GI Review Flashcards
Drugs that can cause leg swelling
Ca Channel blockers
Also: NSAIDS and steroids
Two main causes of acute pancreatitis
alcohol or gallstones
pancreatic calcifications on abdominal imaging
chronic pancreatitis
Less common causes of acute pancreatitis
idiopathic
Metabolic (hypertriglyceridemia, hypercalcemia)
Meds: (GLP-analogues, valproic acid, HCTZ)
fever
RUQ pain
Palpable gallbladder
cholangitis- stone in common bile duct
What hormone causes gallbladder contraction?
CCK
Tumor marker for pancreatic cancer
CA 19-9
Tumor maker in carcinoid tumor
5-HIAA (in urine)
Boerhaave syndrome
esophageal rupture from vomiting.
Leads to mediastinitis and respiratory failrue
Palmar erythema is a sign of
high estrogen levels-> cirrhosis and pregnancy
Zollinger Ellison Syndrome
gastrinoma
Causes jejunal ulcers and chronic diarrhea
severe pain out of proportion to exam
in older person with CAD
Mesenteric ischemia
Older person, debilitated
abdominal distension
massive colon on x-ray
volvulus
Older person
left lower quadrant pain
fever
diverticulitis
1-2 year old
intermittent jelly like stools
Intussusception
Most common cause of Traveller’s diarrhea
E. coli
Diarrhea
no fever
5 hours after exposure
S. aureus
shellfish
water still
after travel
low K
vibrio cholera
HIV chronic diarrhea
cryptosporidium
Also: giardia, Isospora, Cyclospora, CMV
Chronic steatorreha
duodenal biopsy with villous atrophy
Celiac’s
Outdoor exposure
diarrhea
high eosinophils
Strongdyloides
Diarrhea after antiboitic exposure
Colstridium difficule
High indirect bilirubin after stress
No other symptoms
Gilbert’s
5 week old clay stools jaundice HSM increase in direct bilirubin
obstruction of the biliary system
Mild jaundice
elevated LDH
high reticulocyte count
peripheral smear findings
hemolytic anemia
40ish woman
itching
liver disease
high alk phos
primary biliary cirrhosis (Anti-mitochondrial)
Liver disease
Altered mental status
young person
Wilson’s disease
Lab finding in Wilson’s disease
Low ceruloplasm
Diabetes
CHF
liver disease
skin or testicular findings
Hemochromatosis
Test for hemochromatosis
HFE genotype
40ish woman
jaundice
very high transaminases
Autoimmune hepatitis
Anti-smooth muscle antibodies
HBsAg negative
anti-HBc negative
anti-HBs positive
Immune due to hepatitis B vaccination
HBsAg positive
anti-HBc positive
IgM anti-HBc positive
anti-HBs negative
Acutely infected
HBsAg positive
anti-HBc positive
IgM anti-HBc negative
anti-HBs negative
Chronically infected
HBsAg negative
anti-HBc positive
anti-HBs negative
IgG positive
Resolved infection (most common)
AST/ALT ratio >2
alcoholic hepatitis
mechanism of Gilbert’s
deficiency of glucuronyl transferase
Treatment of biliary atresia
liver transplant
Vitamin deficiency in breast milk fed baby
Vitamin D
Transmural inflammation
skip lesions
fitulas
noncaseating granulomas
Crohn’s
Bloody diarrhea
toxic megacolon
continuous lesion
surface inflammation
Ulcerative colitis
Crohn’s
macrocytic anemia
neuro sx
B12 deficiency
Extraintestinal manifestations of IBD
sclerosing cholangitis uveitis arthritis colon cancer risk erythema nodosum pyoderma gangrenosum
dysphagia to both liquids and solids
achalasia
mechanism of achalasia
decreased ability of the lower esophageal sphincter to relax
Vessels that are abnormally connected in esophageal varices
left gastric vein and azygos vein
vessel that bleeds into the duodenum
gastroduodenal artery
100s of polyps at a young age
high malignant potential
Familial adenomatous polyposis
Associated with osteomas, dental, lipomas/skin, ampullary cancers, retinal pigment hypertrophy
in small intestine
Gardner’s syndrome
Proximal LI
associated with endometral/ovarian tumors
Nonpolyposis syndrome (Lynch)
SI LI stomach polyps mucocutaneous pigmentation ovary/breast/uterus/pancreas cancers
Peutz-Jeghers syndrome
LI, SI, stomach
rare malignant potential
hamartomas
congenital abnormalaties
juvenile polyposis
Use and mechanism of N-acetylcysteine
for acetaminophen OD
restores glutathioine availability by binding to NAPQI metbaolite
Onset of ascites while on OCP
Budd-chiari- hepatic vein obstruction
GI AE of methotrexate
hepatic fibrosis
AE of metaclopramide (used for nausea or gastroparesis)
tardive dyskinesia
Drugs that can induce autoimmune hepatitis
Nitrofurantoin
minocycline
neonate
abdominal distention
narrow rectosigmoid with dilitation above
Hirshprung’s
Mechanism of Hirshprungs
failure of migration of neural crest cells
Down syndrome
abdominal distention/vomiting on day 1
double bubble on x-ray
Duodenal atresia
<10 y/o
painless lower GI bleeding
no diarhea
Meckel’s diverticulum
Neonate jaundice hepatomegaly E coli sepsis low glucose urine has reducing substances
galactosemia- from deficiency of galactose-1-phosphate uridyl transferase
Newborn
coughing/chocking in feeds
aspiration pneumonia
tracheo-esophageal fistula
5-6 week old infant
forceful postprandial vomiting
alkalosis
low CL
pyloric stenosis
Diarrhea
mental status change
rash
Vitamin B3 (niacin)
“pellagra”
(3Ds- diarrhea, dementia, dermatitis)
Night blindness
Vitamin A deficiency
Peripheral neuropathy
deficiency of
Vit B1, B6, B12
Macrocytic anemia
Folate or B12 deficiency
Swollen gums
poor wound healing
brusing
Vitamin C deficiency
Neonatal hemorrhage
home birth
Vitamin K deficiency
Rickets
breast fed baby
Vitamin D deficiency
