Intestinal/Diarrhea -> Most Common/DOC/Gold Standards, etc

appendicitis

What is the most common surgical emergency of the abdomen?

Mechanical

What is the most common type of bowel obstruction?

fibrous adhesions

What is the most common etiology of SBO?

small bowel obstruction (SBO)

What shows a “string of beads/pearls” on CT?

Abdominal CT

What is the most common and accurate imaging for SBO?

carcinoma

What is the most common etiology of large bowel obstruction?

Xray

What is the initial diagnostic for sigmoid volvulus?

sigmoid volvulus

What shows a “coffee bean sign” on XRay?

sigmoid volvulus

What shows a “birds beak deformity” on CT with rectal contrast?

CT with rectal contrast

What is the test of choice for sigmoid volvulus?E

Endoscopic decompression

What is the initial treatment of sigmoid volvulus?

cecum, right colon

What is the most common site for acute colonic pseudo-obstruction?

post-op, severe medical illness

What is the most common etiology of acute colonic pseudo-obstruction

abdominal CT with contrast

What truly establishes the diagnosis of acute colonic pseudo-obstruction?

US

What imaging is initially preferred in children and pregnant women coming in with appendicitis symptoms?

CT with contrast

What is the gold standard diagnostic for appendicitis?

Alvarado score

What scoring system is used for appendicitis?

appendectomy

What is the standard treatment for non-perforated appendicitis?

perioperative resuscitation (IV abx, drainage, irrigation) then surgery

What is the treatment for a perforated appendicitis that is unstable or free perforation?

urgent appendectomy

What is the treatment for a perforated appendicitis in a stable patient?

IV abx, percutaneous drainage, surgery

What are the steps to treating a perforated appendicitis in a stable patient that has an abcess?

diverticula

outpouching of colonic wall

diverticulosis

presence of diverticula and typically asx

diverticulitis

inflammation and/or infectious diverticular disease

sigmoid colon (left colon more generally)

Where is the most common site of diverticular disease in Western countries?

abdominal CT with oral/IV contrast

What is the preferred imaging for diverticulitis?

colonoscopy

What should be avoided during acute diverticulitis d/t risk of perforation?

colonoscopy

What should be performed in a pt with diverticulitis after resolution of acute sx (6-8 weeks) if the pt hasn’t had one within the previous year?

diverticular bleeding

What is the most common cause of overt lower GI bleeding?

colonoscopy

What is the test of choice for diagnosing diverticular bleeding?

inflammatory pseudopolyps

What type of polyps are seen in IBD?

adenomatous polyps

What kind of polyp is the most common neoplastic polyp of the colon?

adenocarcinoma

What is the most common type of colorectal cancer?

colonoscopy with biopsy

What is the preferred diagnostic for colorectal cancer?

colorectal cancer

What is an “apple core lesion” on a barium enema associated with?

CEA (carcinoembryonic antigen)

What tumor marker is used to monitor patients with colorectal cancer? (NOT used to screen for or diagnose colorectal cancer)

surgery (resection)

What is the treatment of choice for individuals with resectable colorectal lesions?

APC gene

What gene is often implicated in familial adenomatous polyposis (FAP)?

complete proctolectomy or colectomy with ileoanal anastomosis

What is recommended for individuals with familial adenomatous polyposis (FAP) before 20 y/o?

MLH1 and MSH2

What genes are most implicated in Lynch Syndrome (HNPCC)?

45

What age should colorectal cancer screening start?

10 (or by age 40, whichever is earlier)

High risk individuals for colorectal cancer (first degree relative with CRC) should start screening how many years before their first degree relative was diagnosed?

fluoroquinolone (ciprofloxacin, levofloxacin)

What is the antibiotic of choice for salmonella (non-typhoidal) pts with severe sx, immunocompromised, very young, or very old?

macrolide (azithromycin)

What is the first line antibiotic for treating campylobacter enteritis?

campylobacter enteritis

What is associated with post-infectious Guillain-Barre syndrome and reactive arthritis?

shigella (s. dysenteriae)

What is the most common cause of dysentery?

shigella

What is associated with explosive, bloody, mucoid diarrhea and can have 8-10 stools/day all the way up to 100?

fluoroquinolones

What is the first line antibiotic to treat shigella?

enterotoxigenic E. coli (ETEC)

What is the most common cause of traveler’s diarrhea?

Enterohemorrhagic E. coli 0157:H7 (EHEC)

What bacteria can cause hemolytic-uremic syndrome as a major complication?

NONE

What is the first line antibiotic for Shiga toxin-producing E. coli?

antibiotic use

What is the most common risk factor in developing C. diff diarrhea?

C. diff

What type of infection can present with “accordion sign” on CT?

oral vancomycin or fidoxomicin

What is the antibiotic(s) of choice for C. diff?

norovirus

What is the most common cause of viral gastroenteritis in adults and worldwide?

nitazoxanide

What is the pharmacologic therapy for cryptosporidium?

giardia

What causative agent of infective diarrhea is most commonly associated with foul smelling, greasy, and fatty diarrhea?

tinidazole or metronidazole

What is the pharmacological therapy for giardia?

toxic megacolon

What is a common complication of IBD or infectious diarrhea?