Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Medicine 2 > Exam 2 - GI (liver, gall bladder, pancreas, colon) > Flashcards

Exam 2 - GI (liver, gall bladder, pancreas, colon) Flashcards

1
Q

AST and ALT are formed in which organ?

A

Liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Alk Phos formed in which two organs?

A

Liver and bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Normal bile duct diameter for a 20 y/o?

A

2mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Common Bile duct made of which two ducts?

A

Cystic Duct + Hepatic Duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Role of bile?

A

Emulsifies fat, assists in fat absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe Hepatocellular Pattern (AST, ALK, etc)

A

Up: AST and ALT
Down: Alk Phos

+/- up: Bili

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe Cholestasis Pattern (AST, ALK, etc)

A

Up: Alk Phos
Down: AST, ALT

+/- up: Bili

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Elevated GGT suggests what?

A

Indicator of biliary injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Hepatocellular pattern seen with what sort of injury?

A

Intrahepatic injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cholestatis pattern seen in with what sort of injuries?

A

Extrahepatic (biliary obstruction)

Intrahepatic (primary biliary cholangitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Most common and costly digestive dz?

A

Cholelithiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Etiology of Cholelithiasis?

A

Gall stone in gallbladder.

No inflammation!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Is Cholelithiasis inflammatory?

A

NO!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

5 Fs of Cholelithiasis?

A

Fat, fair, female, forty, fertile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is most common complication of Cholelithiasis?

A

Acute Cholecystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Sx of Cholelithiasis?

A

Most commonly ASx. RUQ biliary colic.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When would Cholelithiasis present with sx?

A

Post-high-fat/greasy meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Does Cholelithiasis make a PT look sick? Fever? Jaundice?

A

NO. They look and feel fine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Dx of Cholelithiasis?

A

RUQ U/S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

LFT in uncomplicated Cholelithiasis? Complicated?

A

Uncomplicated=Normal

Complicated=Cholestasis pattern (up Alk Phos, down AST and ALT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Elevated GGT seen in?

A

Cholestasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Tx of Cholelithiasis?

A

ASx=Expectant manageement.

Sx=Prophylactic cholecyctectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Tx for Cholelithiasis if can’t have surgery?

A

Bile salts for 2 years max.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Eti of Acute Cholecystitis?

A

Inflammation of Gall Bladder d/t cystic duct obstruction by gall stone. 90% of

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What happens to GB in Acute Cholecystitis?

A

Gangrene of GB. GB perforates.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where is pain in Acute Cholecystitis? Fever?

A

RUQ. Sudden epigastric pain onset.

+ fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

When does pain start in Acute Cholecystitis? What triggers it?

A

30 minutes after fatty food or large meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is Murphy’s Sign?

A

In Acute Cholecystitis.

Acute RUQ pain and inspiratory arrest with Gall Bladder palpation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Imaging in Acute Cholecystitis?

A

Initial=U/S

Gold standard=HIDA scan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

CBC and LFT in Acute Cholecystitis?

A

Leukocytosis w/left shift.

Elevated LFTs, no specific pattern.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Tx in Acute Cholecystitis?

A

Admit to hosp. IV fluis, pain mgt, abx. Drain before surgery is complications.

<24h=laparotic cholecystectomy
>24h=open cholecystectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Eti of Choledocolithiasis?

A

Gallstones in Bile Duct. Formed or returned after cholecystectomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Pain location and type in Choledocolithiasis? Fever?

A

RUQ or midepigastric pain. Biliary-type pain. No fever.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

LFTs in Choledocolithiasis?

A

Cholestatic pattern!
Up: Alk Phos, +/- bili
Down: AST, ALT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Dx of Choledocolithiasis?

A

U/S showing gall stone in common bile duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Tx of Choledocolithiasis?

A

ERCP.

Most also have cholecystectomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Eti of Acute Cholangitis?

A

Bacterial infx d/t obstructive gall stone.

M.C.=E. Coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

70% of in Acute Cholangitis due to what?

A

Choledocolithiasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What triad in in Acute Cholangitis?

A

Charcot Triad= Fever, ABD/RUQ pain, jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What pentad in Acute Cholangitis?

A

Reynold Pentad=Charcot + Hypotension + Confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

LFT in Acute Cholangitis?

