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Gi Review for Awesome People > Day 2 > Flashcards

Day 2 Flashcards

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1
Q

jaundice begins gradually, pruritus is common
• Large, smooth, nontender liver, pale stools, steatorrhea. Dark urine- positive for bilirubin. Elongated prothrombin time
Marked elevated of alkaline phosphate
Mild LFT
normal albumin

A

Intrahepatic cholestasis

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2
Q

o Stone, stricture or tumor blocks flow of bile w/I extrahepatic biliary tree
o Patient may have hx of gallstone, biliary tract surgery, malignancy
o Liver is usually enlarged
o Dark stool, pale urine
o Sudden onset of pain from stones
hihg alkaline phosphatase
moderate high LFTs

A

Extrahepatic obstruction

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3
Q

o Hepatitis + anorexia, nausea, abdominal pain, malaise before jaundice
o Hepatic tenderness and some hepatomegaly
o Ecchymoses may be presents
o Transaminases may become very elevated
o Hep C and alcoholism transaminases only 5x normal
o Dark urine, pale stools

A

Hepatocellulcar injury

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4
Q

No bilirubin in urine, but jaundice

A

Unconjugated hyperbilirubinemia

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5
Q

is cirrhosis symptomatic?

A

usually not

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6
Q

common cause of cirrhosis

A

Alcohol consumption
Hep C
Nonalcoholic fatty liver

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7
Q

most common autosomal condition for cirrhosis. Excessive iron overload.

A

Hemochromatosis

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8
Q

Other causes of cirrhosis

A

Wilson’s
Gaucher’s (lyposomal storage disorder)
Primary biliary cirrhosis
Fanconi’s (kidney problem)

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9
Q

if a person presents with varices, ascities, hypersplenism, encephalopathy, peripheral edema. Have GI bleeding, abdominal discomfort, confusion, early satiety.

A

Chronic viral or alcoholic hepatitis

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10
Q

Women presents with hepatomegaly, jaundice, hyperlipdemia, excoriation what do you suspect? Elevated alk phos, SED. Anti-Mito Antibody

A

Primary biliary cirrhosis

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11
Q

Gold standard of diagnosis for liver cirrhosis.

A

Liver biopsy

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12
Q

Patient presents with dyspnea, arthritis, skin discoloration, fatigue. Have damage to liver, heart, pancreas and gonads. Will look grey or bronze like. Elevation transferrin saturation and ferritin

A

Hemochromatosis

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13
Q

What does TIPS stand for?

A

transjugular intrahepatic portosystemic shunt

takes pressure off the portal system

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14
Q

Tx for primary biliary cirrhosis

A

transplant
diet- Vit A, D, K, zinc
meds- (a variety)

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15
Q

caused by HBV (most common) HCV, cirrhosis, hemochromatosis.
Elevated alpha-fetorprotein
will ahve hemorrhage, necrosis

A

Hepatocellucular carcinoma

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16
Q

Tx for hepatocellular carcinoma

A

curative resection

transplant

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17
Q

Uncommon in cirrhotic liver
hematogenous, lymphatic or direct spread
will have hemorrhage and replacement of hepatocytes by malignant cells

A

metastatic carcinoma

18
Q

cancer due estrogens or anabolic steroids. will ahve hemorrhage, necrosis.

A

Hepatocellcular adenoma

19
Q

tx of hepatocellular adenoma

A

discontinue estrogens/ androgens
resect if possible
do periodic imaging

20
Q

Presents with URQ pain, ascities. occlusion of hepatic veins or inferior vena cava caused by hematogenous disease. Dx via doppler US

A

budd chiari syndrome

21
Q

Due to congenital problems, estrogens. Is a blood filled cysts lined single layer of flat epithelium.

A

Cavernous hemangioma

22
Q

Thin walled cyst with clear fluid. Has simple cuboidal endothelium. no co-existing liver dz, congenital. Tx with percutaneous aspiration or surgical

A

Simple liver cyst

23
Q

Present with fever, RUQ colicky pain that radiates. N/V

A

acute cholecystitis

24
Q

will have fatty food intolerance, jaundice, pale feces, pruritus, weight loss

A

chronic cholecystitis

25
Q

What are pigmented stones

A

increased production of bilirubin conjugated

increased biliary calcium and bicarb

26
Q

where can biliary colic refer to?

A

tip of scapula

right shoulder

27
Q

tx for biliary colic (recurrent)

A

laproscopic cholecystectomy

28
Q

distention, edema, ischemia, inflammation along with fever. Acute onset of upper abdominal pain that lasts for several hours and doesn’t subside spontaneously. In epigastrium and radiates to right lumbar and shoulder

A

Acute cholecystitis

29
Q

distention, edema, ischemia, inflammation along with fever. Acute onset of upper abdominal pain that lasts for several hours and doesn’t subside spontaneously. In epigastrium and radiates to right lumbar and shoulder

A

Acute cholecystitis

30
Q

Profound jaundice as a result of compression of common hepatic duct by a cystic duct in the neck of the gallbladder. Dx via US

A

Mirizzi Syndrome

31
Q

Most acute study for acute cholecystitis

A

HIDA

scan is an imaging procedure used to diagnose problems in the liver, gallbladder and bile ducts.

32
Q

prolonged fasting, immobility and hemodynamic instability. Usually in someone with AIDS. WIll have positive Murphy’s and thickened gallbaldder wall. Tx w/ antibiotics and take out gallbladder

A

noncalculus acute cholecystitis

33
Q

cholangitis

A

infection of the common bile duct

medical surgrical emergnecy

34
Q

why is cholangitis a medical/ surgical emergency.

A

Can lead to sepsis, shock and death

35
Q

idiopathic condition, chronic inflammatory fibrosis of the bile ducts. Normally in young men who also have UC

A

primary sclerosing cholangitis

36
Q

common in males with alcoholics, females with gallstones. presents with R or L UQ abdominal pain. Worse when laying down. Swift onset- maximal intensity in 30 minutes. Persists for 24 hours. Can have N/V/ fever

A

acute pancreatitis

37
Q

what serum tests can you do for pancreatitis

A

Serum amylase of lipase (3x ULN)

38
Q

how do you test pancreatic function?

A

seretin stimulation

39
Q

Tx for chronic pancreatitis

A

enzymes replacements
analgesics
nerve blocks
endoscope decompression (obstruction)

40
Q

most common type of gastric cancers.

A

adenocarcinomas (most common)

lymphoma

41
Q

what do most colorectal cancers arise from?

A

adenomatous polyps

Gi Review for Awesome People (4 decks)

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