GI Flashcards
Arthralgias dementia weight-loss fever diarrhea but no hepatomegaly or elevation and LFTs. Jejunal biopsy with foamy macrophages and PAS positive.
Whipple disease (t whippelii) Tx: TMP-SMX or ceftriaxone x 12 months!
Postprandial abdominal cramps weakness and diaphoresis after eating in a patient with a history of gastric adenocarcinoma treated with partial gastrectomy
Early dumping syndrome
- Common post-gastrectomy complication (50% of patients)
- Rapid dumping hypertonic gastric contents into the duodenum and small intestine
AST 1100
ALT 1200
Right upper quadrant abdominal pain
-three possible etiologies?
Acetaminophen poisoning
Ischemic hepatitis
Viral hepatitis
AST 450
ALT 200
GGT elevated
Alcoholic hepatitis
Acidic stool pH, bloating, diarrhea, Asian
Next step?
Tx?
Positive lactose breath hydrogen test after lactose meal
Tx: diet modification
24-year-old male with acute onset mood changes, paranoia, muscle rigidity, gait abnormality, and HSM
- location of lesion?
- cause?
- tx?
Location: basal ganglia
Cause: Wilson’s disease (copper deposition increased 2/2 decreased ceruloplasmin thus decreased excretion)
Tx: trientine or penicillamine (copper chelation) + life-long ZINC
Tumor markers that may be elevated in exocrine pancreatic cancer
CEA
CA 19-9
May also see elevations in: alk phos, bilirubin (total and direct)
Dx with BIOPSY
Treatment for 5 yo with HSM, jaundice, green hue in cornea
Trientine or penicillamine
+
Life long zinc and B6
Watery diarrhea after eating seafood
- 2 possible etiologies
- Tx
Vibrio cholerae (Tx: hydration + tetracycline or doxycycline)
Vibrio parahaemolyticus (less severe, hydration)
Treatment for diffuse esophageal spasm (Dx via barium swallow study)
CCBs
Nitrates
TCAs
+pANCA, FOBT + diarrhea, uveitis, low back pain with abnormal SI joint on radiographs
- Dx
- Tx
UC
Sulfasalazine (5-ASA, ie mesalamine is there active component)
+ASCA, FOBT + diarrhea, uveitis, low back pain with abnormal SI joint on radiographs
- Dx
- Tx
Crohn’s disease
Sulfasalazine (5-ASA, ie mesalamine is the active component)
Most common cause of appendicitis in children
Lymphoid hyperplasia
Most common patients who get volvulus and the most common location where volvulus occurs
-Tx?
Children & Elderly
Cecum & Sigmoid colon
Tx: c-scope decompression
Diverticulitis Tx
1) LLQ pain, fever, leukocytosis, CT: pericolonic stranding, no fluid collection or masses
2) LLQ pain, fever, leukocytosis, CT: pericolonic stranding w/2.5 cm fluid collection
1) PO Cipro + Metro/TMP-SMX/Amox-Clav (and bowel rest) OUTPATIENT
2) INPATIENT IV Moxi + Metro/TMP-SMX/Amox-Clav (and bowel rest)
* > 3cm fluid requires drainage first
