GI and Hepatic disorders Flashcards
How is GERD diagnosed?
Clinically
No need for endoscopy, barium swallow, or Hpylori testing.
Consider endoscopy when…
ALARMS
Anemia Loss of weight Anorexia Recent onset of progressive symptoms Melena or hematemesis Swallowing difficulty
Referral to GI is made for GERD when?
when patients fail with PPI dosing bid and at maximum dose
Upper endoscopy should be performed
Protracted use of PPIs cause adverse effect of micronutrient malabsorption of which nutrients?
Micronutrient malabsorption of
Vitamin B12
Calcium and magnesium
iron
Protracted use of PPIs causes adverse effects, what are they?
Increased risk for Cdiff
pneumonia
fractures
True or false
PPI use for 8 or more weeks causes rebound acidity?
True
Viral or bacterial? WBC 5.5 Neutr 40% Bands 3% Lymphs 55% w/reactive forms
Viral
due to the increased lymphs (NL is 30%)
Normal WBC
Viral or bacterial? WBC 16.5 Neut 71% w/toxic granulation Bands 6% Lymphs 20%
Bacterial High WBC Neutrophilia (NL 60%) Lymphs low (NL 30%) Called a left shift
Mnemonic Nobody likes my educational background…..
Neutrophils 60% Lymphocytes 30% Monocytes 6% debris clean up after infection Eosinophils 3% allergens Basophils 1%
What does it mean when the patient is HBsAG (Hepatitis B surface antigen) Positive
evident with acute or chronic Hep B infection
If they are asymptomatic likely chronic
What does it mean when the patient is Anti-HAV positive?
Antibodies are present for Hepatitis A the person is immune
What does it mean when the patient is Anti-HCV negative?
there is no evidence of past or present exposure to Hepatitis C
What does it mean when the patient is HCV RNA positive?
Evidence of current HCV
What does it mean when the patient is Anti-HBs/HBSab positive?
Evidence of immunity to HBV
ALT is more________specific
Liver
