Gastrointestinal 2
Terms
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- patient presents with sudden onset of severe diffuse abd. pain. Exam reveals peritoneal signs and AXR shows free air under the diaphragm. Rx?
- emergent laparotomy to repair perforated viscus, likely stomach.
- most likely cause of acute LGIB in patients >40
- diverticulosis
- Diagnostic modality used when U/S is equivocal for cholecystitis
- HIDA scan
- Sentinel loop on AXR
- acute pancreatitis
- risk factors for cholelithiasis
- fat, female, forty, fertile, flatulent
- inspiratory arrest during palpation of RUQ
- Murphy's sign - acute chole
- Most common organism causing diarrhea
- campylobacter
- most common organism for diarrhea post abx use
- c. diff
- most common cause of diarrhea after camping
- Giardia
- Most common organism for traveler's diarrhea
- ETEC
- Most common organism for diarrhea after a picnic
- S. aureus (mayonnaise)
- Most common organism causing diarrhea from undercooked hamburger
- E. Coli O157:H7
- Diarrhea from fired rice?
- B. cereus
- Diarrhea from poultry/eggs?
- Salmonella
- Diarrhea from raw seafood?
- Vibrio, HAV
- Diarrhea in AIDS?
- Isospora, Cryptosporidium, MAC
- Pseudoappendicitis?
- Yersinia
- 25y/o Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulae b/t the bowel and skin and nodular lesions of his tibias
- Crohn's
- Extraintestinal manifestations of IBD
- uveitis, anklosing spondylitis, pyoderma gangrenosum, erythema nodosum, primary sclerosing cholangitis
- medical treatment of IBD
- 5-ASA +/- sulfasalazine and steroids during acute exacerbations
- difference between Mallory-Weiss and Boerhaave tears
-
Mallory-Weiss - superficial tear in the esophageal mucosa
Boerhaave - full thickness esophageal rupture - Charcot's triad
-
fever,chills
jaundice
RUQ pain
in the setting of ascending holangitis - Reynold's pentad
-
RUQ pain
jaundice
fever/chills
altered mental status
shock
in setting of suppurative ascending cholangitits - Medical treatment for hepatic encephalopathy
- decreased protein intake, lactulose, neomycin
- first step in the management of patient with acute GIB
- establish ABC's
- 4 y/o child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause
- HUS, E. coli O157:H7
- post-HBV exposure treatment
- immunoglobulin and vaccination
- classic causes of drug-induced hepatitis
- TB meds (INH, rifampin, pyrazinamide) acetaminophen, tetracycline
- 40 y/o obese female with elevated ALP, bilirubin, pruritis, dark urine and clay coloured stools
- biliary tract obstruction
- hernia with highest risk of incarceration?
- femoral
- 50 y/o male with hx of EtOH abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?
-
Confirm acute pancreatitis with elevated amylase, lipase.
NPO, IV fluids, analgesia, O2