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109 Cards in this Set
- Front
- Back
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Ballance's sign
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dullness LUQ, resonant RUQ
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Beck's triad
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JVD
Decreased, muffled heart sounds decreased bp cardiac tamponade |
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bergman's triad
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fat emboli
mental status changes petechiae dyspnea |
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Blumer's shelf
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mets to the rectouterine
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boas sign
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right subscapular pain from cholelithiasis
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Borchardt's triad
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emesis then no emesis
epigastric distension failure to pass an NgTube gastric volvulus |
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Carcinoid
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flushing
diarrhea right sided heart failure |
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Charco's triad
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Fever
Jaundice RUQ pain |
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Chvostek's sign
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twitching of facial muscles
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Courvoisier's law
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enlarged non-tender gallbladder seen w/ obstruction of the common bile duct most commonly w/ pancreatic cancer
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Cullen's sign
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blu periumbilical area- retroperitoneal hemorrhage tracking aroudn to the ant abdominal wall through fascial planes- acute hemorrhagic pancreatitis
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Cushing's triad
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HTN
Bradycardia Irregular respirations |
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Danc'e sign
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Empty right lower quadrant in kids w/ ileocecal intussusception
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Fothergill's sign
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differentiate intra-abdominal mass from 1 in the ab wall if mass is felt while there is tension on the musculature.
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Fox's sign
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ecchymosis of inguinal ligament seen w/ retroperitoneal bleeding
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Hamman's sign/crunch
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crunching on auscultation of the heart from emphysematous mediastinum, seen w/ oerhaave's syndrome, pneumomediastinum
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Homan's sign
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falf pain on forced dorsiflexion of the foot in DVT
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Howship-Romberg sign
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Pain along the inner aspect of the thigh; seen w/ obturator hernia as result of nerve compression.
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Kehr's sign
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severe shoulder pain in pts w/ splenic rupture- referred from diaphragm
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Krukenberg tumor
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mets to the ovary
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Kelly's sign
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visible peristalsis of the ureter
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Laplace's law
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Wall tension = pressure x radius
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McBurney's point
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1/3rd distance form the ant iliac spine to the umbilicus on a line connecting the two
tenderness here is a sign of appendicitis. |
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Meckel's diverticulum rule of 2s
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2% of population
2 of those are symptomatic 2 ft of the ileocecal valve |
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Mittleschmerz
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low quadrant pain in ovulation
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Reynold's pentad
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Fever
Jaundice RUQ pain Mental Status changes Shock/sepsis |
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Rovsing's sign
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palpation of the LLQ-> pain in RLQ- appendicitis
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Saint's triad
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cholelithiasis
Hiatal hernia Diverticular disease |
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Silk glove sign
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indirect hernia sac in peds; sac feels like a finger of a silk glove when rolled.
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Sister Mary Joseph's sign
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Mets to umbilical lymph nodes
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Virchow' snode
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mets to left supraclavicular cancer
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Virchow' striad
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risk factors for thrombosis
stasis abnl endothelium hypercoagulability |
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Trousseau's sign
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carpal spasm after occlusion of blood.
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Valentino's sign
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RLQ pain from perfed peptic ulcer from succus/pus draining into RLQ
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Westermark's sign
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decreased pulm vasc marking on CXR in pt w/ pulmonary embolus
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Whipple's triad
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hypoglycemia
CNS and vasomotor symps Relief of symps w/ admin of glucose |
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Wha is afferent loop syndrome
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afferent loop of billroth II gastrojejunostomy
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ARDS?
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acute resp distress syndrome
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what is blind loop syndrome
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bacterial overgrowth of intestine caused by stasis
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what is boerhaave's syndrome
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esophageal perf
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what is budd-chiari?
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thrombosis of hepatic veins
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dumping syndrome?
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hyperosmolar chyme into the small bowel after vagotomy and a gastric drainage proccedure.
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What is Fitz-Hugh-Curtis syndrome
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perihepatic gonorrhea infection
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what is gardner's syndrome
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GI polyps
SOD- sebaceous cysts, Osteomas, and Desmoid tumors. |
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What is mendelson's syndrome?
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chemical pneumonitis after aspiration of gastric contents
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What is mirizzi's syndrome
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extrinsic obstruction of the common hepatic bile duct from a cystic duct gallstone
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What is ogilvie's syndrome
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nonobstructive colonic dilation
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what is peutz-Jeghers
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benign polyps
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what is plummer-vison syndrome
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esophageal web
iron-deficiency anemia dysphagia spoon-shaped nails atrophic oral and tongue mucosa elderly, 10%- squamous cell carcinoma |
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what is RED reaction syndrome
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skin erythema from vancomycin infusion
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refeeding syndrome
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hypoK, hypoMg, hypophos
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What is Rendu-Osler-Weber syndrome
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GI tract telangiectasia
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what is short-gut?
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malnutrition from 100cm of viable small bowel
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what is sipple syndrome?
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MEN II
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what is tietze's syndrome?
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costochondritis of rib cartilage; aseptic
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what is trousseau's syndrome
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DVT w/ carcinoma
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Wermer's syndrome?
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MEN I
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What is another name for Crohn's
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regional enteritis
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What are common extra-intestinal manifestations of IBD?
