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Flashcards in GI liver and pancreas Deck (27):
1

Alcohol causing pancreatitis?

CHRONIC USE!!!
CHOLELITHIASIS

Sulfa drugs and HIV drugs

remember lipids, serum calceum,

2

Ranson criteria, dont stress numbers but know what you are looking for

GA LAW
Glucose
AST
LDH
AGE
WBC

CA HOBBS
Calcium
Hematocrit decrease
PO2
Base deficit
BUN increase
Sequestration of fluids

3

Base deficit calculcation?

do i need to know it?

4

Pleural effusion with pancreatitis might have what?

amylase in it

5

Why do you use meperidine in pancreatitis?

less sphincter of oddi constriction when compared to morphine

(think P sounds like Pancrease in meperidine)

6

Chronic pancreatitis symptoms?

Can have steatorrhea of cours

7

Most specific test for chronic pancreatitis?

Low fecal elastase!!!

Might have mild up amylase and lipase

8

Tx chronic pancreatitis?

Stop drinking, smoking

Give opioids, supplement pancreatic enzmes

Vitamin supplements, small meals low fats

9

Pancreatic pseudocyst is what? When?

False cyst. Usually iasymptomatic. May have some epigastric duct.

Must rule out from neoplasm.

What to tell is by aspiration. If lots of amylase, it is pancreatic juice (pseudocyst).

Only do if there for 6 weeks, diagnostic reason, or if growing

10

Tumor marker pancreatic cancer?

CEA or CA19-9

11

Migratory thrombophlebitis was discovered by who?

Pancreatic cancer. Trousseau diagnosed himself

12

Insulinoma drug treatment if difficulty resecting?

Diazoxide causes DIAbetes (dia and dia)

Or octreotide

13

Awful rash on face and perineum, what do you consider? Painful and pruritic

Glucagonoma.

Necrolytic migratory something

14

VIPoma is where?

Non beta islet cells. Watery diarrhea! High VIP. High stool osmolality.

15

What is calculus cholecystisit? Who get it?

Inflammation of gall bladder who don't have stones

Patients on TPN or critically ill

16

HIDA does what?

Absorbed by liver and secreted into gall. If it doesn't go into gall bladder, it is obstructred

17

Cholecystitis tx?

Antibiotics then treat after about 2 days

18

Cholangitis is what?

inflammation of bile ducts. Usually from obstruction

19

Charcot triad is HIGH YIELD

RUQ jaundice, fever

cholangitis

You see AST, and ALT b/c it is ducts, so liver issues can happen

20

Reynolds pentad?

Altered mental status and SHOCK
RUQ, jaundice, fever

21

Dx for cholangitis?

HIDA

22

Tx cholangitis?

Endoscopic biliary drainage, IV fluids, antibiotics

then surgery after it cools weeks later

Diff than cholecystitis which you can treat a few days later

23

Gall bladder cancer presentation?

Same symptoms. But no white count. Still high bill and alk phos

24

Primary Billiary Cirrhosis is what?

Tx?

Women love Primarily bitches Cirrhosis (IN WOMEN!)

Autoimmune: Antimitochondrial antibodies. in women (Ursula so give Ursodeoxycholic acid (also has the cholic part in there for biliary tract) and that delays progression.

Definitive tx? Liver transplant

25

Primary Sclerosing Cholangitis?

You get destruction of bile ducts in liver and extra hepatic.

Fatigue, pruritis, hepatomegaly, jaundice

MORE COMMON IN MEN

Associated with Ulcerative Colitis

P Anca

Transplant only tx

Cholangiocarcinoma risk

Beads on String (sclerosinG)

26

Crigler najar tx?

Type 1 is UDPGT issue. Give Plasmapheresis then eventually transplant

If type 2, barbiturates help create more UDPGT activity!!

27

Goodpasture tx?

Plasmapheresis, steroids, immunosuppressants