Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CK IM > GI > Flashcards

GI Flashcards

1
Q

_______ is the idiopathic loss of the normal neural structure of the lower esophageal sphincter (LES)

A

Achalasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pathology of achalasia

A

In achalasia, these inhibitory neurons have been lost, as well as the ability to relax the LES.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Secondary causes of achalasia

A

Chagas disease, gastric carcinoma, or diseases that can infiltrate into the area, such as lymphoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

SSx of achalasia

A

Achalasia presents with progressive dysphagia to both solids and liquids simultaneously and can have regurgitation several hours after eating.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

________ is very accurate and shows dilation of the esophagus, which narrows into a “bird’s beak” at the distal end.

A

Barium esophagography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Achalasia

_____is very accurate and shows dilation of the esophagus, which narrows into a “bird’s beak” at the distal end.

A

Barium esophagography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Achalasia

The most accurate test overall (gold standard) is esophageal________

A

manometry. Manometry shows increased lower esophageal (LES) resting pressure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Achalasia

The best initial therapy is________

A

pneumatic dilation or surgery. Pneumatic dilation should be effective in 80–85% of patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Achalasia

_______injections into the LES are used in those patients not willing to undergo pneumatic dilation,
or in whom it has failed.

A

Botulinum toxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Achalasia

______ will relapse in 6–9 months, and all patients will need reinjection after 2 years

A

Fifty percent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If both pneumatic dilation and botulinum toxin

injections fail, then surgical_______ is performed

A

myotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Esophageal cancer is linked to the synergistic, carcinogenic effect of alcohol and tobacco use for cases of _______ in the proximal two-thirds of the esophagus

A

squamous cell cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Adenocarcinoma is found in the distal third of the esophagus and is associated with
__________ and _______

A

long-standing gastroesophageal reflux disease and Barrett esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The rate of development of cancer from Barrett esophagus is between _________ per year.

A

0.4 and 0.8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

T or F

Squamous and adenocarcinoma are now of equal frequency.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Esophageal CA. Five-year survival is ________

A

5–20%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Esophageal CA

Chemotherapy with a _______ is combined with radiation to control locally metastatic disease

A

5-fluorouracil-based chemotherapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

As many as 80 to 90% of patients with scleroderma will develop diminished esophageal peristalsis from the _______

A

atrophy and fibrosis of the esophageal smooth muscle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Scleroderma (Progressive Systemic Sclerosis)

The most accurate diagnostic test is ______

A

motility studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Scleroderma (Progressive Systemic Sclerosis) Tx

A

Therapy is with proton-pump inhibitors, such as omeprazole. Metoclopramide is a promotility agent that has some modest efficacy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Diffuse Esophageal Spasm and Nutcracker Esophagus

Barium studies

A

Barium studies may show a “corkscrew”’ pattern at the time of the spasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Diffuse Esophageal Spasm and Nutcracker Esophagus

Tx

A

Treatment is with calcium-channel blockers, such as nifedipine, and nitrates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

________is more common and leads to intermittent dysphagia and is not associated with pain. It is also more distal and located at the squamocolumnar junction proximal to the lower esophageal sphincter

A

Schatzki’s ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

_____ is more proximal and is located in the hypopharynx. The dysphagia is sometimes with liquids as well

A

Plummer-Vinson syndrome (PVS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Dx of PVS and Schatzkis ring

A

Both disorders are best diagnosed with a barium swallow or barium esophagram.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Treatment. Plummer-Vinson syndrome may respond to treatment of the

A

iron deficiency. Both are treated with dilation procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

__________ is the outpocketing of the posterior pharyngeal constrictor
muscles at the back of the pharynx

A

Zenker diverticulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

CI in pts with Zenker

A

Endoscopy and the placement of nasogastric tubes are contraindicated because
of the risk of developing perforation of the pharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Patients with Zenker diverticulum are

treated with_______

A

surgical resection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

______ is a nontransmural tear of the lower esophagus that is related to repeated episodes of retching and vomiting

A

Mallory-Weiss syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

SSx of Mallory-Weiss syndrome

A

It presents with painless upper GI bleeding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Dx of Mallory-Weiss syndrome

A

These patients are diagnosed by direct visualization on upper endoscopy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

_____ is the most common reason for epigastric tenderness and pain

A

Pancreatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

_____ is associated with epigastric tenderness in <20% of patients.

A

Ulcer disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

________ a functional disorder in

which there is persistent pain in the epigastric area but all the tests are found to be normal.

A

nonulcer dyspepsia,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

H. pylori can be diagnosed with noninvasive means, such as

A

serology, urea breath testing, and

stool antigen detection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

When testing for eradication, do not use ELISA. Use _______

A

breath test or stool antigen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

T or F

calciumchannel blocking agents and nitrates also lower the sphincter pressure

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

GERD

The most accurate diagnostic test is a ________ but this is only necessary when the patient’s presentation is equivocal in nature and the diagnosis is not clear

A

24-hour pH monitor,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

A small number of persons, usually______, will not respond to PPIs and will need to undergo surgery to tighten the sphincter.

