review Flashcards
nocturnal diarrhea
organic caused not a functional problem but more of an inflammatory issue
inflammatory diarrhea usually presents with
bloody diarrhea except microscopic colitis which is inflammatory but does not present with blood
ways to identify causes of inflammatory diarrhea
stool cultures and colonoscopy w/ biopsys
diarrhea that will slow down if you dont eat
osmotic
diarrhea will not slow down with absence of eating
secretory
carcinoid syndrome is only present when
mets it reaches the liver.
identifying osmotic vs secretory
using the fecal osmotic gap:
osmotic > 125
secretory <50
electrolytes form a major role in this type of diarrhea
secretory
ways to identify steathorrea
- stool for detection of fat
- fecal elastase- pancreatic insufficiency
- serum IgA TTG- celiac
secretin stimulation test
invasive test for checking pancreatic insufficiency since secretin stimulates bicarb release… very sensitive test
NOD2 and CARD15
genetic susceptibility to crohs disease that involves the ileum
IBD is due to a
chronic inflammation mediator imbalance such as TNA-alpha and IL-12 that are elevated pro-inflammatory agents
UC will present with what type of diarrhea
bloody
complication seen only in UC and not in CD
toxic megacolon
long term of UC consequence
colon cancer; risk increases with years and surveillance is needed
microscopic colitis
possible drug induced chronic inflammation disorder of the colon
which one is more common acute colonic ischemia or acute mesenteric ischemia involving small intestine
acute colonic ischemia
which hepatitis viral infection will rarely result in fulmiant liver
HCV
HBsAg+
marker of chronic HBV
antibody produced in HCV
not protective just a marker
anti HBcIgM
acute HBV to the core antigen
resolved acute infection HBV serology
- antiHBs
- anti- HBcIgG
- anti-Hbe
non cirrhotic risk for people with a crhonic infection active immune
Hepatocellular carcinoma
in hereditary hemochromatosis where is starts first the deposits
periportal hepatocytes
- iron overload in blood transfusion starts at kuppfer cells
treatment for PBC and PSC
ursodiol
beaded apperance of the intrahepatic and extraheptic bile ducts
PSC
PSC will have
UC and CD
and there is an increase risk for colorectal cancer- cholangiosarcoma
benign non -neoplastic liver tumor
- nodular hyperplasia: FNH and NRH
2. Bile duct hamartoma
hepatic adenoma associated with
OCP
we have to watch this type of growth carefully due to their neoplastic capability
most common malignant tumor
mets
HCC risk
cirrhosis of any kind
most common cause of Portal HTN
intrahepatic- cirrhosis of sinusoids
what will be values of WHVp and FHVP in portal vein thrombosis
since this occurs pre-hepatic they will have normal values
SAAG > 1.1
cirrhosis- measures albumin gradient
potential triggers of hepatic encephalopathy
- GI bleed
- infection
- renal insufficiency
- sedative
- constipation
sitz marker study
check for constipation
diverticulitis
no bleeding but a lot of pain
diverticulosis
a lot of painless bleeding
most common cause of a small bowel obstruction
adhesion
tests that detect cancer and pre-cancerous polyps
structural tests
