Basics Flashcards
(20 cards)
initial treatment of cirrhotic ascites
restriction of sodium intake to 2 g/d
persistence of ascites despite sodium restriction and maximal (or maximally tolerated) diuretic use
refractory cirrhotic ascites
Mgt refractory ascites
serial large volume paracentesis (LVP)
transjugular intrahepatic peritoneal shunt (TIPS)
SBP is defined by a polymorphonuclear neutrophil (PMN) count of____
250/mm3
gas normally contained in N small intestine
200 ml
An abdominal ultrasound can detect as little as ______ of ascites
100 mL
Pathogenesis in the Absence of Cirrhosis
peritoneal carcinomatosis, peritoneal infection, or pancreatic disease
diarrhoea diminished absorption of one or more dietary nutrients
osmotic diarrhea
diarrhea that is due to small- and/or large-intestinal fluid and electrolyte secretion
secretory diarrhea
stool osmotic gap
2 x (stool [Na+] + stool [K+]) stool osmolality presence of a significant osmotic gap suggests the presence in stool water of a substance (or substances) other than Na/K anions that is presumably responsible for the patient's diarrhea
stool osmotic gap high
> 50
diarrhea, a result of bile acids in the colon stimulating active Cl secretion
bile acid diarrhea, or choleretic enteropathy
Rx: cholestyramine
greater degrees of ileal disease and/or resection
>20 g steatorrhea
no response to cholestyramine
fatty acid diarrhea
a defect in neutral amino acid transport, is characterized by a pellagra-like rash and neuropsychiatric symptoms
Hartnup syndrome
defect in dibasic amino acid transport, is associated with renal calculi and chronic pancreatitis
Cystinuria
due to an absence of the brush border enzyme that converts the proenzyme trypsinogen to trypsin and is associated with diarrhea, growth retardation, and hypoproteinemia
Enterokinase deficiency
Establishing the presence of steatorrhea
gold standard
timed, quantitative stool fat determination
This test is performed to determine the cause of cobalamin malabsorption
THE SCHILLING TEST
test for carbohydrate absorption provides an assessment of proximal small-intestinal mucosal function.
URINARY D-XYLOSE TEST
characterized by a normal mucosal appearance except for the presence of mucosal absorptive cells that contain lipid postprandially and disappear following a prolonged period of either fat-free intake or fasting
Abetalipoproteinemia
