High Yield Flashcards
Describe Zenker’s diverticulum
– Disorder of the proximal esophagus
– Food stuck in the throat, halitosis, and regurgitation
– No pain
– Treatment: surgery
What is the management for patients with severe necrotizing pancreatitis or suspected pancreatic infection?
Obtain blood cultures and start on broad-spectrum antibiotic treatment (imipenem), to decrease the morbidity and mortality associated with the disease
– Can also use: third-generation cephalosporin, pipperacillin, fluoroquinolone, or metronidazole
Describe achalasia
– Lower esophageal sphincter does not relax (high tone)
– Absence or degeneration of ganglia in Auerbach’s plexus
– Manometry: absence of peristalsis
– Esophagram: dilated esophagus with bird’s beak narrowing of the distal esophagus
– Treatment: balloon dilation of the narrowed esophagus or surgery
Describe diffuse esophageal spasm
– Chest pain and dysphasia
– Manometry: high-altitude peristaltic contractions with normal relaxation response
– Esophagogram: classic corkscrew esophagus
– Treatment: anti-spasmodics
Describe scleroderma’s effect on the esophagus
– Loss of distal peristalsis
– Complete atrophy of the esophageal smooth muscle and fibrosis
– Lower esophageal sphincter becomes incompetent (low tone)
– Leads to reflux esophagitis and stricture
What is the most common cause of esophagitis?
– Herpes
– Candida
– Cytomegalovirus
Describe the presentation of prostatitis
– Tender and edematous prostate
– Pyuria and positive urine culture
What is the treatment of nonbacterial prostatitis?
Sitz bath and anti-inflammatory medications
What states do NPH and glargine insulin cover?
The period between meals, as they are basal insulin
What is the pathophysiology of pioglitazone?
– Increases insulin sensitivity
– And oral hypoglycemic agent from the thiazolidinedione (or glitazone) group
What is the pathophysiology of glyburide?
– Increases the production of insulin from beta cells
– And oral hypoglycemic agent from the sulfonylurea group
What is the pathophysiology of acarbose?
– Inhibits the metabolism of disaccharides to glucose in the small intestine
– An oral hypoglycemic agents that is an alpha-glucosidase inhibitor
– Associated with gastrointestinal bloating and flatulence
What is the correlation with potassium and patients in hyperglycemic crisis?
– Patients in crisis have potassium deficit
– K should be added to IV fluids in patients whose K level is norm or low
– If patients are hyperkalemic to begin with, K should be given when potassium levels reach normal limits
When would you start subcutaneous insulin in a patient who had hyperglycemic crisis?
When they start to eat consistently
