Gold Standards
Gold Standard Diagnosis for IBD
Colonoscopy
Signs and symptoms of esophageal cancer
Progressive food dysphagia
weight loss
Chest pain
GI bleed
Vocal hoarseness
Dyspnea
Atypical signs and symptoms of GERD
Chronic cough
Chronic laryngitis
Sore throat
Chest pain and asthma
Which type of hemorrhoid bleeds the easiest?
Internal
What type of bowel obstruction is most commonly treated by a laparotomy?
Complete small bowel obstruction (85%)
Gold standard diagnosis for hiatal hernia
Barium swallow
Anatomical location for the majority of stomach cancers:
1. cardia
2. antrum
3. body
Achalasia
Name the classic signs for acute appendicitis patients
McBurney point tenderness
Psoas sign
Obturator sign
Rovsing sign
Cholangitis treatment:
-ERCP and sphincterotomy (allows for stone removal)
-Can do elective laparoscopic cholecystectomy which is recommended
-IV antibiotics
Gold standard diagnosis for Mallory-Weiss
EGD
Name the specific mutation linked to gastric cancer
cadherin 1 gene (CDH1) – autosomal dominant trait
How is Boerhaave syndrome definitively diagnosed?
CT or contrast esophagography (gastrograffin)
Describe the Mackler triad. What condition is this for?
1. vomiting
2. retrosternal pain
3. SCE
(Boerhaave's syndrome)
Treatment plan for anorectal abscess:
Incision and Drainage right away
Antibiotics if Febrile, immunocompromised, diabetic, or marked cellulitis is present
Cipro 500 mg IV every 12 hours plus metronidazole 500 mg IV every 8 hours
Ampicillin/sulbactam 1.5 g IV every 8 hours
Gold standard diagnosis for achalasia
esophageal manometry
Most common type of exocrine pancreatic cancer
Adenocarcinoma-ductal carcinoma
Endoscopic findings associated with EoE
Mucosal fragility
Whitish papules (representing eosinophilic microabscesses)
Linear furrows
Stacked circular rings - "trachealization"
Strictures
Differentiate the signs and symptoms of a Small vs Large bowel obstruction
Small:
symptoms: abdominal pain/cramping, vomiting, diarrhea (partial) or Obstipation (complete)
signs: Hyperactive, high-pitched peristaltic rushes, palpable bowel loops
Large:
symptoms: develop gradually, distention, vomiting, inability to pass gas or stool
signs: loud borborygmi, distention
Pharmacological agents for IBS:
Antidiarrheal agents (loperamide)
Osmotic laxatives (polyethylene glycol)
Antispasmodic agents (dicyclomine)
Tricyclic antidepressants (amitriptyline)
Gold Standard diagnosis for pancreatic cancer
What gene mutation often leads to colorectal cancer over a period of 10-15 years?
Most CRCs begin with adenomatous polyposis coli (APC) gene inactivation
(Multiple genetic hits are required)
What are specific indications for anti-reflux surgery in GERD patients?
grade C/D, hiatal hernias, stricture ulcers, hemorrhage
Describe Reynold's pentad. What condition is this for?
jaundice
fever
RUQ pain
hypotension
AMS
for cholangitis
Basic treatment and follow up plan for a CRC patient without metastatic disease
Wide surgical resection
Follow up- surveillance colonoscopy: 1 year after surgery, then 3 years if no tumor is found
Then goes to 5 year intervals