GI Flashcards by Corliss Elizabeth

Q

A patient presents with sudden onset of severe, diffuse abdominal pain.
Examination reveals peritoneal signs, and abdominal radiograph reveals free air under the diaphragm.
Management?

A

Emergent laparotomy to repair a perforated viscus.

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Q

The most likely cause of acute lower GI bleeding in patients >40 years of age.

A

Diverticulosis

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Q

Diagnostic modality used when ultrasonography is equivocal for cholecystitis.

A

HIDA scan (hepatobiliary iminodiacetic acid)

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Q

Risk factors for cholelithiasis

A

Fs

Fat, female, fertile, forty, flatulent

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Q

Inspiratory arrest during palpation of the RUQ

A

Murphy sign, acute cholecystitis

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Q

The most common cause of small bowel obstruction in patients with no hx of abdominal surgery

A

Hernia

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Q

The most common cause of SBO in patients with a hx of abdominal surgery

A

Adhesions

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Q

Key organism causing diarrhea:

Most common bacterial organism

A

Campylobacter

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Q

Key organism causing diarrhea:

Recent antibiotic use

A

Clostridium difficile

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Q

Key organism causing diarrhea:

Camping

A

Giardia

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Q

Key organism causing diarrhea:

Traveler’s diarrhea

A

ETEC - enterotoxigenic escherichia coli

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Q

Key organism causing diarrhea:

Church picnics/ mayonnaise

A

S aureus

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Q

Key organism causing diarrhea:

Uncooked hamburgers

A

E coli O157:H7

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Q

Key organism causing diarrhea:

Fried rice

A

Bacillus cereus

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Q

Key organism causing diarrhea:

Poulty/eggs

A

Salmonella

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Q

Key organism causing diarrhea:

Raw seafood

A

Vibrio, hepatitis A virus (HAV)

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Q

Key organism causing diarrhea:

AIDS

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A

Isospora, cryptosporidium, mycobacterium avid complex (MAC)

Q

Key organism causing diarrhea:

Pseudoappendicitis

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A

Yersinia, Campylobacter

Q

A 25-year-old Jewish man presents with pain and watery diarrhea after meals. Examination shows fistulas between the bowel and skin and nodular lesions on his tibias.

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A

Crohns Disease

Q

Inflammatory disease of the colon with an increased risk of colon cancer

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A

Ulcerative colitis (greater risk than Crohns)

Q

Extra intestinal manifestation of IBD

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A

Uveitis, ankylosing spondylitis, pyoderma gangrenosum, erythema nodosum, primary sclerosing cholangitis

Q

Medical treatment for IBD

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A

5-ASA agents and stereos during acute exacerbations

Q

A 30-year old man with ulcerative colitis presents with fatigue, jaundice, pruritus

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A

Primary sclerosing cholangitis

Q

Difference between Mallory-Weiss and Boerhaave tears

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A

Mallory-Weiss is superficial tear in esophageal mucosa

Boerhaave - full thickness esophageal rupture

Charcot triad

RUQ pain, jaundice, and fever/chills

Reynolds pentad

Charcot triad (RUQ pain, jaundice, fever/chills) + shock + mental status change

Medical treatment for hepatic encephalopathy

Decreased protein intake, lactulose, rifaximin

The first step in management of a patient with an acute GI bleeding episode

ABCs

A 4 year old child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely diagnosis and cause?

HUS due to E Coli O157:H7

Treatment after exposure to Hep B virus

HBV immunoglobulin

Classic cause of drug-induced hepatitis

TB medications (INH, rifampin, pytazinamide), acetaminophen, and tetracyclin

A 40-year old obese women with elevated alk phase, bill, pruritus, dark urine, and clay coloured stools

Biliary tract obstruction

Hernia with highest risk of incarceration - indirect, direct, or femoral?

Femoral hernia

Sever abdominal pain out of proportion to the examination

Mesenteric ischemia

Diagnosis of ileus

Abdominal radiographs (or CT scan)

A 50 year old man with a hx of alcohol abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. Management?

Confirm the dx of acute pancreatitis with increased amylase and lipase. Make the patient NPO, give IV fluids, O2, analgesia, and "tincture of time".

Colon cancer region based on symptoms: | Anemia from chronic disease, occult blood loss, vague abdominal pain

Right sided: rare to have obstruction

Colon cancer region based on symptoms: | Obstructive symptoms, change in bowel mvmts

Left sided: "apple-core" lesion

Presents with watery diarrhea, dehydration, muscle weakness, and flushing

VIPipoma (replace fluids and electrolytes, may need surgical resection of tumor, use octreotide)

Presents with palpable, contender gallbladder

Courvoisier sign (suggests pancreatic cancer)