Tulsamedstudy Gi 2

Front 1

Common colon problem in older adults that needs colonoscopy

Back 1

Diverticulitis

Front 2

Are CEA level useful for primary diagnosis, recurrence, or both in colon carcinoma?

Back 2

CEA levels are good only for recurrence and only if levels were elevated before surgery and reduced after surgery
-CEA levels mildly elevated in smokers, benign biliary disease, sclerosing cholangitis, IBd

Front 3

When is adjuvant chemotherapy used in colon cancer?

Back 3

Only for stage III or locally advanced II

Front 4

Lesions that radiation is helpful for in colon cancer

Back 4

Rectal

Front 5

Most common cause of colonic bleeding in the elderly

Back 5

Diverticular bleeding

Front 6

Labs that suggests an upper G.I. Bleed

Back 6

B UN/CR ratio greater than 30 to 1

Front 7

Signs and symptoms of diverticulitis

Back 7

-left lower quadrant pain
- fever
-high WBC
- left lower quadrant tenderness
-no bleeding!

Front 8

Contraction of hypertrophied colonic muscle

Back 8

Painful diverticulosis

Front 9

CT findings in diverticulitis

Back 9

Thickened sigmoid colon
Or paricolic fluid accumulation

Front 10

Treat mild diverticulitis with

Back 10

Outpatient metronidazole for gram-negative an aerobics plus either ciprofloxacin or Bactrim for gram-negative aerobics and close follow

Front 11

Most frequent congenital G.I. anomaly

Back 11

Meckels diverticulum

-Cause 1/2 of GI bleeds in children
-Only ones with gastric mucosa bleed, can also cause obstruction and intussusception

Front 12

Second most common cause of lower G.I. bleeding in elderly

Back 12

Angiodysplasia = vascular ectasia =AVM

Front 13

Patients with HH T, Osler Weber Rendu syndrome, hereditary hemorrhagic Telangiectasia often have a history of____________

Back 13

Epistaxis

Front 14

Treatment for moderate to severe diverticulitis

Back 14

Dual drug therapies best such as aminoglycoside or ciprofloxacin plus clindamycin or metronidazole

Front 15

Thumbprinting is what and scene where?

Back 15

-Submucosal hemorrhage and edema on abdominal x-ray or barium enema
-Seen in ischemic colitis

Front 16

Sudden LL Q pain with an urge to defecate followed by passage of red to maroon stool within one day

Back 16

Colonic ischemia, ischemic colitism

Front 17

Ischemic colitis, if no signs of peritonitis diagnosed with

Back 17

Colonoscopy, usually done without bowel prep to reduce risk of decreasing blood flow due to use of dehydrating agents

Front 18

Clinical presentation of acute mesenteric ischemia?

Back 18

Patient with the other heart disease or cardiac arrhythmia who is acutely ill with vomiting diarrhea and Occult blood

Front 19

Lab findings in bowel infarction? ( acute mesenteric ischemia)

Back 19

Acidosis, increased lactate, elevated amylase
Do angiography If no signs of perforation

Front 20

Mesenteric venous thrombosis is associated with____________ states

Back 20

Hypercoagulable

Front 21

Mesenteric venous thrombosis is also linked to. _____________. ______________ __________________. _________________. ________________

Back 21

Pancreatitis
liver disease (cirrhosis)
intra-abdominal sepsis
sickle cell disease
paroxysmal nocturnal hemoglobinuria

Front 22

Most cases of constipation are due to what

Back 22

Greater than 90% of cases are idiopathic

Front 23

Common gynecologic surgery meeting to constipation in 5% of patients?

Back 23

Hysterectomy

Front 24

Clinical presentation of fecal impaction?

Back 24

Sudden onset of watery stools/incontinence in a person with chronic constipation

Front 25

Colonic transit test function markers

Back 25

Sits markers If they're spread throughout the colon= generalized colonic inertia clustering of markers in the rectosigmoid colon indicates pelvic floor dysfunction

Front 26

Most common causes of pancreatitis in the US

Back 26

EtOH, gallstones

Front 27

ERCP causes pancreatitis in ________percent of patients

Back 27

5-20%

Front 28

Other causes of acute pancreatitis

Back 28

Acidosis DKA,
hypertriglyceridemia,
hypercalcemia,
trauma,
problems resulting in obstruction of Ampula of vater i.e. pancreatic cancer

Front 29

Drugs that can cause Pancreatitis

Back 29

Diuretics
estrogens
azathioprine
oral hypoglycemic
tetracyclines sulfonamides

Front 30

Amylase and lipase and pancreatitis

Back 30

Amylase usually elevated early but decreases in two- three days –
lipase increases later and stays elevated beyond Day 7

Front 31

Hi triglyceride levels in the setting of acute pancreatitis can cause a spuriosly ___________amylase level

Back 31

Normal
additionally, triglyceride levels greater than 1000 mg/dL can cause pancreatitis

Front 32

Physical findings reflecting severe pancreatic Necrosis with multiple organ failure?

Back 32

Hemo concentration
– her: systolic blood pressure less than 90 mm HG tachycardia greater than 130 beats permanent
– lungs PO2 less than 60mmHg
- renal progressive azotemia or oliguria less than 50 mL per hour
-CNS sx Altered sensorium
-Low calcium low albumin

Front 33

Cullen sign
Turners sign

Back 33

Blue around umbilicus
Blue purple around flanks

Front 34

Most common skin signing pancreatitis?

Back 34

Erythema of the flanks caused by extravasated pancreatic exudate

Front 35

Pancreatitis cause is best confirmed by

Back 35

Ultrasound

Front 36

Masses due to acute pancreatitis

Back 36

Acute fluid collections 48 hours,
necrotic tissue 1-2 weeks,
pseudocyst at least four weeks,
abscess 4-6 weeks

Front 37

First test in the work up of etiology of acute pancreatitis

Back 37

Gallbladder ultrasound to rule out gallstones

Front 38

Clinical presentation of chronic pancreatitis?

Back 38

Initially asymptomatic then recurrent bouts of the abdominal pain then steatorrhea and diabetes

Front 39

In acute pancreatitis if amylases still elevated after 10 days think of

Back 39

Leaking pseudocyst

Front 40

Gastric varices in the absence of esophageal varices occur only in

Back 40

Splenic vein thrombosis, which is a complication of both severe acute pancreatitis and chronic pancreatitis

Front 41

ERCP is only done acutely if:

Back 41

Pt has Cholangitis and sepsis

Front 42

Billy Rubin is greater than 2.5 and rising and ultrasound shows a dilated common duct

Back 42

Do MRCP to diagnose common duct stone

Front 43

Conditions that can cause abdominal pain and elevated amylase

Back 43

Acute pancreatitis, acute cholecystitis, intestinal infarction, diabetic ketoacidosis,
perforated ulcer,
ectopic pregnancy