A

<5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

GERD

______ should only be used if the patient has very mild, intermittent symptom

A

H2 blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

GERD

Indication for surgery:

A
  • Refractory side effects with PPIs, e.g., headaches, diarrhea
  • No response to PPIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Pathogenesis of Barrett

A

After several years of GERD, the epithelium of the lower esophagus undergoes histologic change from a normal squamous epithelium to a columnar epithelium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Patients with Barrett esophagus should have a repeat endoscopy every _____years
to see whether dysplasia or esophageal cancer has developed

A

2 to 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Patients with low-grade dysplasia

should undergo repeat endoscopy in ______months to see if the lesion has progressed or resolved.

A

3 to 6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Patients with high-grade dysplasia should have a ______ because of its very high rate of progression to invasive esophageal
carcinoma

A

distal esophagectomy or an endoscopic mucosal resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Barrett

The usual rate of progression to cancer is about ____ per year

A

0.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

PUD

T or F

Tobacco and alcohol cause PUD

A

F

Tobacco and alcohol use can delay healing and are associated with the development
of gastritis, but they do not cause ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Strongest RF for PUD

A

The strongest causal relationship for the development of ulcers is the use of NSAIDs, Helicobacter pylori infection, cancer of the stomach, Zollinger-Ellison syndrome, Crohn’s disease, burns, head trauma, and prolonged intubation and mechanical ventilation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

The presumptive mechanism of the formation of stress ulcers from burns and head trauma is that there is an ________

A

intense vasoconstriction of the vasculature that supplies the gastric mucosa, leading to the sloughing of these cells and ulceration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

The 3 stimulants to the production of acid from the _______

A

parietal cells are gastrin, acetylcholine, and histamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

_____ is produced by G cells in the

stomach, and its release is stimulated by distention of the stomach, the presence of amino acids, and vagal stimulation.

A

Gastrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

the single most important stimulant to gastrin release is ______

A

distention of the stomach.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

____ is released by enterochromaffin-like cells present in the same glandular elements of the stomach that have the parietal and chief cells.

A

Histamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

___ release pepsinogen, which is converted

to pepsin by the acid environment of the gastric lumen.

A

Chief cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

___ directly stimulates the parietal

cells to both release acid and potentiate the effects of acetylcholine and gastrin on the parietal cells.

A

Histamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

_____ is the excessive production and release of gastrin from G cells.
Somatostatin is the counterbalance to this system.

A

Zollinger-Ellison syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

_____ inhibits the release of gastrin

and histamine, as well as having a direct inhibitory effect on the production of acid from the parietal cells.

A

Somatostatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

_____ is released from the S cells of the duodenal lining.

A

Secretin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

The main stimulant to the release of secretin is the presence of _____

A

acid in the duodenum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

_____ inhibits the production of gastrin, as well as stimulates pancreatic and biliary bicarbonate production and release

A

Secretin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

80–90% of duodenal ulcers and 70–80% of gastric ulcers are associated with _____

A

H. pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Traditionally, ____ have been associated with pain on eating, and ____ were thought to be relieved by eating

A

gastric ulcers

duodenal ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Ulcer disease is best diagnosed with ____

A

upper endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

PUD

In those age >45–55 or those with alarm symptoms (weight loss, anemia, heme-positive stools, or dysphagia), _____should be performed.

A

endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

PUD

The advantage of both _____ and _____ methods is that they have the same sensitivity as serology and are able to easily distinguish new versus old disease. When H. pylori has been treated, both become negative

A

breath testing and stool antigen detection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

PUD (H. pylori)

The _____is performed to
see if the organisms present in the biopsy specimen can produce urease, demonstrating the presence of the bacterium.

A

CLO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Tx of H. pylori

A

Use a PPI combined with clarithromycin and amoxicillin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Tx of H. pylori

The other 2 choices of antibiotic are _______

A

tetracycline and metronidazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

The PPI/clarithromycin/amoxicillin regimen should be effective in ____
of patients. Duration of therapy is _____

A

> 90%

10 to 14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

In those who fail therapy, a _____should be performed to see if the reason for failure
was the inability to eradicate the organism

A

urea breath test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

H. pylori Tx

If the organism was eradicated and the ulcer persists, recurs, or worsens, the
patient may need evaluation for____

A

Zollinger-Ellison syndrome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Indications for surgery in PUD:

A
  • UGI bleeding not amenable to endoscopic procedures
  • Perforation
  • Refractory ulcers
  • Gastric outlet obstruction (can change endoscopic dilation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What type of gastritis?

Caused by alcohol, as well as NSAIDs, Helicobacter, head trauma, burns, and mechanical ventilation. Also MC

A

Type B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

______ gastritis is from atrophy of the gastric mucosa and is associated with autoimmune processes, such as vitamin B12 deficiency. Also linked to diminished gastric acid production and achlorhydria

A

Type A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

________

leads to metaplasia as well as possible dysplasia and then to gastric cancer

A

MALT (mucosal-associated lymphoid tissue)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Most patients with gastritis present with ______

A

asymptomatic bleeding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Vitamin B12 deficiency and pernicious anemia

are initially diagnosed with a ______

A

low vitamin B12 level and an increased methylmalonic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

The diagnosis of pernicious anemia is confirmed by the presence of ____ and ______

A

antiparietal cell antibodies and anti-intrinsic factor antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

_____ is hypergastrinemia caused by cancer of the gastrinproducing cells

A

Zollinger-Ellison syndrome (ZES)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Half of these gastrinomas are located in the ____, and a quarter are located in the ______

