GI

Question 1

What is OCTREOTIDE ?

Answer 1

used for esophageal varices

splenchnin vasoconstrictor - somatostatin analogue

Question 2

What do PPIs do in GI bleed?

Answer 2

Pantoprazole = NEUTRALIZE pH = HELPS CLOT FORMATION

Question 3

what is NAPQI and what metabolizes it into a non-toxic molecule?

Answer 3

Liver turns Tylenol into NAPQI (toxic) - glutathione makes NAPQI non-toxic

Question 4

Antidote for Tylenol OD?

Answer 4

N-acetylcyctine

restsores glutathione, or acts as a glutathione reservoir

Question 5

Cirrosis Scoring system is called?

Answer 5

• MELD Score - to predict three month survival of “model of End-Stage Liver DIsease” = cirrhosis severity scoring system - 0-50 and 50 is less likely to survive 3 months
• uses: bilirubin, serum creatinine, INR

Question 6

What scoring system prognosticates liver disease?

Answer 6

• Child–Pugh score - prognosis of chronic liver disease -
• severity of liver disease - higher score (0-15) =poor survival
• bili, albumin, PTT, ascites, hepatic encephalopathy

A (well-compensated disease),
B (significant functional compromise),
C (decompensated disease)

Question 7

• Hepatic Encephalopathy Grading Score

Answer 7

= WEST HAVEN SCORE =( 1-4, 4 is worse)

• I - chaneges in behaviour and minimal change in LOC
  
  • II - gross disorientation, drowsiness, poss asterisks, inappropriate behaviour
  • III - marked confusion, incoherent speech, sleeping most of the time
  • IV - Comatose, unresponsive to pain, decorticate or decerebrate posturing

Question 8

Score for Predicting mortality in Pancreatitis

Answer 8

• BISAP - score of predictors of mortality from Pancreatitis
  
  • BUN >25mg/dl
  • LOC△
  • > 2 SIRS criteria
  • pleural effusion present

Question 9

SIRS criteria

Answer 9

Temp >38.3 or <36.0
RR >20 or PaCO2 <32
HR >90
WBC >12,000 or <4000 or >10% Bands