First Aid: Gastro

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First Aid: Gastro
2011-11-28 13:21:34
internal medicine rotation gastro

internal medicine rotation gastro
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  1. Definition of visceral pain
    • Vague, dull, poorly localized pain
    • Associated with stretching, inflammation, or ischemia of organ capsules
  2. Definition of parietal pain
    Sharp, well-localized pain
  3. Pain of peritonitis
    Rebound tenderness and gaurding
  4. 45 y/o obese female presents with fever, RUQ pain, and nausea exacerbated by eating
  5. Symptoms of lead poisoning
    • Diffuse abdo pain
    • Nausea
    • Confusion
  6. Metabolic causes of abdo pain
    • DKA
    • Acute intermittent porphyria
    • Hypercalcemia
  7. Infectious causes of abdo pain (apart from gastroenteritis)
    • Herpes zoster
    • Mono
    • HIV
  8. Vascular causes of abdo pain
    • AAA
    • Mesenteric ischemia
    • MI
  9. An elderly pain with a history of A-fib, treated with digoxin complains of very severe abdo pain
    Think about mesenteric ischemia
  10. Why does A fib predispose to mesenteric ischemia?
  11. Causes of viral esophagitis
    • Herpes simplex
    • VZV
    • CMV
  12. Causes of bacterial esophagitis
    • Lactobacillus
    • Streptococcus
    • Cryptosporidium
    • Pneumocystis carinii
    • M. TB
  13. Vesicles and discrete erosions of the esophagus on endoscopy indicates...
    HSV or VZV esophagitis
  14. Treatment for candida esophagitis
    Oral fluconazole
  15. Treatment for HSV and CMV esophagitis
    • HSV--acyclovir
    • CMV--gancyclovir
  16. Boerhaave's syndrome
    A tear through the full thickness of the esophagus (as opposed to Mallory-Weiss, which is partial thickness) due to forceful vomiting
  17. Zenker's diverticulum
    An outpouching in the pharynx or esophagus, due to a defect in the muscular wall. Presents with halitosis, frequent aspiration, and esophageal obstruction.
  18. Barium swallow: achalasia v. diffuse esophageal spasm
    • Achalasia--bird's beak
    • DES--corkscrew shaped
  19. Causes of delayed gastric emptying
    • Diabetes
    • Gastroparesis
    • Gastric outlet obstruction
    • Anticholinergics
    • Fatty foods
  20. Complications of GERD
    • Esophagitis
    • Peptic stricture
    • Barrett's esophagus (transformation of squamous epithelium to columnar)
    • Esophageal cancer
  21. Complications of peptic ulcer disease
    • Bleeding
    • Perforation (perforation of the posterior duodenum can lead to pancreatitis)
    • Gastric outlet obstruction