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Examen residencia > GASTRO > Flashcards

GASTRO Flashcards

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1
Q

diagnostico de REFLUJO GE

A
  1. 2 SEMANAS CON IBP
  2. SI NO FUNCIONA 24-hour esophageal pH monitoring is the answer
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2
Q

presentacion no clasica de RGE

A

TOS NOCTURA, NEUMONITIS RECURRENTE

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3
Q

esofago de barret que estudio se hace para confirmar metaplasia

A

biopsia luego de ser observado en endoscopia.

OJO HAY MAS RIESGO DE ADENOCARCINOMA

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4
Q

patient over 50 who has Hx of GERD with either 1) new-onset dysphagia to solids, or 2) dysphagia to solids that progresses to solids and liquids.

A

ADENOCARCINOMA

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5
Q

PASOS DE ESTUDIO DE ADENOCARCINOMA

A
  1. ENDOSCOPIA
  2. BIOPSIA
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6
Q

patient over 50 who is heavy smoker/drinker who has 1) new- onset dysphagia to solids, or 2) dysphagia to solids that progresses to solids and liquids.

A

CARCINOMA DE CELULAS ESCAMOSAS

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7
Q

VENA RESPONSABLE DE VARICES ESOFAGICAS

A

GASTRICA IZQUIERDA

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8
Q

high-volume hematemesis

A

VARICES ESOFAGICAS

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9
Q

TTO VARICES ESOFAGICAS

A
  1. endoscopy + banding.
  2. OCTEOTRIDO
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10
Q

­ insulin high but ̄ C peptide, answer

A

inyección exogena

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11
Q

­ insulin high C-peptide is normal/high

A

insulin production is endogenous.

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12
Q

COMO DIFERENCIAR SI LA PRODUCCION DE INSULINA ES ENDOGENA POR FCOS O POR ISULINOMA

A

First step is checking serum hypoglycemic levels (“serum hypoglycemic” = type II diabetes med that ̄ glucose, such as sulfonylureas and meglitinides). If serum hypoglycemics are negative, then do CT of abdomen to check for insulinoma.

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13
Q

Whipple triad:

A
  1. HIPOGLICEMIA
  2. SX DE HIPOGLICEMIA
  3. MEJORA CON COMIDAS
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14
Q

EFECTOS DE HIPERINSULINEMIA

A

1.INH FORMACION DE CETONAS
2. anovulation / polycystic ovarian syndrome
3.acanthosis nigricans,

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15
Q

funcion de somatostatina

A
  • ̄ secretion of most GI hormones, as well as growth hormone.
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16
Q

hormona producida x cells enteroendocrinas

A

grelina

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17
Q

la leptina producida por adipocitos estimula la secrecion pituitaria de que hormona

A

GnRH

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18
Q

que ulceras pepticas causan dolor 1-2 horas despues de comer

A

ulceras duodenales

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19
Q

Responsible for almost all duodenal ulcers >95%

A

Helicobacter pylori

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20
Q

Mechanism for ulcers caused by h. pulori

A

aumenta­ gastrin levels, which aumenta ­ acid secretion.

  • Produces urease, which causes aumento ­ ammonia production around the organism, allowing it to survive in the acid pH of the stomach.
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21
Q

DIAGNOSIS OF H. PYLORI

A

UREASE BREATH TEST
ANTIGENO EN POPO

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22
Q

TTO H. PYLORI (CAI)

A

CLARITROMICINA
AMOXICILINA
IBP

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23
Q

TTO PARA ULCERAS GASTRICS CAUSADA POR AINES (ABORTO)

Study These Flashcards
A

MISOPROSTOL que es un analogo de PGE1 para aumentar las prostaglandinas que los AINES inh

24
Q

3 mecanismos para la produccion de acido

OJO: Gastrina, histamina , acetilcolina.

Study These Flashcards
A
  • GASTRINA UNIENDOSE A SU RECEPTOR EN CELULAS PARIETALES
  • GASTRINA ESTIMULA A LAS ENTEROCROMAFINAS PARA SECRETAR HISTAMINA Y POST UNION A SU RECEPTOR EN CELULAS PARIETALES
    *ATIVIDAD PARASIMPATICA DIRECTA_ ACH SE UNE A REC MUSCARINICO EN CELULAS PARIETALES
25
3 causas de gastritis
- h. pylori - anemia perniciosa: x desrtuccion de c. parietales - AINES
26
painless, palpable gallbladder in an afebrile patient who’s jaundiced
Courvoisier sign
27
dx de cancer de pancreas
TAC DE ABDOMEN ENZIMAS PANCREATICAS SON NORMALES AUMENTO DE BILIRRUBINA -- ICTERICIA OBSTRUCTIVA
28
4Fs = Fat, Forties, Female, Fertile QUE GENERA
“increased secretion of cholesterol into bile.” para producir los calculos de colesterol
29
colelitiasis en embarazo es comun fisiopatologicamente por:
aumento de progesterona que disminuye la peristalsis biliar
30
DX DE COLELITIASIS
ECO ABDOMINAL
31
DIFERENCIA ENTRE COLELITIASIS Y COLECISTITIS
LA FIEBRE POR INFECCION LUEGO DE OBSTRUCCION POR CALCULO
32
CAUSANTE DE COLECISTITIS ENFISEMATOSA
Clostridium perfringens
33
caundo comenzar colonoscopia para ca de colon
45 - 50 y erepetir cada 10 años
34
colonoscopiaando hacer colonoscopia cunado tiene a papa o hermano con dx de cancer de colon
a los 40 o 10 años previos al dx de faamiliar y repetir cada 5 años
35
cuando hacer colonoscopia en pacientes con CU o crohn
8 dps de dx y dps cada 2-3 años
36
sx de lynch cada cuanto se repite colono y cuando empezar
1-2 años a los 20-25 años empiezas
37
vomito en protectil NO bilioso en neonatos dx ?
estenosis piloro
38
CU o crohn tiene + riesgo de ca de colon
CU
39
Enfermedad inflmatoria rectum ascending, que solo afecta mucosa y submucosa, no hay fistulas, con pseudopolipos y abscesos en criptas y perdidas de haustras
Colitits ulcerativa
40
lugar + frecuente de crohn
ileo terminal
41
lesiones de crohn caracteristicas mostradas en colonoscopia
skip lesssions with cobllestone ulcers (empedrado)
42
tto enfermedad inflamatoria intestinal
sulfazalazina o esteroides
43
cuales son las hepatitis agudas
A y E
44
(+) Surface antibody / (-) Core antibody para hepatitis b
Vacunado inmune
45
(+) Surface antibody / (+) Core antibody
Tuvo hepatitis b y ahora esta inmune
46
- (-) Surface antibody / (-) Core antibody hep b
debe vacunarse contra hep b
47
- (-) Surface antigen / (-) Surface antibody / (+) Core antibody IgM hep B
periodo de ventana
48
hepatitis qeu requiere pre infeccion de hepatitis b
hepatitis D
49
IgG + en hepatitis C que significa
infeccion cronica
50
transaminasa + aumentada durante hepatitis virales
ALT
51
efecto adverso mas importante de estatinas
miopatia
52
3 most important causes of pseudogout.
hemochromatosis, primary hyperparathyroidism, and hypothyroidism
53
is ­ high risk of hepatocellular carcinoma.
hemochromatosis
54
dx de hemochromatosis
ferritin >300 mg/dL. Transferrin saturation high Treat with serial phlebotomy,
55
­ urinary copper + ̄ serum ceruloplasmin, Keiser-Fleischer rings - Parkinsonism in a young patient
wilsons disease
55

Examen residencia (8 decks)

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