A

duodenum

pancreas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Association of ZES

A

A small percentage (<20%) are associated with multiple endocrine neoplasia type 1 (MEN-1) or parathyroid,
pituitary, and pancreatic tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

More than 95% of patients with ZES present with _____

A

ulcer disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

WHy is there steatorrhea in ZES

A

Steatorrhea occurs because lipase is inactivated by the large volume of acid passed into the duodenum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Although an elevated gastrin level is indicative of ZES, it is critical to remember
that all patients on ______have high gastrin levels

A

H2 blockers or PPIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Another way to diagnose ZES is to find an ________

A

elevated gastric acid output while concurrently finding an elevated gastrin level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Other causes of increased gastrin are

A
  • Pernicious anemia
  • Chronic gastritis
  • Renal failure
  • Hyperthyroidism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

After confirming a diagnosis of gastrinoma, the most important step is to determine if the
lesion is________

A

localized or metastatic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

A nuclear test, ______ is 90% sensitive for the detection of metastatic disease.

A

somatostatin-receptor

scintigraphy,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

______ also called delayed gastric emptying, is a disorder that results in
delayed movement of food from the stomach to the small intestine.

A

Gastroparesis,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Gastroparesis

_____ can also weaken the musculature of the bowel wall

A

Electrolyte problems with potassium, magnesium, and calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Tx of Gastroparesis

A

Treatment is with agents that will increase motility of the stomach, such as erythromycin
or metoclopramide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

This is an increasingly rare disorder because of the rarity of the necessity for
surgery in the treatment of ulcer disease

A

Dumping Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Dumping syndrome is caused by 2 phenomena.

A

• First, there is the rapid release of hypertonic chyme into the duodenum, which acts as
an osmotic draw into the duodenum, causing intravascular volume depletion.
• Next, there is a sudden peak in glucose levels in the blood because of the rapid release
of food into the small intestine. This is followed by the rapid release of insulin in
response to this high glucose level, which then causes hypoglycemia to develop

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

When all the causes of epigastric pain have been excluded and there is still pain, the diagnosis is

A

functional or nonulcer dyspepsia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

functional or nonulcer dyspepsia Tx

A

If there is no response to anti-secretory therapy with a PPI, you can try to treat H. pylori by adding clarithromycin
and amoxicillin.

Treating H. pylori will improve symptoms in another 10–20% of patients.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Similar Sx of IBD

A

Both CD and UC are idiopathic disorders of the bowel associated with diarrhea,
bleeding, weight loss, fever, and abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Imaging of IBD

A

Both are most accurately diagnosed with endoscopy and sometimes with barium studies, “string sign” on small bowel follow through after barium meal in CD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

______ more likely to be associated with a palpable abdominal mass because it
has granulomas in the bowel wall that are transmural in nature.

A

Crohn’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

CD is not necessarily continuous, and one hallmark of the disorder is that there are ______or areas of normal tissue in between the areas of disease.

A

“skip lesions,”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

UC is limited exclusively to the ______

A

large bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

______has no skip lesions, no fistula

formation, and no oral or perianal involvement. It is more likely to cause bloody diarrhea.

A

UC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Both forms of IBD can lead to colon cancer after ______ of involvement of the colon

A

8–10 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Complications of Crohn’s disease are calcium

A

oxalate kidney stones, diarrhea, and cholesterol gallstones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

________are associated with CD, and _________ is associated with UC.

A

Anti– Saccharomyces cerevisiae antibodies (ASCA)

antineutrophil cytoplasmic antibody (ANCA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Prothrombin time may be prolonged in CD because of______

A

vitamin K malabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Kidney stones form more often in CD because _______

A

the fat malabsorption results in a low calcium level and an increased absorption of oxalate, which forms kidney stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

_____ derivatives are the mainstay of therapy for IBD in all of its forms

A

Mesalamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

______ is a form of mesalamine released in both the upper and lower bowel; hence, it is
used in CD

A

Pentasa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

____is a form of mesalamine released in the large bowel, and it is most useful
for UC

A

Asacol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

_____ is used exclusively for rectal disease

A

Rowasa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

The difficulty with _____ is that the high load of sulfa delivered causes a number of adverse effects, such as rash, hemolysis, and allergic interstitial nephritis.

A

sulfasalazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Acute exacerbations of IBD are treated with ______

A

high-dose steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Azathioprine and 6-mercaptopurine

are associated with_______but are still used on a long-term basis to try to keep patients off steroids

A

drug-induced pancreatitis,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Ciprofloxacin and metronidazole are used for CD in those with ____

A

perianal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

_____ is used for CD in those who form fistulae or have disease refractory to the other forms of therapy

A

Infliximab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

_____are other forms of mesalamine that are only active in the colon and are used occasionally

A

Balsalazide and olsalazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Surgery is curative in ____; almost 60% of patients will require surgery within 5 years after diagnosis due to refractory symptoms or severe disease

A

UC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

The most common causes of infectious diarrhea are _______ and ____especially
in patients with sickle cell and achlorhydria.

