GI Makenzie Flashcards
1
Q
esophageal adenocarcinoma
A
lower esophagus
most due to Barrett’s
2
Q
tuberous sclerosis
A
any age with rectal hamartomas and extra gastrointestinal benign tumorous lesions.
3
Q
FAP RM
A
obstruction of ampulla of Vater
Gardner Sx, Turcot Sx
4
Q
atresia
A
thin, non-canaliculized, with blind pouch
5
Q
Secondary achalasia
A
Chaga’s disease (T. cruzi destroys myenteric plexus)
6
Q
vit A deficiency in lungs
A
squamous metaplasia
7
Q
River blindness dx
A
nodules: adult worms
eye: microfilariae
Mazzotti test–> DEC causes intense itching
8
Q
C. parvus infection settings
A
endemic kids diarrhea in 3rd world; traveler’s diarrhea; AIDS; swimming pools/city water outbreaks
9
Q
TEF clinical
A
regurgitation, nowhere for food to go —> aspiration —> pneumonia
GERD and esophagitis
10
Q
2 lbs loss per week is a cut of how many calories
A
500 kcal
11
Q
pANCA- / ASCA +
A
Crohn’s
12
Q
esophagitis
A
epithelial damage and inflammation due to GERD
13
Q
trichomoniasis
A
STD flagella protozoa NEVER in intestines*
itching, painful intercourse, yello-green frothy discharge
14
Q
PPI use
A
Best for Peptic Ulcers and GERD
15
Q
pedunculated tubular adenoma
A
a ball-like nodule on the end of along stalk allowing it to move around in the colon lumen, cause intermittent obstruction depending on location, as well as subjecting it to trauma, ulceration, and hemorrhage
16
Q
CRONKHITE-CANADA SYNDROME
A
non-hereditary
older persons associated with colonic hamartomas and generative changes in the integumental and hematologic systems.
17
Q
sucralfate MOA
A
*at pH less than 4, forms a gel
binds both GI epithelial cells and ulcer craters to form a protective barrier against acid and stimulates PGE2 production
18
Q
E. multilocularis
A
cold weather, rodent-canine-human
alveolar
19
Q
GERD histo
A
severity of sx not related to severity of histo
20
Q
giardia trophozoite
A
pear shaped, 2 nuclei “eyes” and ventral adhesive sucking disc
21
Q
Cachexia
A
2nd PEM due to AIDS/advanced Cancer
due to inc TNF, IL-1, IL-6
22
Q
bulimia pulmonary aspiration complications
A
recurrent pneumonia
23
Q
TEF tx
A
surgery immediately after birth, incompatible with life otherwise
24
Q
adenocarcinoma clinical
A
2nd most common
extracellular mucin = dead
25
River Blindness clinical
intense itching, lizard skin, hanging groin, skin nodules
26
Filariasis
infection with microfila of Wuchereria and Brugia by mosquito
tropical regions (***pacific islands***)
elephantitis --> trapped in lymph nodes, induces swelling
27
PEM evaluation
malnutrition in kids: when weight falls to less than 80% of normal weight;
BMI less than ***16***, fat stores-->skin folds, m. mass--> circumference of arm; serum protein (reflects visceral protein cmptment)
28
amebic pulmonary disease
liver abscess ruptures thru diaphragm
pleuritic pain, RUQ pain, brown sputum, SOB
29
biopsy criteria GERD
increased thickness of basal layer, increased height of papillae, inflammation w/ intraepithelial eosinophils
30
TEF types incompatible with life
B, D
31
causes of malnutrition
ignorance, poverty, alcoholism, illness, infection, dieting
32
Boerhaave sx
esophageal rupture
33
carditis
immediately distal to Z line due to H. pylori and GERD
can cause gastric cardia cancer
34
Esopha. adenocarcinoma prognostic
depth, lymph involvement, status of resection margins
35
naltrexone/buproprion
opioid antagonist/dopamine and NE agonist
****black box warning: suicidal****
36
death due to bulimia and anorexia nervosa
cardiac dysfunction due to hypokalemia
37
crypto dx
Kinyoun acid-fast stain
oocysts appear as little red circles
EIA better
38
lansoprazole
approved for use of NSAID ulcers in patients who MUST stay on NSAIDS
39
amebic microscopy
stool O&P x3
gliding motion with pseudopod
Charcot-Leyden crystals
40
isospora belli
***human host only***
AIDS, MSM
acute non bloody diarrhea with ***eosinophilia** and charcot-leyden
41
quadruple therapy
(PPI OR H2RA) + metrodinazole + bismuth + tetracycline
42
