Step 2: First Aid Rapid Review (Gi)

Front 1

pt presents with sudden onset of severe, diffuse abd. pain. exam reveals peritoneal signs and AXR reveals free air under the diaphragm. mgmt?

Back 1

emergent laparotomy to repair perforated viscus, likely stomach

Front 2

most likely cause of acute lower GI bleed in pts >40 yrs old?

Back 2

diverticulosis

Front 3

diagnostic modality used when u/s is equivocal for cholecystitis?

Back 3

HIDA scan

Front 4

sentinel loop on AXR?

Back 4

acute pancreatitis

Front 5

risk factors for cholelithiasis

Back 5

Fat
Female
Fertile
Forty
Flatulent

Front 6

inspiratory arrest during palpation of the RUQ

Back 6

Murphy's sign, seen in acute cholecystitis

Front 7

most common diarrhea organism?

Back 7

campylobacter

Front 8

diarrhea after recent antibiotic use. bug?

Back 8

clostridium difficile

Front 9

diarrhea after camping. bug?

Back 9

giardia

Front 10

traveler's diarrhea. bug?

Back 10

ETEC

Front 11

diarrhea from church picnics, mayonnaise. bug?

Back 11

S. aureus

Front 12

diarrhea from uncooked hamburgers. bug?

Back 12

E. coli O157:H7

Front 13

diarrhea from fried rice. bug?

Back 13

Bacillus cereus

Front 14

diarrhea from poultry/eggs. bug?

Back 14

Salmonella

Front 15

diarrhea from raw seafood. bug?

Back 15

Vibrio, HAV

Front 16

diarrhea from AIDS. bug?

Back 16

Isospora
Cryptosporidium
Mycobacterium avium complex (MAC)

Front 17

diarrhea from pseudoappendicitis. bug?

Back 17

Yersinia

Front 18

25yo Jewish male presents with pain and watery diarrhea after meals. Exam shows fistulas b/w the bowel and skin and nodular lesions on his tibias. Likely cause?

Back 18

Crohn's disease

Front 19

Inflammatory disease of colon with increased risk of colon CA.

Back 19

Ulcerative colitis

Front 20

Extraintestinal signs of IBD?

Back 20

uveitis
ankylosing spondylitis
pyoderma gangrenosum
erythema nodosum
primary sclerosing cholangitis

Front 21

medical tx for IBD?

Back 21

5-aminosalicylic acid +/- sulfasalazine and steroids during acute exacerbations

Front 22

difference b/w Mallory-Weiss and Boerhaave tears

Back 22

Mallory-Weiss: superficial tear in the espophageal mucosa

Boerhaave: full-thickness esophageal rupture

Front 23

Charcot's triad? disease?

Back 23

RUQ pain, jaundice, and f/c in setting of ascending cholangitis

Front 24

Reynold's pentad

Back 24

Charcot's triad plus shock and MS changes with suppurative ascending cholangitis

Front 25

Medical tx for hepatic encephalopathy

Back 25

lower protein intake, lactulose, neomycin

Front 26

1st step in the mgmt of a pt with acute GI bleed

Back 26

establish the ABC's

Front 27

4yo child presents with oliguria, petechiae, and jaundice following an illness with bloody diarrhea. Most likely dx and cause?

Back 27

hemolytic-uremic syndrome (HUS) due to E. coli O157:H7

Front 28

post-HBV exposure tx

Back 28

HBV immunoglobulin

Front 29

classic causes of drug-induced hepatitis

Back 29

TB meds (INH, rifampin, pyrazinamide), acetaminaphen, and tetracyclline

Front 30

40yo obese female with elevated alkaline phosphatase, elevated bilirubin, pruritis, dark urine, and clay-colored spots

Back 30

biliary tract obstruction

Front 31

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

Back 31

femoral hernia

Front 32

50yo man with hx of ETOH abuse presents with boring epigastric pain that radiates to the back and is relieved by sitting forward. mgmt?

Back 32

confirm dx of acute pancreatitis with elevated amylase and lipase. Make pt NPO and give IV fluids, O2, analgesia, and 'tincture of time'