Medicine- GI Flashcards
What is the equation for the discriminant factor in acute hepatitis and tx?
Discriminant factor = 4.6 x(patients PT- Control PT) + bilirubin
Tx= steroids if discriminant factor >32
What is orthodeoxia?
Hypoxia upon sitting upright (Found in hepatopulmonary syndrome)
In a patient with an active chronic hepatitis B infection, what tx is indicated if ALT levels are more than 2 times the upper limit or if cirrhosis is present.
antiviral therapy with tenofovir, entecavir, or pegylated interferon-alpha
IFN-α is, however, contraindicated among patients with autoimmune diseases such as systemic lupus erythematosus (due to exacerbation of disease)
Peritoneal dialysis patient, distended tender abdomen with rebound and elevated white cell count.. dx and next best step?
DX- Peritonitis –> next step - Gram stain of abdominal fluid
Most appropriate next best step in a patient with low-grade dysplasia secondary to Barrett esophagus
Eradication of all areas of intestinal metaplasia via endoscopic mucosal resection and subsequent endoscopic ablation therapy to remove the existing dysplasia and decrease the risk of dysplasia recurrence is the treatment of choice in patients with low-grade dysplasia.
What is a normal AFI
AFI = 8-18
The test of choice for confirming Boerhaave syndrome in a hemodynamically unstable patient
CT scan of the chest
Most appropriate recommendation to prevent future morbidity and mortality in patient with Variceal bleeding.
Endoscopic variceal ligation (EVL) should be performed every 1–2 weeks until the varices have been obliterated, after which endoscopic examination should be performed every 3–6 months.
Test of choice for evaluating oropharyngeal dysphagia.
A videofluoroscopic modified barium swallow
The presence of a rapidly progressive skin lesion with a characteristic necrotic base and purplish borders after minimal trauma in an individual with Crohn’s disease
pyoderma gangrenosum
Patient has biliary-type pain after cholecystectomy increased ALP and dilated common bile duct but no stones visualised… diagnosis and next best step
postcholecystectomy syndrome due either to residual gallstones within the biliary tree or sphincter of Oddi dysfunction.
An ERCP with sphincterotomy should be performed;
How does Hepatocellular carcinoma present
Decompensated liver failure
Weight loss
Cachexia (eg, temporal wasting)
palpable liver nodule
Which noninvasive lab test has high sensitivity for pancreatic exocrine insufficiency
Fecal Elastase
GI manifestations in a patient with sarcoidosis
Abnormal LFTs
Hepatosplenomegaly
(In a patient with Hypercalcemia and hilar adenopathy)
Next best step in and elderly patient with fecal incontinence
Assess for fecal impaction
