QBankin' on doing well? Get after it! (mostly GI/GU/Hep) Flashcards
How does ACEI help prevent diabetic nephropathy?
Reduces glomerular hypertension…first step in the process is glomerular hyperfiltration which leads to glomerular hypertension
When should a kid get a renal/bladder ultrasound?
If a child less than two has a febrile UTI
Recurrent UTIs
UTI in child of any age with FHx of renal or urologic disease, HTN, or poor growth
What can happen after giving erythropoietin?
10mmHg BP jump
A kid presents with s/s of liver failure. What should be looked for?
History of aspirin use…Reye syndrome
A pregnant woman comes in with intense pruritus and is found to have elevated bile acids and transaminases. What does she have?
Intrahepatic cholestasis of pregnancy
A pregnant woman comes in with RUQ pain, malaise, N/V, and signs of liver failure. What is the expected cause? What would be seen on labs?
Acute Fatty Liver of Pregnancy
Hypoglycemia
Mildly elevated liver enzymes
Elevated Bili
Possibly DIC
A patient becomes jaundice with no other symptoms. A liver biopsy shows black pigmentation. What is the likely disease?
Dubin-Johnson syndrome
A lymphoma patient develops a nephrotic condition. What is it? What would it be if the patient had a solid tumor instead of lymphoma?
Lymphoma –> Minimal Change Disease
Solid Tumor –> Membranous Glomerulonephropathy
A decreased quantity of ducts is called ‘ductopenia’. What disease causes ductopenia?
Primary Biliary Cirrhosis
A mom has active HBV while she is delivering a baby. What should the baby be given?
Baby should get both passive (HBIG) and active immunization (recombinant HBV vaccine)
An African patient comes in because he has had a couple episodes of frank hematuria. A UA shows normal looking RBCs. What is the likely cause?
Renal papillary necrosis secondary to sickle cell trait
What can be given to prevent contrast induced nephropathy?
IV fluids
An older patient comes in with abdominal pain. However, the abdominal exam is completely negative except for overly sensitive skin. What is the diagnosis?
Shingles…symptoms can present before the rash
A CHF patient comes in with GI symptoms, CNS symptoms (including color vision alterations), and an arrhythmia. What happened?
Digoxin toxicity
What is given to patients with an expected variceal bleed?
IV flids
IV octreotide
Abx
What is the pathology to hepatorenal syndrome?
Portal hypertension → ↑NO in splanchnic circulation → ↓TPR → ↓BP → renal hypoperfusion → ↑Renin → ↑aldosterone → ↑H2O and Na+ retention → FENa less than 1% (less than 10mEq/L)
Patient has GI symptoms…blah blah blah…PAS-positive material in lamina propria of small intestine. What is it?
Whipple’s disease
A patient presents with GI issues with a history of scleroderma and DM. Labs show signs of malabsorption (megaloblastic anemia). What could be going on? What are other risk factors?
Small intestinal bacterial overgrowth
Other risk factors are ESRD, AIDS, cirrhosis, old age, anatomic anomalies
A patient complains of chest pain with swallowing, but doesn’t feel like the food/drink is getting stuck. What does he likely have? What meds can cause it?
Esophagitis
Tetracyclines Aspirin, many NSAIDs Alendronate KCl Quinidine Iron
What iatrogenic things can increase likelihood of Non-Alcoholic Steatohepatitis?
Drugs: corticosteroids, amiodarone, diltiazem, tamoxifen, HAART
Total Parenteral Nutrition
A patient has chronic HBV. What should be followed?
ALT and HBeAg every 3-6 months
What is the big difference between ‘Breastfeeding failure jaundice’ and ‘Breast milk jaundice’?
Breastfeeding failure causes dehydration
What needs to be done with a simple renal cyst?
Nothing
What is one possible complication of untreated hemochromatosis?
Hepatocellular carcinoma
A 2nd trimester US shows a sac of bowel outside of the body. What is this?
Gastroschisis
A midline abdominal wall defect is covered in peritoneum. What is it?
Omphalocele
What drug is used to treat HBV?
Tenofovir
A patient clinically has celiacs. The biopsy looks like celiacs. But IgA testing is negative. What is likely going on?
Likely has IgA deficiency…check total IgA or get IgG studies
What kind of cancer do oral contraceptives put women at increased risk of developing? What is seen on biopsy?
Hepatic adenoma
Glycogen and lipids
Who is at increased risk of developing toxic megacolon? What should be done to diagnosis toxic megacolon?
Often IBD patients w/in 3 yrs of diagnosis
Get a plain film
A patient has normocytic normochromic anemia, fatigue, and back/chest pain. What should be checked?
This could be multiple myeloma
Urine for Bence Jones proteins (paraproteins)
Electrophoresis for monoclonal protein peak
A patient goes into shock and the next day has transaminase levels through the roof. What should be done?
Nothing…Shock liver (ischemic hepatopathy) will self resolve
What can be given to help with uric acid stones?
Potassium citrate…alkalinizes urine
What is the fancy name for Wilson disease?
Hepatolenticular degeneration
A patient has a nephrotic syndrome. Biopsy shows C3, but no immunoglobulins. What is going on?
Membranoproliferative GN type 2 (dense deposit disease)
IgG antibodies, called C3 nephritic factor, bind to and activate C3 convertase → persistent complement activation and kidney disease
An old patient was recently started on amitriptyline for some reason or another, and now can’t pee. What is going on?
Amitriptyline induced urinary retention…stick a catheter in there
How is meconium ileus managed?
Contrast enema to diagnose
Hyperosmolar enema (gastrogafin) to treat
Surgery if that fails
