Gastrointestinal Flashcards
What is anti-mitochondrial antibody a marker of?
Primary biliary cholangitis
Treat with ursodeoxycolic acid
Steroids not effective
Primary sclerosing cholangitis
65 yo male w/ fatigue and pruritis p-ANCA positive 90% have ulcerative colitis Focal narrowing of intra- and extra-hepatic bile ducts High risk of cholangiocarcinoma
Painless GI bleeding cause
Angiodysplasia
Common in patients w/ vWF and renal disease
Aortic stenosis can cause acquired vWF degradation
Colon cancer screening
Fecal occult blood (every year)
Flex sig (every 5 years) w/ occult blood (every 3 years)
Colonoscopy (every 10 years)
Starting at 50 normally
40 or relative onset age-10 for risky
Pancreatitis mnemonic
I-idiopathic G-gallstone E-ethanol T-trauma S-scorpion M-mumps and malignancy A-autoimmune S-steroids H-hypercalcemia and hypertriglyceridenmi E-ERCP D-drugs
Autoimmune hepatitis marker
Anti-smooth muscle antibody
Marker for autoimmune pancreatitis
IgG4 levels increased
Painless GI bleed episodic
Angiodysplasia
More common in right colon
More common in vwf disease or renal
Also in aortic stenosis which breaks vWF
Biliary colic
Epigastric pain with radiation to right shoulder
Often not colicky in nature but constant
No fever and leukocytosis
Esophageal webs association
Often associated with iron deficiency in Plummer-Vinson syndrome
Reason for dysphagia in polymyositis
Dysfunction of striated muscle in upper 1/3 of esophagus
Colonoscopy polyp severity
Tubular = good Villous = bad
Pancreatitis named signs 2x
Cullen - periumbilical bluish discoloration (indicating hemoperitoneum)
Grey-Turner - Reddish brown coloration around flanks indicating retroperitoneal bleed
small bowel bacterial overgrowth
1) blind surgical loop
2) slowed motility (scleroderma etc)
treat with rifaximin
niacin deficiency
Can be synthesized with tryptophan Commonly seen in corn consumer (niacin in corn is bound and cannot be absorbed) 1) developed world a/w carcinoid syndrome (depletion of tryptophan) or Hartnup syndrome (decreased absorption) Dermatitis - Worse in sun-exposed areas - Rough, scaly and hyperpigmented Dementia Diarrhea -Profuse and watery
