GI Flashcards by Daniel Marino

PBC vs PSC

main difference
common sx
who gets it
common other diseases
Dx tests
ERCP results
trx

PROBABLY HAVE TO REMAKE THIS_THINK!!!!!! how is best way—-ESP HOW TO TIGHTEN ASSOCIATION (not HEPB DNA, do HEPB DNA means ….?)

PBC=autoimmune disease of bile ductules within liver
PSC-concetric fibrosis and scaring of extra hepatic ducts

Fatigue, pruritus, hepatomegaly, alk phos, AST and ALT increase

Women (30-65) vs Men (40)

other Autoimmune vs UC (IDB)

Antimito Ab vs pANCA

PSC-Beads on a string (strictures)

Ursodeoxycholic acid (decrease synthesis of bile) vs both-liver transplant)

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Anterior Tongue 2/3

development
sensation
taste

1st and 2nd brachial arch

mandibular of CN5

Facial nerve

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Posterior 1/3

3rd and 4th brachial arches

glossopharyngeal nerve

Mostly glossopharyngeal, very posterior is vagus nerve

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motor for entire tongue

CN12

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glossitis

inflammation
-beefy red/smoothing (loose surface features)

vitamin B (12,2,3,6) def or Fe def

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Leukoplakia

what is it
RF

keratosis on mucous membranes

smokers

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Hairy Leukoplakia

what is it
RF

white patch on side of tongue

EBV/Immunocomp (HIV)

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Oral Thrush

where
organism
RF

On tongue or buccal mucosa

C. albicans

infants and immunocomp

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Oral herpes

-organism

HSV 1 (more than 2)

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Apthous ulcers

what is it
RF
disease associations

kanker sores

Trauma (biting), citrus fruits, stress, food allergies, b12 def

behcet and chrohns disease

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What cytokines secreted from two types of helper T cells

TH1-IFNgamma

TH2-ILs 4, 5, 10

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TGF B and IL10

both attenuate immune response

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5 classes of medications to trx glaucoma (and general mech)

alpha agonists, beta blockers, acetazolamide, cholinomimetics (M3), PGF2alpha (prostaglandins)

first 3 decrease aqueous humor prod

next 2 increase aquoues humor outflow

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hyperplastic polyps

completely benign

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adenomatous polyps

- 3 types and histo

possibly neoplastic

tubular-lots of glands
tubulovillous-more villi
villous

more villous-more likely to be malignant

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Peutz Jeghers

presentation
PE
assocaitions

multiple benign hamartomas (excess tissue)

hyper pigmented areas in lips, mouth, hands, and genitals

increased risk of many types of cancers

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Chromasomal instability APC pathway

-steps (3)

series of gene mutations leading to colon cancer

loss of APC gene
KRAS mutation (oncogene)
Loss of tumor sup (p53, DCC)

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Microsatellite instability pathway

less common than APC pathway

Lynch syndrome

DNA MMR dysfxn

Colon Cancer RFs (8)

IBD, smoking, high fat/low fiber, ETOH use, obestity, adenomatous polyps, strep bovis bacteremia

colon cancer presentation

general
gi sx
L vs right findings

Fatigue, weight loss, LAD

abomindal pain, bowel obstruction, N/V

L side-change in bowel habits and hematochezia (pencil thin schools)

R side-Fe def anemia

apple core lesions

barium enema finding for colon cancer

tumor marker for colorrecctal cancer

CEA-but non spec-so use for trx

FAP

AD of APC gene

Turcot syndrome

-association

malignant CNS tumors-medulloblastomas

FAP

Gardner sydnrome | -association

FAP + bones nd soft tissue tumors, lipomas, retinal hyperplasia

Lynch syndrome

non-polyposis colorectall cancer AD Prox colon cancer (most cancers are in last 1/3 of colon)

which three bacteria are obligate intracellular bacteria

rickettsia coxciella chlamydia

tibial N damage

decreased plantar flexion | decreased sensation over posterior prox lower leg, lateral margin of foot, and platter surface of foot

what 4 substances serve as chemotactic agents for leukocytes

IL8, leukotriene B4, C5a, and kallikrien

Hep A - tranmission - Labs - trx

fecal oral/poor sanitation IgM during illness, IgG after resolution/vaccine Vaccine availble no trx nec.

which Hep virus are ssRNA last one is...

A, C, D, E Hep B is dsDNA

Hep E - tranmission - special - labs

fecal/oral more likely to get fulminant hepatic failure preggers PCR/Hep E IgM ab

HepD - special - tranmission - mortaility - trx

Delta virus infects only in presence of Hep B (defective) blood/sex highest mortaility pegyllated IFN-a or Hep B vaccine

HepC - chornically infected - US - assocations - transmission - labs - trx

50-85 % remain chronically infected US every 6 mo ofor HCC risk membranoprolfierative glomeruloneph, lymphoma, thyroiditis, PTC,DM, etc blood and rarely sex contact Hep C Ab and RNA to confirm Antiviral

Hep B - Transfer - Chornic infection rate - associations

Sex contact, perinatally, blood 5% chronic as adult, 90% perinatally polyarteritis nodosa, nephophaty, aplastic anima via IC circulating increased risk for HCC

HBsAG | HBsAB

surface Ag active disease surface Ab-recovery from active infection or immunization

HBcAB

Core Ab-history of infection-IgM early, and IgG late

HBeAg

Hep B envelope Ag | - active viral replication and high transmissiblity

HBeAb

hep B envelope Ab | -low transmissibiltiy

HepB DNA

active viral replication-tex when high

when to treat reg women with HepB

when HepB DNA is high | - give baby vaccine and HepBIg within 12 hours birth

Autoimmune hep Ags - type 1 - type 2

1-ANA, and Anti sM Ab 2- Anti liver kidney microsomal Ab and anti liver cytosol Ab these people also have many other autoimmune diseases

probably have to

remake these