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GI Review 2 (CM)
Question | Answer |
---|---|
A screening colonoscopy in a patient 50 years or older with an average risk of colorectal cancer should be done: | every 10 years* |
To diagnose acute pancreatitis order | Serum amylase & Lipase* |
2-4 wk old infant with intermittent, non-bilious projectile vomiting most likely has? | pyloric stenosis* |
This is the most frequent cause of intestinal obstruction in 3-12 month old? | intussusception* |
Always think of Projective Vomiting in young infant | pyloric stenosis |
Diagnosis of pyloric stenosis is by | UGI series or ultrasound |
Treatment of pyloric stenosis involves | pyloromyotomy |
Intestine telescopes in on itself | Intussusception* |
Bloody bowel movement seen during Intussusception is called | Currant Jelly Stools* |
This mass is pathognomonic for intussusception | Sausage shaped mass* |
Hirschsprung Disease is | failure to pass meconium that results in functional obstruction and massive dilation of colon |
Pathophysiology of intussusception | Invagination of portion of intestine into itself |
Treatment for Wilm's tumor | surgery |
Diagnosis for Intussusception is via | Barium enema (is diagnostic and therapeutic) |
Lanugo | fine hair on the face |
People on corn (maize) diets | Niacin deficiency (pellagra)* |
Niacin deficiency AKA | Pellagra* |
3 D's of pellagra | Diarrhea, dermatitis, dementia* |
Folate deficiency causes this type of anemia | macrocytic anemia |
This nutrient plays a key role in nucleic acid synthesis | Folate* |
Early manifestations of this deficiency include occlusive vascular disease and thrombosis | Folate deficiency |
Vitamin B1 deficiency AKA | Thiamine deficiency |
Causes beri beri, mostly in malnourished and alcoholics | Thiamine deficiency (B1)* |
Thiamine deficiency (B1) manifests with | acute heart failure, neurologic deficits, and epilepsy* |
Cobalamin deficiency AKA | Vitamin B 12 deficiency* |
Cobalamin deficiency manifests as this anemia | macrocytic anemia |
Cobalamin deficiency (Vit B 12) manifests with | peripherial neuropathy, parasthesias & demyelination of the corticospinal tract |
Vitamin B6 deficiency AKA | Pyridoxine deficiency* |
Pyridoxine (B6) deficiency presents with | peripheral neuropathy, seborrheic dermatitis, glossitis and cheilosis* |
Deficiency that causes hemolytic anemia in premature infants | Vitamin E deficiency |
Define Cullen's sign | Ecchymosis around the umbilicus* |
Define Grey Turner's sign | Ecchymosis around the flanks* |
Lisker's sign | Tibial bone tenderness that can sometimes be illicited with DVT* |
Kehr's sign | Pain in the left shoulder secondary to splenic rupture |
Abdominal rebound tenderness that indicates peritoneal irritation is what sign | Blumberg's sign |
This marker is present during the window period of Hep B | HBcAg* |
The first serological marker to appear in Hep B infection | HBsAg* |
HBeAg is a marker for | Infectivity with Hep B* |
Is the hepatitis B core antigen | HBcAG* |
Is seen at the end of an infection with Hep B and gives immunity | Anti-HBs* |
History of portal hypertension/ liver disease think | Esophageal varices* |
Dx & Tx of esophageal varices | Endoscopy |
Pyrosis is | Heartburn |
Dysphagia of solids and liquids | Achalasia* |
'birds beak' occurs in | Achalasia* |
Dx of achalasia is made via | Esophageal manometry* |
Transient cystic duct obstruction | Biliary colic* |
Female, fertile, forty, fat | Cholelithiasis* |
Common bile duct stone | Choledocholithiasis* |
Sustained obstruction of cystic duct | Acute cholecystitis* |
Skip lesions are found in | Crohn's disease* |
'string sign' occurs in | Crohn's disease* |
Cobblestoning is seen in | Crohn's disease |
Treatment of Crohn's disease | Sulfasalazine* |
Dx and Tx of mesenteric ischemia via | Angiography |
Second most common cancer death in men and women | Colon cancer |
Apple core lesion on barium enema indicates | Colon cancer* |
Beri beri is seen in this vitamin deficiency | Thiamine deficiency* |
