Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Medicine > Rest Of GI > Flashcards

Rest Of GI Flashcards

1
Q

Risk of esophageal eisonipholis

A

Perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Upper endoscopy

A

Persistent heartburn , dysphagia, odynophagia

Diagnostic, direct visualization, and therapeutic, can take biopsies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Video esophagogreaphy

A

Oropharyngeal dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Barium esophagography

A

Esophageal dysphagia

Differentiate mechanical lesion and motility disorder

Rings, achlasia, proximal lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Esophageal nanometer

A

Motility

Achlasia suspected

Dysphagia where no mechanical obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

PH test esophagus

A

Catheter based-trans nasal catheter

Wireless-capsule in esophagus mucosa

Info about acid reflux -do in ppl with persistent symptoms despite PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Causes of oropharyngeal dysphagia

A

Neurological

Muscular and rheumatologist

Metabolic disorders

Infectious disease

Structural disorders-zenker

Motility disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Clues of mechanical obstruction of esophagus

A

Solid food worse than liquid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Schatski ring

A

Not progressive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Peptic stricture

A

Chronic heart burn, progressice dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Esophageal cancer

A

Progressive dysphagia, over 50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Eosinophilic esophagitis

A

Young, corrugated rings, or white papules, proximal stricture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Achlasia

A

Progressive dysphagia,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diffuse esophageal spasm

A

Intermittent, not progressive, ay have chest pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Scleroderma

A

Chronic heart burn, raynaud

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ineffective esophageal motility

A

Intermittent, not progressice, commonly associated with GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Oropharyngeal dysphagia vs esophageal dysphagia

A

Neck, nasal regurgitation, aspiration, ENT

Chest or neck, food impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cause of structural oropharyngeal dysphagia

A

Zenker
Neoplasm
Cervical web

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Propulsive neurogenic oropharyngeal dysphagia

A

Cerebral vascular accident

Parkinson

ALS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Myotonic propulsive oropharyngeal dysphagia

A

Myasthenia gravis

Polymyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Propulsive esophageal dysphagia (solid and liquid)

A

GERD with weak peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Structural esophageal dysphagia (solid)

A

Intermittent-schatski, web

Progressive-neoplasm

Variable-peptic stricture, eosinophilic esophagitis

Pill esophagitis

Infectious esophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

GERD presentation

A

Esophageal dysphagia with weak peristalsis

Solids and liquids non progressice

Barretts and adenocarcinoma

PH test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Treat GERD

A

Acid suppression and lifestyle modicfications
Decreased etoh and caffeine
Low fat
Bed incline

H pylori eradication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Alarm features of GERD

A

Weight loss, resistant vomiting, constant or severe pain, dysphagia.odynophagia, hematemesis, melena, anemia,
Do endoscopy

Heart burn, regurgitation, dysphagia, patient takes baking sods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Atypical presentation GERD

A

Laryngopharyngeal reflux

Asthma chronic cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Timing of symptoms with GERD

A

30 or 60 min after food and upon reclining

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Diagnose GERD

A

Clinically

Alarm features warrant more studies
Dysphagia, odynophagia, hematemesis, melena, weight loss, vomit, severe pain, iron deficient anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

GERD symptoms that get upper endoscopy

A

Persistent despite treatment or alarm features

For detecting complications of gerd-stricture, barrett, adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Who with GERD gets barium esophagography

A

NOT DIAGNOSIS

In patients with dysphagia or before endoscopy to identify peptic stricture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Who with GERD gets esophageal pH testing

A

Atypical esophageal symptoms or considering anti reflux surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Treat extraesophageal reflux manifestation

A

PPI suggests that acid reflex is causative factor
For 3 months

Do pH test in persist 3 months on PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Hiatal hernia picture

A

Ok? Reflux LES issue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Scleroderma symptoms

A

Esophageal dysphagia, mainly solids, motility propulsion problem
(Ebsent peristalsis combined with severe weakness of the LES )

Progressive

Thickening and hardening of skin fibrosis

Chronic heart burn and raynaud

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Who gets scleroderma

A

30-50 women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Zenker diverticulum

A

Upper esophagus structural

Between cricopharyngeus muscle and the inferior pharyngeal constrictor muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Symptoms zenker

A

Dysphagia, regurgitation, choking, aspiration, voice changes, bad breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Where is zenker diverticulum

A

Jillian’s triangle area of weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Diagnose zenker

A

Barium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Sjorgens syndrome

Who gets it

A

Rheumatologist females 50s postmenopausal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Sjorgens symptoms

A

Dry eyes, dry mouth->oropharyngeal dysphagia, vaginal dryness, tracheo-bronchial dryness

Oral infections (candida) dental carries

Salivary gland enlargement

Keratoconjunctivitis-foreign body sensation in eyes
B cell non Hodgkin lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Barrett sign

A

Goblet and columnar cells

Squamous->columnar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Risk factors barrett

A

Chronic reflux

Truncus obesity independent of GERD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Symptoms BE

A

Not specific
90% asymptomatic

Heart burn regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Diagnose BE

A

Endoscopy suspect

Confirm biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Treat barrett

A

PPI-don’t help barrett but may reduce risk of cancer

Endoscopic therapy to remove dysplastic barret epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Should all people with GERD be screening for adenocarcinoma

A

No just ppl with multiple risk factors for adenocarcinoma

Chronic gerd, hiatal hernia, obesity, white race, male, over 50

Do endoscopy ever 3-5 years if have barrett

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Where are peptic strictures

A

Gastroesophageal junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Risk for peptic stricture

