Gastroenterology Flashcards
(62 cards)
Pancreatic cyst diagnosis
Surveillance with MRI
< 1cm: 2 yrs follow up
1-2 cm : 2 yrs
< 3 cm & asx: annual follow up
Alarming features of pancreatic cyst
- Main pancreatic do more than 5MM
- Change in main pancreatic duct calibre
- obstructive jaundice,
, or associated mass
What is tropical sprue?
A syndrome that occurs in tropical climates characterized by chronic diarrhea, weight loss, and malabsorption of nutrients due to villous atrophy.
It is important to note that the exact cause is unknown.
What are the symptoms of tropical sprue?
Chronic diarrhea, weight loss, malabsorption of nutrients, and glossitis due to iron deficiency.
Glossitis is inflammation of the tongue, often linked to nutritional deficiencies.
What is the suspected cause of tropical sprue?
Unknown, but thought to be due to a microbial infection.
Research is ongoing to identify the specific pathogens involved.
What is the empiric treatment for tropical sprue?
Oral tetracycline 250 mg four times daily.
This treatment has been shown to be effective in managing symptoms.
What does esophagogastroduodenoscopy reveal in cases of tropical sprue?
A scalloped and nodular duodenum.
These findings are indicative of the structural changes associated with the disease.
What histological findings are associated with tropical sprue?
Villous atrophy and intraepithelial lymphocytosis.
These changes reflect the damage to the intestinal lining and immune response.
What physical examination findings are common in tropical sprue patients?
Glossitis, hyperactive bowel sounds, and 2+ lower extremity edema to the shins.
Edema is often associated with malnutrition and fluid retention.
What are adenomatous polyps?
The most common type of colonic polyp that is dysplastic and has malignant potential.
What is the recommended first surveillance colonoscopy interval for patients with any advanced adenoma?
In 3 years.
What defines an advanced adenoma?
≥1 cm or with villous histology or high-grade dysplasia.
What types of lesions on colonoscopy affect the recommended screening interval?
- Hyperplastic polyps
- Sessile serrated polyps (SSPs)
What is the recommendation for surveillance colonoscopy interval for patients who had a piecemeal resection of an adenoma ≥20 mm?
6-month interval.
What is the recommendation for surveillance colonoscopy interval for patients who had 3–4 tubular adenomas <10 mm?
5-year interval.
What is the recommendation for surveillance colonoscopy interval for patients who had >10 adenomas on a single examination?
1-year interval.
What is Gilbert syndrome?
A benign cause of isolated unconjugated hyperbilirubinemia resulting from decreased expression of the UDP-glucuronyl transferase type 1 enzyme.
What percentage of the general population is affected by Gilbert syndrome?
Up to 5%.
What can exacerbate hyperbilirubinemia in Gilbert syndrome?
Fasting or periods of physical stress, such as respiratory illness.
What is the typical total bilirubin level in patients with Gilbert syndrome?
Generally less than 4 mg/dL.
What is Crigler-Najjar syndrome?
A rare disorder that usually manifests shortly after birth with markedly elevated, unconjugated bilirubin levels.
What condition is associated with unconjugated hyperbilirubinemia?
Hemolysis.
Hemolysis sufficient to cause jaundice usually presents with anemic patients and abnormal peripheral-blood smears.
What deficiency can lead to hemolysis that precipitates jaundice?
Glucose-6-phosphate dehydrogenase deficiency.
What condition is indicated by the presence of esophageal varices in the absence of stigmata of chronic liver disease?
Portal hypertension
This finding suggests an underlying condition like schistosomiasis.