A

Campylobacter and Salmonella,

120
Q

Ingestion of refried Chinese food and the

spores. Short incubation period (1–6 hours)

A

Bacillus cereus

121
Q

Reactive arthritis, Guillain-Barré syndrome.Most common cause of bacterial gastroenteritis

A

Campylobacter

122
Q

Found in HIV-positive patients with

<100/mm3 CD4 cells

A

Cryptosporidia, Isospora

123
Q

Associated with the ingestion of contaminated hamburger meat. The organism can release a Shiga toxin, provoking hemolytic uremic syndrome

A

E. coli 0157:H7

124
Q

The ingestion of unfiltered water, as on a
camping trip or in the mountains, or in
drinking fresh lake water.

Can also simulate celiac disease in terms
of causing fat and vitamin malabsorption if it is not eradicated.

A

Giardia

125
Q

Ingestion of chicken and eggs, dairy products

A

Salmonella

126
Q

Patients who ingest contaminated fish
experience vomiting, diarrhea, flushing, and
wheezing within minutes of eating it.

A

Scombroid

127
Q

______ can mimic appendicitis. Also
common in people with iron overload, e.g.,
hemochromatosis.

A

Yersinia

128
Q

Ingestion of raw shellfish, such as mussels,
oysters, and clams. Typically presents as severe systemic gastroenteritis in patients with underlying disease (esp. chronic liver disease)

A

Vibrio parahaemolyticus

129
Q

Also in raw shellfish, but has a particularly
high incidence in people with underlying liver
disease or disorders of iron metabolism

A

Vibrio vulnificus

130
Q

Ingestion of dairy products, eggs, salads.Short incubation period (1–6 hours)

A

Staphylococcus aureus

131
Q

2–6 hours after ingestion of large reef fish
(grouper, red snapper, and barracuda).
Also neurological symptoms → paresthesia,
weakness, and reversal of heat and cold

A

Ciguatera-toxin

132
Q

____are only found when there has been invasion of the intestinal mucosa, as in
dysentery, which is a bacterial infection of the bowel, producing diarrhea and bloody stool.

A

Fecal leukocytes

133
Q

Invasive organisms need 24 to 36 hours to produce their effect and never give blood in the stool within the first few hours of their ingestion. (The only exception is the protozoan _____, which can give blood or white cells in stools.)

A

Entamoeba histolytica

134
Q

The most definitive test for these bacterial

organisms is a _______

A

stool culture.

135
Q

Cryptosporidiosis is diagnosed with a unique test, a _______

A

modified acid-fast test.

136
Q

_____is best diagnosed with an ELISA stool antigen test. A single stool antigen test has 90% sensitivity. Three stool ova and parasite examinations have only 80% sensitivity.

A

Giardia

137
Q

The best empiric therapy for infectious diarrhea is ciprofloxacin or the other ________

A

fluoroquinolones ± metronidazole

138
Q

Scombroid poisoning is treated with _______

A

antihistamines, such as diphenhydramine

139
Q

A newer agent for Giardia is______ which is effective in a single dose

A

tinidazole,

140
Q

Cryptosporidiosis is treated with ____although it has limited efficacy

A

nitazoxanide,

141
Q

The truly effective therapy for cryptosporidiosis is to ____

A

raise the CD4 count to >100/ mm3 with antiretrovirals

142
Q

Nitazoxanide is superior to______ for cryptosporidium.

A

paromomycin

143
Q

______ refers to a spectrum of diarrheal illnesses caused by the toxins produced by this organism, including severe colitis with or without the presence of pseudomembranes

A

Clostridium difficile diarrhea (C. diff)

144
Q

T or F

Any antibiotic can lead to diarrhea with C. diff, although antibiotics that are broad spectrum are more likely to do so

A

T

145
Q

_______diarrhea is largely a nosocomial disease and is the most frequent cause of diarrhea in hospitalized patients

A

C. diff

146
Q

Recent meta-analysis suggests a significant association between C. difficile and the use of ______

A

proton pump inhibitors

147
Q

During the past few years, there has been renewed interest in C. diff diarrhea reflecting
a form of disease that is more frequent, more severe, and more refractory to standard
treatment. These observations are explained by the presence of a new strain of C. diff,
designated ______which produces more toxins A and B and is resistant

A

NAP-1,

148
Q

Both C. difficile toxins A and B exhibit potent ________ and ______ that are
responsible for the clinical manifestations

A

enterotoxic and cytotoxic effects

149
Q

The clinical manifestations of C. diff may vary from ______

A

mild diarrhea to fulminant colitis.

150
Q

C. difficile colitis

The newest preferred method of diagnosis is the ________which may include the real-time polymerasechain reaction (PCR) or loop-mediated isothermal amplification test, both of which detect the toxin A and B genes responsible for the production of toxins

A

nucleic acid amplification (LAMP,

loop-mediated isothermal amplification) assay,

151
Q

C. difficile colitis

_______ is the drug of choice along with discontinuation of antibiotics (if
feasible) and supportive therapy.

A

Metronidazole

152
Q

Oral vancomycin is reserved for the following conditions:

A
  • Failed therapy with metronidazole
  • Organisms resistant to metronidazole
  • Patient is allergic to or cannot tolerate metronidazole
  • Patient is pregnant or a child age <10
  • Patient is critically ill
153
Q

C. difficile colitis

If the symptoms resolve but there is a recurrence (~ 30% in some studies), then ________

A

retreat with metronidazole

154
Q

_______ seems to decrease the number of episodes of recurrent C. difficile colitis

A

Fidaxomicin

155
Q

Lactose intolerance is perhaps the single most common potential cause of diarrhea
because of the enormously high prevalence of_________

A

lactase deficiency

156
Q

ssx of lactase deficiency

A

The diarrhea produced is associated with gas and bloating, but never has blood or leukocytes in it

157
Q

dx of lactase deficiency

A

A precise diagnosis can be established by finding an increased stool osmolality and increased osmolar gap

158
Q

The osmolar gap means that the difference

between the osmolality measure in the stool and the osmolality calculated from the sodium and potassium levels is_______

A

> 50 mOsm/kg.

