Gastro Flashcards
Secondary causes of GERD
Hiatal hernia
Zollinger Ellison Syndrome(Gastrinoma)
Exacerbating factors of GERD
Obesity
Lying down after sleep
Coffee
Alcohol
Smoking
Spicy food?
Triple therapy for H pylori
PPI,Clarythromycin, amoxicillin or metronidazole
Triad of SBP
Fever, abdominal pain and increasing ascites
Tests for synthetic function of liver
1) PT/PTT most important
2) Albumin
3) Bilirubin
4) Glucose
VAGIND acronym for common transaminitis causes
Viral
Alcohol
Gallstones
Ischemia
NASH
DILI(Usually paracet)
alcoholic and ischemic pattern of transaminitis
AST>ALT
Triad of liver failure
Coagulopathy, Jaundice and encephalopathy
Mx of bleeding PUD
IV esomeprazole
Metoclopramide
OGD for clipping
Antibiotics
Mx of bleeding esophageal varices
IV esomeprazole
Octreotide
Abx: IV Roc
Fluid resus
PCT if indicated
+-OGD
+-Sengstaken blakemore/minnesota tube
RFs for bleeding PUD
H Pylori
NSAIDs
Anti platelet/coagulation
Classification system for peptic ulcers
Forrest
When to give IV PPI for PUD
Adherent clot or active bleed/ooze. Clean base can give PO instead
Most common causes of LBGIT
- Cancer
- Diverticulitis
- IBD
- AVMs
- Hemorrhoids
Impt cause to rule out in significant hematochezia
Massive UBGIT
Triad of Budd Chiari syndrome
Abdominal pain, ascites and heaptomegaly
Highest cause of mortality in esophageal varices
Infection: MUST give ceftriaxone on top of octreotide and esomeprazole
Investigation and appearance of achalasia
Video fluoroscopy showing birds beak appearance
Investigation of choice for diffuse esophageal spasm
Esophageal manometry
Appearance of diffuse esophageal spasm on barium swallow
Corkscrew esophagus
max doses of spironolactone and furosemide for ascites
400mg and 160mg
Triad of acute liver failure
Jaundice. coagulopathy and hepatic encephalopathy
Jaundice and coag alone is liver impairment
Scoring system for hepatic encephalopathy
Westhaven score
Cause of HCC without liver cirrhosis
Hep B
Test for Clostridiodes Difficile associated diarrhea
Stool C diff toxin
Best test as indicator of hepatic injury
Coagulopathy: PT/PTT
Causes of thrombocytopenia in cirrhosis
- Splenic sequestration
- Reduced TPO
Drug for treatment of Wilson’s disease
Chelating agents eg penicillamine, trientine, zinc salts
What does MELD score stand for
Model for End stage Liver Disease
Gold standard for dx of esophageal cupture
Contrast esophagography
-ideally use gastrogriffin, barium can cause mediasitinitis
Ideal iron chelating agent for hemochromatosis
Deferoxamine
Mainstay of treatment of primary hemochromatosis
Therapeutic phlebotomy
What is Mackler’s triad
Triad of Chest Pain, Vomiting and pneumomediastinum suggesting Boerhaave syndrome(esophageal rupture)
Why Hep B causes de novo HCC
Integrates into human DNA as it is a DNA virus
Indications for liver transplant
- HCC
- Acute Liver Failure( DILI vs non-DILI)
- Acute on Chronic LF
- End Stage Liver Disease
Suspicious features on US Breast
Mass
Microcalcifications
- Linear and segmented distribution likely malignant
- Microcalcz worse than macro
Asymmetry
Distortion of architecture
Nipple retraction
