Medicine Shelf (My Questions)

Front 1

What is the imaging modality of choice for the diagnosis nephrolithiasis

Back 1

Noncontrast helical abdominal CT scan

Front 2

What should initial screening include in pts with acute abdominal pain?

Back 2

Supine and upright abdominal radiographs to look for air-fluid levels, suggestive of a bowel obstruction, and free peritoneal air, suggestive of a perforated viscus.

Front 3

Abdominal pain, back pain, and syncope

Back 3

Often herald an abdominal aortic aneurysm rupture.

Front 4

Most commonly in elderly patients with atherosclerotic vascular disease with crampy abdominal pain and bloody stool

Back 4

Ischemic colitis: in most cases it is self-limited.

Front 5

Best imaging modality to confirm suspected diverticulitis and evaluate for extraluminal complications

Back 5

Contrast-enhanced CT scan.

Front 6

What is the HUS diagnosis based on?

Back 6

Hemolytic uremic syndrome diagnosis is based on the presence of microangiopathic hemolytic anemia and thrombocytopenia.

Front 7

What can acute radiation protitis cause?

Back 7

Diarrhea and tenesmus within 6 weeks of therapy.

Front 8

What imaging do you use to diagnose chronic pancreatitis?

Back 8

abdominal CT scan

Front 9

How do pts with chronic pancreatitis present?

Back 9

Patients with chronic pancreatitis present with abdominal pain and, in more severe cases, malabsorption and endocrine insufficiency.

Front 10

How is Salmonella gastroenteritis treated?

Back 10

Because Salmonella gastroenteritis is usually self-limited, antibiotic treatment is generally not required for most healthy persons.

Front 11

Lab findings for hepatocellular injury

Back 11

Hepatocellular injury most often results in an elevation of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentrations and often is associated with direct hyperbilirubinemia.

Front 12

Findings in Gilbert Syndrome

Back 12

The incidental finding of indirect (unconjugated) hyperbilirubinemia in an asymptomatic patient with a normal hemoglobin level and otherwise normal liver tests is indicative of Gilbert syndrome.

Front 13

Definitive treatment for pts with symptomatic gallstone disease

Back 13

Cholecystectomy

Front 14

Clinical Diagnosis of acute cholangitis

Back 14

The clinical diagnosis of acute cholangitis is based upon the presence of fever, jaundice, and right upper quadrant abdominal pain and the finding of common bile duct obstruction.

Front 15

what is the preferred route for providing nutrition in pts with severe acute pancreatitis

Back 15

Enteral feeding

Front 16

What are the two most common causes of peptic ulcer disease?

Back 16

NSAIDs and Helicobacter pylori infection, which account for more than 90% of cases.

Front 17

What should be done first for pt with dyspeptic symptoms?

Back 17

NSAIDs are potential causes of dyspepsia and should be stopped or changed in patients with dyspeptic symptoms.

Front 18

What should be done for GI bleeding of obscure origin?

Back 18

In gastrointestinal bleeding of obscure origin, repeat upper endoscopy will identify a bleeding source in a significant proportion of patients.

Front 19

What is a a priority management intervention for gastrointestinal bleeding in hemodynamically unstable patients?

Back 19

Volume restoration is

Front 20

Patients with chronic hepatitis B infection in the absence of cirrhosis may develop hepatocellular carcinoma and should undergo periodic screening.

-what type of screening should be done?

Back 20

alpha-fetoprotein and liver US

-->liver US being more sensitive

Front 21

What is nonalcoholic steatohepatitis associated with?

Back 21

Nonalcoholic steatohepatitis (NASH) is associated with obesity, type 2 diabetes, and hyperlipidemia and is a potential cause of cirrhosis.

Front 22

What is primary sclerosing cholangitis strongly associated with?

Back 22

Primary sclerosing cholangitis is strongly associated with ulcerative colitis and is associated with marked elevations of alkaline phosphatase.

Front 23

Define hepatorenal syndrome

Back 23

The hepatorenal syndrome is defined as development of kidney dysfunction in patients with portal hypertension after exclusion of prerenal azotemia, renal parenchymal disease, or obstruction.

