GI liver and pancreas Flashcards
Alcohol causing pancreatitis?
CHRONIC USE!!!
CHOLELITHIASIS
Sulfa drugs and HIV drugs
remember lipids, serum calceum,
Ranson criteria, dont stress numbers but know what you are looking for
GA LAW Glucose AST LDH AGE WBC
CA HOBBS Calcium Hematocrit decrease PO2 Base deficit BUN increase Sequestration of fluids
Base deficit calculcation?
do i need to know it?
Pleural effusion with pancreatitis might have what?
amylase in it
Why do you use meperidine in pancreatitis?
less sphincter of oddi constriction when compared to morphine
(think P sounds like Pancrease in meperidine)
Chronic pancreatitis symptoms?
Can have steatorrhea of cours
Most specific test for chronic pancreatitis?
Low fecal elastase!!!
Might have mild up amylase and lipase
Tx chronic pancreatitis?
Stop drinking, smoking
Give opioids, supplement pancreatic enzmes
Vitamin supplements, small meals low fats
Pancreatic pseudocyst is what? When?
False cyst. Usually iasymptomatic. May have some epigastric duct.
Must rule out from neoplasm.
What to tell is by aspiration. If lots of amylase, it is pancreatic juice (pseudocyst).
Only do if there for 6 weeks, diagnostic reason, or if growing
Tumor marker pancreatic cancer?
CEA or CA19-9
Migratory thrombophlebitis was discovered by who?
Pancreatic cancer. Trousseau diagnosed himself
Insulinoma drug treatment if difficulty resecting?
Diazoxide causes DIAbetes (dia and dia)
Or octreotide
Awful rash on face and perineum, what do you consider? Painful and pruritic
Glucagonoma.
Necrolytic migratory something
VIPoma is where?
Non beta islet cells. Watery diarrhea! High VIP. High stool osmolality.
What is calculus cholecystisit? Who get it?
Inflammation of gall bladder who don’t have stones
Patients on TPN or critically ill
HIDA does what?
Absorbed by liver and secreted into gall. If it doesn’t go into gall bladder, it is obstructred
Cholecystitis tx?
Antibiotics then treat after about 2 days
Cholangitis is what?
inflammation of bile ducts. Usually from obstruction
Charcot triad is HIGH YIELD
RUQ jaundice, fever
cholangitis
You see AST, and ALT b/c it is ducts, so liver issues can happen
Reynolds pentad?
Altered mental status and SHOCK
RUQ, jaundice, fever
Dx for cholangitis?
HIDA
Tx cholangitis?
Endoscopic biliary drainage, IV fluids, antibiotics
then surgery after it cools weeks later
Diff than cholecystitis which you can treat a few days later
Gall bladder cancer presentation?
Same symptoms. But no white count. Still high bill and alk phos
Primary Billiary Cirrhosis is what?
Tx?
Women love Primarily bitches Cirrhosis (IN WOMEN!)
Autoimmune: Antimitochondrial antibodies. in women (Ursula so give Ursodeoxycholic acid (also has the cholic part in there for biliary tract) and that delays progression.
Definitive tx? Liver transplant
Primary Sclerosing Cholangitis?
You get destruction of bile ducts in liver and extra hepatic.
Fatigue, pruritis, hepatomegaly, jaundice
MORE COMMON IN MEN
Associated with Ulcerative Colitis
P Anca
Transplant only tx
Cholangiocarcinoma risk
Beads on String (sclerosinG)
Crigler najar tx?
Type 1 is UDPGT issue. Give Plasmapheresis then eventually transplant
If type 2, barbiturates help create more UDPGT activity!!
Goodpasture tx?
Plasmapheresis, steroids, immunosuppressants
