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GK F3 E3 > GI misc COPY > Flashcards

GI misc COPY Flashcards

1
Q

What is the main difference between a food allergy and a food intolerance?

A

Food allergy is IgE mediated

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2
Q

Food allergies are the main reason for _____ presenting in the ED

A

anaphylaxis

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3
Q

What are the MCC of food allergies in adults?

A

fish/seafood

peanuts/tree nuts

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4
Q

Food allergy or intolerance?

  • Hives
  • angioedema
  • N/V/D, cramping
A

Allergy

(intolerance you would just have sxs like D, bloating, abd cramping,etc)

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5
Q

How do you tx food allergies (3)?

A
  1. Epinephrine autoinjector
  2. Food avoidance
  3. Allergist referral
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6
Q

Lowest rate of lactose intolerance in what 2 racial/ethnic groups?

A

European and European American

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7
Q

Highest rate of lactose intolerance in what 5 racial/ethnic groups?

A
  1. African American
  2. Hispanic
  3. Asian
  4. Asian American
  5. Native American
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8
Q

Lactose intolerance is uncommon under what age?

A

6

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9
Q

T/F: prevalence of lactose intolerance decreases with age

A

FALSE
prevalence increases with age

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10
Q

What causes lactose intolerance

A

Deficiency of lactase enzyme or less efficient lactase enzyme

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11
Q

What are the main causes of lactose malabsorption?

A

Primary (developmental, congenital)

Secondary (Celiacs, IBD, etc)

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12
Q

Clinical presentation of what?

  • Abd pain
  • bloating
  • flatulence
  • Diarrhea
  • Borborygmi

*symptoms affected by diet*

A

Lactose intolerance

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13
Q

What are the 3 components of diagnosing lactose intolerance

A
  1. Sxs after lactose ingestion
  2. Sxs resolve w/ avoidance of lactose
  3. Lactose hydrogen breath test

(only need 1 and 2 to diagnose)

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14
Q

How do you treat lactose intolerance? (3)

A
  1. Lactose-free diet or lactose restrictions
  2. Enzyme replacement- lactase
  3. Monitor calcium, vit D
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15
Q

Definition of Glucose-6-phosphate dehydrogenase (G6PD) deficiency:

Genetic defect in G6PD, a RBC enzyme that generates ______ and protects RBCs from _____ injury

A

Genetic defect in G6PD, a RBC enzyme that generates NADPH and protects RBCs from oxidative injury

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16
Q

Is G6PD deficiency genetic?

A

yes.

X-linked

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17
Q

G6PD deficiency is associated with what?

A

hemolytic anemia

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18
Q

Clinical presentation of which condition?

  • Jaundice
  • pallor
  • dark urine
  • abdominal/back pain
  • normochromic, normocytic anemia
A

G6PD deficiency

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19
Q

Which condition is usually asymptomatic until a trigger (meds, food, acute illness) causes acute hemolysis

A

G6PD deficiency

20
Q

What type of anemia is seen in G6PD deficiency?

A

normochromic, normocytic

21
Q

What 2 things are seen on peripheral smear in G6PD deficiency?

A

“bite cells”

Heniz bodies

22
Q

Will the anemia seen in G6PD deficiency resolve?

A

Yes. Spontaneous resolution and reversal of anemia

(anemia stimulates erythropoiesis, younger RBCs can withstand the oxidative stress so get resolution)

23
Q

The following meds carry the risk of causing clinical hemolysis in persons with which condition?

  • Sulfamethoxazol (TMP-SMX)
  • Nitrofurantoin
A

G6PD deficiency

24
Q

How do you treat G6PD deficiency? (4)

A
  1. Avoidance of oxidative stress to RBCs

_2. Removal of offending agent*_

_3. Hydration*_

  1. Transfusion for severe anemia
25
Q

The following describes which disease?

  • Localized area of increased bone turnover causing overgrowth of bone
  • Unknown etiology, possibly genetic
A

Paget disease of bone

26
Q

Pathophys of paget disease of bone:

  1. Increased ______ activity–>
  2. ______ in bone–>
  3. Incr. _____ activity–>
  4. Disorganized bone formation
  5. Abnl bones w/ enlarged skeletal deformity
A
  1. Increased osteoclast activity–>
  2. Lytic lesions in bone–>
  3. Incr. osteoblast activity–>
  4. Disorganized bone formation
  5. Abnl bones w/ enlarged skeletal deformity
27
Q

What are the 5 MC locations of Paget Disease of bone?

A

“Some Have Fun Visiting Paris”

1. Pelvis

2. Vertebrae

3. Femur

4. Humerus

5. Skull

(MC polyostotic but can be monostotic)

28
Q

Paget Disease of bone affects 2-3% of people > what age?

A

55

29
Q

What is characteristically seen on labs in Paget Disease of bone?

A

_Elevated alk phos**_

30
Q

What 5 bone changes are seen in Paget disease of bone?

A

1. Bowed tibias

  1. Kyphosis

3. “chalkstick” fractures w/ minimal trauma

  1. Increased hat size
31
Q

Clinical presentation of what disease?

  • Usu. asymptomatic, discovered incidentally
  • aching, deep pain that is worse at night and with weight bearing
A

Paget disease of bone

32
Q

What is seen on a radiographs in a patient with Paget disease?

A

osteolytic lesions

33
Q

What 4 diagnostic tests are used in Paget Disease of bone?

A
  1. bone turnover markers

2. serum calcium

  1. Serum 25-OH vitamin D
  2. Bone scintigraphy
34
Q

Will serum calcium be high or low in Paget Disease of bone?

A

High b/c of bone resorption

35
Q

How do you treat someone with Paget disease that is asymptomatic?

A

monitor

36
Q

What is pharmacologic tx for Paget disease of bone?

A

IV Zoledronate (bisphosphonate)

37
Q

The following are complications of what condition?

  • Hypercalcemia
  • Renal calculi
  • Bone tumors (sarcoma, giant cell tumors)-rare
  • high output heart failure
  • cranial nerve palsies
  • arthritis
  • vascular steal syndrome
  • Radiculopathy or paralysis
A

Paget disease of bone

38
Q

Definition of Rickets:

Deficiency in _____ or _____ leading to altered bone growth and mineralization

A

Deficiency in calcium or phosphate leading to altered bone growth and mineralization

39
Q

What are the 4 typical locations of Rickets?

A
  1. Distal forearm
  2. Knee
  3. Costochondral junctions
40
Q

Clinical presentation of what?

  • _Bowing of weight bearing extremities**_
  • Skeletal fractures
  • Proximal myopathy
A

Rickets

41
Q

Etiology of what?

Decreased intake, malabsorption, or increased excretion of calcium, phosphate or vitamin D

A

Rickets

42
Q

What are the 3 main things seen on labs in Rickets?

A

1. Elevated Alk phos

2. Low phosphorus

  1. low or normal calcium
43
Q

What is seen on radiology in Rickets? (2)

A
  1. widened growth plate at long bones and costochondral junction
  2. Decreased radiopacity of long bones
44
Q

What is seen on radiology in Rickets if disease occurs after growth plate closure? (2)

A
  1. Decreased cortical thickness
  2. Relative radiolucency of skeleton
45
Q

What are the 3 treatments for Rickets?

A
  1. Treat underlying disorder

_2. Vit D replacement*_

  1. Calcium supplementation

GK F3 E3 (24 decks)

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