Most common complication of portal hypertension | esophageal varices |
Corkscrew on Barium swallow | Esophageal spasm* |
Esophageal Cancer associated with smoking | Squamous cell carcinoma* |
Esophageal Cancer associated with alcohol | Squamous cell carcinoma* |
Esophageal Cancer associated with Barrett's | Adenocarcinoma* |
Diagnosis of GERD is by | Barium swallow |
Diagnosis of peptic ulcer disease (PUD) is by | Upper endoscopy |
Gastric adenocarcinoma has a strong connection with | H. pylori and smoking |
First sign of intestinal obstruction is | Hyperactive bowel sounds |
Diagnosis of celiac disease | Mucosal biopsy* |
Most common abdominal cancer in children | neuroblastoma* |
Most common cause of upper GI bleed | PUD* |
Double bubble sign | Duodenal atresia |
Hirschsprung's disease AKA | Congenital megacolon* |
This is caused by the congenital abscense of Meissners and Auerbach's autonomic plexuses enervating the bowel wall | Hirschsprung disease |
A congenital aganglionosis of the colon | Hirschsprung disease |
Treatment for ascities | Salt restriction & bed rest* |
Common complication seen in crohn's disease | Fistulas* |
MCC of gastroenteritis in children | Rotavirus* |
MCC of constipation in kids | Functional (voluntary withholding or diet)* |
Epigastric mass in a child 2-4 weeks old, is most suggestive of | Pyloric stenosis* |
Pernicious anemia is associated with what cancer | Gastric cancer* |
Cancers of skin, esophagus or mouth are usually | Squamous cell carcinomas |
Pain worse after eating, think | Gastric PUD |
Pain relieved with food or antacids | Duodenal PUD |
Zollinger-Ellison syndrome is a | Gastrinoma* |
Liver drains into the | Hepatic duct |
Gall bladder drains into the | Cystic duct |
Pancreas drains into the | pancreatic duct |
Common bile duct drains into the | duodenum |
The hepatic duct, cystic duct, & pancreatic duct all drain into the | Common bile duct |
Two causes of unconjugated bilirubinemia | Hemolysis & Gilberts syndrome |
Murphy's sign is seen in | Acute cholecystitis* |
Primary sclerosing cholangitis presents with | Fatigue, jaundice, puritis, pain* |
Primary sclerosing cholangitis is | Chronic inflammation & fibrosis of the bile ducts |
Fe overload is associated with | Hemochromatosis* |
Cu overload is associated with | Wilson's disease* |
Major risk factor for hepatocellular carcinoma | Hepatitis B* |
Hepatitis seen in India, SE and central Asia | Hep E |
Crohn's disease typically involves the | Terminal ileum & cecum* |
Air/ fluid levels on abdominal upright KUB | Small bowel obstruction |
LLQ Pain & mass, fever, leukocytosis indicates | Diverticulitis* |
Diagnosis of diverticulitis is | Clinical based |
UC always involves the | Rectum* |
With Celiac spruce, the patient can eat | CRAP: Corn, Rice, Aeroroot, Potato* |
Deficiency of vitamin D leads to | Osteomalacia |
A gastric hormone that activates duodenal/ jejunal receptors to initiate peristalis | motilin |
What acid base disorder is seen with mesenteric Ischemia | Metabolic acidosis |
Abdominal pulsatile mass | Abdominal aortic dissection |
Colicky periumbilical pain that becomes constant in RLQ | Appendicitis* |
Disease with RUQ pain that radiates to scapula tip | Cholecystitis* |
+ Kehr's sign | Splenic rupture* |
Left shoulder pain secondary to subdiaphragmatic irritation is due to | splenic rupture* |
+ Lloyd's sign | Pyelonephritis* |
Signs in pancreatitis | Turner's & Cullen's signs* |
current recommendation for colon cancer screening | FOBT yearly, sigmoidoscopy every 5 years & colonoscopy every 10 years |
Inability to hold feces in the rectum | Fecal incontinence |
The reflux of food and stomach acid back into the mouth, brine-like taste | Regurgitation |
Absence of bowel activity (and bowel sounds) due to a direct insult to the gut | Paralytic ileus |
Serous fluid accumulation in the abdominal cavity, from cardiac or liver disease | Ascites |
Define Murphy's sign | Pain over the gallbladder as you press as the patient inspires* |