A

Esophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Symptoms peptic stricture

A

Gradual and progressice development of solid food dysphagia over years

Heartbrurn bc stricture is barrier to reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Diagnosis peptic stricture

A

Endoscopy with biopsy is mandatory to differentiate it from esophageal carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Treat peptic stricture

A

Dilation. At time of endoscopy

PPI do decrease recurrence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Risk factor squamous cell carcinoma esophagus

A

Heavy smoking, alchol, achlasia, Plummer Vinson, Tylosis, hot beverage,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Esophagitis

A

Unresponsive reflux disease with esophagitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What causes esophagitis

A

Gastrin OA Ze
Pill induced esophagitis
Resistance to PPI
Medical noncompliance

Swallowed without water of supine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Most common meds of pill endured esophagitis

A

NSAIDS< potassium chloride pulls, antibiotics, alendronate and risedronate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Symptoms pill endured esophagitis

A

Retrostenal chest pain, odynophagia, dysphagia,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Diagnose pill endured esophagitis

A

Endoscopy may reveal discrete ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Complication pill induced esophagitis

A

Stricture, hemorrhage, perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Prevent pill endured esophagitis

A

Pill with water
Remain upright

Look out for esophageal dysmotility, dysphagia, or stricture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What causes infectious esophagitis

A

Candida, herpes, cmv, in immunosuppressed, diabetes,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Diagnose infectious esophagitis

A

Endoscopy with biopsy and culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

CMV

A

Large shallow superficial ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Herpes esophagitis

A

Multiple small deep ulcerations

Oral ulcers associated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Candida esophagitis

A

Diffuse, liberal, yellow white plaques adherent to the mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Pictures

A

Ok

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are causes of caustic esophageal injury

A

Accidental kids

Deliberate adults suicide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Symptoms caustic esophageal injury

A

Burning, chest pain, gagging, dysphagia, drooling

Aspiration strider wheezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Diagnosis caustic esophageal injury

A

Circulatory status and airway potency and laryngoscopes

Chest and abdominal radiographs-pneumonitis or free perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Complications caustic esophageal injury

A

Phenumonitis

Perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Treat caustic esophageal injury

A

ICU
Nasogastric lovage and oral antidotes may be dangerous and NOT administered

Laryngoscopy to assess need for tracheostomy
Endoscopy
Psychiatric referral
Fasting and monitor start oral

Watch for strictures in coming months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Endoscopic superveillance of esophageal caustic injury for 15-20 years

A

Risk of esophageal squamous carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

Diagnose mallory weiss

A

Endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What do if mallory weiss tears keep bleeding

A

Inject with epinephrine , cautery, mechanical compression with endoscopic therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What may cause eosinophilic esophagitis

A

Food or environmental antigens are through to stimulate an inflammatory response

History of atopy asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Symptoms eosinophilic esophagitis

A

Dysphagia

Food impaction,

Kids similar to gerd but no acid -pain, vomiting, chest pain, failure to thrive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Lab eosinophilic esophagitis

A

Eisoniphilia igE

MULTIPLE CONCENTRIC RINGS

Need biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Treat esophageal eosinophilia

A

Corticosteroids

*dradula dilation of strictures in patients with dysphagia but cautious bc increased risk of perforation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Esophageal webs

A

Mid or upper esophagus,
Asymptomatic not progressice dysphagia

Barium

Boogie dilatory to treat

PPI if have heartburn or require repeated dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Esophageal rings

A

Distal
Dysphagia intermittent not progressive

Large poorly chewed food such as beef cause symptoms

Barium

Boogie dilator

PPI if heartburn or who require repeated dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Zenker

A

Pharyngoesophageal junction between inferior pharyngeal constrictor and cricopharyngeus from loss of elasticity

Retains food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Diagnose zenker

A

Video esophagography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Treat zenker

A

Myotome , surgical diverticulotomy

Small just observe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Who do we suspect eosinophilic esophagitis in

A

Dysphagia and esophageal food impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Complication eosinophilic esophagitis

A

Perforation
Stricture
Food impaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Achlasia

A

No relaxation of LES and no peristalsis in distal two thirds loss of NO in myenteric plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Pseudoachlasia

A

Metastatic tumors invade gastroesophageal junction resulting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Chagas

A

Bite of reduviid bug trypsin cruzi

Ganglion gone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Symptoms achlasia

A

Gradual progressice dysphagia for solids and liquids months to years
Chest pain

Maneuvers to to help esophageal empty

Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Diagnose achlasia

A

Barium and confirm with esophageal manometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Achlasia don’t treat

A

Sigmoid esophagus hugely dilated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Diffuse esophageal spasm

A

Spasm with tight LES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Treat achlasia

A

Botox, dilation, surgery, PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Nutcracker esophagus

A

Hypertensive peristalsis swallowing contractions oo powerful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Symptoms nutcracker

A

Dysphagia solid and liquids not progressice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Diagnose nutcracker

A

Manometry

LES relax normally but elevated pressure at baseline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

Diffuse esophageal spasm

A

Uncoordinated esophageal contraction corkscrew
Rosary bead on barium

LES normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

Symptoms diffuse esophageal spasm

A

Dysphagia to solid and liquids chest pain

Not progressice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Diagnose diffuse esophageal spasm

A

Manometry EGD bariu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Esophageal perforation

A

Trauma from forceful vomiting

Not boerhaave if done with endoscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Diagnose esophageal perfoation

