First Aid Flashcards
Cause of primary achalasia and 2 causes of secondary achalasia
Loss of myenteric Auerbach plexus (high LES pressure)
Chagas disease (T. cruzi) Extraesophageal malignancies (mass effect-paraneopl)
4 causes of esophagitis
Reflux
Infection (Candida, HSV1, CMV)
Caustic ingestion
Medications
Plummer-Vinson syndrome (symptoms and complication)
Triad: dysphagia, iron deficiency anemia, esophageal webs
Risk of esophageal squamous cell carcinoma
4 symptoms of toxic megacolon
Abdominal pain/distension
Bloody diarrhea
Fever
Shock (hypotension, tachycardia)
5 medications for Crohn disease
Corticosteroids Azathioprine Antibiotics (Ciprofloxacin, Metronidazole) Infliximab Adalimumab
4 medications for ulcerative colitis
5-aminosalicylic preparations (mesalamine)
6-mercaptopurine
Infliximab
Colectomy
Ileus associated with 4 conditions
Abdominal surgeries
Opiates
Hypokalemia
Sepsis
Treatment of ileus
Bowel rest
Electrolyte correction
Cholinergic drugs
Colorectal cancer presentation
Rectosigmoid>ascending>descending
Right side bleeds
Left side obstructs
6 causes of cirrhosis
Alcohol Nonalcoholic steatohepatitis Chronic viral hepatitis Autoimmune hepatitis Biliary disease Genetic/metabolic disorders
3 causes of portal hypertension
Cirrhosis
Vascular obstruction (thrombosis, Budd-Chiari sd)
Schistosomiasis
4 conditions with elevated ALP
Cholestasis
Infiltrative disorders
Bone disease
From placenta
6 findings in Reye syndrome (fatal childhood hepatic encephalopathy)
Mitochondrial abnormalities Fatty liver Hypoglycemia Vomiting Hepatomegaly Coma
5 consequences of hyperestrinism from alcoholic liver cirrhosis
Gynecomastia Spider angiomata Loss of sexual hair Testicular atrophy Palmar erythema
Treatment of hepatic encephalopathy
Lactulose +
Rifaximin or Neomycin
Budd-Chiari syndrome associated with 4 conditions
Hypercoagulable states
Polycythemia vera
Postpartum state
HCC
4 causes of unconjugated hyperbilirubinemia
Hemolytic
Physiologic (newborns)
Crigler-Najjar
Gilbert syndrome
3 causes of conjugated hyperbilirubinemia
Biliary tract obstruction (gallstones, cholangiocarcinoma, pancreatic or liver cancer, liver fluke) Biliary tract disease (1* sclerosing cholangitis, 1* biliary cirrhosis) Excretion defect (Dubin-Johnson sd, Rotor sd)
2 causes of mixed hyperbilirubinemia
Hepatitis
Cirrhosis
Treatment of Crigler-Najjar syndromes, type I and II
Type I: plasmapheresis and phototherapy
Type II: phenobarbital
6 manifestations of Wilson disease (before age 40)
Liver disease Neurologic disease Psychiatric disease Kayser-Fleischer rings Hemolytic anemia Renal disease
Treatment of Wilson disease
Penicillamine or Trientine
Oral zinc
6 organs where iron accumulates in Hemochromatosis (after age 40)
Liver (cirrhosis) Pancreas (diabetes mellitus) Skin (pigmentation) Heart (dilated cardiomyopathy/HF) Pituitary (hypogonadism) Joints (arthropathy)
Common cause of death + treatment of Hemochromatosis
Hepatocellular carcinoma
Repeated phlebotomy
Chelation (deferasirox, deferoxamine, oral deferiprone)
Primary sclerosing cholangitis: epidemiology + 3 complications
Middle-aged men with Ulcerative colitis
Secondary biliary cirrhosis
Cholangiocarcinoma
Gallbladder cancer
Secondary biliary cirrhosis: epidemiology and 1 complication
Known obstructive lesions
Ascending cholangitis
3 causes of gallstones
High cholesterol and/or bilirubin
Low bile salts
Gallbladder stasis
8 associations with cholesterol gallstones
Obesity Crohn disease Advanced age Estrogen therapy Multiparity Rapid weight loss Glucose intolerance Hypomotility
4 complications of gallstones
Cholecystitis +++
Acute pancreatitis
Ascending cholangitis (Charcot triad)
Fistula (Gb/GI - pneumobilia and gallstone ileus)
3 causes of cholecystitis
Cholelithiasis +++
Ischemia and stasis
Primary infection (CMV)
1 treatment and 1 complication of porcelain gallbladder
Prophylactic cholecystectomy
Cancer (esp. adenocarcinoma)
12 causes of acute pancreatitis
Idiopathic Gallstones Ethanol Trauma Steroids Mumps Autoimmune disease Scorpion sting Hypercalcemia Hypertriglyceridemia (>1000 mg/dL) ERCP Drugs (sulfa, NRTIs, protease inhibitors)
Diagnosis of acute pancreatitis
2 of 3 criteria
Acute epigastric pain (to back)
Amylase or lipase (specific) 3x upper limit
Characteristic imaging findings
5 complications of acute pancreatitis
Pseudocyst Necrosis Hemorrhage Infection Organ failure Hypocalcemia
3 manifestations of pancreatic insufficiency
Steatorrhea
Fat-soluble vitamin deficiency
Diabetes mellitus
6 risk factors for pancreatic adenocarcinoma
Male >50 yo Tobacco use Diabetes Chronic pancreatitis (>20y) Jewish / African-American
5 adverse effects of Cimetidine (H2 blocker)
Potent inhibitor of CYP450 Antiandrogenic effects Cross blood-brain barrier (confusion, dizziness, headaches) Cross placenta Reduce renal excretion of creatinine
4 indications of Octreotide
Acute variceal bleeds
Acromegaly
VIPoma
Carcinoid tumors
3 GI infections by protozoa: difference + treatment
Giardia lamblia (fatty diarrhea)/Metronidazole Entamoeba histolytica (bloody diarrhea)/Metronidazole Cryptosporidium (watery diarrhea / severe in AIDS)/ Nitazoxanide