Surgical weight loss candidattes
BMI at/above 25 w/ comorbidities
BMI over 40
43
allergic esophagitis
resembles GERD,but no acidic pH and doesn't respond to antireflux therapy
44
amphetamine like weight loss drugs CI
HTN/ CVD
45
giardia recurrence
diarrhea + fatigue
46
colon clinical workup
decreasing MCV, iron levels, FOBT, endoscopy
47
Balantidium coli
***only ciliate infection in humans***
largest intestinal protozoa in humans
transmitted thru pigs
48
docusates and castor oil
surfactants
lower surface tension of stool, wetting and emulsifying agents
49
TEF most common form
Type C: upper esophagus ends in blind pouch and lower esophagus connected to trachea
50
PEUTZ-JEGHERS SYNDROME
in adolescents associated with hamartomatous polyps throughout the GI tract and with a ***significant risk for many malignancies.***
51
trauma eval
IV contrast CT
52
kwashiorkor liver histology
fatty changes (lipid vacuoles are holes in cell's cytoplasm)
53
Thrush
gray-white plaques due to candida
54
Barrett's esophagus
metaplasia of columnar epithelium due to chronic GERD
***adenocarcinoma in 40-60yo white men***
55
villous atrophy
loss of microvilli and villi in GI due to kwashiorkor
56
ulcerative colitis
continuous colonic involvement, beginning in rectum w/ pseudopolyps and ulcer
defects in MPP9
***confined above muscularis mucosa**
*****smoking is protective*******
57
Hydatid disease
Echinococcosis "sheep-dog-human"
**sheep herders***
58
Chinese liver fluke
clonorchiasis/opsithorchiaisis
C. sinesis--> major Asian countries
O. vivernni--> Thailand, Laos, Vitenam
59
Guinea worm dx and tx
adult worm penetrating out of skin on lower leg
role it daily until whole worm extracted (its massive so can take weeks).... DO NOT DO IT FAST
60
intramucosal adenocarcinoma
invades lamina, not barrett's related
61
GERD
reflux into LES, caused by everything good into the world
62
Chyluria
lymph fluid and emulsified fat in urine due to filariasis
63
sliding hiatal hernia
most common, protrusion of stomach above diaphragm creates bell-shaped dilation
64
Schatzki ring
lower esophagus, gastric epithelium undersurface
65
inflammatory polyps
Generally associated with solitary rectal ulcer syndrome, this reactive lesion has no known risk for malignant transformation
66
Granulomatous Amoebic encephalitis (GAE)
acanthamoeba infection
hematogenous spread thru skin and eyes
fatal
67
Web
upper esophageal
5mm protrusion, vascularized fibrous tissue core
episodic dysphagia with "bolting" of solid food
*radiotherapy*
68
giardia cyst
smooth walled, highly refractile with 2-4 nuclei
69
chronic vit A toxicity
anorexia, bone fractures, joint pain, weight loss
70
cryptosporoidium parvus
fecal-oral route P2P OR ***preweaned calves***
***chlorine resistant***
71
S. mansoni
***Puerto rico, large intestine, oval eggs with prominent lateral spine (stool)****
"Man-Snail-Man"
free-swimming cercariae (larva) penetrate human go into lung and liver
miracidium (egg/primary larva) infect snail and rlsd as cercariae
72
Guinea worm special thing
WILL BE ERADICATED.... WITHOUT MEDICINE OR VACCINE---> PUBLIC HEALTH POLICY ONLY
73
intestinal coccidial infection
only infects AIDS
severe, protracted diarrhea
cryptosporidium, isospora, cyclospora
sarcocystis
74
giardia dx
several weeks into trip OR after coming back
immunofluorescence
75
bone marrow in malnourished child is
hypocellular
76
Bisacodyl
stimulant of mucosal water and electrolyte secretion
77
vitamin A stored where
liver
78
eosinophilic esophagitis
YOUNG white males (kids)
79
Mg(OH2) ADR
diarrhea
80
Katayama Fever
first infection with S. mansoni
ACUTE typhoid-like illness
81
esophageal stenosis
fibrous thickening of submucosa w/ atrophy of the muscularis
due to: scarring, reflux, radiation, scleroderma, lye ingestion
sx: progressive dysphagia
82
(neuro)Cysticerosis
T. solium only
infect brain and form cysts, causes mental changes and seizures
***if you see a question on a migrant worker with above sx....****
83
what binds retinol in blood?
