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Examen residencia > GASTRO > Flashcards

GASTRO Flashcards

1
Q

diagnostico de REFLUJO GE

A
  1. 2 SEMANAS CON IBP
  2. SI NO FUNCIONA 24-hour esophageal pH monitoring is the answer
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2
Q

presentacion no clasica de RGE

A

TOS NOCTURA, NEUMONITIS RECURRENTE

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3
Q

esofago de barret que estudio se hace para confirmar metaplasia

A

biopsia luego de ser observado en endoscopia.

OJO HAY MAS RIESGO DE ADENOCARCINOMA

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4
Q

patient over 50 who has Hx of GERD with either 1) new-onset dysphagia to solids, or 2) dysphagia to solids that progresses to solids and liquids.

A

ADENOCARCINOMA

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5
Q

PASOS DE ESTUDIO DE ADENOCARCINOMA

A
  1. ENDOSCOPIA
  2. BIOPSIA
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6
Q

patient over 50 who is heavy smoker/drinker who has 1) new- onset dysphagia to solids, or 2) dysphagia to solids that progresses to solids and liquids.

A

CARCINOMA DE CELULAS ESCAMOSAS

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7
Q

VENA RESPONSABLE DE VARICES ESOFAGICAS

A

GASTRICA IZQUIERDA

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8
Q

high-volume hematemesis

A

VARICES ESOFAGICAS

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9
Q

TTO VARICES ESOFAGICAS

A
  1. endoscopy + banding.
  2. OCTEOTRIDO
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10
Q

­ insulin high but ̄ C peptide, answer

A

inyección exogena

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11
Q

­ insulin high C-peptide is normal/high

A

insulin production is endogenous.

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12
Q

COMO DIFERENCIAR SI LA PRODUCCION DE INSULINA ES ENDOGENA POR FCOS O POR ISULINOMA

A

First step is checking serum hypoglycemic levels (“serum hypoglycemic” = type II diabetes med that ̄ glucose, such as sulfonylureas and meglitinides). If serum hypoglycemics are negative, then do CT of abdomen to check for insulinoma.

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13
Q

Whipple triad:

A
  1. HIPOGLICEMIA
  2. SX DE HIPOGLICEMIA
  3. MEJORA CON COMIDAS
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14
Q

EFECTOS DE HIPERINSULINEMIA

A

1.INH FORMACION DE CETONAS
2. anovulation / polycystic ovarian syndrome
3.acanthosis nigricans,

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15
Q

funcion de somatostatina

A
  • ̄ secretion of most GI hormones, as well as growth hormone.
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16
Q

hormona producida x cells enteroendocrinas

A

grelina

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17
Q

la leptina producida por adipocitos estimula la secrecion pituitaria de que hormona

A

GnRH

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18
Q

que ulceras pepticas causan dolor 1-2 horas despues de comer

A

ulceras duodenales

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19
Q

Responsible for almost all duodenal ulcers >95%

A

Helicobacter pylori

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20
Q

Mechanism for ulcers caused by h. pulori

A

aumenta­ gastrin levels, which aumenta ­ acid secretion.

  • Produces urease, which causes aumento ­ ammonia production around the organism, allowing it to survive in the acid pH of the stomach.
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21
Q

DIAGNOSIS OF H. PYLORI

A

UREASE BREATH TEST
ANTIGENO EN POPO

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22
Q

TTO H. PYLORI (CAI)

A

CLARITROMICINA
AMOXICILINA
IBP

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23
Q

TTO PARA ULCERAS GASTRICS CAUSADA POR AINES (ABORTO)

A

MISOPROSTOL que es un analogo de PGE1 para aumentar las prostaglandinas que los AINES inh

24
Q

3 mecanismos para la produccion de acido

OJO: Gastrina, histamina , acetilcolina.