Front 24

Ulcerative Colitis

Back 24

Ulcerative colitis typically involves the rectum and extends proximally with contiguous inflammation that is generally limited to the mucosa of the colon and rectum.

Front 25

What is 1st line therapy for Ulcerative Colitis?

Back 25

First-line therapy for induction and maintenance of remission in mild to moderate ulcerative colitis is mesalamine or another 5-aminosalicylate agent.

Front 26

Chronic watery diarrhea without bleeding

Back 26

Microscopic colitis is characterized by chronic watery diarrhea without bleeding; the diagnosis must be made by histologic examination of colonoscopic biopsy specimens.

Front 27

Acute cholangitis

Back 27

RUQ pain, fever, jaundice. Bilirubin generally >4 mg/dL (68.4 mmol/L), AST and ALT may be >1000 U/L.

Front 28

Pneumonia

Back 28

Cough, shortness of breath, chest or upper abdominal pain.

Front 29

Acute viral hepatitis

Back 29

Jaundice; AST and ALT generally >1000 U/L.

Front 30

Acute alcoholic hepatitis

Back 30

Recent alcohol intake, fever. Leukocytosis, bilirubin generally >4 mg/dL (68.4 mmol/L), AST usually 2-3 times greater than ALT.

Front 31

Fitz-Hugh–Curtis syndrome (gonococcal perihepatitis)

Back 31

Pelvic adnexal tenderness, leukocytosis. Cervical smear shows gonococci.

Front 32

Cholecystitis

Back 32

Epigastric and RUQ pain that radiates to right shoulder. Mildly elevated bilirubin, AST, and ALT. Ultrasonography shows thickened gallbladder and pericholecystic fluid.

Front 33

Acute pancreatitis

Back 33

Mid-epigastric pain radiating to the back, nausea, vomiting. Elevated amylase and lipase. Usually secondary to gallstones or alcohol. Pain from penetrating peptic ulcer may present similarly.

Front 34

Inferior myocardial infarction

Back 34

Chest/mid-epigastric pain, diaphoresis, shortness of breath. Elevated cardiac enzymes. Acutely abnormal electrocardiogram.

Front 35

Perforating peptic ulcer

Back 35

Postprandial abdominal pain, weight loss, abdominal bruit (chronic presentation); pain out of proportion to tenderness on palpation.

Front 36

Mesenteric ischemia

Back 36

Possible anion gap metabolic acidosis. Abdominal plain films may show classic thumbprinting sign (acute presentation).

Front 37

Small bowel obstruction

Back 37

Colicky pain. Obstructive pattern seen on CT or abdominal series.

Front 38

Aortic dissection/rupture

Back 38

Elderly patient with vascular disease and sudden-onset severe pain that radiates to the back and lower extremity.

Front 39

Diabetic ketoacidosis

Back 39

Blood glucose always elevated, anion gap always present.

Front 40

Acute appendicitis

Back 40

Mid-epigastric pain radiating to RLQ. Ultrasonography and CT may confirm diagnosis.

Front 41

Ectopic pregnancy, ovarian cyst/torsion

Back 41

RLQ or LLQ abdominal pain, nausea, fever; leukocytosis. Suspect in female with unilateral pain.

Front 42

Pelvic inflammatory disease

Back 42

May be RLQ or LLQ; fever; abdominal tenderness, uterine/adnexal tenderness, cervical motion tenderness; cervical discharge.

Front 43

Nephrolithiasis

Back 43

Right or left flank pain that may radiate to groin; hematuria.

Front 44

Pyelonephritis

Back 44

Fever, dysuria, and pain in right or left flank that may radiate to lower quadrant. Urinalysis shows leukocytes and leukocyte casts.

Front 45

Acute diverticulitis

Back 45

Pain usually in LLQ but can be RLQ if ascending colon is involved. CT can diagnose complicated diverticular disease with abscess formation.

Front 46

Toxic megacolon

Back 46

Nonobstructive dilatation of transverse and descending colon. Systemic toxicity. Associated with inflammatory bowel disease and Clostridium difficile infection.