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26 Cards in this Set

  • Front
  • Back
What is assessed by the first five of Ranson's criteria?
2) wbc count
3) LDH
4) AST
5) glucose
What is assessed by the second set of Ranson's criteria?
1) hematocrit fall
2) BUN elevation
3) serum calcium
4) base deficit
5) estimated fluid sequestration
What are the mortality figures of Ranson's criteria?
* less than 2: 0%
* 3 to 5: 10 to 20%
* 6 or more: 50%
When are the two sets of Ransons' criteria applied? Must all be assessed?
first 5 at admission, second 6 during the first 48 hours.
What causes the sweating, weakness, tachycardia associated with hypoglycemia?
epinephrine release during hypoglycemia.
What does Whipple's triad summarize?
clinical findings in patients with insulinomas.
What is Whipple's triad?
1) attacks precipitated by fasting or exertion
2) fasting blood glucose concentrations < 50mg/dL
3) symptoms relieved by oral or IV glucose administration.
What is the treatment of a pancreatic Beta cell insulinoma?
surgical excision (75% are benign adenomas, which are cured by excision)
What is the treatment of epidermoid cancers of the anal canal? Why?
combined external radiation w/ synchronous chemo (FU and mitomycin). surgical results have been disappointing. these met to inguinal, perirectal, and mesenteric nodes.
When is surgery indicated in Crohn's disease?
surgery is usually aimed at complications causing symptoms (obstruction, lack of ability t absorb nutrients, etc.) fistulization is not an idication unless it is betwee bowel and bladder or vagina or some area causing major symptoms.
What is the differential of markedly distended colon?
tumor, foreign body, colitis, but most commonly is either cecal or sigmoid volvulus.
What is the treatment of sigmoid volvulus?
Sigmoidoscopy, which can provide decompression.
What is the usual triple therapy in H. pylori infection?
PPI or colloidal bismuth (pepto bismol), antibiotic (amox or amp), and a nitroimidazole (metronidazole).
How might a cecal volvulus present after an abdominal operation?
several days after the operation, with markedl distended abdomen, an abdominal radiograph demonstrating an air-filled, kidney-bean shaped structure in the LUQ.
How is a cecal volvulus best managed in a patient who recently had prior abdominal surgery?
resection with ileotransverse colostomy.
Does appendicitis occur at an increased rate for pregnant women?
What is the most prevalent extrauterine indication for laparotomy during pregnancy?
Which type of esophageal hernia requires operation sliding or paraesophageal?
paraesophageal because part of the stomach could be incarcerated and necrose.
What is required to diagnose Ogilvie syndrome?
It is a syndrome in which massive cecal and colonic dilation is seen in the absence of mechanical obstruction. it can't be confirmed until mechanical obstruction of the distal colon is excluded by colonoscopy or contrast enema.
What is Zenker's diverticulum?
acquired abnormality. premature contraction of the cricopharyngeus muscle on swallowing, which leads to partial obstruction, beleived to be the cause of this pulsion-type diverticulum. of the pharyngoesophageal junction. high intraluminal pressure results in outpouching of mucosa through oblique fibers of the pharyngeal constrictors.
What is the most common presentation of the Zenker's diverticulum?
What are possible complications of Zenker's diverticulum?
it's above the superior esophageal sphincter, so no mechanism exists to prevent aspiration of the contents of the diverticulum, patients present w/ regurgitation and recurrent aspiration pneumonias.
How is diagnosis of Zenker's diverticulum accomplished?
barium swallow.
What is the treatment of Zenker's diverticulum?
diverticulotomy w/ cricopharyngeal myotomy.
What is the classic triad of hemobilia? how often is that triad found?
Quincke triad is : abdominal pain in RUQ, jaundice, and GI bleeding. it's present in 30-40% of patients w/ hemobilia.
What is the treatment for intrahepatic bleeding?
angiographic embolization can control bleeding in 95% of cases.