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29 Cards in this Set
- Front
- Back
Next step when you see old guy with anemia & BRBPR |
TRANSFUSE (then, EGD/Colonoscopy) -most likely R colon CA |
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if patient had a polyp removed and it was carcinoma in situ or dysplastic (but NO LN***) then what happens? |
just follow up 3-5 years with colonoscopy |
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patient has bloody diarrhea & THICK BOWEL WALL on CT. usually after AAA surgery: |
ischemic colitis (decreased blood flow through IMA to left colon). you will see hemorrhagic ulcers on colonoscopy |
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ulcerative colitis |
rectal & superficial |
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when to do surgery for ulcerative colitis |
fail medical treatment or greater than 10 years with dz |
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SCC secondary to HPV infection |
anal cancer: Dx with anal Pap smear and biopsy if it's positive for HPV |
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Juvenile Peutz-Jeger hyperplastic |
non-malignant colonic polyps |
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patient has high output from ostomy/diarrhea/malabsorption. what is the tx? |
PPI/Octreotide to decrease gastric secretions |
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patient is super tender on the butt, has fevers, doesn't even want to sit down. If they have diabetes what are you worried about? |
ischiorectal abscess can lead to necrotizing infection!!! |
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how long does it take to get c. dif pseudomembranous colitis? |
like a week. WATERY diarrhea |
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Dx for c. dif colitis |
do a stool cx |
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if you see liver mets/malignancy on CT, what's the next step |
no need to biopsy, go straight to surgery |
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only reason to biopsy liver lesion? |
if patient is NOT a surgical candidate and could benefit instead from chemo/radiation |
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patient recently had gastric bypass, now gets sweaty, dizzy, and crampy after eating: |
DUMPING SYNDROME: hypertonic gastric contents empty quickly into the duodenum/s.b. and fluid shifts too quickly and you release vasoactive polypeptides |
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treatment of dumping syndrome |
high fat, low carb diet |
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stone lodged in common duct causes EVERYTHING (including gallbladder & liver) to have trouble |
AST/ALT Alk Phos BILI JAUNDICE!!!! |
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treatment for choledocolithiasis |
supportive + ERCP |
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enlarging the opening of the ampulla of vater |
sphincterotomy |
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ERCP is to remove stones that are LODGED, then what? |
then do cholecystectomy to remove the entire thing so that it never happens again! |
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super sick sepsis/trauma/MODS patient has RUQ colicky pain, WBC, Fever but NO GALLSTONES: |
Acalculous cholecystis: gallbladder is static and ischemic, making perfect environment for enteric organisms to INFECT and cause edema/necrosis |
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tx for acalculous cholecystitis |
percutaneous cholecystectomy + supportive care |
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what Abx to give in cholecystisi? |
metro/cipro |
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obstructive jaundice is post-hepatic |
conjugated: dark urine, pale stools |
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why don't you have a +Murphy's sign in a patient with gallbladder CA (thin/distended gallbladder & painless jaundice)? |
because it's not inflamed, it's just cancerous |
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how to find a pancreatic tumor |
endoscopic u/s |
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migratory thrombophlebitis |
could be pancreatic CA |
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how to find ampullary cancer? |
CT, do ERCP to Bx |
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which cancer will usually be FOBT+? |
ampullary because bleeds into the lumen |
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Dx of cholangioCA? |
ERCP to bx |