A

Cholestatic pattern!
Up: Alk phos, +/- bili
Down: AST, ALT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

CBC in Acute Cholangitis?

A

Leukocytosis w/Left shift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Initial imaging dx in Acute Cholangitis? Test of choice?

A

Initial=ABD U/S

TOC=ERCP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Tx of Acute Cholangitis?

A

-Admit
-ABX=PCN + Aminoglycosides for empiric treatment
ERCP=drain biliary tree and extract gall stone

45
Q

Primary Sclerosing Cholangitis occurs to who?

A

Men, 20-25 y/o

46
Q

Primary Sclerosing Cholangitis increases risk for what?

A

Cholangiocarcinoma, GB cancer, hepatocellular carcinoma

47
Q

Primary Sclerosing Cholangitis highly correlated with what other dz?

A

Ulcerative Colitis

48
Q

Primary Sclerosing Cholangitis leads failure of what?

A

Liver

49
Q

Sx in Primary Sclerosing Cholangitis

A

ASx, fatigue, pruritus

50
Q

PE in Primary Sclerosing Cholangitis

A

ASx, jaundice, splenomegaly

51
Q

LFT in Primary Sclerosing Cholangitis

A

Cholestatic pattern
Up: Alk Phos (a lot!), GGT
Down: ALT, AST

52
Q

Dx of Primary Sclerosing Cholangitis

A

MRCP (other sources say ERCP, lecture notes say MRCP)

53
Q

Tx of symptoms of Primary Sclerosing Cholangitis? Definitive tx?

A

Sx=UDCA for 2 years. Stents. Buys time.

Def=liver transplant

54
Q

What is the #1 GI in-patient issue?

A

Acute Pancreatitis

55
Q

Etiology of Acute Pancreatitis?

A

Intracellular enzyme activation leads to autodigestion of pancreas

56
Q

90-95% of Acute Pancreatitis is which type? Necrosis?

A

Interstitial. No necrosis.

57
Q

2 major Causes of Acute Pancreatitis?

A

EtOH abuse, gall stones

58
Q

Where and what time of pain in Acute Pancreatitis?

A

Sudden midepigastric pain. Radiates (boring) to back.

59
Q

Sx of Acute Pancreatitis?

A

Midepigastric pain, nausea, vomiting, dyspnea

60
Q

PTs with Acute Pancreatitis sit in what position?

A

Lean forward

61
Q

PE of severe Acute Pancreatitis?

A

Tachypnea, hypoxemia, hypotension.
Cullens Sign=bruising of embilicus d/t int bleed
Grey-Turner Sign=discolored flanks d/t severe nectrotizing pancreatisis

62
Q

Describe Cullens Sign and which dz

A

Bruising of embilicus d/t int bleed. Severe acute pancreatitis.

63
Q

Describe Grey-Turner Sign and which dz

A

discolored flanks d/t severe nectrotizing pancreatisis. Severe acute pancreatitis.

64
Q

Which two main labs in Acute Pancreatitis?

A

Amylase and Lipase. Both 3x ULN.

65
Q

Bilirubin in Acute Pancreatitis?

A

Direct bili higher than indirect

66
Q

Fasting Triglycerides in Acute Pancreatitis?

A

> 1000

67
Q

Imaging TOC in Acute Pancreatitis?

A

ABD CT

68
Q

Dx of Acute Pancreatitis required ≥ 2 of…

A
  • Midepigastric abd pain
  • Amylast and/or Lipase 3x ULN
  • Positive CT showing pancreatitis
69
Q

Tx of Acute Pancreatitis?

A

Admit, NPO, IV fluids, analgesia, antiemetics. Find underlying cause.

70
Q

When to repeat labs in Acute Pancreatitis?

A

q8-12h. Check BMP, CBC, etc.

71
Q

Serial Exams in Acute Pancreatitis to prevent what?

A

Prevent fluid overloading!

72
Q

What is Ranson Score in Acute Pancreatitis? Good or bad test?

A

Estimates mortality from pancreatitis. Done on admission (5 tests) and after 48h (6 tests). Poor predictor but used often.

73
Q

What is SIRS Score in Acute Pancreatitis? Specific for it?

A

Preduct severity of pancreatitis. Easily done at bedside. Temp, HR, RR, WBC.

