GI Flashcards
What is Primary Sclerosing Cholangitis?
Autoimmune destruction of the extrahepatic bile ducts
With what condition is Primary Sclerosing Cholangitis commonly seen with?
Ulcerative Colitis
How will Primary Sclerosing Cholangitis present?
Like ascending cholangitis
= RUQ pain, jaundice, fever, AMS, hypotension
How do you diagnose Primary Sclerosing Cholangitis? What will be seen?
MRCP = Beads on a string
What is Primary Biliary Cholangitis?
Autoimmune destruction of intra-and extrahepatic bile ducts
What antibody will be (+) with Primary Biliary Cholangitis?
Anti-Mitochondrial antibody
What is the treatment for Primary Biliary Cholangitiis?
Ursodeoxycholic Acid
What gene is mutated with Wilson’s Disease?
ATP7B
What is the physiology behind Wilson’s Disease?
Reduced Ceruloplasmin formation and copper excretion
What 3 places does copper commonly deposit with Wilson’s Disease?
Eye
Liver
Brain - Basal Ganglia
Levels of Ceruloplasmin and Urine Copper with Wilson’s Disease?
LOW Ceruloplasmin
HIGH Urine Copper
What is the treatment for Wilson’s Disease?
Copper chelators like Penicillamine
What is the physiology behind Hereditary Hemochromatosis?
Increased iron absorption that is unable to be inhibited
What are some signs of Hereditary Hemochromatosis?
- Bronze Diabetes Mellitus
- Arthropathy – commonly MCP joints
- Hypogonadism
- Cardiomegaly
- Hepatomegaly
What are some signs of Hereditary Hemochromatosis?
- Bronze Diabetes Mellitus
- Arthropathy – commonly MCP joints
- Hypogonadism
- Hepatomegaly
- Cardiomegaly
What lab value is extremely HIGH with Hereditary Hemochromatosis?
Ferritin!
What is the treatment for Hereditary Hemochromatosis?
Phlebotomy
Which Hepatitis viruses are DNA viruses?
B and D
Which Hepatitis virus is self-limited and transferred fecal-oral?
Hepatitis A
What antibody to Hepatitis B will only be present if you obtained Hepatitis B through exposure?
IgG HBcAg
The liver normally metabolizes what 2 things that are the mainstay of Cirrhosis symptoms?
Ammonium
Estrogen
What are the signs (2) of Hepatic Encephalopathy?
AMS
Asterixis
Treatment for Hepatic Encephalopathy?
Lactulose
What symptoms are caused by Estrogen Overload with Cirrhosis?
Gynecomastia
Spider Angiomata
Palmar Erythema
What 3 symptoms with Cirrhosis are caused by Portal HTN?
Thrombocytopenia
Ascites
Varices
If the SAAG score is > ____ Cirrhosis is to blame for the Ascites
> 1.1
What is the mainstay of treatment for Ascites with Cirrhosis (2)?
Furosemide and Spironolactone
4 ways to treat bleeding varices?
- EGD with banding
- Ceftriaxone
- Octreotide
- Beta blockers to reduce pressure
4 ways to treat bleeding varices?
- EGD with banding
- Ceftriaxone
- Octreotdie
- Beta blockers to reduce pressure
What is a common complication of Ascites?
Spontaneous Bacterial Peritonitis
How can you diagnose Spontaneous Bacterial Peritonitis?
Paracentesis shows > 250 PMNs in ascitic fluid
What is the treatment for Spontaneous Bacterial Peritonitis?
Ceftriaxone
Whipple disease is an infectious disease caused by Tropheryma Whippelii. It has many possible symptoms. What GI organ is affected?
Small Bowel
What is characteristic of Whipple Disease?
PAS (+) material in lamina propria
What is Angiodysplasia?
Dilated submucosal veins and AV malformations in the RIGHT colon
What will be present intermittently with Angiodysplasia?
Intermittent painless GI bleeding
– AV malformations in the RIGHT colon
How is Angiodysplasia diagnosed and does it need treatment?
Colonoscopy
– Does not usually need to be treated
What is Autoimmune Atrophic Gastritis?
Attack of the parietal cells and IF
How will Autoimmune Atrophic Gastritis present?
Postprandial pain and bloating with a Macrocytic anemia
– Attack of parietal cells and IF
What lab change can be seen with Chronic Pancreatitis?
LOW fecal elastase
Signs of Chronic Pancreatitis?
- Recurrent epigastric pain
- Diabetes Mellitus
- Steatorrhea
- Vitamin ADEK deficiencies
What symptom occurs and when with Gilbert Syndrome?
Episodes of mild jaundice provoked by a stress factor
Gilbert Syndrome has LOW activity of?
UDP Glucuronyltransferase
==> LOW conjugation of bilirubin
What lab value will be elevated with Gilbert syndrome?
Unconjugated bilirubin
What should occur if you perform the D-xylose test?
D-xylose should be absorbed in small bowel and excreted in the urine
If there is LOW D-xylose in the urine, what does that mean?
There is a Small Bowel disease that is preventing its absorption there
