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Ahmed GI Sadness 1 > Fatigue and Weight Loss DSA > Flashcards

Fatigue and Weight Loss DSA Flashcards

1
Q

What is absorbed in the:

  1. proximal SI
  2. distal SI
  3. colon
A
  1. calcium, iron, folate, fats, carbs, triglycerides
  2. vitamin b12, bile salts, water
  3. electorlytes, water
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2
Q

If a pt comes in with fever, chills night sweats, or weight loss associated with their fatigue, you should think of?

A

infection or malignancy

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3
Q

When should you evaluate weight loss?

A

loss of 5-10% loss of body weight over 6 months

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4
Q

When presenting with weight loss, what should all pts receive?

A

stool test for occult blood

men - recta/prostate exam

women - pelvic exam

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5
Q

What are the most common causes of occult bleeding with iron deficiency?

A
  1. Cancer
  2. Vascular abnormalities
  3. Acid-peptic lesions (ex. PUD)
  4. Infections (ex. nematdes, TB)
  5. Medications (ex. NSAIDs)
  6. IBD (CD > UC)
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6
Q

If a premenopausal woman has iron deficiency anemia, it is most likely due to what?

A

menstraul and pregnancy associated iron loss

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7
Q

Patients with iron deficiency anemia should be evaluated for?

A

celiac disease

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8
Q

What is a big difference between colonoscopy and CT colonography?

A

Colonoscopy is diagnostic and therapeutic

CT colonography is diagnostic only

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9
Q

What is a distinguishing sx of Peutz-Jeghers syndrome? What type of polyps are present?

A

mucocutaneous pigmented macules on lips, buccal mucosa, and skin

harmartomatous polyps - not malignant

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10
Q

38 y/o women presents to her ob/gyn one month post-partum. She says her and her husband have decided they do not wish to have any more children. Based on her hx, she is recommended to get a hysterectomy. What condition would have encouraged this?

A

Lynch Syndrome - prophylactic hysterectomy and oophorectomy recommended age 40+ or when they are done having kids

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11
Q

What is Cowden Disease?

A

PTEN multiple hamartoma syndrome

  • hamartomatous polyps and lipomas throughout the GI tract, trichilemmomas, and cerebellar lesions
  • An increased rate of malignancy is demonstrated in the thyroid, breast, and urogenital tract
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12
Q

In tests that detect mutated genes associated with colon cancer, what can cause a false positive? false negative?

A

positive - red meat, iron, aspirin, UGIB

negative - vitamin C, intermittent bleeding

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13
Q

What do you suspect to be the cause of liver cancer in an Asian or African pt? What might have helped prevent this cancer?

A

Hep B or C infection

hep b vaccine

IFN-alpha can prevent liver cancer in those with chronic, active hep c (and maybe hep b)

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14
Q

What do iCCAs arise from? eCCAs?

A
  1. iCCA originates from adult cholangiocytes, trans- differentiation of adult hepatocytes and hepatic progenitor cells
  2. eCCA arises from the biliary epithelium and peribiliary glands
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15
Q

What is a big risk factor for cholangiocarcinomas?

A

Primary sclerosing cholangitis

PSC pts are recommended to get CA 19.9 serum testing and annual imaging for CCA surveillance

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16
Q

What is the major risk factor for GB cancer? What polyps are a risk?

A

cholelithiasis

GB polyps > 10mm in diameter

17
Q

What IBD is associated with toxic megacolon?

A

UC

18
Q

How is chronic hepatitis classified?

A

Grade- histologic assessment of necrosis and inflammatory

activity; based on exam of liver bx

Stage- reflects the level of disease progression and is based

on the degree of fibrosis

19
Q

Pts with cirrhosis should receive what?

A

HAV, HBV, pneumococcal vaccines

yearly influenza vaccines

20
Q

What are atypical sx of celiac disease?

A

dermatitis herpetiformis (not present in IgA deficient pts)

iron deficiency anemia

osteoporosis

21
Q

What type of diarrhea is seen in bile salt malabsorption?

A

watery secretory diarrhea

22
Q

What are the significant lab values for pancreatic insufficiency?

A

decreased fecal chymotrypsin

decreased pancreatic fecal elastase

23
Q

How common is it for ppl w/ pancreatitis to develop DM?

A

80% develop DM after 25 yrs of chronic pancreatitis

24
Q

What is the pneumonic for chronic pancreatitis?

A

TIGAR-O

Toxic-metabolic = alcoholic (45-80% of cases)

Idiopathic (early or late onset)

Genetic (CF, SPINK1, PSTI, PRSS1)

Autoimmune (hypergammaglobulinemia [IgG4], celiac dz)

Recurrent

Obstructive (stone, stricture, or tumor)

25
Q

Where are bile salts reabsorbed?

A

terminal ileum

26
Q

Where is a biopsy performed to dx whipple dz?

A

duodenum –> do PAS to look for macrophages w/ bacilli

27
Q

Is weight loss characteristic of bile salt reabsorption?

A

it is minimal in this dz

28
Q

What lower GI complication is a complication of cystic fibrosis?

A

rectal prolapse

29
Q

What is CEA used for?

A

done before surgery to remove colon CA

also used as a marker of Tx

not for dx

30
Q

What is alpha fetoprotein a marker of?

A

hepatocellular CA

31
Q

What should you consider in a pt w/ painless jaundice, elevated CA 19-9, and hx of UC?

A

cholangiocarcinoma

CA 19-9 specific for pancreatic ductal CA only if there is not a ductal cause

bc pts hx of UC –> incr risk of primary sclerosing choliangitis –> incr risk of cholangiocarcinoma

Ahmed GI Sadness 1 (25 decks)

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