GI Flashcards
Gilbert’s disease
inherited disorder increased indirect (unconjugated) bili
jaundice due to
hematologic disease or
hepatobiliary - intra or extra hepatic
Causes of serum increase of UNCONJUGATED (indirect) bilirubin
hemolysis (intra and extra vascular)
physiologic jaundice of newborn
Gilbert’s dz
G6PD deficiency
Causes of serum increase of CONJUGATED (direct) bilirubin
Dubin-Johnson syndrome biliary tract obstruction intrahepatic cholestasis metastatic liver tumor **hepatocytes work but bili isn't being cleared out
Dubin Johnson labs
elevated direct bilirubin but other LFT all WNL
Cholangitis presentaion
Triad: abd pain, jaundice (conjugated bili), fever/chills
Cholangitis etiology
Most common: obstruction by stone, bacteria ascend from gut into biliary tree and enter bloodstream causing gram neg bacteremia
Cholangitis treatment
ERCP with sphincterotomy, IV Abx: cipro flagyl ampicillin gentamycin sulbactam rocephin zosyn
Extraintestinal manifestation of Chron’s
arthritis spondylitis cholelithiasis (malabsorption of bile salts) clubbing uveitis
Cirrhosis most common complications
ascites (portal HTN)
SBP
encephalopathy
HCC
Spontaneous bacterial peritonitis presentation, cause, and treatment
- Cirrhosis, ascites, fever, altered mental status
- # 1 - E. Coli
- Paracentesis (if abs neutrophil >250 start empiric Abx)
Esophageal or gastric varices hemorrhage tx
IV octreotide
endoscopy
follow up with beta blocker to prevent recurrence
Carcinoid syndrome findings and dx
-tumors found in GI tract and bronchi release humoral factors causing :
flushing, diarrhea, wheezing. Also affects tricuspid and pulm valve
-DX: increase urinary excretion of 5-HIAA
Barrett’s esophagus
changes in esophageal mucosa: squamous to columnar epithelium
-increased risk of adenocarcinoma
Scleroderma associated medical complications
- dysphagia to solids and liquids
- Raynauds
- Pulm disease (interstitial fibrosis or vascular dz)
- Heart disease (acute pericarditis or myocardial fibrosis)
- Kidney disease
