LANGE Gastro

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Chronic GERD Risk Barrets Esoghagus
Hep D Infection Req Hep B
RF for non-healing duodenal Ulcer Smoking
Perifollicular hemorrhages, ecchymoses of legs, bleeding gums, loose teeth and GI bleed Scurvy – lack of Vitamin C
Melanin spots on lips, buccal mucosa, and tongue with bleeding polypoid lesions in the small intestines Peutz-Jeghers syndrome
Telangiectasias on the face and buccal mucosa, and GI tract Rendu-Osler-Weber
Cafe au late pigmentation, pedunculated fibromas, fibromas of GI tract that may bleed Neurofibromatosis
Interferon use is contraindicated in Pts with autoimmune disease, severe liver disease and cardiac arrhythmia
Middle age woman, with elevated cholestatic liver enzymes. No other risk factors. Primary Biliary Cirrhosis
Primary sclerosing cholangitis assoc with? Inflammatory bowel disease
Large volume, water, nonbloody diarrhea w/ N&V Characterizes small bowel diarrhea caused by enterotoxinogenic E.Coli or virus
Inflammatory diarrhea characterized by small volume, bloody diarrhea without prominent nausea Salmonella, shigella, cDiff, Campylobacter
Hep C Maternal-neonatal transmission is low, RNA virus, incubation 6-7 weeks.
Soft tissue thickening of the pericolic fat, diverticula, thickening of bowel wall. CT findings of diverticulitis
MC cause of pill-induced esophagitis NSAIDs
MC malignant tumor of AA male Squamous Cell
MC Malignant tumor of white adenocarinoma
Diverticulosis most often occurs where? Sigmoid Colon
Indicated to confirm celiac sprue in a pt with + serologic testing Intestinal Biopsy
Celiac Sprue serologic test IgA endomysial antibody
Primary biliary cirrhosis Antimitochondrial antibodies
First degree relative with adenomas or CRC, when should you begin screening? 40 yo or 10 year younger than age of diagnosis of affected relative
Mucosal tear of GE junction w/h/o vomiting Mallory-Weiss Tear
Congenital syndrome assoc with anemia and webbing of esophagus Plummer-Vinson
Gastrin-secreting neuroendocrine tumors resulting in acid hypersecretion Zollinger-Ellison Syndrome
Giardia TOC Metronidazole
Campylobacter TOC Eythromycin
Cholera TOC Doxycyline or tetracycline
Cholera and Shigellosis Quinolones
Markle Sign Jar sign, may prove superior to rebound tenderness as a localizing sign of peritoneal irriation. Patients stand on toes, then drop to heels.
Pellagra Niacin Deficiency
3D's of Pellagra Dermatitis, diarrhea, and dementia
Cholelithiasis Test of Choice Ultrasound
Dermatatitis Herpetiformis Nearly all will have Celiac Disease
Whipple Disease Clinical Profile 40-60 yo, arthritis, malabsorption
Crohns Affects terminal ileum, and proximal ascending colon
Ulcerative Colitis Only affects colon, MC distal part
C.Diff Colitis TOC Oral Metronidazole
Most frequent cause of intestinal obstruction before 2 yrs old Intussception
Vit B12 binds Intrinsic factor. What is Intrinsic factor excreted from? Gastric Parietal Cells
Iron Absorption Occurs where? Stomach, duodenum, and upper jejunum
Free Intraperitoneal air on Abdominal XR Peptic Ulcer Perforation
Sudden onset of severe abd. Pain, rigid abdomen, quiet abdomen + free air Peptic Ulcer Perforation
MC cause of acute gastroenteritis in children Rotavirus
Traveler's diarrhea: top offending agent E.coli, then shigella and C. Jejuni
First Line tx for mild-moderate ulcerative pancolitis Oral 5-ASA products ie. Sulfasalazine or mesalamine
Severe or unresponsive ulcerative colitis Immunomodulating agents: Infliximab
Pt hematemesis, what is cause? Peptic ulcer
Develop in majority of critically ill pts w/I 72 hrs? Stress Ulcer
Gastric Cancer Risks H. Pylori and dietary nitrates
Chronic diarrhea, anorexia, malabsorption, and weight loss. Giardia Lambia
MC intestinal protozoal infection in children in US, diagnosis? Giardia Lambia; parasite in stool, or antigen in feces
LUQ/Epigastric pain, radiates to shoulder/back, fever, N/V and shock. Acute Pancreatitis
Gastroenteritis No abdominal pain
Gilbert syndrome Elevations of unconjugated (indirect) bilirubin result from hemolysis or insability to conjugate bilirubin in the liver
Conjugated (direct) bilirubin Results from impaired excretion of bili from liver due to hepatocellular disease ie hepatitis or obstruction of bile ducts from cholelithiasis, sclerosing cholangitis, and cancer of biliary ducts
Elderly woman with henia palpated below the inguinal ligament Rare: obturator hernia
Cause of Thiamine Deficiency Chronic Alcoholism
IBS symptoms abdominal pain relieved by defacation, constipation, loose or watery stools, mucus in stools, and bloating.

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