Gastroenterology Flashcards
In melena, the blood has been in the GIT for at least how many hours?
14 hours
Violaceous striae is usually seen in what case
Cushing’s syndrome
Bruits with audible systolic and diastolic components heard near the midline almost midway between subxiphoid area and umbilicus may suggest
Renal artery stenosis
PUD that has common risk for malignancy
Gastric ulcer
PUD with increased gastric acid secretion
Duodenal ulcer
Gastric - normal
PUD wherein pain awakens the patient from sleep between midnight and 3 AM
Duodenal ulcer
PUD precipitated by food
Gastric
PUD relieved by antacid or food
Duodenal
Test of choice for documenting H. pylori eradication
Urea breath test
Side effect of aluminum OH
Constipation
Side effect of magnesium OH
Diarrhea
Black stools, darkening of tongue and neurotoxicity are ADRs of what anti PUD drug?
Bismuth
Triple therapy for H-pylori eradication
PPI + Clarithromycin or Metronidazole + Amoxicillin or Metronidazole (if not used as second agent)
Most common complication of PUD
Gastrointestinal bleeding
Form of perforation in which ulcer bed tunnels into adjacent organ
Penetration
Least common ulcer-related complication
Gastric outlet obstruction
Most common cause of UGIB
PUD
Large caliber arteriole that runs immediately beneath the GI mucosa and bleeds via a pinpoint mucosal erosion; seen most commonly in the lesser curvature of the proximal stomach
Dieulafoy’s lesion
Vasoactive agents given to patients with variceal hemorrhage to reduce the portal venous pressure acutely by splanchnic vasoconstriction
Somatostatin or octreotide
Endoscopic therapy of choice for variceal hemorrhage
Ligation or banding
Most common and most characteristic symptom of hepatic disease
Fatigue
Sign of hepatic disease that result from recannulation of umbilical vein with collateral veins radiating from umbilicus
Caput medusa
Golden-brown copper pigment deposited un periphery of the cornea
Kayser-Fleischer ring
Kayser-Fleischer rings are seen in what cases
Wilson’s disease
Dupuytrrn contracture and parotid enlargement are seen in what liver disease
Alcoholic liver disease
Slate-gray pigmentation of the skin is seen in what liver disease
Hemochromatosis
Aminotransferase that is more specific as an indicator of liver disease
ALT
AST:ALT > 2 is seen in what condition
Alcoholic liver disease
ALP > aminotransferase is seen in what condition
Cholestatic conditions
Single best acute measure of hepatic synthetic function
Clotting factors
Only clotting factor that is not synthesized in the liver
VIII (synthesized by endothelial cells)
First line diagnostic method if initial blood tests suggest cholestasis
Ultrasound
First test ordered if suspecting Budd chiari syndrome
Doppler US
Hepatobiliary disease with antimitochondrial antibody and elevated IgM levels
Primary biliary cirrhosis
Serology in window period of hepatitis
IgM anti-HBc
Gold standard in diagnosis of HCV infection
HCV RNA
Most frequent indication of liver transplant
Chronic HCV infection
Most feared complication of viral hepatitis
Fulminant hepatitis
Fulminant hepatitis is primarily seen in what 3 hepatitis viruses
B, E, D
TNF inhibitor given in alcoholic liver disease
Pentoxifylline
4 complications that differentiates compensated from decompensated cirrhosis
Variceal hemorrhage
Ascites
Jaundice
Hepatic encephalopathy
Fever, altered mental status, elevated WBC, and abdominal pain or discomfort in the setting of liver cirrhosis
Spontaneous bacterial peritonitis
Most common organism in spontaneous bacterial peritonitis
E. coli
Asterixis is a sign of
Hepatic encephalopathy
Requirement fir diagnosis of fulminant hepatitis
Hepatic encephalopathy
Mainstay treatment for encephalopathy
Lactulose