A

CT of the chest detecting mediastinal air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Treat esophageal perforation

A

NGT, suction, NPA, antibiotic surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Signs of pneumomediastinum

A

Subcutaneous emphysema

Ham mans sign

Dyspnea but do not measure peak expiration flow rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What causes gastric outlet obstruction

A

Peptic ulcer disease

Malignancy

Gastric volvulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Cause of small intestinal obstruction

A

Adhesions, hernia, volvulus, Crohn’s disease, carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

Gastroparesis

A

Diabetics, post viral, post vagotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Small intestine dysmotility cause

A

Scleroderma amyloidosis, chronic intestinal pseudo-obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What causes peritonitis

A

Perforated viscous appendicitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What causes viral gastroenteritis

A

Norwalk rotavirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What causes hemorrhagic gastritis

A

NSAIDS, stress ulcers, alcoholic, portal HTN, ischemia, caustic ingestion, radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Treat stress ulcers

A

Enteral nutrition H2 blockers and PPI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

Treat alcoholic hemorrhagic gastritis

A

Propranolol or nadolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

Manifestation hemorrhagi gastritis

A

Upper GI bleeding, hematemesis, coffee ground emesis, or bloody aspirate in nasogastric suction , melena

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

Diagnosis hemorrhagic gastriris

A

UE

No inflammation on histologic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Treat hemorrhagic gastritis

A

Remove agent and prevent ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

Chronic gastritis changes

A

Superficial (lamina propria)-> atrophic->atrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

Type A gastritis

A

Fundic, body predominant and less common form

Asymptomatic

Old ppl
Autoimmune -achlorhydria, pernicious anemia, gastric cancer risk

Antibodies to parietal cell

Pernicious anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Pernicious anemia gastritis

A

Achlorhydria->hypergastrinemia due to loss of acid inhibition of G cells->hypergastrinemia hyperplasia of gastric Enterochromaffin like cells-> small multicentric carcinoid tumors

Decreased B12
Autoimmune destruction of the gastric fundic mucosa loss of rural folds

Anti IF and ATPase in them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Type B gastric helicobacter pylori

A

Antral predominant from H pylori

Type A was autoimmune

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

Signs of type B gastritis

A

Asymptomatic maybe dyspepsia

Atrophic gastrin, increased risk of gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

Menetrier disease

A

Giant thickened gastric folds involving body

Chronic protein loss

Hypoproteinemia, anascara, may need gastric resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

PUD signs

A

Coffee grounds emesis, hematemesis, melena, hematochezia, gnawing dull aching or hunger like gastric pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

Recovered nasogastric lovage fluid that is _ for blood does not exclude active DU bleeding

A

-

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

H pylori

A

Spiral curved gram negative rod urease producing organism microaerophilic with flagella; colonizers gastric antral mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

Genes h pylori

A

Vac-a can-a

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

Caga positive h pylori

A

Greater risk of ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

Test h pylori

A

Urea breath test, fecal antigen test, endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

Major cause of ulcers not h pylor

A

NSAIDS
Over 60

Corticosteroids

Ze
Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

Warthin silver stsain and immunohistochemistry stain

A

H pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

Serology h pylori

A

H pylori IgA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Possible lab findings h pylori

A 
Anemia
Leukocytosis(perforation)
Up amylase-ulcer penetrate pancreas
Gastrin up Ze
Fall hematocrit (bleeding, )
BUN up-absorption of blood nitrogen from the small intestine and prerenal azotemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Ulcer along posterior wall of duodenum may perforate what

A

Pancreas, liver, biliary tree

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

Complications gastric surgery PUD

A

Obstruction, bezoar, bile reflux gastritis, malabsorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

Differentials with upper GI bleed

A

PUD
Erosive gastritis
Malloy weiss
Varices (portal HTN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Ulcer incidence with COX2 inhibitors, NSAIDS, asprin

A

COX2 less
NSAIDS yes
Asprin if history of PUD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

Cardiovascular complications COX2 inhibitors, NSAIDS< asprin

A

Cox2-INCREASE
NSAIDS-less
Asprin-protective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

DU from h pylori

A

Stimulate G cells

Dyspepsia, burning, epigastric pain, 60-3 hours after meal
Relieved by for

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

Gastric ulcer from H pylori

A

Smoking higher

Normal acid

Dyspepsia, made worse with food
Within 30 min

Anorexia, weight loss

Lesser curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

Treat ulcers

A

PPI

Gastric-exclude malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

Gastric adenocarcinoma

A

Benzpyrene, smoked fish meats,

Signet ring cells, linitis plastica, Virchow node, krukenberg tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

Zollinger ellison

A

Tumors in pancreas, duodenum, lymph nodes

MEN1
-gastrin OA, hyperPTH, increase Ca, pituitary neoplasm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

Diagnose Ze

A

Large mucosal folds on endoscopy

Confirm serum gastrin >1000
Secretin stimulation +

Draw serum PTH, prolactin, LH-FSH, GH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

Treat ZE

A 
PPI
Exploratory laparotomy 
MEN1 Timor respectable 
Treat hyperPTH first may improve 
Chemo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

SE

A

PUD that isn’t responding to treat, proximal duodenum tumor, pancreas, MEN1
Fasting gastrin +
Jupertrophic gastric mucosa
Secretin +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

Gastroparesis

A

Obstruction in absence of mechanical lesions caused by
DM
Postdurgical
Neurologic chagas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

