3-uWorld Flashcards
causes of budd chiari
malignancy(MCC is Hepatocell cancer)
pregnancy
Oral contraceptive
hypercoag state
polycythemia or myeloproliferative disorder
acute budd chiari can involve this presentation____
RAPID development of jaundice and ascites
SEVERE RUQ pain, hepatomegaly
hepatic encephalopathy
gold standard test for budd chiari
venography
surgical tx for budd chiari
angioplasty with stenting
drugs to tx budd chiari
AC
diuretics
possible thrombolytics
you have given stool softnera and topical nitroglycerin/CCB to help this patient’s anal fissures, it has still not resolved, what is the next step to work up for secondary anal fissures and what timeline should you start this workup?
consider Crohn’s dz and do colonoscopy
after 8wks refractory to topical vasodilators/stool softners
complications of sickle cell TRAIT
hematuria
splenic infarct
frequent UTI
renal medullary carcinoma
DVT
priapism
GI placed balloon tamponade or variceal bands, now patient is still bleeding, what is next possible step?
TIPS
you have a patient with epigastric pain, what will make you go for EGD vs Trial with 6wk PPI?****
if they have GERD sypmtpoms–>6wk PPI
if they DONT have GERD sypmtoms–>EGD(>60y) or Hpylori stool/breath(if young)
why is Hpylori serology not a good test, and when should it be used?
it can be positive falsely….it should be used if you want to entirely rule out infx…bcs when negative it is truly negative!
non-pancreatic causes of lipase elevateion
DKA
renal insufficiency
SBO
what is the first diagnositic step in diagnosing SBO-and what will it show….
Plain film XRAY
will show multiple areas of air fluid levels with distended bowel loops
first diagnostic step to evaluate SBO didnt work, what is the NEXT diagnostic exam?
CT abdomen with PO and IV contrast….
NOT SBFT series!!!….only use if CT is non-diagnostic
secondary lactose intolerance can occur through ____ pathyophysiology as a result of _____ cause and can be treated with ___
inflammatory destruction of terminal villi->loss of lactase enzyme
acute viral gastroenteritis or crohn’s
keep lactose restricted diet for a little while until intestinal wall heals
you have afirst degree relative who was diagnosed at age 55 with CC and you just got colonoscopy at age 45, when is the next surveillance colonosocpy?
Q5 y
achalasia is condition with decreased peristalsis of lower esophagus alongside decreased ____
relaxation of lower esophageal sphincter–>acid reflux
oropharyngeal dysphagia signs
coughing spells after swallow liquid
sloooow swallow with prolonged effort
difficulty initiation of swallow with feeling of obstruction at level of neck
nasal regurgitation
