GI Flashcards

1
Q

Celiac Disease

  • Symptoms
  • Diagnosis
  • Treatment
A

Symptoms:
- fatigue, bloody stools, weight loss

Diagnosis

  • Anemia (IDA)
  • LFTs abnormal
  • Anti-TTG, anti-endomysial
  • Definitive=biopsy (crypt hyperplasia, intraepithelial lymphocytes, villous blunting)

*anti-ttg may be negative in IgA deficient

Treatment:

  • Gluten Free Diet
  • If not compliant at risk for T-cell Lymphoma (abd pain, b-symptoms, intestinal obstruction or perforation)
  • no indication for repeat biopsies if sx resolve
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2
Q

Screening in Celiac Disease

A

DXA (perform at time of diagnosis)

Treat with Vit D/Calcium

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3
Q

Microscopic Colitis

A

Symptoms: watery diarrhea without weight loss or abd pain
Diagnosed by biopsy:
- Normal looking mucosa however biopsy may show:
—– intraepithelial lymphocytes, cryptitis
—– Collagen band thickening of the subepithelium

Treatment:

  1. remove offending agent (PPI, NSAID)
  2. Bismuth, loperamide
  3. Budesonide (Oral)
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4
Q

VIPoma

A

Diarrhea and Flushing

Electrolyte abnormalities related to diarrhea

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5
Q

Carcinoid Syndrome

  • Symptoms
  • Diagnosis
  • Treatment
A

Symptoms:

  • Skin: flushing, telangiectasias
  • Pulm: bronchospasm
  • Heart: right sided>left sided valve disease
  • GI: diarrhea
  • Niacin deficiency

Diagnosis:

  • Elevated 24 hour urine 5H1AA
  • CT/Ab pelvis to identify tumor
  • Octreotide scans

Treatment:

  • Octreotide
  • Surgical resection of tumor
  • Surgical resection/platinum based chemo if liver mets
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6
Q

Indications for treatment of hepatitis B

A
  • Chronic infection (IgG) with Continue ALT elevation with HBV DNA >10k
  • immunosuppressive therapy
  • acute liver failure (IgM)
  • test chronic hepatitis B for hepatitis D
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