GI

What is the treatment for symptomatic gallstones?

Elective laparoscopic cholecystectomy.

What are the complications associated with acute cholecystitis?

Acute cholangitis, choledocholithiasis, and gallstone pancreatitis.

How is acute cholangitis diagnosed?

It is diagnosed via ultrasound, but if not definitive, HIDA scan can be performed.

What does Murphy's Sign indicate?

It indicates cholecystitis, where there is a cessation of inspiration upon palpation of the gallbladder.

What is the risk stratification for choledolithiasis?

High risk (Gallstone in CBD/Ascending cholangitis): ERCP +/- sphincterotomy; Intermediate risk: MRCP; Low risk: Endoscopic US.

What is gallstone ileus?

It is a condition causing bowel obstruction due to a gallstone passing through a biliary-enteric fistula.

What is Post Cholecystectomy Syndrome?

It is persistent pain after cholecystectomy.

What is the management for biliary leak post cholecystectomy?

Diagnostic imaging shows relatively normal appearing biliary ducts; treatment may involve monitoring as peritoneum can absorb most leaks.

What laboratory findings are associated with gallstone pancreatitis?

ALT > 150 has a 95% PPV for diagnosing gallstone pancreatitis.

What is Primary Biliary Cholangitis (PBC)?

An immune response against intrahepatic bile ducts, diagnosed using ultrasound suggestive of intrahepatic cholestasis and positive anti-mitochondrial antibodies

What is the recommended treatment for a pancreatic pseudocyst that lasts over 6 weeks?

Endoscopic drainage if painful or rapidly growing.

What is the typical presentation of acute pancreatitis?

Acute epigastric pain that radiates to the back, fever, tachycardia, and hypotension.

What does a Ranson Criteria assessment evaluate for in acute pancreatitis?

It assesses mortality risk based on various clinical and laboratory parameters.

What symptoms characterize chronic pancreatitis?

Malabsorption, mildly increased amylase and lipase, and pain relieved by leaning forward.

How is pancreatitis associated with anatomical defects managed?

Management typically includes dietary modification, analgesia, and possibly enzyme supplements.

What are the key serology markers for Hepatitis B?

HBsAg and IgM Anti-HBc are indicators of acute infection.

What is the treatment for acute hepatitis C?

IFN-alpha and ribavirin, as most develop chronic hepatitis.

What does abdominal ultrasound show in ascites?

Fluid accumulation in the abdominal cavity can be assessed.

What is the recommended management for spontaneous bacterial peritonitis (SBP)?

Third generation cephalosporins (like ceftriaxone) or cefotaxime.

What complications arise from chronic viral hepatitis?

Progression to cirrhosis and hepatocellular carcinoma.

What is the significance of CEA in colorectal cancer?

It is used to monitor treatment efficacy and surveillance post-resection, not for screening.

What is primary sclerosing cholangitis?

A chronic liver disease characterized by progressive inflammation and scarring of the bile ducts, often associated with inflammatory bowel disease. Characteristic onion skin pattern

How is PSC diagnosed?

Diagnosis is typically made through a combination of imaging studies such as MRCP, liver biopsy, and blood tests indicating cholestasis.

How is PSC managed?

Endoscopic interventions for strictures and ursodeoxycholic acid for some

What is emphysematous cholecystitis?

A severe form of gallbladder inflammation characterized by the presence of gas-forming bacteria, often leading to necrosis and perforation.

How is emphysematous cholecystitis diagnosed?

Diagnosis is typically confirmed through imaging techniques like ultrasound or CT scan, which reveal gas within the gallbladder wall or lumen.

When hyperactive bowel sounds are present, what should you think about?

Consider conditions like gastroenteritis or early intestinal obstruction.

What should absent bowel sounds make you think about?

Peritonitis, complete obstruction, and ulcer perforation

What will be seen with atraumatic splenic rupture?

Signs of free fluid or blood in the abdominal cavity on imaging, and potential splenic lacerations.

What causes atraumatic splenic rupture?

Conditions like mononucleosis, trauma, or certain hematological disorders.

What should be done in atraumatic splenic rupture?

Immediate surgical evaluation and possible splenectomy.