Not specific for Acute Pancreatitis.

74
Q

What is #1 cause of Chronic Pancreatitis?

A

EtOH abuse.

Idiopathic 25%.

75
Q

Is damage to pancreas reversible in Chronic Pancreatitis?

A

No. Irreversible dmg to pancreas.

76
Q

What happens to tissue and histologic findings in Chronic Pancreatitis?

A

Histologic abnormalities. Fibrosis, atrophied/destroyed exocrine and endocrine tissue.

77
Q

If PE in Chronic Pancreatitis impressive? What might see?

A

No, mostly unimpressive. Weight loss, abd pain, anorexia.

78
Q

What is poop like in Chronic Pancreatitis?

A

Steatorrhea (fatty and foul smelling poop!)

79
Q

Are there biomarkers for Chronic Pancreatitis?

A

Nope

80
Q

Easy or hard to dx early and mild Chronic Pancreatitis?

A

HARD!

81
Q

Imagine for Chronic Pancreatitis? When?

A

ABD CT showing necrotic pancreas.

Only for initial dx, not after.

82
Q

Tx of Chronic Pancreatitis?

A

Low fat diet, no EtOH.
Abd pain=Hard to treat, try TCAs. Avoid opiates.
Steatorrhea=pancreatic enzyme
Whipple procedure, total pancreatectomy.

83
Q

What is Diverticulosis?

A

Mucosal sac-like herniations protruding through colon muscle layer

84
Q

Where is 95% of Diverticulosis?

A

Sigmoid colon due to HIGH pressure

85
Q

Diverticulosis sx or asx?

A

70-80% Asx

86
Q

Is colon muscle wall inflammed in Diverticulosis?

A

NO

87
Q

What is main cause of lower GI bleed?

A

Diverticulosis?

88
Q

Dx for Diverticulosis?

A

Colonoscopy

89
Q

Tx for Diverticulosis?

A

High fiber diet, fiber supplements

90
Q

Etiology of Diverticulitis? What percent of diverticulosis?

A

Inflammation of diverticulum secondary to obstruction/infx causing distension. 4%.

91
Q

Where is pain in Diverticulitis? Lasts how long?

A

LLQ pain. Constant for days.

92
Q

PE of LLQ in Diverticulitis?

A

Rigid. Tender, palpable mass.

93
Q

Imaging to dx Diverticulitis?

A

ABD CT w/IV contrast, +/- PO contrast

94
Q

WBC and guaiac in Diverticulitis?

A

Elevated WBC.

Positive stool guaiac.

95
Q

Tx of micro perf in Diverticulitis? Abscess?

A

Micro perf=Medical tx

Abscess=I.R. drainage

96
Q

Tx of free perf in Diverticulitis? Significant obstruction?

A

Free perf=Emergency surgery

Sig obstruction=Urgent to emergent surgery

97
Q

Which ABX and bacteria to tx in Diverticulitis?

A

Entero and gram - anaerobes (B. Frag).

Cipro + Flagyl

98
Q

When and what in follow-up of in new dx Diverticulitis?

A

6 weeks post-abx get colonoscopy if not had in past year

99
Q

What is main cause of hematochezia/lower GI bleed?

A

Diverticular Bleed

100
Q

Diverticular Bleed caused by injury to what?

A

Injury to vasa recta from recurrent injury

101
Q

What is major source/location of Diverticular Bleed?

A

Right colon, hepatoflexure

102
Q

Diverticular Bleed often self-limited?

A

Yes!

103
Q

Pain in Diverticular Bleed?

A

No! Painless!

104
Q

PE if bad Diverticular Bleed?

A

Hemodynaically unstable. Pallor, tachycardia.

105
Q

Normal labs in Diverticular Bleed?

A

Yes, normal labs.

106
Q

How to dx Diverticular Bleed?

A

Colonoscopy after resuscitation

107
Q

Resuscitation in Diverticular Bleed?

A

2 large bore IVs, type & cross-match blood, transfuse PRBCs

108
Q

Tx of active Diverticular Bleed?

A

Colonoscopy w/submucosal epi or endoscopic tamponade

109
Q

Tx if fail colonoscopy treatment and unstable in Diverticular Bleed?

A

Segmental colectomy

Clinical Medicine 2 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions