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GIT 2 Flashcards

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1
Q

Chronic mesenteric ischemia CM?

A

Creamy postprandial abdominal pain

Food aversion and weight loss

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2
Q

Diagnosis?

A 
Malnutrition and abdominal bruit
CT angiography(preferred),doppler U/S
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3
Q

Management?

A

Risk reduction and nutrition support

Endovascular and open surgical procedure

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4
Q

chronic hepatitis C patient treatment?

A

antiviral(sopospuvir,valperavir)

reduce alcohol damaging behavior(alcohol)

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5
Q

stress ulcer CM?

A

painles GI bleeding( occult bleeding or obivious like melena and hematocasia)

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6
Q

Risk factors?

A 
Shock
sepsis
DIC
mechanical ventlation
traumatic spinal/brain injury
high corticosteroids
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7
Q

Pathogenesis?

A

GI hypoperfusion
Acumulation of uremic toxins
Reflux bile salt

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8
Q

managment?

A

PPI proflaxis for high risk

PPI and endoscopy(for sever bleeding)

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9
Q

acute colonic ischemia?

A

Occur < 24 hour from Hypotension
Crampy leaft side abdominal pain
Overt Hematocasia

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10
Q

common area?

A

leaft spleenic flexure and sigmoid

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11
Q

first test to do after we found cholistatic pattern hyperbilirubinimia?

A

Abdominal U/S

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12
Q

what it Identify?

A

Intrahepatic(narow bile duct)/extahepatic obstraction(wide bile duct)

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13
Q

Room diagnostic criteria for irritable bowel disease?

A

Recurent abdominal pain >=3 day/month in the last three month.plus 2 of the following

  • symptom inprovment after bowel movt
  • change in frequency of bowel movement
  • Change in consistency of bowel movt
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14
Q

warning sign or sign indicate other etiology?

A

Nocturnal/worsening abdominal pain
Rectal bleeding
Heamatologic/electrolyte abnormality
Wight loss

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15
Q

clinical presentation of achalasig?

A

chronic difficulty in swalowing of solid and liquid food
heart burn
wight loss
regurgitate solid and liquide food

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16
Q

diagnosis?

A

Manometrey?Increase LES resting tone/decrease lE perstalisis and incomplete LES relaxation
Barium esophagogram:small bird break narowing at GE junction

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17
Q

Managment?

A

UE endoscopy
Laparascopic myotomy or ballon diltion
Butolinium toxin,nitrate and CCB

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18
Q

Globus sensation?

A

feeling of food stuck in back of throght
It is functional disorder
diagnosis of exclusion
nothing can foun in barium swallow

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19
Q

patient with unilateral burning,constant pain ,with parastesia w/o rash and ovios diagnosis?

A

Herpes zoster(the pain preceeds the rash-as a result ptient may have onley pain symptom)

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20
Q

laxative abuse future?

A

common in female young health care workers
frequent(10-12) and nocturnal; diarrhea
metabolic alkalosis(unlike another case of diarrhea)-
melanosis coli (if abuse bisacodyl)
diagnosis with stool laxative screening

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21
Q

whay metabolic alkalosis?

A

Laxative diarhoa-K loss–impaired CL/Bicarb transport–increase serum bicarb

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22
Q

melanosis coli?

A

dark broun discoloration of bowl and nearby LN

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23
Q

folate deficiency and alcohol?

A 
can develop whithin 5-6 week
megaloblastic anemia
pancytompnia
heamocystenimia
Low reticulocyte count
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24
Q

chrons disease CM?

