Gastrointestinal and Nutrition Flashcards
IVF in dehydrated young children
normal saline
GGT and ferritn - classify how?
both acute phase reactants seen in alcoholic liver disease
preggo with s/s of appy - what next?
ultrasound
unconjugated hyperbilirubinemia + positive urine urobilinogen indicative of what process?
hemolysis
Serum-to-Ascites Albumin Gradient (SAAG) differentiates ascites fluid origin from portal or non-portal HTN etiologies.
Equation: SAAG = peritoneal fluid albumin concentration - serum albumin concentration. ____ or greater = portal HTN (i.e. cirrhosis, cardiac ascites, etc).
1.1
mgmt of pyloric stenosis
wait for surgery, manage with IVF and potassium replacement
MCC of esophageal reupture
endoscopy
abdominal pain after cardiac event (even weeks ago) + elevated amylase and/or metabolic acidosis –> dx?
–> Acute Mesenteric Ischemia
diagnstic test for (test and dx): upper esoph sphincter dysfunction and esophageal dysmotility.
herniation forms superior to the UES and posteriorly between cricopharyngeal muscle.
Zenker
-contrast esophagram
painless GI bleeding Associated/dx in advanced RENAL DISEASE and vWD and AORTIC STENOSIS.
angiodysplasia
Rim enhancing perisigmoid fluid collection with n/abd pain/f. after sigmoid divertcula and
perisigmoid stranding found on CT.
acute diverticuitis
Pt with Hemophilia A needs surgery - give what pre-operatively?
DDAVP (desmopressin) to increase factor 8 by causing vWF release from endothelial cells.
Emergent laparotomy needed. Pt is on warfarin with INR of 2.1. Do what?
FFP or concentrated vitK factors
Blunt abdominal trauma in stable pts - next step if: (a) Alert? (b) not alert
Alert? (a) Yes, then FAST exam. (b) No, then serial abd
exams +/- Ct scan.
Pts with cirrhosis and portal HTN and ascites and peripheral edema - may develop _____, which causes a pleural effusion.
hepatic hemothorax. pleural effusio ndue to hemodiaphragm defect MC on right side
Post-op or critically ill patient with unexplained fever and RUQ tenderness and leukocytosis. Possible jaundice or abnormal LFTs.
Think ACALCULOUS CHOLECYSTITIS due to GB stasis or ischemia from local inflammation.
Rapid, massive increase in transaminases (in thousands) with mild elevation in Br and alk phos post-hypotension
shock liver or ischemic hepatic injury
Jaundice and sustect pancreatic cancer - location and first test
head of pancreas, do us
No jaundice, suspect pancreatic cancer - location and first test
body and tail. do abd CT
What immune deficiency assoc with celiac?
IgA
What test needs to be done to dx celiac if pt is also IgA decient
IgA anti-ttG and IgA anti-endomysial ab will be ENGATIVE. NEed to do small bowel bx to see villous atrophy. DONT TRUST IgA DIAGNSTIC TESTS IN CELIAC FOR RULING OUT.
RF for adenocarcinoma esophageal cancer v. SqCCa of esophagus
AdenoCa = obesity, GERD
SqCCa = smoking, alcohol, caustic injury
succussion splash indicates?
gastric obstruction - astric malignancy, peptic ulcer disease, crohn disease, strictures (with pyloric stenosis) secondary to ingestion of caustic agents, and gastri bezoars.
Achalasia and esophageal stricture sx VS gastric outlet obstruction sx
Symtoms of GOO = postprandial pain and early satiety and vomting. VS Achalasia and esophagea stricture = dysphagia.