Diagnose gastroparesis

A

Gastric scintigraphy-with low fat meal assess gastric emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Treat gastroparesis

A

Metoclopramide -risk of tardive dyskinesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Food bolus impaction

A

Inability to swallow including saliva

149
Q

Postvagotomy

A

Rapid food passage into small intestine->distension due to osmotic flow of water into lumen
Nausea and diarrhea, palpitations, sweating , hypoglycemia

Eat small meals, ingest solid and liquid separately

150
Q

Post gastrectomy

A

Dumping syndrome
Weak, tachycardia, poop, epigastric full, 30 min after eat
Cramps

151
Q

5789hematemesis

A

Vomit blood coffe grounds

152
Q

Hematochezia

A

Bright red blood in rectum massive UGIB 100mL

153
Q

Source of UGIB

A

Proximal to ligament of treitz

154
Q

Diagnose and treat UGIB

A

Endoscopy

155
Q

Angioectais

A

Submucosal vessels caused by chronic intermittent obstruction of submucosal veins
Bright red stellate appearance
Throughout GI right colon

156
Q

Telangiectasia

A

Small, cherry red lesions caused by dilation of venues that may be part of systemic conditions or sporadic

Hereditary-loser Weber rendu of CREst

157
Q

Dieulafoy lesion

A

NSAIDS
Bleed
Submucosal artery

158
Q

UGIB assessment

A

Shock(acidosis, increased lactate)

Hematocrit not reliable of severity

159
Q

How stabilize UGIB

A

Two large bore IV lines for diagnostic tests

Give saline or lactated ringer

Give PRBC hemoglobin should rise

160
Q

BUN/Cr in UGIB

A

30:1

161
Q

Treat UGIB

A

PPI IV or oral

Ocreotide -reduce splanchnic blood flow

162
Q

BUN PUD

A

30:1 bc absorption of N from SI and prerenal azotemia

163
Q

Hypotension with onset pain , what else consider besides PUD

A

Ruptured aortic aneurysm, mesenteric infarction, or acute pancreatitis

164
Q

How diagnose ulcer penetration

A

CT

165
Q

Gastric outlet obstruction

A

Narrow pylorus or duodenal bulb

Less commonly associated with PU bc h pylori and PPI control

166
Q

LGIB

A

Hematochezia(10% UGIB)

See with colonoscopy

Distal to ligament of treitz

Increased risk with asprin, antiplatelet agents, NSAIDS

167
Q

LGIB differential

A

Under 50-infectious colitis, anorectal disease, IBD, neoplasm , crohns, celiac

Over50-diverticulosis, angiectasis, malignancy or ischemia, angioctasias, telangiectasia, neoplas, hemorrhoids, fissure, ischemic colitis

168
Q

Most common cause of LGIB

A

Diverticulosis

169
Q

Ischemic colitis

A

Older with atherosclerosis

Crappy ab pain, followed by bloody diarrhea

170
Q

Clinical manifestation LGIB

A

Black tarry melena proximal to ligament of treitz

171
Q

Diagnostic test LGIB

A

Anoscopy, nuclear bleeding scans, SI push enteroscopy, capsule imaging

172
Q

Diverticulosis

A

Most common in sigmoid

Increases with age

173
Q

Diverticulosis

A

Asymptomatic
90%
Hemorrhage from ascending colon and self limited

174
Q

Treat diverticulosis

A

High fiber

175
Q

Acute mesenteric ischemia

A

Periumbilical pain out of proportion to tenderness (writhing pain but PE unimpressive)-NOT MALINGERING

Food fear

176
Q

Diagnose acute mesenteric ischemia

A

Abdominal c ray bowel distension thumb printing (submucosal edema)
CT angiography
Laraptomy

177
Q

Ischemic colitis

A

Severe lower ab pain followed by rectal bleeding

S ray thumb printing

178
Q

Hemorrhoids

A

Anoscopic axam

Treat with site baths

179
Q

External hemorrhoid

A

Pain

Over 24-48 hours

180
Q

Occult gastrointestinal bleed

A

Not apparent to patient

181
Q

Identify occult bleeding

A

FOBT, FIT(fecal immunochemical test), iron defiency anemia

182
Q

6777what should patient with iron defiency anemia be evaluated for

A

Celiac, IgA antitransglutimase of duodenal biopsy

183
Q

Meckel diverticulitis diagnose

A

Technetium 99 scan

184
Q

What causes toxic megacolon

A

C diff, UC,

185
Q

Most commmon cause acute liver failure

A

Acetaminophen

186
Q

Perforated viscous

A

Any hallow organ (esophagus, stomach, intestine, uterus, bladder)
Emergency surgery

Free air under diaphragm seen on CT or plain X ray

187
Q

What initiates appendicitis

A

Obstruction of appendix

188
Q

Diagnose appendicitis

A

CT US

189
Q

Strangulated hernia

A

Tender, firm, irreducible mass, bowel infarcts and dying need surgery!!

