FA GIT II Flashcards
(44 cards)
Lab Levels?
Deposition of hemosiderin (iron), caused by iron deposition.
How much can total body iron reach in hemochromatosis
50 g, enough to set off metal detectors at airports
How do you treat hereditary hemochromatosis?
Repeated Phlebotomy Deferoxamine
Hemochromatosis HLA Type Association
Associated with HLA-A3
What happens in secondary biliary cirrhosis? How does it present? Labs? Complicated by?
Extrahepatic biliary obstruction (gallstone, biliary stricture, chronic pancreatitis, carcinoma of the pancreatic head)-> increased pressure in intrahepatic ducts-> injury/fibrosis and bile stasis
What happens in primary biliary cirrhosis? Presents? Labs? Associated with?
Autoimmune reaction-> lymphocyte infiltrate + granulomas. Increase in serum mitochondrial antibody, including IgM
What is Primary Sclerosing Cholangitis? Presents? Labs? Associated with? Can lead to?
Unknown cause of concentric “onion skin” bile duct fibrosis-> alternating strictures and dilation with “beading” of intra and extrahepatic bile duts on ERCP
Gallstones causes and what are the types?
Caused by increased cholesterol and/or billirubin, decreased bile salts and gallbladder stasis all cause stones.
Cholesterol Stones? What percentages? Causes?
Radiolucent with 10-20% Opaque due to calcifications- 80% of stones, associated with obesity, Crohn’s disease, cystic fibrosis, advanced age, clofibrate, estrogens, multiparity,rapidd weight loss, and native american origin.
Pigment Stones
Radiopaque- seen in patients with chronic hemolysis, alcoholic cirrhosis, advanced age, and biliary infection.
What can gallstones cause?
can most often cause cholecytisis, also ascending cholangitis, acute pancreatitis, and bile stasis
How do you diagnose and treat gallstones
Diagnose with ultrasound. Treat with cholecystectomy.
What are some risk factors for gallstones?
Female, Fat, Fertile, and Forty. 4F’s
What is murphy’s sign
Inspiratory arrest on deep palpation due to pain.
What is charcot’s triad of cholangitis?
Jaundice, Fever, Right Upper Quadrant Pain
Cholecystitis
Inflammation of gallbladder, usually from gallstones. Rarely ischemia or infectious (CMV).
What happens in acute pancreatitis? Causes? Presentation, Labs, Can lead to?
Autodigestion of pancreas by pancreatic enzymes.
What can chronic pancreatitis lead to
Can lead to pancreatic insufficiency, steatorrhea, fat-soluble vitamin deficiency, and diabetes mellitis
Chronic Calcifying Pancreatitis is strongly associated with? Increased risk of?
Alcoholism and Smoking, Increasing Risk of Pancreatic Cancer
Presents with?
Prognosis averages 6 months or less, very aggressive, usually already metastasized at presentation, tuors more common in pancreatic head (obstructive jaundice).
Name some proton pump inhibitors, Mechanism of action, and clinical use?
Omeprazole and lansoprazole
Name some H2 blockers, Mechanism of action, Clinical Use
Cimetidine, Ranitinde, Famotidine, Nizatidine
What are some of cimetidine’s side effects?
Potent inhibitor of P450, antiandrogenic efffects (prolactin release, gynecomastia, impotence, decreased libido in males), can cross blood brain barrier (confusion, dizziness, and headaches) and placenta. Decreases renal excretion of creatinine.
What are ranitidine’s side effect?
Decreased renal excretion of creatinine.
