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128 Cards in this Set
- Front
- Back
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constipation Tx
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1.increase fiber 30g/d
2.increase fluids 3.bulk-forming, emollient laxatives |
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pain in testicle
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referred pain of ureteral obstruction
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AAA Tx
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good IV acccess, type, cross
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severe abdominal pain out-of-proportion to exam
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mesenteric ischemia
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MI + gnawing abdominal pains after eating + wt loss
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chronic mesenteric ischemia
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HIV + odynophagia + esophagitis
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candida/CMV/herpes
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full-thickness tear esophagus
(Tx) |
Boerhaave's syndrome
(surgery) |
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partial-thickness tear esophagus
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Mallory-Weiss syndrome
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drugs,hormones lowering LES tone
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1.CCB
2.nitrates 3.estrogen 4.progesterone |
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high-grade Barrett's Tx
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resection
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non-high-grade Barrett's Tx
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lifetime endoscopy
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Barrett's does/doesn't regress
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doesn't
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early satiety + vomiting + wt loss
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gastric outlet obstruction
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free air under diaphragm
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perforation
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duodenal ulcer blood type association
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type O
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secretin
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gastrin inhibitor
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PUD surgery indication
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refractory to meds 12 wks
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gastric ulcer blood type association
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type A
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all/some gastric ulcers are biopsied
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ALL
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drugs causing pancreatitis
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1.furosemide
2.thiazides 3.estrogen 4.antiretrovirals |
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gastric varices indicates...
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splenic vein thrombosis (pancreatitis complication)
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pancreatitis
<48 hrs 1-4 wks 4-6 wks |
pleural effusion (high amylase)
pseudocyst abscess |
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chronic pancreatitis Tx
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1.pain control
2.abstain alcohol/fatty foods 3.pancreatic enzyme supplement |
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CCK release stimulated by...
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1.fats
2.amino acids |
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cholesterol stones commonly seen in...
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1.rapid wt loss
2.OCT 3.ileal disease |
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cholecystitis dx test
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HIDA (nl = gallbladder outline in 1 hr) (abnl = no outline)
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cholecystitis tx
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1.gall bladder removal (definitive)
2.pain control 3.2nd/3rd gen ceph |
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acalculous cholecystitis = increased/decreased M&M?
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increased M&M
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ascending cholangitis dx test
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ERCP
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ascending cholangitis tx
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1.ERCP
2.fluids, vasopressors 3.antibiotics |
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PSC Tx
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liver transplant
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dupuytren's contracture
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cirrhosis
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alcoholic cirrhosis + vomiting Tx
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1.fluids
2.octreotide |
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cirrhosis + ascites Tx
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spironolactone
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most sensitive serum marker for alcohol binging
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GGT
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hepatic encephalopathy Tx
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1.lactulose
2.protein restrict 3.neomycin 4.empiric abx |
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PBC Tx
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liver transplant
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most common cause of portal HTN worldwide
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schistosomiasis
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acute variceal bleeds mortality rate
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50%
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early liver dz - protein intake
late liver dz - protein intake |
early liver dz - high protein
late liver dz - low protein |
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most common SBP bug
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e.coli
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azotemia + Na retention + oliguria
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hepatorenal syndrome
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hepatorenal syndrome dx
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1.urine Na < 10
2.hypoNa |
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hepatorenal syndrome tx
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none
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HBV Tx
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lamivudine
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HCV Tx
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ribavirin + IFN
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liver transplant match needs
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1.size
2.ABO |
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painless rectal bleeding
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diverticulosis
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most common cause of massive lower GI bleeds in age>60
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diverticulosis
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most common cause of nosocomial enteric infection
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c.difficil
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pseudomembranous colitis complication
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toxic megacolon
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inflammatory bowel sx improve with...
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nicotine
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aphtous ulcers
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Crohn's
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lead pipe colon
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ulcerative colitis
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early appendicitis = visceral/parietal pain?
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visceral pain (dull, periumbilical)
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late appendicitis = visceral/parietal pain?
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parietal pain (RUQ tenderness)
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pain in associated dermatomes = visceral/parietal pain?
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parietal pain
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peritonitis Sx
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1.rebound tenderness
2.involuntary guarding |
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45 y.o. obese female
c/o fever, RUQ pain, nausea worse after eating fatty foods |
cholecystitis
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26 y.o. female
c/o severe LLQ pain, vaginal bleeding, light-headedness, last menstruation 6 wks ago |
ectopic pregnancy
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28 y.o. female
c/o diffuse abd pain, nausea, confusion, stained glass class |
lead poisoning
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elderly + abd pain
always consider...? |
vascular causes
1.AAA 2.mesenteric ischemia 3.MI |
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30 y.o. HIV female
dysphagia, intranuclear inclusions (bx) |
CMV esophagitis
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30 y.o. HIV female
dysphagia, vesicles, discrete erosions on EGD |
HSV, VZV esophagitis
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30 y.o. diabetic female,
dysphagia, nodular filling on barium esophagram |
Candida esophagitis
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Candida esophagitis Tx
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fluconazole PO
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HSV esophagitis Tx
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acyclovir IV
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CMV esophagitis Tx
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ganciclovir IV
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esophageal rupture mortality rate
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50%
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Boerhaave's syndrome - common site
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weak (L) posterolateral wall of distal esophagus
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Boerhaave's syndrome - etiology
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1.forceful vomiting
2.cough 3.trauma |
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Mallory-Weiss syndrome - etiology
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forceful vomiting
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subQ & mediastinal emphysema due to...
