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ICTCM Year 4 > Western Internal Medicine Test #2 > Flashcards

Western Internal Medicine Test #2 Flashcards

1
Q

Main risk factor for gastritis

A

HP bacteria

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2
Q

What medication do you add if a patient has gastritis and anemia?

A

Vitamin B 12

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3
Q

4 types of stomach cancer

A

Tubular gland cancer
Mucosa gland cancer
Pulpiform cancer
Diffuse cancer

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4
Q

What are the two organs spread to from stomach cancer?

A

Liver and lung

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5
Q

Paracancer syndromes?

A

Periphlebitis, dyspigmentation under axilla, skin color change

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6
Q

How is stomach cancer diagnosed?

A

Gastroscopy, biopsy

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7
Q

Main treatment for chronic gastritis

A

If because of HP bacteria: colloidal bismuth and emoprazole, lansoprazole

If not because of HP bacteria: stop NSAIDS, if bile reflux take hydrotalcite, aluminum hydroxide

Stop drinking alcohol and smoking. Eat fresh vegetables and fruits, less smoked meat and preserved foods.

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8
Q

Main cause of cirrhosis in Asia and US?

A

Asia - hepatitis

US - alcoholism

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9
Q

3 signs of portal hypertension

A
  1. Spleen enlargement
  2. Collateral circulation build up
  3. Ascites
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10
Q

Common complication of cirrhosis

A

HEPATIC COMA

also upper gastric bleeding, infection, hepatorenal syndrome

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11
Q

What is the main complication of cirrhosis that causes death

A

Hepatic coma

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12
Q

Hepatitis A transmission

A

fecal - oral, contaminated food, water, shellfish

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13
Q

Hepatitis B transmission

A

Percutaneous, sexual, perinatal

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14
Q

Hepatitis C transmission

A

Percutaneous, sexual

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15
Q

Hepatitis D transmission

A

Percutaneous, sexual, requires Hep b transmission

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16
Q

Hepatitis E transmission

A

Fecal - oral

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17
Q

Which hepatitis types are acute

A

Hep A, Hep B, Hep C, Hep D, Hep E

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18
Q

Which hepatitis types are chronic

A

Hep B, Hep C

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19
Q

Hep A serology

A

Acute: Anti HAVIgM

Post exposure: Anti-HAVIgG

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20
Q

Hep B serology

A

HBsAG+

21
Q

Hep C serology

A

HCV RNA

22
Q

Hep D serology

A

Anti HDV

23
Q

Hep E serology

A

Anti-HEVIgM

24
Q

Hep A vaccination

A

Yes

25
Q

Hep B vaccination

A

Yes

26
Q

Hep C vaccination

A

No

27
Q

Hep D vaccination

A

immunize against Hep B

28
Q

Hep E vaccination

A

No

29
Q

Typical body sign of cirrhosis

A

The liver is hard and large upon palpation

30
Q

What kind of medication can cause stomach cancer/ulcer?

A

NSAIDS

31
Q

What is the routine test for stomach cancer/ulcer?

A

HP bacteria

32
Q

Lab test to diagnose Duodenal ulcer

A

Stool is mucussy and bloody, colonoscopy

More pain after eating

33
Q

Main risk factor of HCC (liver cancer)?

A

Cirrhosis (hep B infection, aflatoxin)

34
Q

Which organs spread to by liver cancer?

A

Lung

35
Q

Reliable features of angina

A

left chest sharp and fixed pain that radiates

36
Q

Reliable features of gastric pain

A

Dull constant upper abdominal pain

37
Q

Reliable features of liver pain

A

Right lower abdominal pain

38
Q

Reliable features of kidney pain

A

Severe waxing and waning pain radiating from the back to the front

39
Q

Reliable features of gallbladder pain

A

Murphy’s syndrome

40
Q

Reliable features of pancreatic pain

A

belt like pain

41
Q

Reliable features of appendix pain

A

McBurney’s syndrome

42
Q

Which abdominal pain is relieved with vomiting?

A

Gastric obstruction

43
Q

Which abdominal pain is not relieved with vomiting?

A

Angina?

44
Q

Case study gastric pain/gastritis

A

Upper abdomen irregular distending pain for 3 years, usually happens after improper diet, sometimes with acid reflux, belching, ECG is negative.

Diagnosis: gastroscope, biopsy, HP breath test

Treatment: stop NSAIDS, no alcohol or smoking

45
Q

Case study stomach cancer

A

Upper abdomen discomfort, no appetite, weight loss for one month

Lab test: gastroscope

Treatment: surgery, chemotherapy

46
Q

Case study duodenal ulcer

A

Recurrent upper abdominal pain, gets worse when hungry, relieved after food, the pain gets worse after food then vomits, distending pain reduced. Mild dehydration, upper abdomen water sound

DU with pyloric obstruct

Lab tests: stool test, colonoscopy

Diagnosis: colonoscopy

Differentiation: can find bacteria in the stool, chron’s disease does not have blood in the stool, IBS has no blood in the stool

47
Q

Case study HCC/liver cancer

A

Right upper abdomen distending pain getting worse and worse, spider agonise on the face, right upper abdomen pressing pain, emaciation, the liver feels large and hard to touch

Lab test: AFP, ultrasound, CT scan, x ray

Differentiate: cirrhosis, liver disease/hepatitis, liver abscess

Treatment: surgery, chemo, radiation

48
Q

Symptoms of cirrhosis decomposition

A 
Liver function decline
Jaundice
Anemia/bleeding
Female hormones increase, male decreasee
Liver pain
Spider angioma
Spleen enlargement

ICTCM Year 4 (12 decks)

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