
scintigraphy
35
tx for 30 year old with sore throat and difficulty breathing, has normal oropharynx and lung exams, is febrile with otherwise normal vitals, and thumbprinting on lateral soft tissue neck?
epiglottis tx - abx/iv pain control, ent consult
36
backpacker gets diarrhea 2 weeks after trip. How is this diagnosed and tx?
giardia ova and parasite smear on fecal sample tx metronidazole
37
HIV patient gets diarrhea after fishing on a fresh water lake. What parasite cause is associated with drinking untreated water in this patient?
cryptosporidium
38
diagnostic test for hematuria if CT not available
IVP
39
disposition for patient with RUQ US, fever, and pain
OR
40
all patients who are discharged with painless lower GI bleed require what subsequent study?
colonoscopy
41
Most likely cause of SBO in 66 year old who has only had a chole?
adhesions
42
small vs large bowel obstruction?
SBO has stair step pattern and air fluid levels LBO can see large bowel
43
60 year old on digoxin present with severe abd. Pain with minimal tenderness. Dx?
mesenteric infarction | - pain out of proportion
44
what is the next diagnostic test indicated for 60 year old with a fib and abd pain with minimal tenderness?
angiography - rule out mesenteric infarction
45
25 year old female has abd pain, lower gi bleed, and joint pain. most likely dx?
crohns effects joints, eyes, liver, skin
46
pt presents with RUQ pain, subsequent US shows air in GB wall. Disposition?
emergent chole ephysematous chole
47
contracted GB with all walls outlined. Dx? Tx? risk?
porcelain GB urgent surgery, cancer risk
48
6 month old with intermittent severe abdominal pain requires what diagnostic tets?
air enema (barium) intussusception - plain film = soft tissue mass RUQ and absent liver edge. US - telescoping bowel
49
poor prognostic indicators in patient with pancreatitis?
at admission GLOWS (glucose > 200, LDH > 700, > 55 years, WBC . 16,000, SGOT (AST) > 250) 48 hours: hct decr by 10%, BUN rise > 5, Ca < 8, PaO2 < 60, base deficit > 4, fluid > 6L
50
tx is next indicated for patient with known alcoholic liver failure who presents with hematemesis?
IV octreotide
51
Next step for patient who presents with a button battery stuck in the esophagus? What about in stomach?
prepare for immediate removal in esophagus serial XR in stomach
52
40 year old patient with history of PUD presents with early satiety, vomiting after every meal, and weight loss has what complication?
gastric outlet obstruction hemorrhage, perforation, and penetration
53
20 year old female presents with multiple episodes of abd pain and constipation, occasional non-bloody diarrhea. pain improves with BM. most likely etiology?
irritable bowel syndrome

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