159
Q

Other causes of an increased stool osmolar gap are ____

A

magnesium and polyethylene glycol in the stool, also nutrient malabsorption → pancreatic insufficiency, celiac sprue, and
bacterial overgrowth

160
Q

Rx of SSx of lactase deficiency

A

should occur within 24 to 36 hours.

161
Q

Rx of SSx of celiac disease,

A

take weeks after stopping the ingestion

of gluten-containing foods.)

162
Q

_______ is an idiopathic disorder in which there is increased frequency of the normal peristaltic and segmentation contractions of the bowel. Pain is often relieved by a bowel movement.

A

IBS

163
Q

SSx of IBS

A

Twenty percent of patients with IBS have constipation only. A large number have diarrhea alone or diarrhea alternating with constipation. Everyone has pain.

164
Q

Dx criteria for IBS

A

• Pain relieved by a bowel movement or by a change in bowel habit (e.g., when you
develop diarrhea, the pain goes away)
• Fewer symptoms at night
• Diarrhea alternating with constipation

165
Q

There is no clear definitive therapy for IBS. All patients should be placed on a ______

A

highfiber diet in an attempt to increase the bulk of the stool

166
Q

IBS

Those with diarrhea-predominant disease
should receive antidiarrheal agents, such as ______

A

loperamide or diphenoxylate.

167
Q

MOA of anti-spasmodics for IBS

A

The presumptive mechanism of these agents is that they will relax the bowel wall musculature and diminish the pain

168
Q

IBS Resistant cases may respond to?

A

TCA

169
Q

MOA of TCA for IBS

A

The presumptive mechanism is that the tricyclics are anticholinergic and will relax the bowel.

170
Q

A newer agent is ______, which is used in constipation-predominant IBS.

A

tegaserod

171
Q

tegaserod cx

A

diarrhea

172
Q

_____ is used in diarrhea-predominant IBS, and it slows motility

A

Alosetron

173
Q

Bronchial carcinoids are rare but are

highly symptomatic because _____

A

the serotonin produced from a bronchial carcinoid does not get detoxified in the liver and is released directly into the circulation

174
Q

Carcinoid syndrome

A rash may develop from______which is a direct result of the carcinoid.

A

niacin deficiency,

175
Q

Serotonin and niacin are both produced from _______ If there is an overproduction
of serotonin, it produces a tryptophan deficiency, which leads to a deficiency of ________

A

tryptophan.

niacin.

176
Q

Endocardial fibrosis also occurs because of a constant exposure of the right side of the heart to the serotonin. This leads to __________

A

tricuspid insufficiency and pulmonic stenosis.

177
Q

Carcinoid syndrome

Therapy is generally based on controlling the diarrhea with _____which is a
somatostatin analog.

A

octreotide,

178
Q

Iron malabsorption occurs if there is involvement of the ___where iron is normally
absorbed

A

duodenum

179
Q

Iron deficiency anemia is evident in all patients with _______

A

celiac sprue.

180
Q

_______is from damage or loss of the mucosal surface of the terminal ileum.

A

Vitamin B12 malabsorption

181
Q

All of the malabsorption syndromes present with chronic diarrhea. The only unique feature of celiac disease is ________

A

dermatitis herpetiformis

182
Q

In addition to the usual presentation of a fat

malabsorption, ______ is characterized by dementia (10%), arthralgias (80%), and ophthalmoplegia.

A

Whipple disease

183
Q

Celiac disease is first diagnosed by testing for the presence of ____ and _____

A

antiendomysial and antitransglutaminase antigliadin antibodies

184
Q

Dx of Celiac

The most accurate test is a small bowel
biopsy, which shows_______

A

flattening of villi.

185
Q

Celiac

Just removing gluten (wheat, rye, and oats) from the diet is not a very accurate way of establishing the diagnosis because the ________

A

circulating antibodies will continue to be present for weeks after stopping the ingestion of gluten

186
Q

Chronic Pancreatitis

The most accurate test, although rarely done, is a ________

A

secretin test, or finding a low trypsin leve

187
Q

_____was performed in the past to help distinguish between celiac disease and chronic pancreatitis.

A

d-xylose testing

188
Q

If there is no absorption of d-xylose, it means there is a_______

A

bowel-wall abnormality

189
Q

d-xylose was absorbed and excreted in chronic pancreatitis, but not in ______

A

celiac disease, Whipple disease, or tropical sprue, in which there is a bowel-wall abnormality

190
Q

______is malabsorbed in pancreatic insufficiency and celiac disease. Pancreatic enzymes are necessary to absorb this

A

Vitamin B12

191
Q

The single most sensitive test for Whipple’s disease is a_______

A

polymerase chain reaction (PCR) of the bowel biopsy.