190
Q

Irreducible hernia

A

Can’t be manipulated back into cavity

191
Q

Incarcerated hernia

A

Imprisoned

192
Q

Obstruction hernia

A

Loop of bowel non functioning with normal blood supply

193
Q

Strangulated hernia

A

Cut off the blood supply to the content

194
Q

Acute colonic pseudo obstruction (olive syndrome)

A

Severe abdominal distension in post op state with severe medical illness

Nausea, vomiting,

195
Q

Spontaneous primary bacterial peritonitis

A

Review

196
Q

AAA rupture

A

With increasing size of aneurysm

197
Q

Aortic aneurysms

A

No symptoms, detect routine exam palpable or incidental finding

Harbinger pain of rupture and represents a medical emergency
Acute rupture with no warning

Acute pain and rupture

198
Q

Who gets aortic aneurysm screening

A

Men 65-75 who have ever smoked

199
Q

Aortic dissection

A

Tear of intima

Along the right lateral wall of the ascending aorta where the hydraulic shear stress is high

200
Q

Ectopic preg

A

Transvaginal ultrasound with no intrauterine preg

Most common cause maternal death first trimester

201
Q

Ovarian torsion

A

Surgical emergency
Prompt diagnosis

Can get rupture, bleeding, cysts, neoplasma,

Right side bc increased length of the utero ovarian ligament on the right and the sigmoid on the left, limiting space for movement

202
Q

Presentation ovarian torsion

A

Sudden onset severe unilateral lower abdominal pain maya develop after episodes of exertion

203
Q

Detect ovarian torsion

A

Transvaginal US with Doppler is primary

Greater than 4 cm ovary due to cyst, tumor or edema is most common finding associated with torsion

204
Q

Testicular torsion

A

Emergency
Neonatal period and puberty
12-18
Testicle of neonates with prenatal torsion is not salvageable

205
Q

Sign of testicular torsion

A

Pain is abrupt in onset and severe and is usually associated with nausea or vomiting
Painful!!

Swollen tender high rigid testis with abnormal transverse line, scrotal skin changes, ipsilateral loss of cremasteric reflec

206
Q

Diagnose testicular torsion

A

Doppler US

207
Q

Crohns genes

A

CARD15/NOD2 16p

208
Q

Genes US

A

HLADR2

209
Q

Extraintestinal manifestations IBD

A

Joints arthritis
Erythema nodosum, pyoderma gangrenosum

Thromboembolic events DVT< nephtolithiasis with irate or calcium oxalate stones may occur in CD

210
Q

Infectious enterocolitis and UC

A

Clinically and endoscopically indistinguishable need stool

211
Q

UC

A

Crypt abscess, blood diarrhea, ulcerated pseudopolyps, smoking protective

212
Q

CD

A

Non caseating granuloma,
Strictures,
Creeping fat

Aphthous ulcers
Smoking worsens

213
Q

What other disease have non caseating granuloma

A

Sarcoidosis

214
Q

Erythema nodosum

A

UC

215
Q

Pyoderma gangrenosum

A

UC

216
Q

Diagnose UC

A

Sigmoidoscopy

217
Q

Colon cancer UC

A

Start colonoscopy every year or two 8 years after diagnose bc increased disease proximal to rectum

5asa decrease risk of colonic ancer

218
Q

CD

A

Cobblestone fistulae, oxalate kidney stones, bile salt malabsorption, intestinal obstruction, stop smoking

219
Q

Carcinoma and CD

A

Annual screening to detect dysplasia annually with 8 or more years of CF

Both rare

220
Q

Diagnose CD

A

Sigmoidoscopy, colonoscopy, barium enema, upper GI, small bowel series

221
Q

CD CBC

A

Anemia

222
Q

Serum albumin CD

A

Hypo from protein loss

223
Q

ESR CD

A

INCREAED CRP

224
Q

UC RISK

A

MEGACOLON LEAD PIPE FROM LOSS OF HAUSTRA

225
Q

Crohns abscess

A

On CT
Give broad spectrum antibiotics
Percutaneous drainage or surgery

226
Q

Symptoms intestinal obstruction with CD

A

Intravenous fluids with nasogastric suction

Low roughage diet-low fiber

227
Q

Retroperitoneal phlegmon or abscess

A

Fever, chills, tender abdominal mass, leukocytosis

228
Q

Enterocolitica fistula

A

Diarrhea, weight loss bacterial overgrowth

229
Q

Colovesical, enterovesical fistula

A

Urinary infections

230
Q

Colovaginal enterovaginal fistula

A

Malodorous drainage

231
Q

Enterocutenaous or colocutaneous fistul

A

Skin, surgical scare

232
Q

Perianal disease

A

Large painful skin tags, anal fissures, perianal abscesses, fistulae

233
Q

Treat perianal disease

A

Colorectal surgeon

Metronidazole, ciproflaxin, tacrolimus

234
Q

Diagnose perianal disease/fistula

A

Pelvic MR

235
Q

Resection more than 100 c, terminal ileus

A

Fat malabsorption

Low fat diet and parenteral B12

Bile acid not absorbed cause secretory diarrhea

Steatorrhea

OXALATE KIDNEY STOMES -cholesterol gallstones

236
Q

How prevent oxalate kidney stones

A

Calcium supplements

237
Q

Glucocorticoids for IBD adverse events

A

Mood changes, insomnia, buffalo hump, weight gain (striae), edema, increased serum glucose levels, acne, and moon faces

