KEY TERMS Flashcards
Stillborn fetus Symptoms Include: Flattened Face Large, Low Set Ears Limb Deformities
Hallmark of this syndrome?
Potter’s Syndrome
Hallmark: Renal Agenesis –> Incompatible with life
This results in Oligohydrominos due to the decreased ability to urinate in-utero.
Causes of Oligohydrominos
ACE-I: Benzapril, contraindicated in pregnancy
99mmTc-Pertechnetate Scan
Detects presence of gastric mucosa
Accumulation of 99mmTc-Pertechnetate in Right lower quadrant
DDx for Meckel’s Diverticulum that contains ectopic gastric mucosa
“Red Current Jelly Stools”
Intussusception
Rapid Onset ED with (+) nighttime erections
MCC: Psychogenic impotence
Virchow’s node
Supraclavicular node that is hard and enlarged: 1st clinical sign of occult gastric cancer
Sister Mary Joseph nodule
Periumbilical mass that will show Gastic CA mets
Bilateral ovarian mass
Think mets from: stomach: Krukenburg tumor breast pancreas gallbladder
Mucin producing ovarian tumor
Krukenburg tumor
Signet Ring Cells
Krukenburg tumor
Manometry: Disorganized non-peristaltic contractions of the body of the esophagus
aka: “cork-screw” esophagus”
DES
progressive dysphagia to solids –> solids + liquids
Esophageal cancer
epigastric pain 1-3 hours after a meal or at night?
Duodenal ulcer
pain with deep breathing
Pleuritic chest pain
- PE
(-) Couvasier’s sign with systemic signs of cholecystitis
Pancreatic CA at the head of the pancreas - will back up the bile duct, thus enlarging the gallbladder. But the problem isn’t in the gallbladder itself - so no pain on palpation
(+) couvasier’s sign
Cholecystitis
pruritis, dark urine, pale stools
obstructive jaundice
Sudan III stain
Stool stain
identifies fat in stool
DDx of malabsorption: > 7 g/day of excreted fat
large fundic folds in a patient with epigastric pain
Think Zollinger-Ellison Disease
Gastrin has a trophic effect
- Decreased Ceruloplasmin
- increased hepatic Copper
DDx: Wilson’s disease
high serum ferritin
hemochromatosis
increased UA oxalate
associated with intestinal malabsorption
Calcium oxalate renal stones may form
Sucralfate
drug that will line the ulcerated gastric/duodenal mucosa
Helps duodenal ulcers to heal, but less effective at preventing ulcer recurrence if H. pylori (+)
Metclopromide
DA agonist
Pro-kinetic, anti-emetic
Used in: Gastroparesis, vomiting, and nausea prevention
Misoprostol
PGE1/2 analog
- prevent NSAID-related ulcers
- used with Mifepristone as an abortifacient
- used to speed up labor
- used to keep the PDA open
Lactulose
Used in hepatic encephalopathy.
colonic bacteria metabolize lactulose to an acidic molecule that will take NH3 to NH4+, which cannot be absorbed.
“ammonia trap”
High BUN
renal failure
heart failure
dehydration
anything that decreases your GFR
On US: distended gallbladder gallbladder wall thickening Pericholecystic fluid (+) sonographic murphy's sign
Acute cholecystitis
CEA
Classically elevated in:
Nml
Pathogenic
Nmlly produced in the embryonic pancreas, liver and intestine
Abnormal elevation: Classic is, colonic CA.
However this is non-specific because CEA is also found in breast, pancreatic and gastric CA + IBS, cirrhosis, and pancreatitis
smokers also have > CEA than non-smokers
this is for tracking only, and not DDx
Ureterosacral Ligament carries?
As it courses above the External Iliac Artery and just lateral to the Internal iliac -
Carries the Ureter, Uterine, vaginal, and inferior vesicle arteries
in the ligament the ureter is medial, and deep to the uterine artery
Marked atrophy of GI villi
Celiac
Distended M0 in the intestinal lamina propria
Whipple disease
T. whippelli
PMNs in the crypt lumen
UC
Intestinal inflammation with granulomas
Crohn’s Dx
Massive infiltration of the intestinal lamina propria with ATYPICAL lymphocytes
GI lymphoma
Explosive diarrhea and nausea with normal GI villi
Lactase Df.
meconium ileus
neonatal GI obstruction
In CF, if there is decreased water secretion = can happen
heartburn
regurgitation
dysphagia
Barium swallow: dilated esophagus with no peristalsis
CREST syndrome
not accompanied by increased gastric acid
“birds beak” Barium swallow
Achalasia
Abnormal GEJ
Sliding hiatal hernia = stomach will be above the diaphragm - so it is seen on CXR = weird.
anti-centromere Ab
Primary biliary cirrhosis
florid duct lesion
pre-cirrhotic primary biliary cirrhosis
shows granulomatous inflammation of interlobular bile ducts and heavy portal tract infiltrate with inflammatory cells
Very similar process to GVH
Green liver with micro nodules
progressed primary biliary cirrhosis
Mallory bodies
neutrophil infiltration
fibrosis
liver
Alcoholic hepatitis
microvesicular steatosis
Reye’s syndrome
(+) hemosiderin deposition
Hemochromatosis
GGT elevation
specific serum marker for alkaline phosphatase origin in the biliary Dx.
(+) GGT = (+) biliary damage
High PT and Low s[albumin]
severe liver damage = really bad prognosis
bleeding time
marker of PLT function
not a specific marker for hepatic disease
AST>ALT by a factor of 2
Classic for Alcoholic liver Dx
ST-segment elevation
MI
inferior MI
Block of Right Coronary artery:
this also supplies the SA/AV nodes
often an Inferior MI will show with Bradycardia
use of Atropine can precipitate ____
acute closed - angle glaucoma
inuit/asian = inc. risk
HBx protein
made by latent HBV: will disrupt normal Cell cycle regulation, binds p53
HCV in a normal liver = HCC?
less likely than HBV driven HCC.
HCV will commonly lead to HCC in an “altered environment” = aka cirrhotic liver
Glycogen - rich cuboidal epithelial pancreatic tissue
Serous Pancreatic CA
columnar mucinous epithelium - pancreas
mucinous cystic neoplasms
atypical cells formatting papillary projections in pancreas
papillary variant of pancreatic adenocarcinoma
epithelial cells lining a cyst
True pancreatic cyst.
not just granulation and fibrous tissue
