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22 Cards in this Set
- Front
- Back
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What treatments are available for crohn's disease
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5-ASA agents
Mesalamine, Sulfasalazine (5-ASA+Sulfa abx) <--activated in colon only Azothioprine or Mercaptopurine> Methotrexate Anti-TNFa (infliximab, adalimumab) <-- good for HLA-B27 Steroids |
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What are the MC causes for Small Bowel Obx?
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ABC
Adhesions Bulge (hernia) Carcinoma (MCly colorectal) |
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What is the MC benign small bowel tumor?
What is the MC malignant small bowel tumor? |
Benign: Leiomyoma. Same for uterine
Malignant: Adenocarcinoma |
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HYQ: what is the next step in the management of a pt that comes to the ER with severe ab pain and AXR shows free air in the abdomen?
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Free air in ab= Perforation
immediate laprotomy |
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HYQ: A recent cuban immigrant with symptoms of malabsorption is found to have megaloblastic anemia.
What is the disease and what is the treatment? |
Tropical Sprue
Folate, Abx (tetracycline, sulfa) for 3-6 mo |
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HYQ: what is the classic time frame for which post-op ileus resolves in the different parts of the gut?
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Stomach: 48-72hr
Small Intestine: 24 Large Intestine: 3-5d |
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Elderly pt presents to the ER with vomiting and abdominal pain and distention. ABX shows two distinct but sequential portions of bowel in the sigmoid colon that are distended with air. What is the treatment?
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Volvulus
Colonoscopy |
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Describe the diff signs that might be seen in appendicitis?
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Psosas sign: Pain with passive hip extention
Obturator sign : Pain with passive internal rotation of flexed hip Rovsings sign: RLQ on palpation of LLQ |
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Pain out of proportion to the abdominal exam is classic for what?
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Acute Mesenteric Ischemia**
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What characteristics ARE and which ARE NOT a/w IBS?
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IBS: 12wks/yr, pain relieved with defication, a/w change in stool frequency or form
NOT IBS: sxs of malabsorption, wt loss or anorexia, progressively worsening pain, pain preventing sleep |
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What tumors (4) can cause a secretory diarrhea?
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Carcinoid
VIPoma Gastrinoma Medullary thyroid CA |
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What is the most likely cause of malabsorption in a pt with a (+) sudan stain in the stool sample and normal D-xylose test?
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Pancreatic Insuficiency
(+) sudan indicates steattorhea (+) D-Xylose indicates that the intestinal villi are intact and can abs carbs |
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What is the TX for Whipple disease?
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TMP-SMX or Ceftriaxone for at least 12-mo
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What serum antibodies are seen in cases of celiac sprue?
What's the buzz phrase? |
Anti-gliaden, Anti-endomycial
"blunting of the villi" gluten intolerance common in downs dermatitis herpatiformis |
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What serum lab findings might help you distinguish Crohn's from UC?
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(+)ASCA = chron's
(+) pANCA = UC |
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Jejunal biopsy shows Foamy macrophages on PAS
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Whipple dz
TMP-SMX or Ceftriaxone for 12mo |
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QH: ____ is the MCC of acute diarrhea in children
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Rotavirus
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QH: 1/2 of pts with IBS have comorbid _____
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Psychiatric Sxs, Depression, Anxiety
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"Thumb Printing" and CT showing air within bowel wall and bowel wall thickining
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Ichemic Colitis
More Common on the left, but sparing the rectum b/c of colorectal circulation |
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HLA-B27
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PAIR
Psoriatic Arthritis Ankylosing spondylitis IBD Reitter's syndrome |
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Treatment for Ileus?
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NPO until bowel sounds return
Motility agents: Erythromycin, Neostigmine, Metoclopromide (reglan) |
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"Double Bubble" and "Birds Beak" on ABX
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Volvulus
occurs in elderly and infants H/P: Obstipation |
