GI Flashcards
Where is Celiac Disease located in the GI tract?
what is another name for this disease?
Small bowel
Sprue
What is Celiac Disease
Autoimmune reaction to alpha-gliadin in gluten
resulting in loss of villie and absorptive area
leading to malabsorption, bolating and pain
Key terms for this diangosis
Rash on neck/elbows/truck with bloating, abd pain and weight loss
Celiac Disease
What is the rash seen with Celiac Disease
where is it located ?
Dermatitis Herpetiformis
Itchy, extensor surfaces, neck, trunk and scalp
What lab test is best for Celiac Disease
IgA antibody
transglutaminase antibody
what is the definitive diagnosis for Celiac Disease
Colonoscopy with small bowel biopsy
small bowel will have blunted villi
What is the treatment for Celiac Disease
Gluten free diet
No wheat, rye or barley
can eat rice and corn
what are s/s of Lactose intolerance
abd pain, loose stools, flatulence,
borborygmi (loud grumbling) with ingestion of milk products
what is the best test of choice for lactose intolerance
Hydrogen breath test
-hydrogen is produced by unigested lactose being fermeted by the colon bacteria
Vitamin C - another name
Ascorbic acid
what are some reasons someone would be Vitamin C deficent
they are not eating fruits and vegetables
smoker
A lack of Vitamin C will lead to what disease ?
Scurvy- weakness, vascular fragility (collagen doesn’t produce right)
recurrent hemorrhaged in gums, skin (around hair follicles) and joints
impaired wound healing
hyperkeratotic papules
3 H’s - Hyperkeratosis, hemorrhage, hematologic
Key terms for this disease- vascular fragility, red dots seen in the gums, skin and joint pain
wounds have delayed healing and hyperkeratotic papules
Scurvy = Vitamin C deficency
3 H’s - Hyperkeratosis, hemorrhage, hematologic
A lack of Vitamin D will lead to what disease in adults ?
in children?
Osteomalacia = diffuse body pains, weakness and fractures, *looser lines (fracture lines in the bones)
Rickets - children = bowed legs, fracutures, dental problems
Key terms for this disease- child with bowed legs multiple fractures, dental teeth issues, developmental delays ad muscle weakness
Rickets - children
A lack of Vitamin D
Ergocalciferol is treatment for what ?
Vitamin D
What does Vitamin A do ?
it is for Vision immune function embryo development hematopoiesis- making new RBC's skin and cells health
A lack of Vitamin A will lead to what disease ?
Vision changes- especially night blindness*
immune decrease- poor wound healing
squamous metaplasia*
Bitot spots- white spots on the conjunctiva
xeropthalmia- dry eyes
alopecia- loosing hair
taste loss
Bitot spots are seen in what Vitamin deficency?
Vitamin A
Key terms for this diagnosis- squamous metaplasis, poor wound healiing, white spots on the conjuncitva, dry eyes, loosing hair with taste loss
Vitamin A
What is the other name for these vitamins B1 B2 B3 B6 B12
B1- Thiamine B2- Riboflavin B3- Niacin B6-Pyridoxine B12- Cobalamine
Thiamine, what vitamin?
B1
Riboflavin, what vitamin?
B2
Niacin, what vitamin?
B3
Pyridoxine, what vitamin?
B6
Cobalamine, what vitamin?
B12
What is the most common cause for Vitamine B1 deficency
Thaimine- Alcoholics
B1 deficency can lead to what 3 conditions ?
- beriberi
- wernicke’s
- Korsakoff’s dementia
What is Beriberi ?
Vitmain B1 deficency two types Dry and Wet
Dry- parasthesia (numbness), demyelination, symmmeteric impairment of sensory and motor relfexes
muscle wasting
Wet- high urine output failure, dilated cardiomyopathy and edema
what is Wernicke’s Encephalopathy ?
Vitamin B1 deficency causing
- opthalmoplegia (eye muscles dont work)
- ataxia (hand bumping, cant walk straight)
- Global confusion
Key terms for this diagnosis- symmeteric sensory and motor loss, muscle wasting
B1 deficiency- Dry Beriberi
Key terms for this diagnosis- high urine output failure, dilated caridomyopathy and edma
B1 deficiency- Wet Beriberi
Key terms for this diagnosis- cant move eye’’s around due to weakness, ataxia with raised hands, and confused.
B1 deficiency- Wernicke’s Encephalopathy
what is Korsakoff’s Dementia?
B1 deficiency- resulting in memory loss mainly short term, confabulation. that is irrevesible
Key terms for this diagnosis- resulting in memory loss mainly short term, confabulation. that is irreversible
B1 deficiency- Korsakoff’s Dementia
What does vitamin B2 cause?
Riboflavin- oral-ocular-gential syndrome
1. oral- mouth lesion, magenta colored tongue
angular cheilitis
2. ocular- photophobis and corneal lesions
3. genital- scrotal dermatitis
Key terms for this diagnosis-
lesions in the mouth, red colored tongue, angular cheilitis, corneal lesions and scrotal dermatitis
B2 Riboflavin deficiency
What does Niacin deficiency cause?