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full-thickness tear
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45 y.o. obese female
fever + RUQ pain + nausea + pain worse after eating fatty foods Dx? |
cholecystitis
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28 y.o. female
diffuse abd pain + nausea + confusion working as stained-glass class Dx? |
lead poisoning
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abd pain
hypotension atherosclerosis Hx pulsatile mass Dx? |
AAA
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63 y.o. obese male
pain in "kidney" for 3 days MI x2 Hx No back tenderness Dx? |
AAA
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52 y.o. woman
3 mos early satiety + wt loss + vomiting |
gastric outlet obstruction
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amylase levels in renal insufficiency
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persistently elevated
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drugs causing pancreatitis
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1.thiazides
2.furosemide 3.estrogen 4.antiretrovirals |
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Ranson's criteria
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mortality risk for pancreatitis
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Ranson's criteria
risk factors |
1.age > 55
2.BS > 200 3.WBC > 16K 4.SGOT > 250 5.LDH > 700 |
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sentinel loop
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distention and/or
air-fluid levels near site of abd distention |
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gastric varices w/o esophageal varices
dx? |
splenic vein thrombosis due to pancreatitis
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cholecystitis dx test
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HIDA
(+) = no gallbladder outline (-) = gallbladder outline in 1 hr |
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Dupuytren's contracture commonly seen in...
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cirrhosis
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Dupuytren's contracture
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palmar fascia contraction --> 4th finger flexion
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alcoholic cirrhosis + blood vomit is fluid resuscitated
next step? |
octreotide
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acetaminophen toxicity Tx
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acetylcysteine
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carcinoid tumor mets
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1.regional LNs
2.liver (graver Px) 3.lung |
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carcinoid tumor prevalence
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1/3rd of all primary gut neoplasms
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flushing,hypotension
diarrhea R) valvular dz dx? |
carcinoid syndrome
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carcinoid tumor dx tests
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1.>10mg/24hr urine 5-HIAA
2.elevated serum & urine 5-HT 3.abdominal CT |
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carcinoid tumor Tx
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1.surgery excision
2.radiation 3.antihormonal Tx |
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carcinoid syndrome Px
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3 yr median survival
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diverticulosis pathophysiology
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muscular wall defect
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most common site of diverticulosis
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sigmoid colon
(narrowest area of colon - highest pressures) |
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70 y.o. male
low-fiber diet at risk for? |
diverticulosis
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diverticulosis Tx
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bleeding scan & embolization
surgery (if refractory) |
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diverticulitis etiology
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fecal material impaction in diverticular neck
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80 y.o. male
fever high WBC sigmoid mass (not always) LLQ pain |
diverticulitis
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diverticulitis Tx
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1.NPO, IVF, pain control
2.abx |
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vancomycin MOD
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NEVER PO
except for c.difficle |
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35 y.o. female
fever crampy, diffuse abd pain watery diarrhea hx pneumonia dx? |
c.difficle
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pseudomembranous colitis dx tests
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1.toxin in stool
2.fecal leukocytes 3.sigmoidoscopy |
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pseudomembranous colitis Tx
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1.vancomycin PO
2.metronidazole PO |
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long colon loop
"thumbprinting" (bowel-wall edema) dx? |
pseudomembranous colitis
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irritable bowel syndrome
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alteration in bowel motility
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irritable bowel syndrome dx
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r/o other causes of diarrhea
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% pts w/(-) FOBT + colon CA
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50%
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polyp found on colonoscopy
next step? |
1.bx, polypectomy
2.f/u colonoscopy 3 yrs |
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20 y.o. vomiting pt
next step? |
1.2 large-bore IVs
2.EGD |
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endocarditis bugs associated w/colon CA
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1.strep bovis
2.clostridium septicum |
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HNPCC inheritance pattern
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autosomal dominant
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FPC (familial polyposis coli) Tx
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total colectomy
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polyposis coli
supernumerary teeth osteomas fibrous dysplasia (skull) dx? |
Gardner's syndrome
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multiple polyposis (small intestine)
multiple pigmented melanin macules (oral mucosa) dx? |
Peutz-Jeghers syndrome
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80 y.o. male
anemia high CEA, elevated LFTs pencil-thin stools |
L) colon CA + liver mets
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IBD Tx
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1.sulfasalazine
2.meselamine 3.corticosteroids 4.abx 5.immunomodulators |
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sulfasalazine components
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5-ASA + sulfapyridine
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sulfasalazine used to Tx...
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1.IBD (5-ASA)
2.RA (sulfapyridine) |
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inflammation of bowel muscoa only
bloody diarrhea rectal pain |
ulcerative colitis
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inflammation of all bowel-wall layers
fistulas, abscesses tender RLQ mass granulomas |
Crohn's disease
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skip lesions
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Crohn's disease
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continuous lesions
lead pipe colon |
ulcerative colitis
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uveitis
erythema nodosum colitic arthritis |
Crohn's disease
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OK to give HBV vaccine in pregnant woman?
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yes.
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medical resident
fever jaundice fatigue 2 wks returning fr/India trip |
hep E
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