retinol blinding protein
84
ectopic tissues
postcricoid region, circular red-orange flat area ("inlet patch")
may ulcerate, contains cardiac-fundic glands
85
H2RA use
***nocturnal acid secretion bc ONLY basal pumps***
*ulcers, GERD*,
Zollinger-Ellison, acute stress
86
Vit A functions
epithelial growth and differentiation, FA metabolism, maintenance of immune system and normal vision
87
Marasmus
loss of somatic compartment (skeletal muscle) *serum protein normal*
***anemia, "shrunken old person"***, diminished subq fat, growth retardation, inc infections
88
pancreatic heterotopia (ectopic pancreatic)
***ductal carcinoma possible***
NOT Barrett's esophagus
89
bulimia
amenorrhea, arrhythmia (hypokalemia), pulmonary aspiration of gastric contents, esophageal and gastric rupture
90
tubular adenoma
greater than 50% of older population
low grade dysplasia
91
vitamin A deficiency diseases
celiac disease, mineral oil, gastric bypass, IBS
92
River Blindness
Onchocericiasis
Simulium flies transmit at FAST MOVING streams in TROPICAL AFRICA
93
dog tapeworm
d. caninum
thru fleas, "cucumber seeds" around anus
94
reactive arthritis
rare giardia SE
the large joints
95
antacid and drug interactions
DEC bioavailablity of most drugs
96
biliary diversion with duodenal switch
diarrhea and foul smelling gas, long recovery, lots of money
***largest BMI lost, but Greatest complication rate***
97
pANCA+/ASCA-
Ulcerative colitis
98
Cowden Syndrome
in children and adolescents associated with colonic hamartomas as well as *** extra gastrointestinal benign and malignant tumors.***
99
esophageal congential disorders
usually connected with a cardiac abnormality
100
roux en Y bypass
second best loss, but highest mortality
101
who is eligible for weight loss meds?
BMI over 30
BMI over 27 with other disease (i.e DM)
102
Orlistat
rx of Alli; malasorb fat (lipase inhibitor)
**severe liver impairment and death***
can use in patients with HTN/CVD
103
Cancer in barium swallow
apple core appearance
104
protein deprivation is greater than reduction in calories
kwashiokor
105
what causes food disorder amenorrhea
low levels of GnRH
106
colon neoplasm lessons learned
- malignant tumors may only appear late in course, especially those in the cecum
- do serial FOCT
- stage doesn't equal biologic potential
107
Juvenile polyp clinical
hereditary
**rectal bleeding, digital clubbing, anemia***
108
achalasia sx/tx
megaesophagus (dilation above LES); SCC
esophagomyotomy and dilation at LES
109
toxo encephalitis
***AIDS pts*** due to ***reactivation***
110
misoprostol use/ ADR
prevention of NSAID ulcers in high risk patients
***DO NOT USE IF PREGNANT, CAUSES UTERINE CONTRACTIONS***
111
liraglutide
decreases appetite thru GLP-1 agonist
* **black box warning: thyroid tumors****
* **colon CA***
112
bismuth subsalicylate diarrhea
tx mild-moderate traveler's diarrhea
113
E. histolytica tx
(Metronidazole OR Tinidazole) + (Iodoquinol or paromycin)
114
dientamoeba fragilis
flagellate, not amoeba
***no cyst, only troph***
transmitted in pinworm eggs and ascaris eggs
115
orbera
highest rate of premature removal
116
Bitot's Spots
keratin debris
bilat, triangular, raised white plaques
117
Cowden Syndrome clinical
only in intestines
if have more than one extra intestinal -oma, check for PTEN mutation
118
Zenker's diverticulum
above UES, at pharynx
common with aspiration pneumonia, neck mass
119
vit A deficiency urogen
***nephroliathiasis***
| hematuria, hydronephrosis
120
CMV esophagitis
punched out mucosal ulcers
* **endothelium w/stromal cells***
* **intranuclear with clear halo and cytoplasmic granulations**
121
retinol carrier
chylomicrons
122
severe GERD micro
****neutrophils****
123
loperamide
piperidine butryamide derivative with little CNS penetration (aka.. little abuse)
124
Lorcaserin
decreases appetite thru increasing serotonin (5HTC2 agonist)
125
Abscess eval
oral and IV contrast CT
126
hyperplastic
on left side of colon, no critical positives
short crypts, crowded tips
***stellate outline***
127
name a Vit A provitamin
B-carotene
128
Bulk-forming laxatives
| dietary fibers
methylcellulose, calcium polycarbophil
***absorb water to soften stool and increase bulk***
129
Gall stones
female, fat, forty w/ postrandial epigastric pain
on U/S: echogenic, acoustical shadowing, thick wall, pericholecystic fluid
130
secondary malnutrition
malabsorption, storage/use, or excess loss/need
131
polyp risk management
>1.0 cm, increasing size, time present, increasing villous component, high grade dysplasia
