UWORLD Flashcards
patient with septic shock has huuuuuuuge increase AST/ALT, little increase in total bile/alk phos
shock liver (ischemic hepatic injury)
3 criteria for acute liver failure
- hepatic encephalopathy
- PT/INR > 1.5
- elevated transaminases
What conditions make a diverticulitis “complicated”?
abscess, fistula, perforation, obstruction
How to treat diverticulitis abscesses?
<3cm - IV abs, observation
>3cm/worsening symptoms - surgery
young woman on OCPs, develops dull RUQ pain, cholesttatic symptoms, solitary hyper echoic/solid lesion in liver
hepatic adenoma
how to work up bilious emesis in neonate
- immediate x-ray
- CONTRAST studies to determine level of obstruction
Neonate (hours old) has bright green vomiting, has not had a bowel movement yet, CFTR F 508 mutation
meconium ileus
likely 2/2 CF
child with impaired adaptation to darkness, photophobia, dry sealy skin, xerosis cornea, hyperkeratosis shoulders/butocks, extensors, silver grey plaques on bulbar conjunctiva (Biltot spots)
vitA deficiency
4 week intermittent bloody diarrhea, develops more severe symptoms with fever, hypotension, and diffuse abdominal tenderness, decreased bowel sounds
toxic megacolon (likely from undx IBD) CONFIRM WITH ABDOMINAL X-RAY to see dilated bowel loops
positive urobilinogen in urine vs positive bilirubin in urine
urobilnogen - high unconj bilirubin
bilirubin - high conj bilirubin
how do dx pancreatic cancer (most sensitive test)
IMAGING
u/s or abdominal CT of U/s inconclusive
CA-19-9 tumor marker good for evaluating treatment response BUT NOT FOR SCREENING
which cause of anion gap metabolic acidosis can cause rectangular envelope shaped stones and renal acute renal failure
ethylene glycol
which cause of anion gap met acidosis can cause blindness
methanol
elderly patient with cardiac risk factors develops acute abdominal pain that worsens, becomes diffuse, associated with metabolic acidosis, elevated amylase and phosphate
acute mesenteric ischemia
acidosis is from increased lactate from ischemia
IBD with noncaseating granulomas on biopsy
chron’s
IBD associated with toxic megacolon
UC
IBD associated with pseudopolyps
UC
frequent water diarrhea (10-20 BMs per day), hypokaelima, metabolic alkalosis, dark brown discoloration of colon with pale patches of lymph follicles
laxative abuse
(melanosis coli is black discoloration)
could be VIPoma but this isn’t a/w melanosis
chronic relic pain, voiding symptoms, pain with ejaculation, negative urine culture, positive for leukocytes
chronic prostatitis (noninfectious chronic prostate inflammation)
rx long QT syndrome
beta blocker with pacemaker to prevent exertion heart rate and prevent torsades
person with churn’s s/p ideal resection presents with patchy alopecia, pustular crusting skin rash, impaired taste
zinc deficiency
person with churn’s s/p ileal resection presents with thyroid dysfunction, heart failure symptoms
selenium deficiency
person with chron’s s/p ileal resection presents with fragile hair, skin depigmentation, neurologic dysfunction…
copper deficiency
GI side effect of isoniazid
DRUG INDUCED HEPATITIS
