GI 2 Flashcards
MC type of intestinal tumor
tubular, typically in the rectosigmoid area
“stalk with raspberry like head”
villous intestinal tumor
higher risk of cancer
“velvety cauliflower”
familial polyposis
- 1000s of adenomas
- 100% cancer risk by midlife
order of tests for appendicitis
ultrasound, CT
MC small bowel malignancy location
duodenum, adenocarcinoma
where does colorectal cancer mets to?
liver #1, lung, bones, brain
Dukes staging
A-tumor penetrates into mucosa of bowel only
B1-penetrates into, but not through muscularis propria
B2-tumor goes through muscularis propria
C1-is B1 + lymph nodes C2-B2 + lymph nodes
D-distant mets
Tumor grade
T1-submucosa
T2-muscularis propria
T3-through muscularis into subserosa
T4-directly invades other organs
Node grade
N0-no regional lymph node mets
N1-1 to 3 regional ln
N2-4 or more regional ln
N3-node along blood vessel
MCC of anal bleeding
hemorrhoids
fistula
opening from inside to outside that is abnormal
main liver functions
- bile production
- metabolism, detox, excretions
bile route
R/L hepatic duct, CHD, CBD, pancreatic duct, duodenum
cirrhosis presents with
ascites, jaundice, esophageal varices
what test should you order for possible hepatic failure?
PT/INR
portal HTN
portal blood can’t flood through to the vena cava b/c of fibrosis, leading to edema
the blocked blood causes vessels to dilate causing varices/medusa
first alcoholic liver disease exposure leads to…
steatosis, reversible until fibrosis occurs
severe alcohol exposure leads to
alcoholic hepatitis, reversible
if you continue to drink after alcoholic hepatitis….
you get cirrhosis, micronodular then “hobnail”, irreversible
Wilson’s disease
disorder of copper metabolism, effects hepatocyte transfer of copper into bile
Hep A B C D E
fecal/oral bloodborne, all fluids except stool bloodborne goes w/B waterborne fecal contamination, pregnancy
chronic hepatitis (> 6 months) leads to
macronodular cirrhosis
IGM vs IGG for hepatitis
IGM will be positive during window period bc it is the first ab made
IGG posiive means chronic hepatits
once IGM converts to IGG, you are chronic
envelope tell us
how infectious the person is
adenoma
benign tumor of hepatocytes, common w/females on OCP
MCC of hepatocellular carcinoma
Hep C, alpha-fetoprotein is a good marker
cholelithiasis
stones, pain that comes and goes after eating that resolves, use pain meds and elective cholecystectomy
cholecystitis
inflammation/blockage of cystic duct, constant RUQ pain, ABX and emergent cholecystecomy
reynolds pentad
fever, RUQ pain, jaundice, hypotension and altered mental status
test of choice for gallstones
HIDA scan
MC gallbladder cancer
adenomacarcinoma
MCC of pancreatitis
alcohol and gallstones
also scorpion bite can cause
acute pancreatitis presenting symptoms
worse lying down, better sitting up, pain in epigastric region radiating toward back
dx w/CT
MC pancreatic cancer
ductal adenocarcinoma of the pancreas head
CA 19-9 marker
DX of DM
random sugar >200, fasting >126
3 common symptoms seen with DM
polyuria-diuresis
polydipsia-blood is becoming hypertonic, water dilutes Na levels
polyphagia-glucose not going into cells
3 common diseases associated with DM
neuropathy
myopathy
retinopathy