238
Q

5 Asa SE

A

Acute interstitial nephritis

239
Q

Sulfasalazine is administered with ___

A

Folate

240
Q

UC surgery

A

Protocolectomy

241
Q

CD surgery

A

Fix obstruction , abscesses, persistent symptomatic fistulas

242
Q

Anti TNFa risk

A

Non melanoma skin cancer, non Hodgkin lymphoma

243
Q

Azathioprine or 6-MP for IBD CD UCwhat test before

A

TPMT functional activity is recommended prior to initiation

Non Hodgkin , allergic, toxicity

244
Q

Why should prophylaxis be given to all hospitalized IBD patients

A

Risk of venous thromboembolic disease

Also social support

245
Q

Antibiotics for IBD

A

Ciproflaxin, cyclosporine

246
Q

Recurrent intrahepatic cholestasis

A

Early in life may persist for a lifetime
Benign but not in familial forms

Conjugated

247
Q

Intrahepatic cholestasis of pregnancy

A

Conjugated

Benign
Recurrence with preg or OC

248
Q

Post hepatic causes

A

Gallstones, inflammation, tumors

249
Q

Diagnose obstructive jaundice

A

Conjugated
US
Cholangiography

250
Q

Hepatocellular vs cholestatic

A

ATL ALT

ALP and bilirubin

251
Q

Hemolysis

A

Indirect bilirubin

Anemia,

252
Q

Gilberts

A

Indirect elevated

NO ABNORLA LIVER TESTS

253
Q

Differential for Obstructive jaundice conjugated

A 
Bile duct stone
Neoplasm
Cancer
Hepatocellular jaundice, 
Pyogenic cholangitis
254
Q

Right hepatic duct block

A

Ok

255
Q

Cystic duct block

A

Ok

256
Q

Sphincter oddi block

A

Ok

257
Q

Left hepatic duct block

A

Ok

258
Q

Common bile duct block

A

Ok

259
Q

NAFLD lab

A

Alt ast up

260
Q

Acute cholecystitis

A

Leukocytes

261
Q

Choledocholithiasis

A

Stone remove and antibiotics

262
Q

Biliary dyskinesia(bile cant move)

A

Similar symptoms to biliary colic-RUQ pain, limits activities, nausea

263
Q

How diagnose biliary dyskinesia

A

US no stones or anything

Normal liver enxymes, conjugated bilirubin, amylase
HIDA scan-normal gallbladder

264
Q

Abnormal gallbladder

A

Ejection fracture lesss than 35 ->cholecystectomy

Or stone seen

265
Q

Risk of gallstones

A

Female
Age
Carb intake
.W if cirrhosis and hep c

266
Q

Cholesterol or pigment

A

Stones

267
Q

Brown stomes

A

Bacterial

Asian

268
Q

Cholesterol pigment

A

Cholesterol

269
Q

Pigment stone

A

Calcium bilirubinate

270
Q

Symptoms cholelithiasis

A

RUQ pain after meals right scapula NV

271
Q

Diagnose cholelithiasis

A

Bilirubin

US-acoustic shaddow

272
Q

Where are most gallstones

A

Cystic duct

273
Q

What causes acalculous cholecystitis

A

Acute illness , fasting, hyperalimenataion, carcinoma, infection

274
Q

Labs acute cholecystitis

A

HIDA scan obstructed duct

Leukocytosis, bilirubinemia, AST, ALP, GGT< Amylase

275
Q

Gallbladder in acute cholecystitis

A

Wall thickening, pericholecystic fluids, Murphy

276
Q

Complication s cholecystisis

A

Perforation, pericholecystic abscess , peritonitis, emphysematous, emphysema

277
Q

Choledochilitis

A

Common bile duct stone

ERCP or EUS

Can lead to acute ascending cholangitis

RUQ pain fever chills

278
Q

Treat cholecocholithiasis

A

Cholecystectomy

ERCP with sphincterotomt and stone extraction or stent placement if the procedure of choice

279
Q

Ascending cholangitis

A

Charcot triad
Reynaud pentad-altered mental status and hypotension

Endoscopic emergence

Risk factor for cholangitis

280
Q

Primary sclerosing cholangitis

A

Men
Cholangiocarcinoma

Associated with IBD (UC), CVD, DM,

Beads on a string onion skinning

281
Q

Primary biliary cirrhosis

A

Old females

AMA positive antibodies

282
Q

Chronic cholecystitis

A

Chronic gallbladder inflammation
Asymptomatic
Porcelain-calcified x ray
Bad prognosis

283
Q

Courvoisers gallbladder associated with what

A

Cancer of head of pancreas

284
Q

Porcelain gallbladder

A

Associated with gallbladder carcinoma take it out@

285
Q

Treat cholelithiasis

A

Just do cholecystectomy for ppl with symptoms , previous complications, porcelain

Laparoscopic cholecystectomy

Treat with ursodeoxycholic acid

286
Q

Treat acute cholecystitis

A 
NPO 
Nasogastric suction 
IV fluids
Analgesics
Antibiotics
Surgery-if complication
287
Q

Treat cholecocholithiasis

A

Cholecystectomy and ERCP
When CBD stones are suspected prior to laparoscopic cholecystectomy , preop ERCP with endoscopic papillotomy and stone extraction is the preferred approach

288
Q

Cholangitis treat

A

Treat like acute cholangitis

289
Q

Treat primary sclerosing cholangitis

A

No good therapy
Glucocorticoids, methotrexate, cyclosporine not good

Liver transplant in end stage cirrhosis

290
Q

US benefits

A

No radiation safe in preg

291
Q

EUS benefits

A

No radiation

Diagnostic and therapeutic

292
Q

CT scan

A

Contrast used
Angiography for vessels->ischemic colitis

Good for soft tissue and bones

293
Q

MRI

A

Radiation
Soft tissue
MRCP for GI

294
Q

MRCP

A

Magnetic resonance cholangiopancreatography

Pancreas and biliary tree can see stones

295
Q

ERCP

A

Endoscopic retrograde cholangiopancreatography

Invasive biliary tree and pancreatic duct
Measure INR first

296
Q

HIDA

A

Hepatobiliary scan

See GB
Abnormal-GB most seen (stones)

