GI Flashcards
what do parietal cells release?
HCl acid
intrinsic factor
what do chief cells release?
pepsin
what do G cells release?
Gastrin
secretin in released by what part fo the intestines?
duodenum (it inhibits gastric production and signals the pancreas to release bicarb)
gold standard test for GERD?
24h ambulatory pH monitoring
gold standard test for achalasia
esophageal manometry
tx of choice for active esophageal varices
endoscopic ligation
meds used in esophageal varices
octreotide, vasopressin
PPI, Abx
what can be used for esophageal varices if bleeding cannot be controlled with endoscopic interventions or medications?
balloon tamponade
Side effect of TIPS procedure
encephalopathy
gold standard dx for gastritis and PUD
endoscopy
gold standard for H pylori testing
endoscopy w/ bx
best screening test for zollinger ellison syndrome
fasting gastrin level
what inhibition test is performed with zollinger ellison syndrome?
secretin
hereditary conjugated hyperbilirubinemia d/t decreased hepatocyte excretion of conjugated bilirubin
Pt will have grossly black liver on bx
dubin-johnson syndrome
Dublin, direct, dark
hereditary unconjugated hyperbilirubinemia with normal LFT
crigler-najjar syndrome Gilbert syndrome (more common)
what is the inital test and the gold standard test for acute cholecystitis
U/S
HIDA
MC cause of fulminant hepatitis
acetaminophen
what are sxs of fulminant liver dz
encephalopathy coagulopathy jaundice asterixis ascites
what hepatits viruses are fecal-oral
A E
IV drug users are at risk of developing what hepatits infxn
C
what does hep D need to cuase infection
HepB
Hep B medications?
alpha-interferon 2b lamivudine adefovir tenofovir entecavir
hepatic venous outflow obstruction
budd-chiari syndrome (hepatic vein obstruction)
how do you dx and tx budd-chiari syndrome
U/S
shunts, balloon angioplasty w/ stent, anticoagulation
what tumor marker is used to track hepatocellular carcinoma?
alpha-fetoprotein
what is cholestyramine used for?
pruritis d/t increased levels of bile salts
idiopathic autoimmune d/o of intrahepatic small bile ducts
Associated with anti mitochondrial antibody
usually incidental finding with high alkaline phosphate
Primary biliary cirrhosis
Tx for Primary biliary cirrhosis
urodeoxycholic acid (reduce progression)
autoimmune progressive cholestasis, diffuse fibrosis of intrahepatic and extrahepatic ducts
associated with UC
primary sclerosing cholangitis
tx for primary sclerosing cholangitis
transplant, stenting to relieve sxs
autosomal recessive copper accumulation in liver, brain, kidney, cornea
wilsons dz
tx for wilsons dz
D-pencillamine (chelates copper)
zinc + ammonium tetrathiomolybdate (enhance fecal excretion)
mc cause of small bowel obstructions
large bowel?
adhesions
obstruction
test of choice to dx lactose intolerance
hydrogen breath test
abx used in diverticulitis
cipro/bactrim + metronidazole
dx for UC vs crohns
UC = felx sig Crohns = upper GI series with small bowel follow through
how should colon CA screening be performed for…..
- average risk
- 1st degree relative >60y
- 1st degree realtive <60y
4, lynch
5, FAP
- @50 fecal occult = annual, colonoscopy = e 10
- @40 fecal occult = annual, colonoscopy = e 10
- @40 (or 10 yrs prior) fecal occult = annual, colonoscopy = e 5 yrs
4, @ 20-25, colonoscopy q 1-2 yrs - @10-12, felx sig
deficiency associated with loss of night vision, imparied immunity, bitot’s spots (white spots on conjunctiva d/t squamous metaplasia)
Vitamin A
hyperkeratotic follicular papules
Hemorrhage (gums, skin, joints)
Hematologic (anemia, glossitis)
Scurvy (Vit C, ascorbic acid)
softening of the bones with bowing and rachitic rosary in children
looser lines for adults
vitamin D
Rickets (children)
osteomalacia (adults)
ETOH mc cause
wernickes
beriberi (nervous system changes or HF)
Thiamine (B1)
one drunk man
oral-ocular-genital syndrome
oral (magenta tongue, lesions)
ocular (photophobia, corneal lesions)
Genital (scrotal dermatitis)
Riboflavin (B2)
2 nuts are involved
diarrhea, dementia, dermatitis
high corn diet
Niacin (B3)
3 D’s
chronic ETOH, peripheral neuropathy, sz HA.
Pyridoxine (B6)
parasthesias, gait abnormalities, memory loss, macrocytic anemia
cobalamin B 12
short incubation
ate dairy products, mayonnaise, meats or eggs
prominent V, abd cramps, HA, D
staph aureus
similar to staph
Contaminated foods
Vomiting, cramps D
Bacillus cereus
rice water stools
raw shellfish
Tx?
vibrio cholerae
fluids!
tetracyclines
travelers D
unsanitary drinking water
Tx?
enterotoxigenic e coli
fluids!
FQ
strinkingly high lymphocytes, pseudomembranoue colitis
Tx?
C. diff
metronidazole
vanc PO
can lead to guillain barre syndrome
undercooked poultry
gram negative S, comma, seagull shaped
tx?
campylobacter enteritis
fluids
erythromycin
tenesmus, explosive D, mucoid/bloody D
febirle szs in children
Tx?
shigella
Bactrim, FQ
sickle cell pts are at high risk of osteomylitis with this infxn
pea soup stools
Tx?
salmonella (typhoid fever)
FQ
noninfectious D affects the ___
Infectious D affects the ____
small intestine
Large intestine
frothy, greasy, fould smelling poo
contaminated streams
Tx?
Giardia lambia
metronidazole
GI colittis, dysentery, liver abcess
tx?
abebiasis
metronidazole
farmers around contaminated soil
malabsorption, rhythmic motion of eyes with chewing
Tx?
whipple’s dz
PCN
