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GIT steep 2 > GIT 2 > Flashcards

GIT 2 Flashcards

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1
Q

Chronic mesenteric ischemia CM?

A

Creamy postprandial abdominal pain

Food aversion and weight loss

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2
Q

Diagnosis?

A 
Malnutrition and abdominal bruit
CT angiography(preferred),doppler U/S
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3
Q

Management?

A

Risk reduction and nutrition support

Endovascular and open surgical procedure

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4
Q

chronic hepatitis C patient treatment?

A

antiviral(sopospuvir,valperavir)

reduce alcohol damaging behavior(alcohol)

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5
Q

stress ulcer CM?

A

painles GI bleeding( occult bleeding or obivious like melena and hematocasia)

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6
Q

Risk factors?

A 
Shock
sepsis
DIC
mechanical ventlation
traumatic spinal/brain injury
high corticosteroids
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7
Q

Pathogenesis?

A

GI hypoperfusion
Acumulation of uremic toxins
Reflux bile salt

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8
Q

managment?

A

PPI proflaxis for high risk

PPI and endoscopy(for sever bleeding)

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9
Q

acute colonic ischemia?

A

Occur < 24 hour from Hypotension
Crampy leaft side abdominal pain
Overt Hematocasia

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10
Q

common area?

A

leaft spleenic flexure and sigmoid

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11
Q

first test to do after we found cholistatic pattern hyperbilirubinimia?

A

Abdominal U/S

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12
Q

what it Identify?

A

Intrahepatic(narow bile duct)/extahepatic obstraction(wide bile duct)

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13
Q

Room diagnostic criteria for irritable bowel disease?

A

Recurent abdominal pain >=3 day/month in the last three month.plus 2 of the following

  • symptom inprovment after bowel movt
  • change in frequency of bowel movement
  • Change in consistency of bowel movt
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14
Q

warning sign or sign indicate other etiology?

A

Nocturnal/worsening abdominal pain
Rectal bleeding
Heamatologic/electrolyte abnormality
Wight loss

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15
Q

clinical presentation of achalasig?

A

chronic difficulty in swalowing of solid and liquid food
heart burn
wight loss
regurgitate solid and liquide food

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16
Q

diagnosis?

A

Manometrey?Increase LES resting tone/decrease lE perstalisis and incomplete LES relaxation
Barium esophagogram:small bird break narowing at GE junction

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17
Q

Managment?

A

UE endoscopy
Laparascopic myotomy or ballon diltion
Butolinium toxin,nitrate and CCB

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18
Q

Globus sensation?

A

feeling of food stuck in back of throght
It is functional disorder
diagnosis of exclusion
nothing can foun in barium swallow

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19
Q

patient with unilateral burning,constant pain ,with parastesia w/o rash and ovios diagnosis?

A

Herpes zoster(the pain preceeds the rash-as a result ptient may have onley pain symptom)

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20
Q

laxative abuse future?

A

common in female young health care workers
frequent(10-12) and nocturnal; diarrhea
metabolic alkalosis(unlike another case of diarrhea)-
melanosis coli (if abuse bisacodyl)
diagnosis with stool laxative screening

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21
Q

whay metabolic alkalosis?

A

Laxative diarhoa-K loss–impaired CL/Bicarb transport–increase serum bicarb

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22
Q

melanosis coli?

A

dark broun discoloration of bowl and nearby LN

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23
Q

folate deficiency and alcohol?

A 
can develop whithin 5-6 week
megaloblastic anemia
pancytompnia
heamocystenimia
Low reticulocyte count
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24
Q

chrons disease CM?

A

GI

Extra GI

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25
Q

GI?

A 
Malabsorbition
Abdominal pain 
Non bloody diharoa
Oral ulcer 
Wight loss
Fistula and abscess formation
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26
Q

Extra Gi?

A

skin:erythema nodusum,pyoderma gangrulosum
MSK:artheritis
Eye:uvietes/sceleritis/episcleritis

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27
Q

Diagnosis future?

A

LAB
Endoscopy
Radiography

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28
Q

LAB?

A

IDA
Lukocytosis
Inflamatory markers

29
Q

Endoscopy?

A

coblestoning(normal and ulcerative lesion intermitentely)

Skip lesion

30
Q

Radiography?

A

Stricture

Bowel wall thickning

31
Q

Managment?

A

5-ASA -drug,corticosteroid,antibiotic
Azathioprine
anti TNF therapy

32
Q

Primary billiary cholangitis CM?

A

afect middele age women
progresive fatigu and pruritis
hepatomegaly,jaundice and cirhosis
cutanous xantelasma and xantoma

33
Q

pathogenesis?

A

autoimune intrahepatic bile duct distruction–bile stasis –

34
Q

lab?

A

increase ALP and TA
antimitocondrial Ab
sever hypercholestronimia(HDL>LDL)–Not risk for atherosclerosis

35
Q

treatment?

