Western Internal Medicine Test #2 Flashcards
Main risk factor for gastritis
HP bacteria
What medication do you add if a patient has gastritis and anemia?
Vitamin B 12
4 types of stomach cancer
Tubular gland cancer
Mucosa gland cancer
Pulpiform cancer
Diffuse cancer
What are the two organs spread to from stomach cancer?
Liver and lung
Paracancer syndromes?
Periphlebitis, dyspigmentation under axilla, skin color change
How is stomach cancer diagnosed?
Gastroscopy, biopsy
Main treatment for chronic gastritis
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.
Main cause of cirrhosis in Asia and US?
Asia - hepatitis
US - alcoholism
3 signs of portal hypertension
- Spleen enlargement
- Collateral circulation build up
- Ascites
Common complication of cirrhosis
HEPATIC COMA
also upper gastric bleeding, infection, hepatorenal syndrome
What is the main complication of cirrhosis that causes death
Hepatic coma
Hepatitis A transmission
fecal - oral, contaminated food, water, shellfish
Hepatitis B transmission
Percutaneous, sexual, perinatal
Hepatitis C transmission
Percutaneous, sexual
Hepatitis D transmission
Percutaneous, sexual, requires Hep b transmission
Hepatitis E transmission
Fecal - oral
Which hepatitis types are acute
Hep A, Hep B, Hep C, Hep D, Hep E
Which hepatitis types are chronic
Hep B, Hep C
Hep A serology
Acute: Anti HAVIgM
Post exposure: Anti-HAVIgG
Hep B serology
HBsAG+
Hep C serology
HCV RNA
Hep D serology
Anti HDV
Hep E serology
Anti-HEVIgM
Hep A vaccination
Yes
Hep B vaccination
Yes
Hep C vaccination
No
Hep D vaccination
immunize against Hep B
Hep E vaccination
No
Typical body sign of cirrhosis
The liver is hard and large upon palpation
What kind of medication can cause stomach cancer/ulcer?
NSAIDS
What is the routine test for stomach cancer/ulcer?
HP bacteria
Lab test to diagnose Duodenal ulcer
Stool is mucussy and bloody, colonoscopy
More pain after eating
Main risk factor of HCC (liver cancer)?
Cirrhosis (hep B infection, aflatoxin)
Which organs spread to by liver cancer?
Lung
Reliable features of angina
left chest sharp and fixed pain that radiates
Reliable features of gastric pain
Dull constant upper abdominal pain
Reliable features of liver pain
Right lower abdominal pain
Reliable features of kidney pain
Severe waxing and waning pain radiating from the back to the front
Reliable features of gallbladder pain
Murphy’s syndrome
Reliable features of pancreatic pain
belt like pain
Reliable features of appendix pain
McBurney’s syndrome
Which abdominal pain is relieved with vomiting?
Gastric obstruction
Which abdominal pain is not relieved with vomiting?
Angina?
Case study gastric pain/gastritis
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
Case study stomach cancer
Upper abdomen discomfort, no appetite, weight loss for one month
Lab test: gastroscope
Treatment: surgery, chemotherapy
Case study duodenal ulcer
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
Case study HCC/liver cancer
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
Symptoms of cirrhosis decomposition
Liver function decline Jaundice Anemia/bleeding Female hormones increase, male decreasee Liver pain Spider angioma Spleen enlargement