192
Q

A positive Tropheryma whippelii biopsy shows ________

A

foamy macrophages that are PAS positive.

193
Q

______ is used when celiac patients have dermatitis herpetiformis.

A

Dapsone

194
Q

Chronic pancreatitis can be managed by ______

A

orally replacing all the deficient enzymes

195
Q

Tropical sprue is treated with ______

A

trimethoprim/sulfamethoxazole or doxycycline for 6 months

196
Q

_______ is associated with GI lymphoma and adenocarcinoma; patients are at risk for adenocarcinoma of the intestine.

A

Celiac disease

197
Q

Celiac sprue is associated with _____

(10-15% of cases); it is unclear whether therapy with gluten-free diet decreases incidence of lymphoma

A

lymphoma (enteropathy-associated T cell lymphoma)

198
Q

Diverticulosis is presumably caused by a _______

A

lack of fiber in the diet to give bulk to stool.

199
Q

Diverticula are more common on the left in

the______ but bleeding occurs more often from diverticula on the right because of _____

A

sigmoid,

thinner mucosa and more fragile blood vessels

200
Q

Diverticulitis is confirmed by ______

A

CT scanning

201
Q

_____ and _______are relatively contraindicated in diverticulitis because there is a slightly higher risk of causing perforation.

A

Barium studies and endoscopy

202
Q

Diverticulitis is treated with antibiotics such as ______ and ______

A

ciprofloxacin and metronidazole

203
Q

The most common cause of constipation is generally a ________

A

lack of dietary fiber and insufficient fluid intake

204
Q

Drugs causing constipation

A

Calcium-channel blockers, oral ferrous sulfate, hypothyroidism, opiate
analgesics, and medications with anticholinergic effects, such as the tricyclic antidepressants, all cause constipation.

205
Q

Drug treatment of constipation includes _______

A

milk of magnesia, cascara, bisacodyl, and docusate (Colace).

206
Q

The lifetime risk of colon cancer is ____.

A

> 6%

207
Q

Diets that are high in _____ and _____lead to an increased risk for colon cancer, and smoking also increases the risk for colon cancer

A

red meat and fat

208
Q

Patients present with heme-positive, brown stool and chronic anemia when the cancer is in the _______

A

right side of the colon

209
Q

______are more often associated with symptoms of obstruction and with narrowing of stool caliber.

A

Left-sided lesions and cancer of the sigmoid

colon

210
Q

Endocarditis by _____ and ____ is often associated with colon cancer

A

Streptococcus bovis and Clostridium septicum

211
Q

Colon CA

_________ is clearly the most accurate diagnostic test. _______ will only
reach the lesion within the distal 60 cm of the colon.

A

Colonoscopy

Sigmoidoscopy

212
Q

Cancer that is localized to the _____, ______ and _______

can easily be resected and cured.

A

mucosa, submucosa, and muscularis layers

213
Q

Colon CA

Widespread disease is treated with chemotherapy. The mainstay of chemotherapy for GI malignancies, such as colon cancer, is ______

A

5-fluorouracil (5FU).

214
Q

Colon CA

Treatment for a single liver metastatic lesion is _______

A

surgical resection

215
Q

The standard screening recommendation for colon cancer is annual fecal occult
blood testing or colonoscopy every ____

A

10 years.

216
Q

False-positive stool guaiac tests can be caused by_______

A

aspirin, NSAIDs, red meat, and poultry.

217
Q

False-negative guaiac tests can be caused by ______

A

vitamin C

218
Q

If adenomatous polyps have been found on a previous colonoscopy, repeat colonoscopy in
______

A

3–5 years

219
Q

In those who have a family history of colon cancer, screening should begin at _______

A

age 40, or 10 years earlier than the family member, whichever is younger

220
Q

Hereditary Nonpolyposis Syndrome (Lynch Syndrome

A

By definition, the syndrome consists of having 3 family members in at least 2 generations with colon cancer

221
Q

Hereditary Nonpolyposis Syndrome (Lynch Syndrome

CA associated with it:

A

There is a very high incidence of ovarian and endometrial cancer in this
syndrome as well. Up to 30% of patients develop endometrial cancer.

222
Q

Hereditary Polyposis Syndromes gene defect

A

The adenomatous polyposis coli gene (APC) confers 100% penetrance for the development of adenomas by age 35 and of
colon cancer by age 50.

223
Q

Flexible sigmoidoscopy for familial adenomatous polyposis should be done ________

A

every 1 to 2 years beginning at age 12.

224
Q

Hereditary Polyposis Syndromes: if polyp found, what to do?

A

As soon as polyps are found, a colectomy should be performed, and a new rectum should be made from the terminal ileum

225
Q

By contrast, juvenile polyposis syndrome confers about a ______risk of colon cancer

A

10%

226
Q

polyps of the juvenile polyposis syndrome are ______

A

hamartomas

227
Q

_____ is another polyposis syndrome with hamartomas that gives only a very
slightly increased risk of cancer compared with the general population. These polyposis syndromes can present with rectal bleeding in a child

A

Cowden syndrome

228
Q

______ is the association of colon cancer with multiple, soft-tissue tumors, such
as osteomas, lipomas, cysts, and fibrosarcomas

A

Gardner syndrome

229
Q

Gardner syndrome

The osteomas have a particular predilection
for the _____

A

The osteomas have a particular predilection

for the mandible.

