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From Flashcardlet > MKSAP: GI > Flashcards

MKSAP: GI Flashcards

0
Q

Why are alcoholics at a higher risk of developing acetaminophen hepatotoxicity?

A

-chronic alcohol use causes a depletion in the stores of glutathione (used for metabolism of alcohol) –> also needed for the metabolism of acetaminophen –> so they can develop toxicity at lower doses

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1
Q

3 Most common causes of aminotransferase values of > 5000 U/L?

A
  1. Acetaminophen hepatotox
  2. Hepatic ischemia
  3. Viral hepatitis (ex. Herpes simplex)
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2
Q

Tx for acetaminophen toxicity?

A

-N-acetylcysteine

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3
Q

5 Ssx of achalasia?

A
  1. Dysphagia
  2. Regurgitation
  3. Weight loss
  4. Chest discomfort
  5. “Bird beak” sign on barium swallow = dilated esophageal lumen and smooth muscle narrowing at esophageal outlet
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4
Q

What is elevated in Gilbert’s syndrome?

A

-indirect (unconjugated) bilirubin

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5
Q

What does the acronym HELLP syndrome stand for?

A
  • Hemolysis
  • Elevated Liver enzymes
  • Low Platelets
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6
Q

Tx for HELLP syndrome?

A
  • delivery of fetus

- usually resolves within 48 hrs of delivery

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7
Q

What 2 groups of pts is herpes hepatitis seen most often in?

A
  1. Pregnant pts

2. Immunocomp pts

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8
Q

Aminotransferase values in a pt with hepatic ischemia?

A

-will be high (>5000), but then will rapidly improve over a few days

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9
Q

Pseudoachalasia: what is it?

A
  • sx of achalasia caused by a tumor

- usually seen in pts >60 yrs –> do an endoscopy on elderly pts that present with sx of achalasia!

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10
Q

6 “Alarm sx” of abdominal pts?

A
  1. Hematochezia
  2. Weight loss
  3. Family Hx of colon cancer
  4. Fever
  5. Anemia
  6. Chronic severe diarrhea
    * *require careful evaluation
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11
Q

Relationship of nausea and vomiting in relationship to the pain of acute appendicitis?

A

-n/v follow the onset of pain

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12
Q

How does uncomplicated diverticulitis present?

A

-left lower quadrant abdominal pain and fever

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13
Q

Dx of diverticulitis?

A
  • abdominal CT
  • colonoscopy should be done several weeks after resolution –> do not do colonoscopy during acute flare up bc complications such as: can occur
    1. Abscess
    2. Fistula
    3. Obstruction
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14
Q

Tx for diarrhea predominant IBS?

A

-loperamide

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15
Q

What is a common cause of self-limited, mild pain, hematochezia in eldery pts?

A

-ischemic colitis

16
Q

How does acute mesenteric artery ischemia usually present?

A

-sudden, severe, generalized abdominal pain

17
Q

What is the most common cause of acute mesenteric artery ischemia?

A

-arterial embolism originating from the heart, most often due to afib

18
Q

What is the best initial imaging study for a pt with possible pancreatic adenocarcinoma?

A

-helical CT scan of abdomen

19
Q

How do pts with severe cholangitis usually present (4)?

A
  1. Fever
  2. Jaundice
  3. Altered mental status
  4. Abdominal pain
20
Q

Ssx of acute cholecystitis (4)?

A
  1. Prolonged right upper quadrant abdominal pain
  2. Fever
  3. Leukocytosis
  4. Hyperbilirubinemia
21
Q

What liver dz are pts with inflammatory bowel dz at higher risk for developing?

A

-primary sclerosing cholangitis

22
Q

Grey-Turner’s sign?

A
  • ecchymosis of the flanks
  • suggests pancreatitc hemorrhage due to pancreatic necrosis
  • very rare presentation of acute pancreatitis
23
Q

When should repeat endoscopies be done for pts with barrett’s esopagitis?

A

-endoscope with bx every 3 yrs

24
Q

What 3 situations would make you suspicious of a gastrinoma in a pt?

A
  1. Multiple ulcers
  2. Ulcers in unusual locations
  3. Ulcers that recur frequently, esp in absence of NSAID use!

**zollinger-ellison syndrome

25
Q

5 alarm features for gastric malignancy with dyspepsia?

A
  1. Weight loss
  2. Bleeding
  3. Early satiety
  4. Vomiting
  5. Anemia
26
Q

Serologic testing for H. Pylori

A
  • can be done if the pt doesnt have any alarm sx (if they do, they need an endoscopy!)
  • test blood, serum, &/or saliva for IgG antibody to H. Pylori –> will remain positive for months
27
Q

What is the most common cause of occult gastrointestinal bleeding in pts > 60yrs?

A

-angiodysplasia = vascular malformations

28
Q

What is fulminant hepatic failure? What is the first thing that should be done?

A
  • clinical syndrome of severe acute liver failure and encephalopathy in a pt w/out a hx of liver dz
  • immediate evaluation for liver transplant should be done!
29
Q

4 Ssx of primary biliary cirrhosis?

A
  1. Puritis
  2. Hypercholesterolemia
  3. Cholestatic liver dz
  4. Positive antimicrobial antibody titer
30
Q

What prophylaxtic tx should pts with large esophageal varicies undergo?

A

-nonselective beta-blocker –> decrease splanchnic blood flow

31
Q

How often should a lt with pan-colitis (for more than 10 yrs) undergo a colonoscopy with bx?

A

-every 1-2yrs for cancer surveillance

From Flashcardlet (79 decks)

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