old alcoholic man, worsening midepigastric pain radiating to the back
N/V, steatorrhea
no rebound, similar sx in past
dx is ___
finding on imaging
chronic panc
pancreatic calcifications
woman w severe epigastric pain radiating to back
no alcohol/drugs
inc lipase/amylase
test to determine etiology
or ____
RUQ ultrasound
TG measurement
old man, recurrent severe RUQ pain, N/V, jaundice
Fever, elevated alk phos, WBC
mechanism of findings ___
dx is ___
obstructed CBD
acute cholangitis
woman w RUQ pain, esp when eating greeasy food
labs normal
dx is ____
secretion of __ is causing sx
biliary colic
CCK
elderly man, LLQ pain and fever, no temp
dx is _____
mechanism __ of protrusions in ___
diverticulitis
inflammation, colonic wall
elderly man, epigastric pain radiating to the back, wl, jaundice
inc amylase/lipase, ALP
mass in pancreas
screen w elevated ___
CA 19-9
young woman, vomiting bright red blood
history of freq vomiting, has since become more forceful
dx is ____
mallory weis syndrome
MA woman, epigastric pain
hx of previous gastric/duodenal ulcers
H pylori is negative
more ulcers found
dx is ___
excessive secretion of __
ZE syndrome
gastrin
severe pain OoP to exam, older person w CAD
dx is ___
mesenteric ischemia
young woman, sudden lower ab pain
could be ___
w dyspareuia, chronic discharge dx is ___
ectopic pregnancy
PID
paroxsymal, severe pain, cannot sit still, hematuria
dx is __
nephrolithiasis
old person, debilitated, ab distension, massive colon on xray
dx is ____
sigmoid volvulus
1-2 yr old pt, intermittent jelly-like stools
dx is ___
intussusception
old man, flatulence/ab cramping
watery stools after trip to another country
resolved w loperamide/bismuth
dx is ___
caused by ___
travelers diarrhea
ETEC
young woman, multiyear history of constipation/bloating/loose stools w mucus
no inflammatory findings
dx is ____
irritable bowel syndrome
young man, vomiting after eating tuna salad
stomach cramping/loose watery stool
cause of sx ____
staph aureus
shellfish exposure, travel w low K
microorganism is ___
classically described as __
Vibrio species
rice water stools
HIV, chronic watery diarrhea
C G I C C
crypto giardia isospora cyclospora CMV
chronic steatorrhea
duodenal biopsy w villous atrphy
dx is ____
look for ab to ___
celiac disease
TTG
outdoor exposure w high eosinophils and diarrhea
dx is ___
stronglyoides
watery diarrhea, facial flushing
dx is ____
look for high ____
carcinoid syndrome
5 HIAA
young male, yellow eyes post illness
labs normal
dx is ____
deficient in ____
gilbert syndrome
glucuronyltransferase
young boy, jaundice, dark urine, gray stools
hepatomegaly, inc direct bilirubin
mechanism is ___
obstructed biliary system
mild jaundice, inc LDH, reticulocytes, peripheral smear shows schistocytes
dx is ____
hemolytic anemia
MA woman, pruritis, very high alk phos
dx is ___
antibodies present __
PBC
antimitochondrial
liver dz, altered mental status, young person
dx is ___
low ___
wilsons disease
ceruloplasmin
diabetes, CHF, liver dz, skin/teste findings
dx is ____
mutation in _)___
hemochromatosis
HFE gene
MA woman, jaundice, high transaminases
dx is _____
antibodies present
autoimmune hepatitis
ASMA, ALKMA
man w jaundice, dark urine
history of UC
elevated alk phos, bilirubin
CT shows dilated peripheral ___
mild dilatin of __
normal ____
dx is _____
intrahepatic duct
hepatic duct
bile duct
PSC
transmural inflammation, skip lesions, fistulas, noncaseating granulomas
dx is ____
chrons disease
bloody diarrhea, toxic megacolon
dx is ____
UC
extraintestinal manifestations common in S/U/A
risk of ___
sclerozing cholangitis, uveitis, arthritis
colon cacer
tender nodules on shins is ____
necrotic skin ulcers w purple/red borders is __
erythema nodosum
pyoderma gangrenosum
woman w difficulty swallowing food/liquid
hx of GERD
ct shows bird beak
dx is ___
dec ability of ___ to ____
achalasia
LES, relax
hx of GERD, upper endoscopy shows intestinal metaplasia
dx is ____
risk of ____
Barrets Esophagus
adenocarcinoma
hernia protrudes through external inguinal ring, does not enter inguinal canal
medial to inferior epigastric artery
type of hernia
direct inguinal hernia
young boy, severe RLQ pain, anorexia/fever
rebound/guarding
resists active extension of hip
dx is ___
inflammation over ___
AA
psoas major muscle
old man, vomiting bright red blood
exam shoes jaundice, spider angiomas, ascites, splenomegaly
dx is ___
anastamoses for bleedign
cirrhosis
left gastric vein and azygous vein
old woman, vomiting bright red blood
taking lots of NSAIDs, EGD shows bleeding ulcer on posterior duodenum
vessel source is ____
gastroduodenal artery
100+ polyps at young age, assc w osteomas, dental findings, lipomas/skin findings, retinal pigment hypertrophy
dx is _____
Gardner syndrome
PJS assc w O/B/U/P tumors
ovary, breast, uterus, pancreas
small/large intestine and stomach w hamartomas, congenital abnormalities
dx is ____
juvenile polyposis
acetominophen OD tx w __
restores ___ as precursor, binds ____
N acetylcysteine
glutathione, NAPQI
OCP, develops ascitees
concerned for ___ which is obstructed ____
may lead to ____
Budd chiari syndrome, hepatic vein
hepatic adenoma
SE of MTX
hepatic fibrosis
Metoclopromide for N/gastroparesis/neuro sx
SE include ___
ie smacking lips, protruded tongue, tics/troticollis
tardive dyskinesia
autoimmune hepatitis can be caused by __ and ____
nitrofurantoin/minocycline
infant, fails to pass meconium
enema shows narrow rectosigmoid jxn, dilated above
dx is ____
failed ____
hirschprung dz
NCC migration
Down syndrome, ab distension/vomiting
xray shows ___
dx is ____
double bubble
duodenal atresia
young boy, painless lower GI bleeding w out diarrhea
dx is ___
meckels diverticulum
infant, jaundice/hepatomegaly, E coli sepsis
low glucose, reducing substances in urine
dx is ___
galactosemia
young infant, postprandial vomiting, alkalosis/ low Cl
dx is ____
pyloric stenosis
hernia in inguinal canal, lateral to the inferior epigastric artery
dx is ___
presistent ___
indirect inguinal hernia
processus vaginalis
diarrhea, dementia, rash
dx is ___
deficient in ___
pellagra
Niacin/B3
night blindness
deficient in ___
excess retinol is ___
Vitamin A
teratogenic
PN may be caused by
__, __, ___ deficiencies
VB1 (thiamine_
VB6 (pyridoxine)
VB12
macrocytic anemia caused by
__ deficiency, normally in __
__ deficiency w neuro sx
found in __
can be low by __ dz
folate, vegetables
VB12, animal products
terminal ileum
swollen gums, poor wound healing, bruising
deficient in ___
dx is ___
VC
scurvy
neonatal hemorrhage, deficient in ____
VK
rickets in breast fed infant
deficient in ____
Vitamin D