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34 Cards in this Set

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What is a Carnett sign?
• used to diagnose abdominal wall tenderness
• examiner paintains a finger on the tender area and the patient is asked to sit-up halfway
• same or increased tenderness of the tender area is positive for an abdominal wall syndrome
What is the most common cause of upper GI bleeding?
peptic ulcer disease
What is the most common cause of apparent lower GI bleeding? of actual lower GI bleeding?
• upper GI bleeding is the MCC of apparent lower GI bleeding
• hemorrhoids is the MCC of actual lower GI bleeding
What are the top 3 most common causes of large bowel obstruction?
1. neoplasm
2. diverticulitis
3. sigmoid volvulus
What is the most common presentation of gallstones?
biliary colic
How can upper GI bleeding affect the BUN level?
upper GI bleeding may elevate the BUN level
What medication can be used used to treat esophageal varices?
octreotide
What are foods that can exacerbate GERD?
• caffeine
• chocolate
• ethanol
• fatty foods
• nicotine
What is a Hammon crunch?
• air in the mediatstinum being moved by the beating heart
• seen in esophageal perforation
Broad spectrum IV antibiotics are given to patients with esophageal perforation to cover aerobic and anaerobic organisms. What are example of antibiotics that can be given?
• single drug coverage (Pipercillin/Tazobactam)
• double drug coverage (cefotaxime or ceftriaxone + clindamycin or metronidazole)
What are clinical signs in pediatric patients that are consistent with foreign body ingestion?
• palatal abrasion
• peritoneal signs
• red throat
• temperature elevation
What are medications that can be used to lower esophageal sphincter relaxation to resolve esophageal food impaction?
• glucagon
• nifedipine
• nitroglycerin
Where in the intestine do ingested sharp objects most commonly cause perforation?
ileocecal valve
What is the procedure of choice for foreign body retrival?
endoscopy
What in the history would suggest gastric outlet obstruction?
• early satiety
• frequent vomiting
• nausea
• weight loss
How is a definitive diagnosis of PUD made?
upper GI series using barium or direct endoscopic visualization
What is the easiest test in the ED to test for H. pylori?
rapid serologic detection of IgG antibodies
What are complications from misdiagnosis of appendicitis?
• adhesion formation
• bowel obstruction
• infertility
• intraabdominal abscess
• wound infection
What is the most common extrauterine surgical emergency in preganancy?
appendicitis
What are predisposing factors for hernias?
• conditions that increase intraabdominal pressure (ex. ascites, pregnancy)
• COPD
• family history
• GU abnormalities
• lack of developmental maturity
• surgical incision sites
• undescended testes
What are causes of umbilical hernias?
• ascities
• increased abdominal distention secondary to obesity
• pregnancy
What are common causes of hemorrhoids?
• ascites
• constipation
• increased portal venous pressure
• ovarian tumors
• pregnancy
• radiation fibrosis
• staining
What is the most common cause of painful rectal bleeding?
anal fissures
Where do most anal fissures occur?
midline posteriorly
What are clinical features of anal fissures that distinguish it from other anorectal disorders?
sharp cutting pain occuring during defecation that subsides between bowel movements
Clinically, at what serum bilirubin level does jaundice usually become noticable?
2.0-2.5 mg/dl
What are the 5 cayses of postoperative fever (5 W's)?
• wind (respiratory)
• water (UTI)
• wound
• walking (DVT)
• wonder drugs (pseudomembranous colitis)
How many days after surgery do postoperative UTIs usually occur?
3-5 days
How many days after surgery to DVTs usually develop?
5 days
How many days after surgery do wound infections typically manifest?
7-10 days
How long does small bowel, gastric, and colonic function take to return to normal after GI surgery?
• small bowel: with 24 hrs
• gastric: within 2 days
• colon: within 3 days
What disease is diagnosed by Giemsa stain?
Malaria
What are 2 distinguishing features of acalculous cholecystitis?
• frequently occurs as a complication of another process
• patients frequently are gravely ill on initial presentation
What are some medications associated with acute pancreatitis?
• acetominophen
• calcium
• diuretics
• furosemide
• glucocorticoids
• indomethacin
• INH
• OCP
• rifampin
• salicylates
• tetarcycline
• warfarin