(+) Murphy's sign | cholecystitis* |
Point tenderness over McBurney's Point indicates | Appendicitis* |
Define Psoas sign | Pain as patient raises right leg against resistance |
Define obturator sign | Pain as you flex patient right hip and internally rotate |
Define Rovsing sign | Right side pain with left side pressure |
Inflammatory bowel disease that increases risk for colon cancer | Ulcerative colitis* |
Tenesmus | Feeling of incomplete evacuation of the rectum |
Raised tender red purplish nodules seen in IBD | Erythema nodosum |
Tenesmus is suggestive of | Proctititis |
95% of colon cancers are | Adenocarcinomas* |
Colon cancer metastasizes to the | Liver and then the lung |
Rectal cancer metastasizes to the | Liver or lung |
Most common type of Abdominal pain, is | general and/or undiagnosed abdominal pain |
Cholelithiasis (ultrasound or CT) | ultrasound |
treat diarrhea with | fluoroquinolone |
High-sensitivity fecal occult blood test (FOBT), which checks for hidden blood in three consecutive stool samples, should be done | every year (no meat for 5 days) |
indicates active or ongoing infection Hep B infection | Hepatitis b surface antigen (HBsAg) |
Most sensitive test for diagnosis of iron deficiency anemia? | A low serum ferritin |
Antibiotics can cause | C.diff colitis |
Most common complaint of abused children | Abdominal pain |
WBCs seldomly over 15,000 | Appendicitis |
Pyloric Stenosis can develop in | neonates |
Reynold's pentad indicates | Cholangitis* |
Reynold's pentad includes | Pain, fever, jaundice, hypotension, & mental confusion |
Charcot's triad includes | RUQ Pain, fever (>40), jaundice |
Classic history of painless jaundice is seen in | Pancreatic cancer* |
Define cholangiocarcinoma | Cancer of bile duct wall |
'Beads on a String' is seen in | Primary sclerosing cholangitis (PSC) |
Diverticulosis most commonly affects the | Sigmoid colon* |
Define acute diarrhea | Less than 6 weeks in duration, mostly due to viral infections |
Define chronic diarrhea | More than 6 weeks in duration |
Bulky, frothy, oily stools think | Fat malabsorption |
Difficulty swallowing | Dysphagia |
Painful swallowing | Odynophagia |
Split, tear or erosion in epithelium of anal canal usually due to large or hard to pass stools | Anal fissures* |
Anal fissure are usually located | Posteriorly* |
Parietal cell secretes | HCL |
Sister Mary Joseph nodes are seen in | Gastric cancers* |
Two most common causes of PUD | H. pylori & NSAIDs |
Define anal fistula | Abnormal opening between anal canal & perianal skin |
Painless bleeding after defecation | Internal hemorrhoids |
Triad of malabsorption disease | Chronic diarrhea, weight loss & nutritional deficiency |
Gold standard test for malabsorption | Quantitative stool fat test |
Inflammatory response of small bowel to ingestion of gluten proteins found in wheat, rye, & barley | Celiac disease |
Cutaneous variant of celiac disease | Dermatitis herpetiformis* |
Intensely pruritic papulovesicular rash of trunk, scalp, & extremities seen in celiac disease | Dermatitis herpetiformis |
Most common malignancy associated with celiac disease | Lymphoma |
Inflammatory disease of small bowel secondary to overgrowth of coliforms | Tropical spruce |
Hyperparathyroidism can cause this GI issue | Acute pancreatitis |
Peutz-Jeghers syndrome | Melanin spots on the lips, buccal mucosa & tongue and bleeding polypoid lesions in the small intestines |
Rendu-Osler-Weber | Telangestagias on the face and buccal mucosa and similar lesions in the GI tract |
Blue - Rubber-Bleb-Nevus | Cavernous hemangiomas of the skin and similar lesions in the small intestines |
Neurofibromatosis | Café au late pigmentation with peduncalated fibromas and bibromas in the GI tract that may bleed are associated with |
More than 50% of cases of pill induced esophagitis results from | Tetracycline |
Describe Markle sign or jar sign | Have patient stand on toes and then drop quickly to heels to find location of abdominal pain |
