Test 29 - IM GI/GU Flashcards
What happens to kidneys if hypertension is left untreated?
Renal scarring - atherosclerotic lesions of the afferent and efferent arterioles. Glomerular sclerosis. Nephrosclerosis showing intimal thickening and luminal narrowing.
Patients with carcinoid syndrome are at risk of developing a deficiency in what vitamin or mineral? Why?
Niacin (B3). Because carcinoid tumor produces lots of serotonin. Serotonin is synthesized from tryptophan. Tryptophan is also used to produce niacin.
What is the presentation of acute epididymitis?
fever, painful enlarged testes, irritation when voiding
What are the differences and causes of sexually transmitted v non-sexually transmitted acute epididymitis?
Sexually transmitted acute epididymitis:
- More common in young people
- Presents with pain at the tip of the penis and urethral discharge
- Caused by gonorrhea and chlamydia
Non-sexually transmitted:
- occurs in older persons
- Associated with UTI symptoms
- Causes by E. coli most commonly then, pseudomonas,
What are symptoms of diffuse esophageal spasm?
spontaneous pain, pain triggered by hot or cold foods
resolves with sublingual nitrates that cause relaxation and stop the spasm
How do you diagnose diffuse esophageal spasm?
Esophageal manometry - shows repetitive non-peristaltic high amplitude contractions wither spontaneously or after ergonovine stimulation
Differentiate carcinoid syndrome v VIPoma presentation/ signs/ symptoms
Both have: episodic flushing, diarrhea, weight loss, lethargy, nausea, vomitting, abdominal pain. (from liver mets producing systemic symptoms)
Carcinoid syndrome: Tumor is in small bowel w/ liver mets.
VIPoma: tumor is in tail of pancreas with liver mets. Diarrhea is more watery and volumous, leading to signs of dehydration (muscle cramps, dry oral mucosa). HYPOKALEMIA on labs is a huge clue. Also hyperglycemia due to increase glycogenolysis.
