UWORLD Flashcards
(22 cards)
What is the hallmark of ischemic liver injury?
Rapid and significant increase in aminotransferases with modest increase in AP and bilirubin
In ischemic liver injury , if the patient survives sepsis, how much time does it take for the liver ezy,es to normalize.
1-2 weeks
What kind of nutrition is recommended in patients with moderate to severe burns?
Enteral within 24 hours
Main benefits of enteral feeding ?
Preserve gut mucosa integrity and prevent bacterial translocation
What is the triad of Beckwith Wediemann syndrome?
Macroglossia, hypoglycemia, omphalocele or umbilical hernia
How is the Dx of hereditary hemochromatosis confirmed?
HFE genetic testing
At what ferritin level HH patients must do urgent phlebotomy?
Ferritin > 1000, cuz they are at increased risk for irreversible end organ damage ( cardiomyopathy, cirrhosis, arthritis, DM)
Valsalva and erythematous mass with concentric rings in rectum :
Rectal prolapse
In rectal prolapse, do patients typically complain of severe pain?
No, it is abdominal discomfort rather than pain
Diagnostic requirements of acute liver injury?
AST/ALT > 1000
Signs of hepatic encephalopathy
Synthetic dysfunction,INR>=1.5
What clinical feature differentiates ALF from acute hepatitis?
Hepatic encephalopathy
What are two risk factors for uncontrolled inflammation and disease progression despite medical therapy in crohn disease?
Smoking and young age <30 years
Recurrent intussusception, atypical site, atypical age and persistent rectal bleeding despite reduction should raise suspicions for ?
Pathologic lead point ( most commonly meckel’s diverticulum, less common small bowel tumors or polyps , HSP)
Meckel diverticulum is diagnosed by?
Meckel scan, nuclear scintigraphy to detect gastric mucosa
When is surgical management indicated in intussusception?
If enema reduction fails or signs of peritonitis are present
What are indications for surgery in cases of necrotizing enterocolitis
- Pneumoperitoneum
- Clinical deterioration despite medical management
Immediate management of NE
- Discontinuation of enteral feeding
- Fluid repletion iv
- Blood cultures and abx
- NG decompression
Shock that is refractory to fluid resuscitation and vasopressors, what to do
Hydrocortisone
Ddx of postoperative fever with hypotension
Severe sepsis, PE, acute adrenal insufficiency
What is classic presentation of acute adrenal insufficiency
Hypotension, hypoglycemia, hyponatraemia, hyperkalemia and fever
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