230
Q

_______is the association of hamartomatous polyps in the large and small
intestine with hyperpigmented spots

A

Peutz-Jeghers syndrome

231
Q

Peutz-Jeghers syndrome

Most common presentation is with abdominal pain due to_______

A

intussusception/bowel obstruction.

232
Q

______ is simply the association of colon cancer with central nervous system
malignancies

A

Turcot syndrome

233
Q

There is an association of endocarditis from ______ and colon cancer;

A

Streptococcus bovis

234
Q

If the patient has a history of cirrhosis of the
liver, or if there is occult cirrhosis (as found in a long-term alcoholic), _____ should be
added to this initial management plan to decrease portal hypertension

A

octreotide

235
Q

The hematocrit should be maintained at ______in older patients and those who may have coronary artery disease

A

≥30%

236
Q

_____will also stop acutely bleeding varices,

but there is a much higher complication rate later on, such as stricture formation

A

Sclerotherapy

237
Q

If banding is not effective in stopping an acutely bleeding esophageal varix, then _______

A

TIPS (transjugular

intrahepatic portosystemic shunting) should be performed.

238
Q

The most common, long-term complication

of TIPS is worsening of _______

A

hepatic encephalopathy.

239
Q

A______ to tamponade the site of bleeding in the stomach or esophagus is rarely
used and is only a temporary bridge to surgery.

A

Blakemore tube

240
Q

____ is a nonselective beta-blocker used in the long-term management of portal
hypertension to decrease the frequency of bleeding

A

Propranolol

241
Q

upper GI bleeding is defined as

bleeding occurring proximal to the_____ which anatomically separates the duodenum from the jejunum.

A

ligament of Treitz,

242
Q

Lower GI bleeding is most commonly caused by _______

A

diverticulosis, angiodysplasia (also know as

AVM or vascular ectasia), hemorrhoids, cancer, and inflammatory bowel disease.

243
Q

In upper GI bleeding, occult blood–positive brown stool can occur with as little as______

A

5 to 10 mL of blood loss

244
Q

Melena develops when at least _____ of blood have been lost.

A

100 mL

245
Q

_____ is defined as a >10-point rise in pulse when the patient goes from the supine to the
standing or sitting position. It is also defined as a >20-point drop in systolic blood pressure on a change in position.

A

Orthostasis

246
Q

______ is the most accurate test to determine the etiology of both upper and
lower GI bleeding.

A

Endoscopy

247
Q

A nuclear bleeding scan can detect low volume bleeds ______

A

0.1–0.5 mL/min.

248
Q

_____ however, is useful in extremely high-volume bleeding in which so much blood is coming out that endoscopy cannot see the source. It may then be used prior to either embolization of the site of the bleeding or hemicolectomy.

A

Angiography,

249
Q

Despite all of these methods, an etiology of GI bleeding cannot be determined in about 5% of patients. This is often because ____

A

the upper endoscope only goes as far as the ligament of Treitz, and the lower endoscope only reaches just past the ileocecal valve.

250
Q

The newest modality to visualize the small bowel is_______, in which a patient swallows a capsule with an electronic camera that can transmit thousands of images to a receiver near the patient

A

capsule endoscopy

251
Q

______ is a CT scan used to try to detect cancer without the need of endoscopy

A

Virtual endoscopy

252
Q

The majority of cases of pancreatitis are due to _______

A

alcoholism and gallstones.

253
Q

Drugs causing ACUTE PANCREATITIS

A

Medications such as pentamidine, didanosine (DDI), azathioprine, and sulfa derivatives,
like sulfamethoxazole/trimethoprim and thiazide diuretics

254
Q

How does hyper TG cause pancreatitis

A

Hypertriglyceridemia, in which elevated triglycerides are broken down to fatty acids,
causing inflammation of the biliary tract and eventual pancreatitis

255
Q

How does ERCP cause pancreatitis

A

Endoscopic retrograde cholangiopancreatography (ERCP), presumably because of back pressure from injection of the contrast material into the ductal system

256
Q

Premature activation of _______ while still in the pancreas (common pathway of most causes of pancreatitis). This results in autodigestion of the pancreas

A

trypsinogen into trypsin

257
Q

In acute panc

What is a more Sp marker of dse?

A

Lipase is more specific to the pancreas than is the amylase

258
Q

Acute Panc

An increased severity of disease and a worse prognosis are indicated by the _____

A

presence of decreased serum calcium, elevated white cell count, hypoxia, and elevated glucose, LDH, and AST

259
Q

The glucose will go up in the most severe forms of pancreatitis because of _____

A

the loss of both endocrine function and insulin production.

260
Q

The most accurate test to determine the severity of pancreatitis is the _____ which is more accurate than a sonogram for the presence of inflammation, as well as for detecting necrosis, pseudocysts, abscesses, and the presence of ductal stones

A

CT scan,

261
Q

The single most accurate test for the detection of biliary and pancreatic ductal pathology is the________

A

ERCP

262
Q

ERCP is sometimes necessary to _____

A

remove a stone in the pancreatic duct or to dilate a stricture.

