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Gastro 8 (Colorect)


What type of immunodeficiency increases the risk of anaphylactic transfusion reaction? IgA deficiency
Patients with silicosis are at higher risk of what type of infection? TB
Patient presents with a sudden onset of severe, diffuse abdominal pain (AXR reveals free air under the diaphragm). What is the next step in the management? Emergent Laparotomy
A 20 y/o pateint with a strong famil history of colon CA is found to have an autosomal dominant mutation in the APC gene. What prophylactic measures should this patient take to prevent furture morbidiy and mortality? Flexible sigmoidoscopy or colonoscopy yearly starting at age 10. When multiple adenomas are identified, then coloectomy is indicated. Upper GI endoscopy at the time of colectomy (or early 30s) then q3-5yrs if no lesions.
A 60 yr old man undergoes colonoscopy and is found to have 3 sall tubular adenomas that are completely removed. When should he undergo his next colonoscopy? 3 years
A 40 yr old man tell you that his father had colon cancer at age 53. When should this man's first colonoscopy be scheduled? 43 yrs
What tumor marker is used in colon cancer pts? CEA
What gene is responsible for familial adenomatous polyposis? APC gene mutation
Name the precancerous colon polyps tubular adenomas, tubulovillous adenomas, villous adenomas
What are the next steps in management of a pt that presents to the ER with massive lower GI bleeding? monitor VSs, IV access with 2 large IVs, blood vol resuscitation, type and cross(2U PRBC), CBC, COags, NGT lavage to r/o upper GI bleed, surgery consult. If colonoscopy nondiagnostic or not feasible then radionucleotide scan.
A pt in the ER has just thrown up his second basin full of blood. He is drunk and tachycardic. What is the next step in managing this pt? IVF resuscitation
What lab is often elevated in pts with an upper GI bleed? BUN
During a routine exam, a 70 yr old man if found to have new-onset iron-deficiency anemia. What should you suspect and investiate further? Colon CA, stool guiac or colonoscopy
What are common etiologies of upper GI bleeds? PUD(55%), Esophageal varices(14%), AV malformations(6%), TUmors/erosions, mallory-weiss tears
What are the mcc of lower GI bleeding? Diverticulosis, ischemia, hemorrhoids/fissures, neoplasms, polypectomy
How is volue status assessed in a pt with GI bleed? HR, BP, Urine output
Colorectal cancer is treated with ___________and __________node dissection. Surgical resection and 12 node regional lymph node dissection
Which 3 Familila polyposis syndromes are associated with APC gene mutation? FAP, Gardner's syndrome, Turcot syndrome
Created by: shelybel



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