Another name for rebound tenderness | Blumberg sign |
Cullen's sign is associated with | Retroperitoneal bleeding & pancreatitis |
Pregnancy is associated with improvement in | migranes and PUD |
Microcytic anemia in a patient that is over 50 year old, think | Colon cancer |
40 % of advanced neoplasms in colon are located | Proximal to the splenic flexture |
Colonoscopy for IBD patients is done | Yearly, 8 years after diagnosis |
Alcoholic fatty liver presents with | RUQ pain, tender hepatomegaly and elevated transaminase levels |
Inflammatory polyps are associated with which IBD | Ulcerative colitis |
Define esophageal varices | Dilated submucosal veins in lower esophagus |
Hematemesis with severe retrosternal 'tearing' pain | Boerhaave's syndrome |
Complains of dysphagia/ odynophagia; get an | Endoscope (EGD) |
Nonpropulsive hyperperistalysis of esophagus | Diffuse esophageal spasm (DES) |
Schatzki rings | Smooth, circumferential structures in the distal esophagus |
Esophageal web may result from | Iron deficiency anemia |
White male with long standing GERD | Barrett's esophagus |
Treat Barrett's with | Long term PPIs / ablation |
Best test & most cost effective for H. pylori diagnosis | Stool antigen* |
H. pylori treatment | Amoxicillin, clarithromycin & a PPI* |
H. pylori treatment for PCN allergic patient | Metronidazole, clarithromycin & a PPI* |
Zollinger Ellison syndrome is seen with | Recurrent PUD, PUD with hypercalcemia and a serum gastrin level above 150 |
Most common cancer world wide | Gastric cancer* |
Peptic ulcer disease where patients lose weight | Gastric ulcer disease |
Peptic ulcer disease where patients gain weight | Duodenal ulcer disease |
Jaundice occurs at a total bili of | Above 3 |
labs in Gilbert's disease show | Increased total bili, increased indirect, decreased direct |
Primary sclerosing cholangitis is often associated with | UC (IBD)* |
Most common etiologies of acute pancreatitis | Gallstones & ETOH abuse |
Helpful tumor marker for pancreatic cancer | CA 19-9* |
Painless jaundice | Pancreatic cancer* |
Treatment for hemochromatosis | Weekly phlebotomy |
Kay-Fleischer ring on eye exam | Wilson's disease |
Treat Wilson's disease with | Penicillamine |
ALT >> AST (20 times elevated) | Viral hepatitis |
Most common indicator for liver transplant | Hep C* |
Most common blood borne infection | Hep C* |
Leading cause of chronic liver failure | Hep C* |
Most common metastatic cancer | Hepatocellular neoplasm* |
Tumor marker for Hepatocellular neoplasm | AFP* |
Patients with celiac spruce cannot eat | NO BROW: Barley, rye, oats wheat |
MCC of lower GI painless bleeding in patients above 50 | Diverticular hemorrhage* |
Most common area for diverticulosis | Sigmoid colon* |
Second most common cause of cancer death | Colon cancer* |
Indirect inguinal hernia | Goes through the internal inguinal ring |
Direct inguinal hernia | Through the back wall of the inguinal canal |
Femoral hernia | Protrusion through the femoral ring |
Hiatal hernia | Stomach/ intestines protrudes into chest cavity through diaphragm defect |
Hemochromatosis trait is | Autosomal recessive |
Hemophilia A & B trait is | X linked recessive |
Child swallowed Drano, what to do | Lavage (anything toxic)* |
Cell change in Barrett's esophagus is from | Squamous to columnar epithelium |
Outpouching of the upper esophagus | Zenker's diverticulum |
Rosary bead appearance in esophagus | Diffuse esophageal spasm |
Tumor marker for pancreas | CA 19-9* |
Tumor marker for liver | AFP* |
Tumor marker for colon | CEA* |
Tumor marker for ovarian | CA 125* |
Tumor marker for prostate | PSA* |
Which types of hepatitis are acute | Hepatitis A & E |
Which types of hepatitis can become chronic | Hepatitis B, C & D |
Which types of hepatitis are transmitted via the fecal oral route | Hepatitis A & E |
Which types of hepatitis are transmitted by blood & body fluids | Hepatitis B, C & D |
Tumor marker for seminoma testicular cancer | HCG* |
