Block 5 Flashcards
structures in: falciform lig vs hepatoduo lig vs hepatogastric lig vs gastrocolic lig vs gastrosplenic lig vs splenorenal lig
lig teres hepatis, patent paraumbilical (caput medusae) vv vs portal 3ad vs gastric vessels vs epiploic vessels vs short gastrics, L gastroepiploic vs splenic a/v, panc tail
duo vs jeju/ileal atresia
2x bubble -> failed recanalize distal duo, dil stomach & prox duo, w/ Down syndrome vs 3x bubble -> dil stomach, duo, prox jeju; disrupted mesenteric vessels -> ischemia nec
tracheoeso fistula
from polyhydramnios -> stenosis, H type, distal TEF; neonates drool/choke at 1st feeding, cyanotic d/t laryngospasm; dx if can’t pass NG tube into stomach
gold standard dx for cirrhosis? HFE sxs? GERD tx?
transjug liver bx. inc intest absorption of Fe -> bronze DM, arthralgia, cirrhosis, hep ca, DCM, testic atrophy, dec hepcidin/inc ferritin, dec transferrin saturation. lifestyle, wt loss, avoid triggers; Mg hydroxide but AE diarrhea, HOTN, hyporeflex; Nissan fundoplication for refractory
which test measures liver’s synthetic ability vs liver’s injury? what does high AST mean? hep ca marker?
inc PT(/INR), PTT, unconj bili, dec albumin vs AST/ALT. APAP > alc inc AST -> chk GGT or 5’ nucleotidase for alc dmg. AFP
tropical sprue path & sxs. diff about celiac?
blunt villi, crypt hyperplasia, whole small intest, B9/12 defic, steatorrhea. lymphocytes in lamina propria, only duo affected
chronic gastritis vs metaplastic atrophic gastritis. Menetrier
type A = autoimmune parietal cells -> pernicious anemia; type B = H pylori -> 3/4x therapy vs chronic inflam -> intest metaplasia -> goblet cells. mucosal hypertrophy/gastric atrophy -> no HCl/IF -> protein losing enceph, hypoalbumin -> gastric adenoca; hypertrophied rugae; wt loss, anorexia, vomit, epigast pain, edema
Peutz. Ogilvie syndrome. Budd Chiari
AD LOF STK11 -> hamar polyps + pig (lips > hands). pseudoobstruction b/c dil colon w/o lesion, assoc w/ narcotics, hosp/nursing home pts, recent surg. portal v thrombosis; assoc w/ hypercoag, polycy, nutmeg mottled liver (patchy hem + centrilob nec), congestive liver dz
ascending cholangitis: Charcot 3ad vs Reynold’s 5ad. AIDS cholangiopathy. gallstone ileus
fever, RUQ pain, jaundice vs 3ad + AMS, sepsis; fatal from SBC (extrahep). recurrent bili tree infxn by Cryptosporidium > CMV -> bili tree obstruction. gallstone stuck in ileocecal valve -> erode -> cholecystoenteric fistula -> air in bili tree
hep hemangioma vs focal nodular hyperplasia vs hep adenoma vs hep ca vs hep angiosarcom vs hep mets. ca marker?
venous malform vs aberrant dystrophic a, central stellate scar vs ocp or anabolic steroids, spont or rupture vs 3ad abd pain, ascites, hepatomeg; from HB/CV, Aspergillus, HFE, Wilson, a1 trypsin defic, fatty liver, autoimmune; dx w/ high AFP, US/CT/MRI; tx surg, liver transplant vs arsenic, vinyl Cl vs from GI, br, lung. AFP
medullary cystic kidney dz vs multicystic dysplastic kidney
AD cysts @ medullary jxn -> gout vs abnl differentiation of metanephric parenchyma -> unilat hyperplasia, Potter
bile acid resin vs ezetimibe vs fibrates vs niacin vs omega 3 FA
no bile acid recycling -> chol make more new bile acid -> HMG makes more chol, inc LDLR; AE inc TG, gallstones, no ADEK vs no chol intest absorption -> HMG make more chol, inc LDLR vs dec VLDL & TG, inc HDL vs dec V/LDL & TG, inc HDL; AE flush b/c PG -> NSAIDs, hyperuric/gly, inc LFT -> heptox vs dec VLDL & apoB prod -> dec TG, inc LDL & HDL; AE belch
uremia sxs. panc adenoca risk factors
N/V, PLT dysfxn/bleed, asterixis, encephalopathy, pericarditis, anorexia. chronic panc, cysts, CF, smoke, obese, fhx
carcinoid
neuroendo tumors secreting sero -> diarrhea, flushing, pulm valve, tricuspid regurg, altered trp metab -> pellagra. dx 5HIAA. tx octreotide, surg; mets to liver
direct vs inguinal vs fem hernia. fem triangle vs fem sheath
Hesselbach, covered by ext spermatic fascia vs deep -> superficial inguinal ring w/ spermatic cord, failed process vaginalis, + hydrocele; covered by all 3 layers spermatic fascia vs below inguinal lig in medial fem space (potential space), females, more likely incarc/strang. NAV vs AVL (deep inguinal LN, fem canal)