132
Primary Amebic meningoencephalitis (PAM)
Naegleria infection
stagnant, warm fresh water in the Southern US
***fatal***
133
Acanthamoeba keratitis
ocular pain, corneal lesions
134
crohn disease
skip lesions, transmural inflammation ulcerative fissures
**defects in epithelial tight junctions and transport**
****transmural****
135
Barrett's related dysplasia
***esophageal adenocarcinoma***
does NOT invade lamina
velvety mucosa
136
PEUTZ-JEGHERS SYNDROME
| clinical and tx
before 11yo
***small intestines, oral mucosa***
tx: survelliance
137
(late) Vit A deficiency
corneal xerosis, corneal ulcers (keratomalacia)
138
infectious agents esophagitis
IC patients or DM
***Candida***, HSV, CMV
139
z-line
junction btwn squamous and columnar mucosa at G-EJ
140
Giardia life cycle
ingestion of 10-25 cysts
trophocytes colonize duodenum and upper SI
141
esophageal SCC sx
extreme weight loss, dysphagia, anorexia
invasion into muscularis propia
142
amphetamine like weight loss drugs
all rls NE; decrease appetite
phentermine, diethylpropion, phendimetrazine
143
opioids
antidiarrheal
dec gi motility, dec secretion of fluids
144
Decubitus view
used in neonates to assess free air and perforated necrotizing enterocolitis
145
antacids
weak bases that neutralize acid
146
Giardia clinical
***yellow foul frothy floating diarrhea**** that is watery and can lead to malabsorption
incubation is 1-2 wks
147
Saline laxatives (osmotic)
Mg salts, PO4 salts
osmotic pressure causes retain water in colon, stimulates peristalsis
148
Blastocystis hominis
amoeba; MSM 50%
diarrhea, n/v, ab pain, decreased appetite
149
protein deprivation is less than reduction in calories
marasmus
150
anorexia nervosa
amenorrhea, constipation, dry skin, low albumin, hypokalemia, osteopenia, hypothyroid
151
E. histolytica
large intestine (enteric) amebiasis
MSM STD, fecal contaminated food
invades lg intestine, liver, and brain/lung with flask-shaped cyst by trophozoite invasion
152
what receptor on the liver uptakes retinol
ApoE receptor
153
chronic alcoholism problems
defective GI absorption, abnormal usage and storage
**thiamine, pyridoxine, folate, vitamin A**
154
IBD take home
don't ask about diarrhea, ask about characteristics
155
metoclopramide black box warning
tardive dyskinesia
156
Guinea Worm Infection
Dracunculiasis
***Sudan***, ingestion of Cyclops crustaceans found in **Step wells**
larvae in Cyclops, adults in humans
157
FAP
greater than 100
colonic carcinoma in teens-thirties
158
Esophageal SCC
upper/middle third of esophagus
due to deficiency of vitamins, Betel nuts
159
traction diverticula
mid-esophagus, TB or radiation
160
acute vit A toxicity
blurred VA, HA, N/V, stupor
161
villous adenoma
associated with fluid/electrolyte abnormality
***likely to malignant***
tx: segmental colectomy due to "carpet" forming
162
hiatal hernia
separation of diaphragmatic crura and widened foramen
163
Proton pump inhibitor MOA
***---prazole*** NEED ACTIVATED (prodrug)
***irreversibly*** inhibit H/K-ATPase pump in parietal cells at BOTH stimulated and basal
164
Misoprostol MOA
analog of PGE1
dec acid secretion, ***inc mucus and bicarb***
165
chemical esophagitis
basic worse>>>acid
transmural injury with heme, necrosis
166
Guinea Worm clinical
blister formation in skin with itching and redness
cellulitis and septicemia
167
esophageal varices death clues
blood stains, unusual body position
may protrude into lumen
168
microsporidia clinical
chronic diarrhea
keratoconjuctivitis
dx: TEM
169
bismuth ADR
black oral cavity and stool
170
epiphrenic diverticula
immediately above LES, due to achalasia
nocturnal regurgitation, markedly inflammed
171
amebic liver abcsess
fever and RUQ pain, abcess in RT lobe of liver
***do NOT complain of concurrent bowel sx****
172
sarcocysosis in human intestine
sexual/definitive stage
173
Lung fluke life cycle
penetrate intestines, enter lung and become adults
cough, swallow, feces water (Cerceriae)
174
SYSTEMIC Antaacid
NaHCO3
175
H. nana
autoinfection, arthropod-human in infected grain
176
PEM
inadequate dietary intake of protein and calories to meet body needs
177
PAM passage
invades nasal mucosa, passes thru cribriform plate/olfactory nerve into brain
178
***River blindness tx***
ivermectin (kills microfila)
179
kwashiorkor
loss of visceral compartment (organs)
***normal weight
180
PAM sx
severe frontal HA, change in smell, meningitis sx
***dead w/in 3 days***
181
What disease mimics TB?
