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F3 E3 Shea > 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
The following describes which disease? * Localized area of increased bone turnover causing overgrowth of bone * Unknown etiology, possibly genetic
Paget disease of bone
26
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
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
What are the 5 MC locations of Paget Disease of bone?
"Some Have Fun Visiting Paris" **1. Pelvis** **2. Vertebrae** **3. Femur** **4. Humerus** **5. Skul**l (MC polyostotic but can be monostotic)
28
Paget Disease of bone affects 2-3% of people \> what age?
55
29
What is characteristically seen on labs in Paget Disease of bone?
_**Elevated alk phos\*\***_
30
What 5 bone changes are seen in Paget disease of bone?
**1. Bowed tibias** 2. Kyphosis **3. "chalkstick" fractures** w/ minimal trauma 4. Increased hat size
31
Clinical presentation of what disease? * Usu. asymptomatic, discovered incidentally * aching, **deep pai**n that is **worse at nigh**t and with weight bearing
Paget disease of bone
32
What is seen on a radiographs in a patient with Paget disease?
osteolytic lesions
33
What 4 diagnostic tests are used in Paget Disease of bone?
1. bone turnover markers **_2. serum calcium_** 3. Serum 25-OH vitamin D 4. Bone scintigraphy
34
Will serum calcium be high or low in Paget Disease of bone?
High b/c of bone resorption
35
How do you treat someone with Paget disease that is asymptomatic?
monitor
36
What is pharmacologic tx for Paget disease of bone?
IV **_Zoledronate_** (bisphosphonate)
37
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**
Paget disease of bone
38
Definition of Rickets: Deficiency in _____ or _____ leading to altered bone growth and mineralization
Deficiency in **_calcium_** or **_phosphate_** leading to altered bone growth and mineralization
39
What are the 4 typical locations of Rickets?
1. Distal forearm 2. Knee 3. Costochondral junctions
40
Clinical presentation of what? * _**Bowing of weight bearing extremities\*\***_ * Skeletal fractures * Proximal myopathy
Rickets
41
Etiology of what? Decreased intake, malabsorption, or increased excretion of calcium, phosphate or vitamin D
Rickets
42
What are the 3 main things seen on labs in Rickets?
**1. Elevated Alk phos** **2. Low phosphorus** 3. low or normal calcium
43
What is seen on radiology in Rickets? (2)
1. **widened growth plate** at long bones and costochondral junction 2. **Decreased radiopacity** of long bones
44
What is seen on radiology in Rickets if disease occurs **after growth plate closure**? (2)
1. Decreased cortical thickness 2. Relative radiolucency of skeleton
45
What are the 3 treatments for Rickets?
1. Treat underlying disorder _**2. Vit D replacement\***_ 3. Calcium supplementation

F3 E3 Shea (24 decks)

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