Test 2 - Created June 23 Flashcards
Mallory-Weiss vs Boerhaave
MW: mucosal tear, hematemesis, do upper GI
Boerhaave: transmural (bores through), crepitus and crunching sound (Hamman sign), do esophagography with water-soluble contrast, surgery consult
GI clinical findings of celiac
D, steatorrhea, wt loss, abd. pain, flatulence, bloating, ulcerative jejunitis, T-cell lymphoma
non-GI findings of celiac: skin, endo, bone, heme, neuropsych
skin: dermatitis herpetiformis, atrophic glossitis
endo: vit.D def, 2* hyperPTH
bone: osteomalacia, osteoporosis, rickets
heme: Fe def
neuropsych: peripheral neuropathy, depr, anx
antibodies for celiac disease
anti-endomysial
anti-tissue transglutaminase
when higher doses needed for levothyroxine
malabsorption (celiac for ex.), iron, calcium, sucralfate, CYP450 drugs (phenytoin, carbamazepine, rifampin), obesity, pregnancy, overt proteinuria
when to give RBC transfusion in pt with upper GI bleed
Hgb < 7 g/dL, hemodynamically unstable, OR sxs of severe anemia (CP, syncope)
when to give octreotide in setting of upper GI bleed
with variceal hemorrhage
when to give albumin infusion for GI issue
spontaneous bacterial peritonitis or large-volume paracentesis
when to give platelet transfusion
life-threateing bleed and plt’s < 50k OR in those taking anti-plt agents
sxs/signs of PBC
fatigue, itchy, infl. arthritis, tan, RUQ discomfort, xanthelasmata or xanthomata
dx and tx of PBC
dx: elev alk phos; +anti-mitochondrial Ab
tx: ursodiol, liver transplant
complications of PBC
osteopenia and osteoporosis
antibody for type 1 autoimmune hepatitis
anti-smooth muscle
sxs/signs of hemochromatosis
tan, DM, arthropathy, CMP
B2 deficiency
angular cheilosis and stomatitis
B1 deficiency
wet beriberi (CMP, polyneuropathy) and Wernicke-Korsakoff
B3 deficiency
dermatitis, D, dementia
chronic mesenteric ischemia: presentation and dx test
dull, crampy epigastric pain after eating; h/o of atherosclerotic dz; “intestinal angina”; need angiography
sxs of Dyspepsia
burning epigastric pain, N/V, epigastric fullness, heartburn
workup for Dyspepsia
over 60: upper endoscopy
< 60: H. pylori test; scope if high risk (bleed, wt loss, more severe sxs)
biliary colic presentation and workup
EPISODES of epigastric or RUQ discomfort with radiaiton to the back and R shoulder; N/V, sweaty; < 6h; benign PE; do U/S
when to do CCK cholescintigraphy on biliary colic patient
having typical biliary colic sxs but NO gallstones on prior imaging; CCK cholescintigraphy looks for functional GB disorder