263
Q

When pancreatitis is very severe, such as when there is >30% necrosis visible on the CT scan, the risk of ________ increases

A

infected and hemorrhagic pancreatitis markedly increases

264
Q

______ develop only 2 to 4 weeks after the episode of pancreatitis

A

Pseudocysts

265
Q

Pseudocysts should be drained if there is ________. Asymptomatic pseudocysts do not need to be drained unless there is concern.

A

pain, fistula formation, and rupture or if the pseudocyst is expanding in
size

266
Q

Signs of Severe Necrotizing Pancreatitis

______ blue discoloration around umbilicus
→ due to hemoperitoneum

_______ bluish purple discoloration of the flanks → tissue catabolism of
Hb.

A

Cullen sign:

Turner’s sign:

267
Q

when at least ______of liver function has been lost, the synthetic capacity of the liver is diminished

A

70 to 80%

268
Q

Dx of SBP

A

A total white cell count >500/mm3 or the presence of >250/mm3 neutrophils are the criteria to determine the presence of infection

269
Q

_____ and _____ are the drugs of choice for SBP and albumin infusion decreases risk of hepatorenal syndrome

A

Cefotaxime and ceftriaxone

270
Q
  • When this gradient, or SAAG, is >1.1, __________ is generally the cause.
  • When the SAAG is <1.1, it means the ascitic fluid albumin level is high. _________generally give a SAAG <1.1.
A

portal hypertension, as from cirrhosis,

Cancer and infections

271
Q

Encephalopathy is managed with ________ a nonabsorbed disaccharide that
bacteria metabolize in the colon, making it more acidic. This converts the NH3 to NH4
+, or ammonia to ammonium.

Ammonium is not absorbed very well, and this leads to an overall increased excretion of ammonia from the body.

A

neomycin or lactulose,

272
Q

Although vitamin K is often given because of the elevated prothrombin time, it is not effective because _____

A

the liver is not able to synthesize clotting factors,

273
Q

Primary biliary cirrhosis has a strong association with other autoimmune diseases, such as _______

A

Sjögren syndrome, rheumatoid

arthritis, and scleroderma

274
Q

MC Sx of PBC

A

The most common symptoms are fatigue and pruritus

275
Q

MC labs of PBC

A

The most common abnormality is an elevation

of alkaline phosphatase and gamma glutamyl transpeptidase (GGTP).

276
Q

PBC

The most specific blood test is the ____

A

antimitochondrial antibody

277
Q

Mx of PBC

Bile acid medication, such as _____, are used with variable success

A

ursodeoxycholic acid and cholestyramine

278
Q

This is an idiopathic disorder of the biliary system most commonly associated
with inflammatory bowel disease (IBD)

A

Primary Sclerosis Cholangitis

279
Q

PSC

Cancer of the biliary system can develop in ____of patients from the chronic inflammation.

A

15%

280
Q

The most specific test for primary sclerosis cholangitis is an _____ This is the only chronic liver disease in which a liver biopsy is not the most accurate test.

A

ERCP or transhepatic

cholangiogram.

281
Q

There is an overabsorption of iron in the duodenum, leading to iron buildup in a number of tissues throughout the body. This leads to chronic hepatic inflammation and fibrosis.

A

Hemochromatosis

282
Q

Hemochromatosis

MC finding of hemochromatosis

A

Cirrhosis is the most common finding

283
Q

Hemochromatosis

_____ occur with increased frequency because of their avidity for iron

A

Vibrio vulnificus and Yersinia infections

284
Q

Hemochromatosis

screening

A

Screening for the disorder is by finding an elevated iron level and diminished
iron-binding capacity. The ferritin is also elevated.

285
Q

Hemochromatosis

The most accurate test is ______

A

a liver biopsy and

abnormal C282Y gene;

286
Q

Initial MX of Hemochromatosis

A

Phlebotomy is used to remove large amounts of iron from the bodyit removes
far more iron than do the chelating agents deferoxamine and deferasirox.

287
Q

______ is an autosomal recessive disorder leading to the diminished
ability to excrete copper from the body. There is also increased copper absorption from the
small intestine

A

Wilson disease

288
Q

_______develop because of copper deposition in the kidney

A

Fanconi syndrome and type II

proximal renal tubular acidosis

289
Q

Dx of WD

A

The most specific blood test is a low ceruloplasmin level, but a low ceruloplasmin
level alone is not enough. There is also a high urinary copper level.

290
Q

Tx of WD

A

The most specific blood test is a low ceruloplasmin level, but a low ceruloplasmin
level alone is not enough. There is also a high urinary copper level.

291
Q

In WD,

Occasionally, there is a ______when the copper levels go high and are toxic to the red cells

A

hemolytic anemia

292
Q

Function of the alpha-1 antitrypsin (AAT)

A

AAT protects the lungs so they can have normal function. AAT is made in the liver; without enough of it, the lungs become damaged, leading to emphysema

293
Q

Genetic makeup of pts with AATD

A

Patients with AATD have 1 normal copy and 1 damaged copy, or they have 2 damaged
copies.

294
Q

AATD MC Sx

A

The most prominent finding is emphysema developing at a young age in a nonsmoker

295
Q

Dx of AATD

  • ______, which examines a person’s genes and determines his genotype
  • ______, which determines the type of AAT protein a person has
  • _______, which determines the amount of AAT in a person’s blood
A

Alpha-1 genotyping

AAT PI type of phenotype test

AAT level test

CK IM (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions