GI/Endocrinology Flashcards

1
Q

What occurs with Lactose Intolerance?

A
  • Deficiency in Lactase = Accumulation of Lactose
  • Bacteria metabolizes Lactose into Hydrogen Gas
    = Pain, bloating, farting and diarrhea after eating dairy
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2
Q

What are 2 ways to diagnose Lactose Intolerance?

A
  • Hydrogen Breath test
  • Removal of dairy and symptoms resolve
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3
Q

What is Irritable Bowel Syndrome?

A

Recurrent abdominal pain relieved by defecation with changes in stool form/frequency and NO CAUSE

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4
Q

What is Irritable Bowel Syndrome?

A

Recurrent abdominal pain relieved by defecation with changes in stool form/frequency and NO CAUSE

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5
Q

Does Irritable Bowel Syndrome present with diarrhea or constipation?

A

Both are possible subtypes!

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6
Q

What is the mainstay treatment for Irritable Bowel Syndrome? (2)

A

Lifestyle modifications + Psyllium (fiber)

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7
Q

What rash is associated with Celiac Disease?

A

Dermatitis Herptiformis
= papulovesciular rash on EXTENSOR surfaces

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8
Q

Dermatitis Herpetiformis

A

Papulovesicular rash on EXTENSOR surfaces
– seen with Celiac Disease

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9
Q

What are the symptoms of Celiac Disease?

A
  • Foul smelling and floating stools
  • Fatigue and Iron Deficient Anemia
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10
Q

What are the symptoms of Celiac Disease?

A
  • Foul smelling and floating stools
  • Fatigue and Iron Deficient Anemia
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11
Q

What is diagnostic of Celiac Disease?

A

Small bowel biopsy = Villous atrophy

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12
Q

What is diagnostic of Celiac Disease?

A

Small bowel biopsy = Villous atrophy

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13
Q

What antibody may be (+) with Celiac Disease?

A

IgA Anti-Tissue Transglutaminase

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14
Q

What is the physiology behind Urge Incontinence?

A

Sudden detrusor muscle contraction causing urge to void = leakage of urine

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15
Q

What are 2 possible treatments for Urge Incontinence?

A
  1. Oxybutynin
  2. Mirabegron
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16
Q

MOA for Oxybutynin and Mirabegron for the treatment of Urge Incontinence?

A

Oxybutynin = M3 Antagonist (blocks detrusor)
Mirebegron = Beta3 Agonist (detrusor relax)

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17
Q

Acromegaly is due to elevated GH. How will it present in kids and why?

A

Gigantism due to incomplete closure of growth plates

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18
Q

How will Acromegaly present in adults?

A

Large hands, feet, face and visceral organs
High Glucose
CHF

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19
Q

How will Acromegaly present in adults?

A

Large hands, feet, face and visceral organs
High glucose
CHF

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20
Q

What should you check if you suspect Acromegaly?

A

ILGF-1
– This is (+) by GH which then (+) glucose

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21
Q

If ILGF-1 is elevated, what should be done next if you suspect Acromegaly?

A

Glucose suppression test
= Will FAIL to suppress with Acromegaly

22
Q

What is the treatment for Acromegaly?

A

Surgery of Anterior Pituitary tumor

23
Q

If you do not see a pituitary gland on brain imaging, what should be done?

A

Nothing
= Empty Sella Syndrome (pituitary ectopically functioning)

24
Q

What is secreted by the Posterior Pituitary?

A

ADH
Oxytocin

25
Q

With SIADH, what occurs?

A

Too much ADH tells kidney to reabsorb too much water

26
Q

What are the levels of the Urine and Serum Osm with SIADH?

A

Urine = HIGH
Serum = LOW

27
Q

What are the levels of the Urine and Serum Na+ with SIADH?

A

Urine = HIGH
SIADH = LOW

28
Q

What 2 things can cause SIADH?

A

Small cell lung cancer
Brain lesion

29
Q

What is Diabetes Insipidus?

A

LOW levels of ADH which cause urine to be super dilute

30
Q

Central Diabetes Insipidus

A

Low production of ADH

31
Q

Nephrogenic Diabetes Insipidus

A

Kidney non-responsive to ADH

32
Q

What are the levels of Urine and Serum Osm with Diabetes Insipidus?

A

Urine = LOW
Serum = HIGH

33
Q

What are the levels of Urine and Serum Na+ with Diabetes Insipidus?

A

Urine = low
Serum = HIGH

34
Q

What test should be done if you suspect Diabetes Insipidus and what is the result?

A

Water deprivation test
= Urine Osm will NOT correct

35
Q

If you suspect Diabetes Insipidus and it corrects with ADH, what is the diagnosis? If it does not?

A

If it corrects = Central
If it does not = Nephrogenic

36
Q

Treatment for Central and Nephrogenic Diabetes Insipidus?

A

Central = DDAVP
Nephrogenic = Diuresis

37
Q

What is Addison’s Disease? 2 major causes?

A

Low Cortisol production
1. Autoimmune
2. TB

38
Q

2 signs of Addison’s Disease? (low cortisol)

A
  • Hyperpigmentation
  • Orthostatic Hypotension
39
Q

What antibodies are present with Graves disease?

A

TSH receptor antibodies

40
Q

What 2 other signs besides hyperthyroid signs will be present with Graves?

A

Exophthalmos
Pretibial myxedema

41
Q

Result of the RAIU scan with Graves? What is the treatment?

A

Increased uptake everywhere
= PTU or Methimazole to stop new thyroid hormone production

42
Q

Signs of a Thyroid storm?

A

Fever > 104
Afib/shock
AMS
Hypotension

43
Q

Signs of a Thyroid Storm?

A

Fever > 104
Afib/shock
Hypotension
AMS

44
Q

3 things to give if Thyroid storm is present?

A

Propranolol
PTU/Methimazole
Steroids to stop conversion to T3

45
Q

3 things to give if Thyroid storm is present?

A

Propranolol
PTU/Methimazole
Steroids to stop conversion to T3

46
Q

What is Struma Ovarii?

A

Ovarian tumor that releases T4

47
Q

What precedes Subacute Thyroiditis?

A

Viral infection

48
Q

Signs of Subacute Thyroiditis?

A

PAINFUL goiter
Fever
Hyperthyroid signs

49
Q

What antibodies are positive with Painless and Postpartum Thyroiditis?

A

(+) TPO (thyroid peroxidase)

50
Q

Describe the evolution of Painless or Postpartum Thyroiditis

A

Hyperthyroid phase
Hypothyroid phase
Resolution

51
Q

Describe Hashimoto Thyroiditis

A

Permanent Hypothyroidism

52
Q

Are goiters often present with Thyroiditis? Painful?

A

Yes
- Painful = Subacute Thyroiditis