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Step 3 > OME - Day 12 > Flashcards

OME - Day 12 Flashcards

1
Q

Colicky right upper quadrant abdominal pain: what’s the diagnosis and next step?

A

Gallstones, cholelithiasis, get an ultrasound

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2
Q

Gallstones and dilated common bile duct on ultrasound, diagnosis?

A

Choledocholithiasis

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3
Q

Inspiratory arrest on palpation of the gallbladder shows what?

A

Murphy’s sign, positive for cholecystitis

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4
Q

Right upper quadrant pain, jaundice, and fever is what diagnosis?

A

Ascending Cholangitis, Charcot’s Triad

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5
Q

Right upper quadrant pain, jaundice, fever, altered mental status and hypotension; what do you do?

A

ERCP (first) and antibiotics (at the same time), Ascending Cholangitis (Reynold’s pentad)

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6
Q

What antibiotics for Ascending Cholangitis?

A

Cipro + Metronidazole or Ampicillin + Gentamycin + Metronidazole

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7
Q

What are the risk factors for gallstones?

A

Female, Fat, Forty, Fertile, and Native American

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8
Q

What are the ultrasound findings for a cholecystitis?

A

Pericholecystic fluid, thickening of gallbladder wall, gallstones

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9
Q

You get an ultrasound and you aren’t sure if it is cholecystitis - what do you get?

A

HIDA scan

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10
Q

Biopsy of esophagus reveals 30 eosinophils per high power field, what is the next step?

A

PPI (not oral steroids? treat eosinophilic esophagitis as GERD first)

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11
Q

Guy tries to kill himself by drinking battery acid. What do you do?

A

Protect airway, EGD, maintain NPO

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12
Q

How do you treat candida esophagitis?

A

Oral fluconazole

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13
Q

How do you treat HSV esophagitis?

A

Valaciclovir or Acyclovir

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14
Q

Odynophagia and a white cottage cheese on the mouth that can be removed, what’s the diagnosis?

A

Candida esophagitis

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15
Q

Old lady on oral antibiotics in a nursing home complains of odynophagia, what’s the diagnosis?

A

Pill-induced esophagitis

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16
Q

Oral lesions, vesicles on an erythematous base and odynophagia in an AIDS patient, what’s the diagnosis?

A

HSV esophagitis

17
Q

Biopsy of Achalasia will show what?

A

Absence of Auerbach Plexus

18
Q

Bird’s peak on barium swallow, diagnosis?

A

Achalasia

19
Q

Corkscrew esophagus on barium swallow, diagnosis?

A

Diffuse Esophageal Spasm

20
Q

Dysphagia, Webs, and Iron Deficiency Anemia, diagnosis?

A

Plummer-Vinson Syndrome

21
Q

Esophageal cancer of the lower esophagus with risk factors?

A

GERD, Adenocarcinoma

22
Q

Esophageal cancer of the upper esophagus with risk factors?

A

Squamous Cell Carcinoma, smoking and alcohol

23
Q

GERD and scleroderma - tx?

A

PPIs

24
Q

Halitosis, old man, regurgitates undigested food - what’s the diagnosis?

A

Zenker’s Diverticulum (do a Barium Swallow)

25
Q

How do you treat Diffuse Esophageal Spasm?

A

Nitro spray or calcium channel blockers.

26
Q

Paroxysmal dysphagia to large caliber food, diagnosis?

A

Schatzki’s Ring

27
Q

What is the best next step after Achalasia on the esophagram, and why?

A

EGD with biopsy to rule out pseudoachalasia (aka cancer)

28
Q

What is the best treatment for Achalasia?

A

Myotomy

29
Q

Burning retrosternal chest pain better with sitting up and antacids, diagnosis?

A

GERD

30
Q

Nocturnal asthma without daytime Asthma, diagnosis?

A

GERD

31
Q

Salmon colored lesion on endoscopy of the esophagus - diagnosis?

A

Barrett’s Esophagus

32
Q

Treatment for Barrett’s Metaplasia?

A

High dose PPI

33
Q

Treatment for Esophageal Dysplasia?

A

Ablative therapy (you won’t have to chose which)

34
Q

Treatment for Esophageal Adenocarcinoma?

A

Resection

35
Q

What is the first step in management of GERD?

A

PPIs

36
Q

What is the biopsy of Barrett’s Esophagus going to look like?

A

Intestinal Metaplasia

37
Q

When do you go straight to EGD for GERD without treating?

A

Nausea, Vomiting, Weight Loss, Anemia

38
Q

When do you go to EGD for GERD without alarm symptoms?

A

After 6 weeks of PPI

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