Tumor marker for non-seminoma testicular cancer | AFP* |
Best test to evaluate the livers synthetic functions | Prothrombin time & INR |
Diabetes in a young person with a GI complaint | gastroparesis |
common causes of food-borne toxin-induced diarrhea | Staphylococcus aureus, clostridium perfringens, and bacillus cereus |
Daycare associated diarrheal illness | rotavirus |
vitamin B2 aka | riboflavin |
Cardiomegaly and congestive heart failure with a high cardiac output is associated with a deficiency of | thiamin (vitamin B1) |
H2-Receptor Antagonists (H2RAs) include | Cimetidine, ranitidine, Famotidine & nizatidine |
MOA of H2-Receptor Antagonists (H2RAs) | Inhibit gastric secreation by blocking histamine (H2) receptors on parietal cell |
uses of H2-Receptor Antagonists (H2RAs) | Dyspesis, GERD, PUD |
ADRs of Cimetidine | drug fever, ED & gynecomastia |
Proton Pump Inhibitors (PPIs) include | Omeprazole, lansoprazole |
MOA of Proton Pump Inhibitors (PPIs) | Inhibits parietal cell H/K ATP pump |
PPIs should be administered | 30 to 60 minutes before first meal |
uses of Proton Pump Inhibitors (PPIs) | GERD, PUD, Zollinger Ellison syndrome, H. pylori |
ADRs of Proton Pump Inhibitors (PPIs) | iron deficient & pernicious anemia, fractures |
Four neurotransmitter sites important in the vomiting reflex | Inner ear (M1: Muscarinic; H1: Histamine) & Systemic (D2: dopamine, 5-hydroxytryptamine 3: serotonin) |
uses of Dimenhydrinate (dramamine) | motion sickness |
All febrile patients admitted with ascites must have this performed | Abdominal paracentesis |
Diagnosis of Mallory Weiss tear with | Esophagogastroduodenoscopy (EGD) |
Esophageal varices presents with | Hematemesis, melena & hematochezia |
Treat esophageal varices with | EGD, variceal banding; Sclerotherapy |
Long term treatment of esophageal varices | Beta blockers, No ETOH |
Boerhaave's syndrome is secondary to | Instrumentation (EGD) |
Pill induced esophagitis caused by | NSAIDs, KCl, Alendronate (Bisphosphonate) Doxy (tetracyclines) |
Treat Achalasia with | Botox injections at LES, myotomy |
Diagnosis Zenker's Diverticulum with | Barium esophagram |
Esophageal web causes connective tissue effect called | Plummer Vinson syndrome |
Treat esophageal web by | Treating iron deficiency anemia |
Diagnosis for esophageal cancer | Endoscopy with biopsy |
50% of patients with GERD develop | Reflux esophagitis |
GERD presents with | Heartburn, regurgitation, nausea, throat irritation & cough |
Heartburn exacerbated by meals, bending over, recumbency, relaxes LES & weight gain | GERD |
Workup for GERD | 4 weeks on PPIs, test for H pylori |
Complicated disease or alarm symptoms with GERD | GI bleeding, anemia, dysphagia, odynophagia, wt. loss, NSAID use, ulcer disease |
In unresolved GERD do | Endoscopy, pH monitoring, fundoplication |
Screening in Barrett's | Endoscopy every 3 - 5 years |
EGD shows orange/ salmon colored changes to mucosa | Barrett's esophagus |
Most common PUD | Duodenal |
Age for duodenal peptic ulcer disease | 30 - 55 y/o |
Age for gastric ulcer diseased | 50 - 70 y/o |
PUD is more common in | NSAID and H. pylori infection |
Risk factors for NSAID Gastropathy | Age, Hx PUD/ bleed, NSAID overuse, concomitant corticosteroid tx |
Red flags to get and EGD | Anemia, weight loss, + hemoccult stools, hematemesis, melena, persistent vomiting, dysphagia |
Treatment for PUD if under 50 and no red flags | PPI for 4 weeks, check H. pylori |
Gold standard diagnosis for PUD | Endoscopy (EGD) |
Do not have to rescope this ulcer | Duodenal ulcer |
Treatment for gastric ulcer | PPI bid for 1 month; PPI qd for 1 month; and rescope after 6 -8 weeks |
Complications of PUD | Perforation, gastric outlet obstruction, bleeding |
Normal level of total bilirubin | 0.2 - 1.2 |
Elevated bilirubin levels are due to | Abnormal formation, transport, metabolism & excretion |
Bilirubin levels in Choledocholithiasis | Increased total bili, increased direct, decreased indirect |
Most common stones in Cholelithiasis | Cholesterol |
