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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

Viral hepatitis prodrome symptoms

fever, painful hepatomegaly, dislike of alcohol and cigarettes, serum transaminase increase and peaks