A
  • GASTRINA UNIENDOSE A SU RECEPTOR EN CELULAS PARIETALES
  • GASTRINA ESTIMULA A LAS ENTEROCROMAFINAS PARA SECRETAR HISTAMINA Y POST UNION A SU RECEPTOR EN CELULAS PARIETALES
    *ATIVIDAD PARASIMPATICA DIRECTA_ ACH SE UNE A REC MUSCARINICO EN CELULAS PARIETALES
25
Q

3 causas de gastritis

A
  • h. pylori
  • anemia perniciosa: x desrtuccion de c. parietales
  • AINES
26
Q

painless, palpable gallbladder in an afebrile patient who’s jaundiced

A

Courvoisier sign

27
Q

dx de cancer de pancreas

A

TAC DE ABDOMEN
ENZIMAS PANCREATICAS SON NORMALES
AUMENTO DE BILIRRUBINA – ICTERICIA OBSTRUCTIVA

28
Q

4Fs = Fat, Forties, Female, Fertile QUE GENERA

A

“increased secretion of cholesterol into bile.” para producir los calculos de colesterol

29
Q

colelitiasis en embarazo es comun fisiopatologicamente por:

A

aumento de progesterona que disminuye la peristalsis biliar

30
Q

DX DE COLELITIASIS

A

ECO ABDOMINAL

31
Q

DIFERENCIA ENTRE COLELITIASIS Y COLECISTITIS

A

LA FIEBRE POR INFECCION LUEGO DE OBSTRUCCION POR CALCULO

32
Q

CAUSANTE DE COLECISTITIS ENFISEMATOSA

A

Clostridium perfringens

33
Q

caundo comenzar colonoscopia para ca de colon

A

45 - 50 y erepetir cada 10 años

34
Q

colonoscopiaando hacer colonoscopia cunado tiene a papa o hermano con dx de cancer de colon

A

a los 40 o 10 años previos al dx de faamiliar y repetir cada 5 años

35
Q

cuando hacer colonoscopia en pacientes con CU o crohn

A

8 dps de dx y dps cada 2-3 años

36
Q

sx de lynch cada cuanto se repite colono y cuando empezar

A

1-2 años a los 20-25 años empiezas

37
Q

vomito en protectil NO bilioso en neonatos dx ?

A

estenosis piloro

38
Q

CU o crohn tiene + riesgo de ca de colon

A

CU

39
Q

Enfermedad inflmatoria rectum ascending, que solo afecta mucosa y submucosa, no hay fistulas, con pseudopolipos y abscesos en criptas y perdidas de haustras

A

Colitits ulcerativa

40
Q

lugar + frecuente de crohn

A

ileo terminal

41
Q

lesiones de crohn caracteristicas mostradas en colonoscopia

A

skip lesssions with cobllestone ulcers (empedrado)

42
Q

tto enfermedad inflamatoria intestinal

A

sulfazalazina o esteroides

43
Q

cuales son las hepatitis agudas

A

A y E

44
Q

(+) Surface antibody / (-) Core antibody para hepatitis b

A

Vacunado inmune

45
Q

(+) Surface antibody / (+) Core antibody

A

Tuvo hepatitis b y ahora esta inmune

46
Q
  • (-) Surface antibody / (-) Core antibody hep b
A

debe vacunarse contra hep b

47
Q
  • (-) Surface antigen / (-) Surface antibody / (+) Core antibody IgM hep B
A

periodo de ventana

48
Q

hepatitis qeu requiere pre infeccion de hepatitis b

A

hepatitis D

49
Q

IgG + en hepatitis C que significa

A

infeccion cronica

50
Q

transaminasa + aumentada durante hepatitis virales

A

ALT

51
Q

efecto adverso mas importante de estatinas

A

miopatia

52
Q

3 most important causes of pseudogout.

A

hemochromatosis, primary hyperparathyroidism, and hypothyroidism

53
Q

is ­ high risk of hepatocellular carcinoma.

A

hemochromatosis

54
Q

dx de hemochromatosis

A

ferritin >300 mg/dL. Transferrin saturation high
Treat with serial phlebotomy,

55
Q

­ urinary copper + ̄ serum ceruloplasmin, Keiser-Fleischer rings - Parkinsonism in a young patient

A

wilsons disease

55
Q
A

Examen residencia (8 decks)

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