Exam (elaborations)
Foundations CBR20 – Gastrointestinal
Foundations CBR20 – Gastrointestinal
[Show more]
Content preview
Foundations CBR20 – GastrointestinalWhat pain medication is best for biliary colic? ✔️Ans - NSAIDS, it is
prostaglandin mediated pain
US with +gallstone and dilated common bile duct ✔️Ans -
Choledocolithiasis, ± Jaundice, Rx: ERCP
Gold standard for diagnosing choledocolithiasis? ✔️Ans - MRCP. ERCP and
endoscopic US are good as well but they are invasive.
How sensitive if Murphy's sign for Acute Cholecystitis? ✔️Ans - 65-70%
What are possible US findings in Acute Cholecystitis? ✔️Ans - Gallstones,
gallbladder wall thickening (>3mm), pericholecystic fluid, sonographic
Murphy's
Who is most at risk for Acalculous Cholecystitis? ✔️Ans - Inflammed GB but
NO stone; typically in very sick (hospitalized) or elderly
Fever + RUQ pain + Jaundice ✔️Ans - Charcot's Triad; Reynold's Pentad:
add AMS, hypotension; Cholangitis: biliary obstruction with ascending
bacterial infection; HIGH Mortality, Rx: abx, ERCP vs surgery
Chronic RUQ abd pain, Jaundice, Weight Loss ✔️Ans - Cholangiocarcinoma
What is the risk of cancer in patients with a Porcelain Gallbladder? ✔️Ans -
25%
What arthropod is associated with pancreatitis? ✔️Ans - Scorpion
Abdominal pain with bruising around the flank and umbilicus? ✔️Ans -
Hemorrhagic Pancreatitis; Ecchymosis of left flank (Grey-Turner sign),
umbilical ecchymosis (Cullen sign)
Does lipase level coorelate with severity of disease in Pancreatitis? ✔️Ans -
No
, What are the components of Ranson's Criteria in Acute Pancreatitis? ✔️Ans
- Predicts mortality; At admission: Age > 55, WBC > 16k, Glucose >200, LDH >
350, AST > 250; At 48hr: Ca < 8, Hct drop > 10%, PO2 < 60, BUN increase >5,
Neg base excess > 4, Fluid sequestration > 6L
What is a potential consequence of Chronic Pancreatitis? ✔️Ans -
Malabsorption when 90% affected
Painless jaundice and palpable gallbladder (Courvoisier sign) ✔️Ans -
Pancreatic Cancer; most common at head of pancreas, high mortality, high CA
19-9; also may have "Trousseau's sign" (migratory thrombophlebitis)
What is the difference between incarcerated and strangulated hernias?
✔️Ans - Incarcerated: stuck; Strangulated: ischemic (requires surgery)
What is the underlying pathology in Achalasia? ✔️Ans - Impaired
relaxation of the lower esophageal sphincter (LES), absence of peristalsis;
most common esophageal motility disorder. Pts will present with dysphagia
and they will "raise their arms above their heads" or "straighten their backs"
after eating to increase intraesophageal pressure
Chest pain after vomiting, ill-appearing ✔️Ans - Boerhaave's Syndrome:
full-thickness perforation of esophagus causing mediastinitis; Mackler's Triad:
SQ emphysema + chect pain + vomiting; "Hamman's Crunch" (crunching
sound around heart); Dx: esophagram (water soluble) or CT w/ contrast; Rx:
abx, surgical consult
On what side of the esophagus is rupture most common ✔️Ans - Left side
(distal posterolateral esophagus)
What condition predisposes to spontaneous rupture of the esophagus?
✔️Ans - Esophageal Candidiasis (consider in HIV patient); Rx: oral
fluconazole, IV fluconazole if pt is septic or cannot tolerate PO.
Regurgitating food and recurrent aspiration pneumonia ✔️Ans -
Esophageal Diverticula (Zenker's is pharyngeal mucosa above UES)
Kid with witnessed choking episode ✔️Ans - Esophageal (or tracheal)
foreign body; do thorough workup so this is not missed
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Studyhall. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for CA$15.12. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81989 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now