3'D's Diarrhea Dementia Dermatitis (foods high in niacin are usually meats) this person with a deficieny will be vegan
Key terms for this diagnosis
diarrhea, confused cant remember, dermatitis rash/skin bumps
Niacin (B3) deficiency
What does Pyridoxine B6 deficiency cause?
peripehral neruopathy flaky skin headaches anemia sore tongue stomatitis seizures
What are some common causes of Pyridoxine B6 deficiency
Alcohol Isoniazid Oral contraceptives vegans malabsortption from celiac or crohn's PPI's
What does B12 deficiency cause
Coblamine *pernicious anemia neruo symptoms parasthesia gait abnormalities memory loss dementia glossitis macrocytic anemia with hypersegmented neutrophils
What is Pernicious anemia?
Vitamin B12 deficency- cobalamine
autoimmune destruction/loss of gastric parietal cells that decrease intrinsic factor
what is the best test for Pernicious anemia
Schilling test
tests for the antibody
what is the most common cause of gastroenteritis?
Norovirus
what is the most common cause of gastroenteritis in children?
Rotavirus
describe non-invavsie gastroenteritis
vomiting watery voluminous diarrhea
with no fecal WBC’s or blood
describe invasive gastroenteritits
vomiting watery voluminous diarrhea
with fecal WBC’s or blood, fevers
key terms for this diagnosis- food contamination most common in diary, mayonnaise, meats and eggs
self-limiting
Staphylococcus
Key terms for this diagnosis- diarrhea with no WBC’s, ctaminated food with fried rice. usually self-limitis
Bacillus Cereus
Key terms for this diagnosis- gram negative rod. transmitted through contaminated food and water usually abroad. outbreaks during poor sanitation and over crowing. copious watery rice water stools
gray no odor blood or pus.
fatal due to hypovolemia
Vibrio cholerae
Key terms for this diagnosis- unpeeled fruits, unsanitary drinking water/ice usually after traveling
Enterotoxogenic E. Coli
What is the treatment for Enterotoxogenic E. Coli
Fluoroquinolone (ciprofloxacin, levofloxacin)
Key terms for this diagnosis- nosocomial diarrhea
overgrowth of normal flora
Clostridium Difficlile
complications of Clostridium Difficlile
Lymphocytosis
Pseudomembranous colitis
toxic mega colon
treatment for Clostridium Difficlile
Metronidazole
vancomycin
name all invasive gastroenterisis
Shilgella Yersina Entercolotici Salmonella Enterohemorrhagic E. Coli 0157:H7 Camypylobater Enteritis
key terms for this diagnosis- Gram neg rod
crampy lower abd pain, high fever, explosive watery diarrhea with mucous or blood. WBC >50,000
in children- febrile seizures.
Shingella
Diagnostic tests for Shigella
WBC >50,000
sigmoid = punctate areas of ulceration
Treatment for Shigella
Trimethoprim-Sulfamethoxazole (bactrium)
fluroqinolones - ciprofloxacin
key terms for this diagnosis- containmined pork, milk water or tofu
abd pain in right low quad- mimic appendicitis
abd guarding
fevers
Yersinia Enterocolitica
Treatment of Yersinia Enterocolitica
Fluoquinolones- ciprofloaxcin, levofloxacin
key terms for this diagnosis- gastroenteriris from poultry, dairy or exotic pets like retiles-turtles
high risk patients- immunocomproised with pea-soup stools, fevers*
Salmonella typhimurium
Treatment for Salmonella typhimurium
Fluroquinolones
ceftriazone -> two weeks if severe
key terms for this diagnosis- gastroenteriris from undercooked gorund beef, unpasterurized milk/apple cider, day care or contaminated water
bloody diarrhea with fevers
Enterohemorrhagic E. Coli 0157: H7
Treatment for Enterohemorrhagic E. Coli 0157: H7
controversial
increases risk of HUS in children
key terms for this diagnosis- gastroenteritis from gram neg rod from poulty, raw milk, water and dairy cattle
watery diarrhea that turns to bloody diarrhea
with fevers
Camplyobacter Enteritis (seagull shaped rod)
C. Jejuni
most common in post-infectious guillain Barre syndrome
What is the most common cause of bacterial enteritis in the united states
Camplyobacter Enteritis
C. Jejuni
Treatment for Camplyobacter Enteritis
Erythromycin*
fluoroquinolones
doxycycline
Key terms for this diagnosis- contaminated water from streams/wells
beavers are the reservior
frothy greasy foul smelling diarrhea
no blood or pus
Giardia lamblia
how do you avoid Giardia lamblia
boil water for 1 min to kill cysts
Treatment for Giardia lamblia
Metronidazole (flagyl) - tinidazole, albendazole, quinacrine
in children- furazolidone
What is the most common amebiasis in travelers or developing countries?
Entamoeba Histolytica
key terms for this diagnosis- found in a travler, dysentery, amebic liver abcess
Entamoeba Histolytica
Treatment for Entamoeba Histolytica
Metronidazole (flagyl)
what is the most common cause of diarrhea in AIDS patients
Cryptosoridium
what are some cause of Rapid transit of Gi contents causing Osmotic Diarrhea
Lactulose (sugars that pull water into the gut)
Sorbitol (sugars that pull water into the gut)
Antacids (pepto, tums, alka-selzer, milk of magnesia)
what are some cause of Bacterial overgrowth causing Osmotic Diarrhea
Whipple’s disease- Tropheryma whippelii
Tropical sprue
what are some cause of Malabsorption abnormalities causing Osmotic Diarrhea
celiac sprue
pancreatic insufficiency
lactose intolerance
normal osmotic gap large volume diarrhea with fasting
secretory diarrhea
what are the causes of Secretory Diarrhea
- serotonin
- calcitonin
- gastrin
- Thyroxine
* laxative abuse
