GI Labs

Question 1

hypocalcemia

Answer 1

pancreatitis - freed fat binds to calcium

Question 2

alkaline phosphatase

Answer 2

elevated in gallstones

Question 3

lipase

Answer 3

3x elevated in pancreatitis (more specific than amylase)

Question 4

hematocrit elevated

Answer 4

dehydration if diarrhea

Question 5

24 hour fecal fat test used to dx

Answer 5

celiac dz

Question 6

alcohol-related problems (liver enzymes)

Answer 6

AST will be 2x ALT

Question 7

PT/INR elevated

Answer 7

think of liver damage d/t lack of clotting factors formed

Question 8

labs are all normal, but pt c/o wt loss, bloating, diarrhea… pain relieved w/ defacation

Answer 8

IBS

Question 9

low albumin

Answer 9

possibly due to liver dysfunction in making protein, would suspect ascites

Question 10

B12 low - where might the dz be?

Answer 10

ileum - this is site of absorption

Question 11

Fe and folate low - where might the dz be?

Answer 11

duodenum - site of absorption

Question 12

NAAT stool test is used for what

Answer 12

C. diff

Question 13

leukocytosis

Answer 13

cholangitis, appendicitis, cholecystitis

Question 14

urine is tea colored - why

Answer 14

elevated direct/conjugated bilirubin

Question 15

ECRP - what area are you looking in

Answer 15

bile ducts, pancreatic ducts

Question 16

stool is light colored

Answer 16

elevated direct/conjugated bilirubin

Question 17

bili metabolism

Answer 17

macrophage: heme to bilverdin
bilverdin to unconjugated bili
Liver conjugates the bili
bili in the bile>bili/cystic duct> GB
GB > small intestine
bili > urobili > stercobili (stool)
or bili > urobilogen > urobilin (urine)
or bili > urobiligen > bili (recycled)

Question 18

urine is very dark and heme positive - why

Answer 18

elevated indirect bili

Question 19

obturator sign

Answer 19

flex the R hip and rotator inwards

Question 20

psoas sign

Answer 20

R hip extension against resistance

Question 21

murphy sign

Answer 21

push up toward liver (RUQ) have pt inhale - if they stop the inhale d/t pain, positive

Question 22

mcburneys point

Answer 22

RLQ

Question 23

rovsing sign

Answer 23

Pressure on LLQ, release, pain?

Question 24

turner/cullen sign

Answer 24

pancreatitis

Question 25

what is a postive HIDA?

Answer 25

can’t see the GB, means cholecystitis

Question 26

expected labs cholecystisis

Answer 26

leukocytosis, bili, alk phosphatase, LFT elevated

Question 27

tx cholecystitis/cholangitis

Answer 27

amp/sulbac

levo/metronidazole

Question 28

painless jaundice

Answer 28

pancreatic cancer

Question 29

travelers diarrhea

Answer 29

TMP SMX

Question 30

c. diff tx

Answer 30

metronidazole