Flashcards in Gastroenterology Deck (59)
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1
acute pancreatitis labs and imaging
- inc serum amylase/lipase
- **ALT > 150 biliary pancreatitis
IMAGING:
-**CT with IV contrast
- Xray shows sentinel loop (dilation segment) with no peristalsis (caused by inflammation of pancreas)
2
Cullen's sign
- periumbilical hemorrhage visible as a bruise under umbilicus (acute pancreatitis)
3
Grey-Turner sign
flank hemorrhage - looks like bruise in flank region (acute pancreatitis)
4
chronic pancreatitis labs/imaging
- CT, US and XRay shows calcification; CT and US also show dilated pancreatic ducts and pseudocyst
- Inc serum ALP, serum glucose,
- Amyase and lipase will either be increased or normal
5
peritonitis labs/imaging
- plain films of abdomen
- peritoneal fluid analysis (examine neutrophil count)
- tests to r/o other causes (Liver fxn, CBC, Abd US, UA)
6
most common cause of death from portal HTN/liver cirrhosis
rupture of esophageal varices
7
most common type of hiatal hernia
sliding
8
in sliding hernia, where is the gastroesophageal junction
above the diaphragmatic esophageal hiatus
9
imaging for hiatal hernia
- barium swallow, endoscopy, esophageal manometry (procedure for measuring LES pressure)
- gastroscopy with biopsy (to r/o barrett's esophagitis and cancer)
10
Esophageal carcinoma m/c in males or females?
males, common cause of cancer death
11
Risk factors of Squamous Cell Carcinoma Esophageal Carcinoma
4S's: Smoking, Spirits (alcohol), Seeds (betel nut), Scalding hot liquids
12
Imaging for esophageal cancer
- barium swallow (very sensitive for detecting masses but NOT diagnostic)
- Esophagoscopy (visualize and biopsy)
- Endoscopic US - MOST SENSITIVE for depth of tumor (T staging) and can see presence of LN (N staging)
- CT scan (look at local disease and for metastases)
- bronchoscopy (for middle and upper 1/3 of esophagus, can help exclude invasion of trachea)
13
PUD diagnosis
- Endoscopy (95% accurate)
- must biopsy gastric ulcers (to check for cancer), but not duodenal
- Urea breath test
14
most common gastric carcinoma
adenocarcinoma
15
most common age group gastric carcinoma
50-59 yo
16
common mets from gastric cancer
liver, lung, brain
17
imaging gastric carcinoma
- esophagogastro-duodenoscopy & biopsy
- CT chest/abdomen/pelvis
18
ALT > AST could indicate
viral hepatitis (ALT elevated in fatty liver)
19
AST > ALT
alcoholic hepatitis
20
If ALP >>>> ALT, rule out what?
bone disease
21
ALP and GGT increased indicates
liver cholestasis or hepatocellular carcinoma
22
Conjugated bilirubin (CB) < 20%
unconjugated hyperbilirubinemia (extravascular hemolytic anemia)
23
CB 20-50%
mixed hyperbilirubinemia (viral hepatitis)
24
CB > 50%
conjugated hyperbilirubinemia (liver cholestasis)
25
low serum albumin
hypoalbuminemia = severe liver disease
26
increased prothrombin time (PT)
- hepatic protein synthesis impairment
- liver cirrhosis
- vitamin K deficiency
27
Decreased BUN
liver cirrhosis
28
increased Serum ammonia
- cirrhosis
- reyes syndrome
29
alpha-fetoprotein (AFP) is a marker for
hepatocellular carcinoma
30