297
Q

OCG

A

Oral cholecystogram /cholecystography

298
Q

Contrast medium tablets swallowed bight before
X ray
Evaluate GB for stones

A

Ok

299
Q

Plain x ray gallbladder

A

Porcelain

KUB-kidney ureter, bladder

Small amount of radiation
Non invasive
Cheap
See stones

300
Q

Cholangiography

A

Percutaneous transhepatic (through skin)
Radiation
Uses iodine contrast

Intraoperative-in OR while doing cholecystectomy

301
Q

EGD

A

Esophagogastroduodenoscopy

Use endoscope
Diagnostic and therapeutic
See esophagus and stomach

302
Q

Colonoscopy

A

Invasive
Need prep
Colonscope
Diagnostic and therapeutic

303
Q

The diagnosis of acute pancreatitis two of the three criteria

A

Abdominal pain in epigastric may radiate to back

Threefold increase in serum lipase and/or amylase and

Confirmatory findings of acute pancreatitis on abdominal imaging

304
Q

Causes of acute pancreatitis

A 
Gallstones 
Alcohol
Hypertg
Trauma(surgery)
Post op

Divisum
Scorpion
Autoimmune

305
Q

Risk factors acut epancreatitis

A

Smoking
High dietary glycemic load
Fat
Age

306
Q

Protective factors acute pancreatitis

A

Vegetables

Statins

307
Q

Symptoms acute pancreatitis

A

Nausea, vomiting, sweating, abdominal tenderness, distension and fever, pain shock, radiate to back

308
Q

PE acute pancreatitis

A

Left shift

Cullen grey turner

309
Q

Lab acute pancreatitis

A

Lipase 3x up

If salivary gland disease and intestinal perforation/infarction are excluded

310
Q

What other disease may cause amylase elevation

A 
Intestinal obstruction
Gastroenteritis
Mumps
Ectopic preg
Administration of opoids
Ab surgery
311
Q

Acute pancreatitis saponification

A

Ya and have low serum ca

Hyper tg->check a lipid panel for SAP etiology

Hemoconcentration->pancreatic necrosis

Hypoalbuminemia and marked elevations of serum LDH are associated with increased mortality rate

312
Q

Imaging acute pancreatitis

A

X ray-Sentinel loop (air filled)

Colon cutlass sign (gas filled segment)

CT-confirm and help look at complications

Rapid bolus IV contract CT-avoid is serum cr >1.5

MRI-fluid collection in pancreas correlates with mortality

EUS-biliary disease

ERCP-complication is pancreatitis-DO IT IN PATIENTS WITH CHOLANFITIS, JAUNDICE, BILE DUCT STONE , ASPIRATION OF BILE FOR CRYSTAL ANALYSIS MAY CONFRUM

313
Q

Treat acute pancreatitis

A

ICU

Aggressive IV fluid

No oral alimenataion and parenteral analgesics

Eliminate precipitating factors

314
Q

Risk factors for high levels of fluid sequestration in acute pancreatitis

A

Younger age, alcohol , higher hematocrit, higher serum glucose, systemic inflammatory response syndrome in first 48 hours of hospital admission

315
Q

How treat hypocalcemia with tetany in acute pancreatitis

A

Calcium gluconate IV

316
Q

How treat coagulopathy or hypoalbuminemia in acute pancreatitis

A

Infusion fresh frozen plasma or serum albumin

317
Q

How treat shock with acute pancreatitis

A

Vasopressin

PRBC

318
Q

Somplications SAP

A

Necrotizing pancreatitis
Intravascular volume depletion

Ileus

Elevations in amylase

Necrosis-pseudocysts

ARDS

Abscess

319
Q

_ or _ should be considered with any change in clinical course to monitor for complications acute pancreatitis

A

CT MRI

320
Q

Assessment of severity acute pancreatitis

A

Ransom criteria

Apache II

Bedside index for severity ina cute pancreatitis

Haps (harmless acute pancreatitis score0

321
Q

Apache ))

A

Over 8 high mortality

322
Q

Bedside index for severity in acute pancreatitis

A

BUN>25 age over 60

0-5
01% death
5 27% death

7-8 100%

323
Q

HAPS

A

Non severe course with 98% accuracy
No ab tenderness, rebound , guarding
Normal hematocrit

Normal serum creatinine level

324
Q

Revised Atlanta classification of the severity of acute pancreatitis

A

Mild-no organ failure, no local complications

Moderate-transient oragan failure, maybe local complications

Severe-persistent oral fail

325
Q

CT grade of severity index for acute pancreatitis

A

A-normal pancreas, b-pancreatic enlargement, cpancreatic inflammation and or peripancreatic fat, d single acute peripancreatic fluid collection , e-two or more acute peripancreatic fluid collection or retroperitoneal air

SIRS and elevated BUN on admission with a rise in BUN within first 24 hours
-increased .com

0-4

4, over 50% pancreatic necrosis, 17% mortality

326
Q

Chronic pancreatitis

A

Irreversible damage to pancreas
Pancreatic exocrine or endocrine insuffiency

Get DM and malabsorption

327
Q

Most frequent cause of chronic pancreatitis

A

Alcoholism

TIGARO

328
Q

Autoimmune pancreatitis

A

IgG4 autoantibodies

CFTR predispose
PRSS1 SPONK1

PAIN 
Steatorrhea malabsorption (exocrine pancreas insuffiency)
329
Q

Lab chronic pancretitis

A

No specific lab test for chronic pancreatitis

Amylase normal

Fecal elastase 1 and small bowel biopsy are useful int he evaluation of pets with suspected pancreatic steatorrhea

