GI Flashcards
first line PBC
urso
complication of CT cyst drainage in echinnococcus
anaphylaxis! cyst contents are very antigenic
kernitcerus presents with:
hypotonia
seizures
choreoathetosis
hearing loss
when is jaundice pathologic?
- on first day of life
- bilirubin rises >5mg/day
- bili > 19.5 in a term baby
- hyperbilirubinemia (>2) after 2 weeks of life
recurrent aspiration PNA in newborn babe
TEF –> food traveling to lungs
most common TEF
EA with dital TEF
radiographic sign seen in pyloric steonsis?
What is the best test?
string sign with barium swallow
best FIRST test= US
best dx test= upper GI series
CHARGE syndrome
C= coloboma of eye, CNS H=heart defects A= atresia (choanal) R= retarded development G= genital/ urinary defects, hypogonadism E= ear anomolies, deafness
presentation of intussusception
currant jelly stool
sausage mass
bilious vomiting
assoc with HSP
norovirus incubation
12-48hours
fecal oral
watery diarrhea, vomiting
dx of lactose intolerance?
hydrogen breath test –> will have inc hydrogen
bowel surgery in chrons?
remember to do as many BOWEL SAVING procedures as possible
extraintestinal manifestations of celiac
skin: dermatitis herpetiformis
neuro: peripheral neuropathy
gyn: intertility
obvs other autoimmune things
if you suspect celiac but TTG is neg/ dec IGa, what shold you test?
IgG for gliadin
fever, jaundice, pale stools, dark urine, n/v in someone who recently traveled to third world country
Hep A
***anicteric manifestations in children
w/u of suspected borheave’s when hemodynamically stable vs unstable
stable: gastrographin
unstable: CT
when is barium CI?
when you have any supicion of esophageal perf –> causes mediastinitis
pneumotosis intestinalis
NEC! premature infant
if bad, will see metabolic acidosis
manifestations of whipples?
diarrhea arthralgias neuro changes valve insufficiency hyperpigmentation
+PAS macs in lamino proprio
tx with IV ceftriaxone
if you had to pick one, first line for c. diff colitis?
oral metro (cheaper than vanc)
staph food poisoning incubation vs salmonella
1-3 hours v 1-3 days (+bloody)
esophageal varices proph?
propanolol + banding q1-2 weeks
if above fails, placement of TIPS
flushing, wheezing, R sided heart abnormalities in setting of diarrhea
carcinoid
dx= 5HIAA
tx= octreotide
pyogenic liver abcess
bugs: e. coli, klebs most common
people with galbladder dz at risk
oral thrush with odynphagia and dysphagia in HIV patient?
tx for esophagitis as well –> fluconozole
sialidentitis
acute infx of parotid gland
- elderly, post of patient or ICU patient
- prevent with hydration and oral hygeine
- bug= Staph A
- tx with naf, metro, clinday
anti core vs HbeAg
core ab means chronic infx, envelope means new or reactivated
***envelope actively sheds during replication of active cirus
tx for chronic heb b
INF a
if patient is immunosuppressed or has autoimmune disease, use something like tenofavir
most common lead point for children with repetitive intussception?
meckel’s
intususception will show concentric rings of bowel on tranverse section
most common cause of diarreal illness in kids?
rotavirus
can be detected by stool ELISA
palpable mass on DRE/ LLQ in acute diverticulosis?
yes, suggests pericolonic inflammation. It’s a thingk.
diagnostic/ treatment step in GI bleed that is hemodynamically unstable, not responding to resusutative efforts and hasn’t yet been localized?
angiography
how do you w/u a gastrinoma?
first, check fasting gastrin levels
if high (>1000) and low pH= gastrinoma if between 100-1000, do sectretin stim (secretin --| gastrin)
**associated with MEN1
treatment of MALToma
1st: erradicate h pylori
2nd: chemo/ rad if that fails
acid fast oocytes in diarrhea of HIV patient
cryptosporidium
how do you tx toxic megacolon?
conservatively
bowel rest, correct lytes
abx if from c diff
at risk of perf.
antismooth muscle ab
autoimmune hepatitis
don’t forget about this as a cause for cirhosis!!
non caseating granulomas with neutrophils in the crypts in a 60 yo man
chrons
bimodal age dist!!
ADEK deficiency in ZES?
ZES decreases pH –> pan lipases require an alkaline environment to emulsify fat –> impaired absorption
E defi- can manifest as gait disturbance
melanosis coli
pigmentation of colonic mucosa from laxative abuse
look for a patient with a psych histroy and many episdoes of watery diarrhea during the day and night .
elevated Mg can be sign of abuse
breast feeding failure jaundice
- first week of life
- infrequent volume of feeds causes slow transit time, GI tract reabsorbs bili
<10% of bili is conjugated because gut only resorbs unconjugated bili
***breast milk jaundice will present at 1-2 weeks
psoas sign
pain with hip extension
- usefull in PSOAS ABCESS= subacute, low grade fever
- retrocecal appy
