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Gastro 5 (Sm Int.)
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Question | Answer |
---|---|
What is the next step in the management of a pt that comes to the ER with severe abdominal pain and AXR show free air in the abdomen? | Exploratory lap |
Which form of IBD causes perianal fissuring and fistulas? | Crohn's dz |
In which form of IBD would you see a "lead pipe" appearance on barium enema? | Ulcerative colitis (UC) |
What serum lab finding might help you distinguish Crohn's form UC? | Crohn's will have a +ASCA and UC will have a +pANCA |
What are the mcc of small bowel obstruction? | ABCs: Adhesions, bulge(encarcerated hernias), Cancer. Less common causes are volvulus, intussusception, Crohns, gallstone ileus, bezoar, bowel wall hematoma from trauma, inflamm stricture, congenital stricute, congenital malformation, radiation enteritis |
What are the classic signs small BO? | abdominal pain, n/v, +/- recent flatus/small BM, hyperactive high-pitched bowel sounds |
What radiologic findings help you confirm the dx of SBO? | dilated loops of small bowel proximal to the obstruction seen on plain film abdominal series or CT scan of the abdomen. |
What is the mc benign small bowel tumor? | leiomyoma |
What is the mc malignant small bowel tumor? | adenocarcinoma |
What is the mcc of large bowel obstruction? | Neoplasms |
What is the treatment for Crohn's dz? | 5-ASA (mesalamine and sulfasalazine), Azathioprine or metcaptopurine for maintenance, anti-TNF agents, exacerbations use steroids and abx. |
Which signs and sx are associated with IBS? | Abdominal pain relieved with defecation, a change in stool frequency or form, straining, urgency, feeling of incomplete passage, bloating and mucus |
The abdominal pain for ischemic colitis is ____more/less severe than small bowel ischemia? | Less severe |
In Crohns dz which part of the GI tract might be involved? | It can involve the entire GI tract. |
Crohn's or UC?: watery diarrhea | Crohns |
Crohn's or UC?: skip lesions | Crohns |
Crohn's or UC?: "lead pipe" colon, w/o haustra and colon shortoning | UC |
Crohn's or UC?: treatment is Mesalamine | Crohns |
Crohn's or UC?: significant increased risk of colon CA? | UC |
Crohn's or UC?: bloody diarrhea | UC |
Crohn's or UC?: colectomy is curative | UC |
Always order a ______test in a woman with abdominal pain. | b-hCG |
Postoperative ileus typically lasts _____days | <5 |
Volvus tends to occur in ______ and ______ (which population of people). | elderly and infants |
A "double bubble" sign on AXR indicates what?? | Volvulus |