330
Q

Imaging chronic pancreatitis

A

Calcifications x ray

CT calcifications-tumefactive chronic pacnreatitis concer for pancreatic cancer

EUS-enlarge pancreat sutoimmune

331
Q

Treat chronic pancreatitis

A

abstain from alchol
Control pain with acetaminophen, NSAIDS, tramadol

Low fat diet

332
Q

Complications chronic pancreatitis

A

Chronic abdominal pain , DM, opoid narcotic addition, steatorrhea, malnutrition, pancreatic cancer

333
Q

Manic ause of death chronic pancreatitis

A

Pancreatic cancer

334
Q

Pancreatic adenocarcinoma

A

Trousseau sign of malignancy

Smoking, fat, male, old, DM, cirrhosis, family history, courvoiser sign, painless jaundice ,

335
Q

MEN

A

AD
Type 1 pancreatic neuroendocrine islet cell tumors

Insulinoma , gastrin OA

336
Q

Insulinoma

A

Insulin secretion hypoglycemia

337
Q

Gastrin OA ZE

A

MEN1

Nonbeta islaet cell tumors, hypersecretion of gastrin , peptic ulcers, refractory to standard Tx , found in duodenum,

338
Q

Men 1 tumors

A

Parathyroid(hyperca, PTH)

Pancreas (gastrin OA Ze, insulinoma)

Pituitary

339
Q

MEN2A

A

Thyroid (calcitonin)
Adrenal (pheochromocytoma)
PTM hyperca and ph

340
Q

MEN 2B

A

Marfanoid
Medullary thyroid cancer
Pheochromocytoma
Neuromas

341
Q

Problem with free unconjugated bilirubin

A

Toxic to CNS

Usually bind albumin , if not can cross BBB

342
Q

Why large amounts of unconjugated bilirubin in baby

A

Hemolysis inadequate clearance shorter half life
Inadequate conjugation

UGT levels low

343
Q

What causes unconjugated bilirubin

A

Hemolysis

344
Q

Breast feeding/breast milk jaundice

A

Function of dehydration and decreased excretion of bilirubin in the stool

Presence of bilirubin de conjugating enzymes in milk

345
Q

Is conjugated hyperbilirubinemia ever non pathological

A

No

346
Q

Why do babies have increased bilirubin production

A

Erythrocyte enzyme deficiencies

Blood group incompatibility

Structural defects in RBC
G6PD defiency

347
Q

Why do babies have impaired conjugation of bilirubin

A

Gilbert
Crig naj

Ugt1a1 defiency

348
Q

Why babies have increased enterohepatic circulation

A

Decreased intake, decreased passage of stool

349
Q

ABO incompatibility

A

No big deal in first preg but after Rh antibodies can cross placenta and hurt Rh+ fetus causing hydrops fetalis

If mom is type O or Rh negative

350
Q

If mom is type I or Rh negative what should we test infants cord

A

Direct antibody test Coombs

Blood type

Rh determination

351
Q

How does Coombs test work

A

Patient sample put with anti-HU IgG Coombs reagent and get agglutination if positive for presence of mothers AB on surface

352
Q

Conjugated hyperbilirubinemia

A

Biliary atresia cholestasis

353
Q

Acute bilirubin toxicity

A

High unconjugated

354
Q

Risk for hyperbilirubinemia

A

Jaundice in first 24 hours, gestational age 35-36 weeks
Bruising
Exclusive breastfeeding
Asian

355
Q

What should be gotten on exam with jaundice baby

A

TSB

356
Q

Prolonged jaundice greater than 3 weeks

A

2 months? Gilbert?

Breast milk jaundice

357
Q

Treat baby bilirubin

A

Phototherapy which osomerizede bilirubin making it water soluble

358
Q

Biliary atresia

A

Progressive destruction inflammatory process affecting extra and intrahepatic biliary tree

First few weeks

Cholestasis jaundice, hepatomegaly, alcholic stools

359
Q

Crigler najjar syndrome and phenobarbital

A

Type 1 no decrease in bilirubin

Type II decrease with phenobarbital

360
Q

Baby gastroesophageal reflux

A

Passage of gastric contents into esophagus

Happy spitter

361
Q

Baby GERD

A

Hard to feed, cry a lot, arch and scream, not gaining weight

362
Q

Treat GERD baby

A

Surgery

Fundoplication
More common in developmentally delayed children
Usually not until older and only if gerd is putting the child’s nutrition or respiratory status at risk

363
Q

Intussusception baby

A

Ileum invaginsttes into colon at ileocecal valve junction

364
Q

Clinical intussusception

A

Bright red blood mucus and currant jelly stools
Lethargy
Palpable tubular mass in abdomen
Air enema coiled spring

365
Q

Treat intussusception

A

Pneumatic reduction air enemies

366
Q

Pyloric stenosis

A 
2-4 weeks 
Boys 
Hypochloremic, hypokalemia, metabolic alkalosis, nontender epigastric olive sized area, 
Dehydration poor weight gain 
US
367
Q

Hirschsprung

A

Meconium none or require repeated rectal stimulation to induce bowel movements

Poor feeding villous vomiting

368
Q

Celiac disease symptoms

A

Diarrhea, failure to thrive, distended belly, cvomiting

Clin Medicine (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions