GI 2 Flashcards
management of BRBPR
less than age 40, anoscopy
40-50 sig or colonoscopy
above 50 OR alarm signs, colonoscopy
alarm signs: change in bowel habits abd pain weight loss IDA fam hx colon CA
ALT greater than 150
biliary pancreatitis
dx of acute pancreatitis
at least 2 of 3
- acute severe epigastric pain radiating to back
- elev amylase or lipase greater than 3 times nl
- imaging
triple bubble sign
& risk factors
jejunal atresia
mom: vasoconstrictive drugs, cocaine, smoking
indications for draining pancreatic pseudocyst
lasts longer than 6 weeks
larger than 5 cm
becomes secondarily infected
sphincter of oddi has high pressures, which show sphincter of oddi dysfunction. next step?
ERCP with sphincterotomy
all patients with cirrhosis should get what test
endoscopy (to r/o esophageal varices, because it’s the #1 cause of death in cirrhosis patients)
ultrasound every 6 months to evaluate for liver masses
D-xylose test shows decreased amounts in urine :( not normal!
proximal small intestine disease (celiac)
HELLP liver manifestations
centrilobular necrosis
hematoma formation
thrombi in portal capillary system
all lead to distention of liver capsule
eggshell calcifications in liver
hydatid cyst from Echinococcus
worse prognoses for polyp
villous adenoma
sessile adenoma
greater than 2.5 cm
diagnosed AFP. next step?
proctocolectomy at time of diagnosis
emphysematous cholecystitis vs gallstone ileus
emphysematous cholecystitis: GB wall infection from gas producing organism; causes decreased or absent bowel sounds
gallstone ileus: hyperactive bowel sounds
sxs of VIPoma
watery diarrhea hypokalemia (muscle weakness) achlorhydria flushing N/V pancreatic tail tumor
sxs of carcinoid
flushing
diarrhea
bronchospasm
tumor in small intestine usually
liver path of Reye syndrome (ASA)
microvesicular fatty infiltration / steatosis
liver path: cirrhosis and periportal eosinophilic inclusion bodies
alpha 1 antitrypsin deficiency
liver: macrovesicular fatty infiltration
alcoholic hepatitis
NAFLD
endoscopy / biopsy of stomach positive for adenocarcinoma. next step? and management?
CT for staging
if low stage, resect
if high stage, chemo, maybe palliative surgery
liver: Mallory bodies
alcohol
Wilsons disease
liver: PAS positive
alpha 1 antitrypsin deficiency
causes of gastric outlet obstruction
gastric CA PUD crohns disease stricture with pyloric stenosis from caustic ingestion bezoar
colon CA screen for IBD
start 8 yrs after dx
ever 1-2 yrs
if find dysplasia, do prophylactic colectomy
colon CA screen for FAP
start age 10-12
every year
colon CA screen for HNPCC
start age 20-25
every 1-2 yrs
only meds that work for crippler najjar, type 1 and 2
1: phenobarbital
2: phenobarbital or clofibrate
labs of Reye syndrome
incr ALT, AST, bilirubin, Alk Phos, ammonia, PT, LDH
definition of fulminant hepatic failure and management
hepatic encephalopathy that develops within 8 weeks of onset of acute liver failure
liver transplant
hepatic hydrothorax
- sxs
- management
right sided transudative pleural effusion
salt restriction and diuretics
TIPS or liver transplant
variceal hemorrhage… transfuse if Hb
less than 9
initial management of variceal bleed
IVF
octreotide
ATBs
beta blocker if stopped
balloon tamponade if didn’t, then TIPS