Common symptom of biliary colic | Nocturnal pain |
Acute cholecystitis presents with | Intense persistent pain, n/v, fever, murphy's sign |
Acute cholecystitis labs show | Leukocytosis with a left shift |
Female with generalized fatigue, jaundice & puritis | Primary biliary cirrhosis |
Diagnosis of primary biliary cirrhosis by | Liver biopsy, + AMA (anti-mitochondrial antibody) |
Treatment of primary biliary cirrhosis | Bile acid sequestrates (URSOdiol), transplant |
Diagnosis of autoimmune hepatitis | Increased AST/ALT, + ANA (anti-nuclear antibody), + ASMA (anti-smooth muscle antibody) |
Treatment of autoimmune hepatitis | Prednisone/ immunomodulators (azathioprine) |
PSC leads to | End stage liver failure |
Nontender palpable gallbladder with history of weight loss | Cholangiocarcinoma |
Klatskin tumor most commonly occurs at | Junction of right & left main hepatic ducts |
Cancer associated with primary sclerosing cholangitis | Cholangiocarcinoma |
Meds that cause acute pancreatitis | Azathioprine, pentamide, valproate, thiazides |
Acute pancreatitis presents with | Sever epigastric pain, n/v, tachycardia, orthostasis, dehydration, hypotension |
Diagnosis of acute pancreatitis | Increased serum amylase & lipase, leukocytosis with left shift, CT |
ICU admission of acute pancreatitis if | AMS, hypoxemia, HCT >50, oliguria, tachycardia with hypotension |
Ranson's criteria is for | Necrotizing pancreatitis |
Ranson's criteria includes | Age > 55, WBC > 16,000, BS > 200, LDH > 350, AST >250 & low serum calcium |
Most common area of pancreatic cancer | Head of pancreas |
Diagnosis of pancreatic cancer with | CT & CA 19-9 |
Pancreatic cancer presents with | Vague epigastric pain straight through to the back, painless jaundice, weight loss, anorexia |
Hep A infection possible if patient has | Foreign travel, flooded area of US, or poor sanitation |
Vaccinated patient to Hep B will show positive to | Anti HBsAg only |
Immunity (recovered) patient to Hep B shows | + Anti HBsAg; + Anti HBcAg; (+/-) Anti-HBe |
Chronic active Hep B shows | (+) HBsAg; (+) Anti HBsAg; (+) Anti-HBe |
Chronic active infections of Hep B | (+) HBsAg, (+) Anti-HBcAg,(+) HBeAg |
Always done to confirm Hep C | liver biopsy |
Treatment for Hep C | Pegylated interferon with ribavirin |
MCC of cirrhosis | Alcoholic hepatitis |
Confirm non-alcoholic fatty liver (NASH) with | Liver biopsy |
Hepatocellular neoplasm mets to | Lung, colon, breast & prostate |
Manage Crohn's or UC with | Aminosalicylates/ 5ASA (mesalamine) to Immunomodulators (azathioprine) to biologics |
Risk of infection with disease with IBD meds with | Immunomodulators/ biologics |
Biological therapies include | Remicade, humira, cimzia |
Aminosalicylates/ 5ASAs include | sulfasalazine |
ADR of Azothioprine (Imuran) | Pancreatitis, check LFTs/CBC every 90 days |
Immunomodulators used in IBD | Azothioprine (Imuran) |
MCC of small bowel obstruction | Previous surgery (adhesions) |
Treatment for small bowel obstruction | NG tube, Bowel rest |
50 y/o with history of atherosclerotic heart disease, hypoperfusion of the bowel vasculature | mesenteric ischemia |
Secondary to removal of small intestines | Short bowel syndrome |
If more than 50 cm of Ilium is resected patient needs | Monthly B-12 injection |
Acute, painless, large volume maroon or BRB in pt. > 50 y/o | Diverticular hemorrhage |
Treat diverticular hemorrhage with | Metronidazole & ciprofloxacin for 10 -14 days |
Precedes most colon cancers | Adenomas |
Hernia with a history of previous surgery | Incisional |
Causes of lower GI bleed in patients < 50 | Infectious colitis, IBD, fissures, hemorrhoids |
Group A streptococcus pharyngitis presents with | Fever, absences of cough, tender cervical lymphadenopathy, & tonsiller exudates |
Primary sclerosing cholangitis leads to | Cholestatic liver disease |
SE of cimetidine (Tagamet) | HAs, Dizziness, skin rashes, loss of libido & gynocomastia |
Secretin inhibits | Release of gastrin |