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A PIE SACK
Aphthous ulcers Pyoderma gangrenosum Iritis Erythema nodosum Sclerosing cholngitis Arthritis, ankylosing spondylitis Clubbing of fingers kidney- amyloid, nephrotic syndrome |
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Crohn's epi:
incidence populations sex distribution |
3-6/100,000
jew, low in black; F>M 25-40; 50-65 |
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UC:
incidence populations sex distribution |
10/100,000
Jews, low in AA, + FHx in 20% M>F 20-35; 50-65 |
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What are the initial symptoms of Crohn's and UC?
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Crohn's- ab pain, diarrhea, feer, weight loss, anal disease
UC- bloody diarrhea, fever, weight loss |
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what is backwash ileitis?
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mild inflammation of the terminal ileum in UC;
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which involves the anus? UC or crohn's
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crohn's
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which involves the rectum? UC or crohn's
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UC
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what are the mucosal findings in crohn's?
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aphthoid ulcers
granulomas linear ulcers transverse fissues swollen mucosa Full thickness wall invovlement |
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what are the mucosal findings in UC?
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granular, flat mucosa
Ulcers Crypt abscess Dilated mucosal vessels Pseudopolyps |
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what meds are used for IBD?
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sulfasalazine
roids metronidazole azathioprine, infliximab |
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what is infliximab?
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TNF-alpha antibody
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what looks like a lead pipe on barium enema?
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chronic UC
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what are the intraop findings in crohn's?
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fat creeping onto the antimesenteric border of the small bowel
short and thick mesentery thick bowel wall fistula abscess |
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what is teh operation for short strictures of the small bowel in crohn's?
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stricturoplasty.
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what is pouchitis?
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inflammtion of the pouch of an ileoanal pull through.
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what do you need for crohn's resection?
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grossly negative margins
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What is an anal fistula?
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rectum to perianal skin
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what causes an anal fistula?
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crypt/gland infection
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what are the signs and symps of anal fistula?
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perianal drainage, perirectal abcess, "diaper rash, itching
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what disease should be considered with fistula in ano?
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Crohn's
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how is the dx made?
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exam, proctoscope
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what is goodsall's rule?
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ant. fistulas go straight
post. curl like a tail |
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What is the management of anal fistula?
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define the anatomy, marsupialization of the tract
- sitz baths and dressing changes - seton placement if fisutla is through the sphincter muscle |
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what is a aseton?
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thick suture placed through fistula tract to slow transection of sphincer muscle- allow scar tissue formed to hold sphincter muscle in place. allow for continence
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what % develop abcess after a fistula?
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50%
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how do you find an opening to the fistula in the OR?
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methylene blue- look for bubbles.
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what are the signs of a perirectal abscess?
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rectal pain, drainage of pus, fever, perianal mass
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what is the cause of a perianal abcess?
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crypt abscess in dentate line w/ spread.
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what is an inflammatory polyp?
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pseudo polyp in UC
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what is a hamartomatous polyp?
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normal tissue in abnormal configuration
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what is a hyperplastic polyp?
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normal, benighn
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what are the neoplastic polyps?
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tubular adenomas
tubulovillous adenomas villous adenomas |
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what determines malignant potential of a polyp?
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size, histo, atypia?
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what is the most common type of adenomatous polyp?
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tubular
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what is the size cut off for a polyp to have tumor potential?
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2cm is high risk
33-55% |
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What is the cancer potential of a polyp?
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villous > tubovillous > tubular
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What is the % of carcinomas found in the polyps?
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tubular- 5%
tubulovillous 20% Villous- 40% |
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where are polyps found?
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rectosigmoid
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what are the signs/symps of rectal polyps?
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bleeding, change in bowel habits, mucus per rectum, electrolyte loss, totally asymptomatic
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what are teh diagnostic tests for polyps?
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fecal occult blood, CBC, BE, endoscopy; all suspect tissue should be biopsied and sent to path.
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what is the Rx of polyps?
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endoscopic resection;
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What gene is affected in FP?
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APC gene
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What are teh signs/ symps of SBO?
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ab discomfort, cramping, nausea, ab distention, emesis, high-pitched bowel sounds
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What labs should be ordered w/ an SBO?
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E-lytes, CBC, type and screen, urinalysis
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what are classic electrolyte/acid-base findings w/ proximal obstruction?
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hypovolemic, hypochloremic, hypokalemic, alkalosis
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what must be ruled out on an SBO exam?
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hernia incarceration
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what major AXR findings are associated w/ SBO?
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distended loops of bowel, air fluid levels on upright film
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what is the danger of complete SBO?
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closed loop strangulation of the bowel-> necrosis
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what is the initial management of all pts w/ SBO?
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NPO, NGT, IVF, Foley
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what are the tests that can differentiate partial from complete SBO?
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CT w/ oral contrast, small bowel follow through.
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what are teh causes of SBO?
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ABC
GIVES BAD CRAMPS Adhesions Bulge- hernia Cancer Gallstone ileus intussusception Volvulus External compression SMA syndrome Bezoars, Bowel wall hematoma Abcesses Diverticuliltis Crohn's disease Radiation enteritis Annular pancreas Meckel's diverticulum Peritoneal adhesions Stricture |