Lung fluke
182
Barium swallow
assess for aspiration risk and sensation to aspiration
evaluate esophagus only
183
HSV esophagitis
ulcers
***multinucleated squamous cells***
***Cowdry A intranuclear inclusions**
184
esophageal diverticula
out pouching of alimentary tract that includes all layers
185
pseudoachalasia
due to a neoplasm at/near E-GJ
186
Loiasis clinical
***Calabar swelling*** pain, conj-itis, edema of eyelids
187
megaloblastic anemia
Vitamin B12 deficieny due to fish worm!
| boards love this
188
LS versus SS Barrett's
LS: extends 3+ cm from G-EJ
SS: less than 3 cm from G-EJ
189
Wolbachia
primary cause of inflammation in river blindness
**doxy** tx
190
micro GERD
eosinophils, basal cell hyperplasia, ballooned squamous cells, vasc. dilatation,
elongation of lamina propria papillae into upper 1/3 of epithelium
191
exercise amount needed
225 min/week
192
Chinese river fluke sx
epigastric pain, tenderness over liver, jaundice, hepatomegaly, cirrhosis
***cholangiocarcinoma***
193
esophageal cancer spread
through lymphatics in submucosa
194
effective weight loss %
5% of body weight over 3 months
195
achalasia
"failure to relax"
lack of progressive peristalsis w/ lack of relaxation at LES with swallowing and increased LES tone
196
Barrett's micro
intestinal type (***goblet cells***)
fibrotic lamina, thickened mucosa, erosion
197
castor oil
converted to ricinoleic acid (***anionic***), dec absorption and inc peristalsis
fast, and lasts for days
198
Histamine H2 receptor antagonist MDR
***--tidine***
competitive
dec vol of gastric juice and H+
dec pepsin secretion
199
vit C deficiency
fragile vessels, impaired wound healing, bone disease, pseudo-paralysis, frog-legging
200
PAM/GAE tx
miltefosine (rarely works)
201
Chinese fluke eggs
ovoid with ***operculum*** and ***knob*** at opposite ends
202
Mallory-Weiss tear
longitidunal tear at G-EJ due to severe retching (alcoholics!)
tx with support, balloon tamponade (Severe)
203
endobarrier
too unsafe, illegal in us
204
River blindness life cycle
nematodes become adult worms in skin nodules, microfilariae rlsd into body in skin and eye
205
giardia transmission
resistant to chlorine, need to filtrate too; city water can still be infected
***board exam question***
206
Tapeworm
Taeniasis, T. solium/saginata
Human-Undercooked meat- Human
huge worms pass in stool (like 15 ft long...)
