AR disorder characterized by copper accumulation in liver, brain, eye, kidney Presents in childhood or adolescence Personality changes, parkinsonian-like features, kayser-fleischer rings in eyes
Dx: low levels ceruloplasmin, increased hepatic copper content, increased urinary excretion of copper
Abx that cause C-Diff
Clindamycin and Ampicillin
Hemorrhage of a duodenal/gastric ulcer occurs where more frequently and involves which artery?
posterior > anterior (gastric > duodenal)
If rupture gastric –> L gastric artery
If rupture duodenum –> gastroduodenal artery
Relationship between ulcers and getting better or worse with food
Gastric –> pain is Greater with meals, weight loss
Duodenal –> Decreases with meals, weight gain (associated with hypertrophy of Brunner glands)
Hemolytic-uremic syndrome caused by what and what is the triad?
A severe, life-threatening complication that occurs in about 10% of those infected with Escherichia coli (E. coli) O157:H7 or other Shiga toxin-producing E. coli.
(often from an undercooked hamburger, can cause bloody diarrhea)
Characterized by thrombocytopenia, anemia, uremia
Pancreatic gastrinoma, gastrin secreting tumor that induces parietal cells to secrete acid resulting in peptic ulcer disease Can occur in MEN1
congenital disorder characterized by the lack of both Auerbach’s (myenteric) plexus and Meissner’s (submucosal) plexus. The absence of these elements of the enteric nervous system results in impaired bowel peristalsis and function
-Due to failure of neural crest cell migration. Associated with mutations in the RET gene.
most common tumor of the adrenal medulla in adults
Triad: HA, diaphoresis, tachycardia (about half of pts also have paroxysmal hypertension)
Thyroid Storm (what is it, what is the presentation and what is the treatment)
stress-induced catecholamine surge, which leads to the sudden release of large amounts of thyroid hormone in a short period of time. Thyroid hormone has many of the same actions as the sympathetic nervous system. It up-regulates B1-adrenergic receptors in the heart, and causes increased heart rate and stroke volume (together increasing cardiac output).
- Presents with agitation, delirium, fever, diarrhea, coma, and tachyarrhythmia (cause of death). May see increased ALP due to bone turnover
tx: 3 P’s: β-blockers (e.g., Propranolol), Propylthiouracil, corticosteroids (e.g., Prednisolone).
VIPoma (Verner-Morrison syndrome)
non-α, non-β islet cell pancreatic tumor
-Copious Watery Diarrhea, Hypokalemia, and Achlorhydria (absence of HCL in gastric secretions) (WDHA syndrome).
Esophageal varices formed from the anastomoses of ______ with ______may lead to life-threatening hemorrhage in a cirrhotic liver from alcoholism
the left gastric vein (from the portal circulation) with the azygos vein (from the systemic circulation)