A

GI

Extra GI

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25
GI?
``` Malabsorbition Abdominal pain Non bloody diharoa Oral ulcer Wight loss Fistula and abscess formation ```
26
Extra Gi?
skin:erythema nodusum,pyoderma gangrulosum MSK:artheritis Eye:uvietes/sceleritis/episcleritis
27
Diagnosis future?
LAB Endoscopy Radiography
28
LAB?
IDA Lukocytosis Inflamatory markers
29
Endoscopy?
coblestoning(normal and ulcerative lesion intermitentely) | Skip lesion
30
Radiography?
Stricture | Bowel wall thickning
31
Managment?
5-ASA -drug,corticosteroid,antibiotic Azathioprine anti TNF therapy
32
Primary billiary cholangitis CM?
afect middele age women progresive fatigu and pruritis hepatomegaly,jaundice and cirhosis cutanous xantelasma and xantoma
33
pathogenesis?
autoimune intrahepatic bile duct distruction--bile stasis --
34
lab?
increase ALP and TA antimitocondrial Ab sever hypercholestronimia(HDL>LDL)--Not risk for atherosclerosis
35
treatment?
``` ursodeoxycholic acid(delay progress) liver transplant in advanced case ```
36
complication?
malabsorbtion metabolic bone disease(osteoporesis & osteomalasia) hepatocellular carcinoma
37
chronic pancreatitis CM?
intermittent abdominal pain that radiates to back and relieved by leaning forward and sitting and exacerbated by some minute after a meal malabsorbtion diharoa weight loss Diabetes
38
Risk factor?
chronic alcohol usage recurent gall stone/tumour obstraction cystic fibrosis autoimmune
39
diagnosis?
CT/MRCP(calcification/dilation of duct and pancreatic enlargment) amylase--can be normal/nonspecific--not used for diagnosis
40
managmennt?
pain managment alcohol and smoking seccasion small/frequant meal pancreatic enzyme suplementation
41
how to d/t chrons from UC?
``` GI Involvement microscopy gross finding clinical manifestation intestinal complicatiion ```
42
GI Involvement?
CD-anywhere mouth to anus(mainly ileum and colon), skip lesion, perianal involvement with rectal sparing) UC-rectum(always) and colon,continous lesion
43
microscopy(more diferentiating)?
CD-non-casating granuloma | UC-no granuloma
44
gross feature?
CD-Coblestoning, linear ulcer, creping fat, and TM Infn | UC-Mucosa and SM infn and pseudopolyp
45
CM?
CD-RLQ pain with watery diarrhea (bloody if colon involved). | UC-bloody diarrhea and varying location AP
46
Intestinal complication?
CD-stricture/fistula and abscess | UC-Toxic megacolon
47
treatment?
similar initial 5-ASA with corticosteroid maintenance--Ani TNF alpha and azattropin
48
lactose intolerance?
mainly adult watery diarrhea that associated with food, Bloating(due to bacteria metabolize lactase to SCFA and H) chronic cramping abdominal pain
49
pathophysiology?
deficiency of brush border L enzyme deficiency can be congenital acquired, or progressive deficient.
50
diagnosis?
negative guiac test | hydrogen breath test
51
Treatment?
Diet adjustment and enzyme supplementation
52
How to d/t from another malabsorptive disease?
MAD--grassy diarrhea and wt loss
53
From IBD?
IBD-posetive guiac test
54
from clostridium difficile?
CD-acute, mild fever, and bloody
55
from small bowel bacterial overgrowth?
SBBO--grassy diarrhea and will have associated motility disorder like DM and spontaneous and jujunocolic fistula
56
Acute liver failure triads?
Elevated transaminase(often elevate>1000) Sign of hepatic encephalopathy SIgn of decrease liver synthetic ability(PT increment)
57
etiology?
``` Viral hepatitis(except C) drug toxicity autoimmune hepatitis ischemia Wilson disease malignant infilitration ```
58
other sign of ALF?
``` Thrombocytopenia RF(especially in acetaminophen toxicity) Pruritis Jaundice(mild) RUQ pain Hypoglycemia ```
59
acetaminophen-induced ALF mechanism?
Acetaminophen metabolizes into NAPQI, which is hepatotoxic. NAPQ normally detoxified by NADPH Factor like chronic alcoholism deplete NADPH and predispose to AC toxicity.
60
diffuse esophageal spasm pathophysiology?
Uncoordinated simultaneous contraction of the esophageal body. Normal esophageal relaxation
61
Symptoms?
Intermittent chest pain | Dysphagia both solid and liquid
62
Diagnosis?
Manometry: Interment peristalsis, multiple simultaneous contractions. Esophagogram:corkscrew pattern
63
Treatment?
Calcium channel blocker | Alternative: Nitrates and tricycle
64
eosinophilic esophagitis?
Food impaction Dysphagia Heart burn
65
alcoholic hepatitis CM?
``` jaundice, anorexia, and fever RUQ pain and epigastric pain Abdominal distension nnd ascitis Proximal muscle weakness Hepatic encephalopathy ```
66
Lab?
``` Elevated AST/ALT..<300 AST:ALT ratio >2 Elevated Gama glutamyl transferase, INR, and bilirubin Leukocytosis with neutrophil predominate Decrease albumin if malnutrition Abdominal imaging show fatty liver Macrocytic anemia Thrombocytopenia ```
67
Indication for transplant in ALF?
Grade 3/4 HE PT>100 second Creatnin>3.4
68
fAB follow-up and management?
no dysplasia 12-month interval screening for colonoscopy | start at age 10-12

GIT steep 2 (4 decks)

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