A 
ursodeoxycholic acid(delay progress)
liver transplant in advanced case
36
Q

complication?

A

malabsorbtion
metabolic bone disease(osteoporesis & osteomalasia)
hepatocellular carcinoma

37
Q

chronic pancreatitis CM?

A

intermittent abdominal pain that radiates to back and relieved by leaning forward and sitting and exacerbated by some minute after a meal
malabsorbtion diharoa
weight loss
Diabetes

38
Q

Risk factor?

A

chronic alcohol usage
recurent gall stone/tumour obstraction
cystic fibrosis
autoimmune

39
Q

diagnosis?

A

CT/MRCP(calcification/dilation of duct and pancreatic enlargment)
amylase–can be normal/nonspecific–not used for diagnosis

40
Q

managmennt?

A

pain managment
alcohol and smoking seccasion
small/frequant meal
pancreatic enzyme suplementation

41
Q

how to d/t chrons from UC?

A 
GI Involvement
microscopy
gross finding
clinical manifestation 
intestinal complicatiion
42
Q

GI Involvement?

A

CD-anywhere mouth to anus(mainly ileum and colon), skip lesion, perianal involvement with rectal sparing)
UC-rectum(always) and colon,continous lesion

43
Q

microscopy(more diferentiating)?

A

CD-non-casating granuloma

UC-no granuloma

44
Q

gross feature?

A

CD-Coblestoning, linear ulcer, creping fat, and TM Infn

UC-Mucosa and SM infn and pseudopolyp

45
Q

CM?

A

CD-RLQ pain with watery diarrhea (bloody if colon involved).

UC-bloody diarrhea and varying location AP

46
Q

Intestinal complication?

A

CD-stricture/fistula and abscess

UC-Toxic megacolon

47
Q

treatment?

A

similar
initial 5-ASA with corticosteroid
maintenance–Ani TNF alpha and azattropin

48
Q

lactose intolerance?

A

mainly adult watery diarrhea that associated with food,
Bloating(due to bacteria metabolize lactase to SCFA and H)
chronic cramping abdominal pain

49
Q

pathophysiology?

A

deficiency of brush border L enzyme deficiency can be congenital acquired, or progressive deficient.

50
Q

diagnosis?

A

negative guiac test

hydrogen breath test

51
Q

Treatment?

A

Diet adjustment and enzyme supplementation

52
Q

How to d/t from another malabsorptive disease?

A

MAD–grassy diarrhea and wt loss

53
Q

From IBD?

A

IBD-posetive guiac test

54
Q

from clostridium difficile?

A

CD-acute, mild fever, and bloody

55
Q

from small bowel bacterial overgrowth?

A

SBBO–grassy diarrhea and will have associated motility disorder like DM and spontaneous and jujunocolic fistula

56
Q

Acute liver failure triads?

A

Elevated transaminase(often elevate>1000)
Sign of hepatic encephalopathy
SIgn of decrease liver synthetic ability(PT increment)

57
Q

etiology?

A 
Viral hepatitis(except C)
drug toxicity
autoimmune hepatitis
ischemia
Wilson disease
malignant infilitration
58
Q

other sign of ALF?

A 
Thrombocytopenia
RF(especially in acetaminophen toxicity)
Pruritis
Jaundice(mild)
RUQ pain 
Hypoglycemia
59
Q

acetaminophen-induced ALF mechanism?

A

Acetaminophen metabolizes into NAPQI, which is hepatotoxic.
NAPQ normally detoxified by NADPH
Factor like chronic alcoholism deplete NADPH and predispose to AC toxicity.

60
Q

diffuse esophageal spasm pathophysiology?

A

Uncoordinated simultaneous contraction of the esophageal body.
Normal esophageal relaxation

61
Q

Symptoms?

A

Intermittent chest pain

Dysphagia both solid and liquid

62
Q

Diagnosis?

A

Manometry: Interment peristalsis, multiple simultaneous contractions.
Esophagogram:corkscrew pattern

63
Q

Treatment?

A

Calcium channel blocker

Alternative: Nitrates and tricycle

64
Q

eosinophilic esophagitis?

A

Food impaction
Dysphagia
Heart burn

65
Q

alcoholic hepatitis CM?

A 
jaundice, anorexia, and fever
RUQ pain and epigastric pain
Abdominal distension nnd ascitis
Proximal muscle weakness
Hepatic encephalopathy
66
Q

Lab?

A 
Elevated AST/ALT..<300
AST:ALT ratio >2
Elevated Gama glutamyl transferase, INR, and bilirubin
Leukocytosis with neutrophil predominate
Decrease albumin if malnutrition
Abdominal imaging show fatty liver
Macrocytic anemia
Thrombocytopenia
67
Q

Indication for transplant in ALF?

A

Grade 3/4 HE
PT>100 second
Creatnin>3.4

68
Q

fAB follow-up and management?

A

no dysplasia 12-month interval screening for colonoscopy

start at age 10-12

GIT steep 2 (4 decks)

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