207
triple therapy
PPI + cmycin + (metrodinazole OR amox)
208
laxatives uses and abuses
helps with constipation, used before bowel surgery
weight loss
209
bismuth subsalicylate
coats craters, increases mucus and bicarb, inhibits pepsin
210
HAMARTOMATOUS POLYPS
often associated with hereditary disorders that may have ***serious extra-intestinal manifestations***
211
Filariaris dx
test blood ***AT NIGHT*** for microfila
| filarial dance sign on U/S
212
achalasia cause
T-cell mediated destruction of myenteric ganglion cells
213
illness malnutrition
illnesses cause **inc BMR***
214
hiatal paraesophageal hernia
("rolling")
separated portion of greater curvature of stomach enters thorax through widened foramen
215
Snail Fever
AKA Schistosomiasis AKA bilharziasis
216
achalasia micro
absence of ganglion cells in Auerbach/myenteric plexus
collagen replaces nerves
inc in CD3 T cells
hyperplasia (resembles GERD)
217
areas of high pressure
upper esophageal sphincter (cricopharyngeus)
***lower esophageal sphincter*** @ esophagogastric junction
218
Fish worm
Diphyllobothiasis
***fresh water, raw fish***
219
E. histolytica differentiating features
***ingested RBCS***
perph chromatin: fine and dispersed
Karyosome: sharp and central
Cyst nuclei: 4 or less
Cyst chromatoidal bars: rounded ends
220
mineral oil
dec absorption of fat soluble vitamins
221
hematemesis ddx
esophageal varices, gastritis, esophageal laceration, peptic ulcer
222
Filariaris clinical
***repeat, prolonged exposure necessary***
| elephantitis (obstructive stage)
223
Giardia lamblia
AKA Giardia duodenalis; flagellate protozoa
temperate climates
waterbourne; daycare kids and MSM
***beavers can transmit***
224
tarry stools
suggest upper GI bleed/stomach
225
sarcocystosis
***2 sep. hosts necessary: carnivorous host (sexual) and herbivorous (intermediate)
226
phentermine/topiramate
decreases appetite thru NE, GABA
227
antacid and renal function
can have systemic toxicity if renal function decreased
228
primary malnutrition
one or more of essential components is missing
229
Calabar swelling
transient, painful swelling on any part of body with intense itching
230
esophageal varices
***alcoholics***, hepatic schistosomiasis
dilated tortuous submucosal vessels develop due to severe portal htn --> portal shunting to azygous veins
231
cyclospora
contaminated fresh produce (raspberries! mesclun lettuce!)
oocyst ingestinon
watery diarrhea, UV microscope (green)
232
octreatide MOA and use
synthetic analog of somatostatin
***pancreas and GI hormone secreting tumors, AIDS diarrhea***
233
Lung fluke
paragonimiasis, "man-snail-crab-man"
raw fresh water crabs, Asia
rust colored sputum, cough, SOB, chest pain
234
best weight loss drug for pt with htn/dm
orlistat
235
E. histolytica dysentery and colitis
recurrent ab cramping and diarrhea, bloody stool
necrotizing colitis is fatal
236
trachea-esophageal fistula (TEF)
canalicular cnxn btwn esophagus and trachea
237
sarcocysosis in human muscle
intermediate stage
238
Chinese liver fluke life style
"man-snail-freshwater fish-man"
encysted larvae found in fish, mature in bile ducts, miracidia in feces
snails eat, mature to cercariae
fish eat
239
metoclopramide
cholinergic agonist and D2antagonist
dec reflux by increasing LES pressure
240
S. haematobium
***Africa, ME; urinary bladder, bladder CA risk***
****eggs have terminal spine (urine)*****
241
microsporidia
***obligate intracellular***
infectious spores: coiled polar filament (extrusion into host)
242
fetal malnutrition
iron deficiency if fed artificial milk
243
ocular toxo
retinochoroiditis
244
Mansonella
symptomless form of filariasis
245
serrated adenoma
assoc. with FAP
sigmoid colon and rectum
***adenocarcinoma greatly inc***
246
(early) Vit A deficiency
night blindness (no rods), conjunctival xerosis, Bitot's spots, xerophthalmia
247
toxoplasmosis
***Cats***
undercooked meat, litter box, transplacentally, **blood transfusions***
248
Chronkhite-Canada sx clinical
splitting of nails, vitiligo (skin pigment changes) later in disease
***poor quality of life***
249
Non-systemic
CaCO3, Al or Mg OH, Al/Mg combo
250
cimetidine ADR
inhibits cyp450, alters rate
**increases toxicity of second drug***
251
Al(OH2) ADR
constipation
252
sessile tubular adenoma
low flat/dome shaped, broad base no stalk
253
Lactulose and Mannitol (osmotic)
hydrolyzed to short chain FAs
osmotic pressure causes retain water in colon, stimulates colonic propulsive motility
254
which diseases require a snail?
liver flukes, intestinal flukes, lung flukes, and schisto
255
Loiasis ("eyeworm disease")
**Congo River Basin***, ***DAY biting Chrysops flies***
