Term
| where is ethanol absorbed |
|
Definition
|
|
Term
|
Definition
|
|
Term
| where is thiamine absorbed |
|
Definition
|
|
Term
|
Definition
| sudden onset peritoneal signs (gaurding, rebound, silent abdomen), generalized, hematemesis, free air under diaphragm, limits movement, hypotension, tachycardia |
|
|
Term
|
Definition
|
|
Term
|
Definition
generalized acute abdomen, fever, leukocytosis
parencentesis PMN >250, high protein, low glucose, LDH>serum LDH |
|
|
Term
|
Definition
| ceftriaxone and gentamycin |
|
|
Term
| #1 cause lower GI bleed >60yo |
|
Definition
|
|
Term
| indicators of upper GI bleeding |
|
Definition
| hematemesis, coffee groung emesis, melena |
|
|
Term
| indicators of lower GI bleeding |
|
Definition
| hematoschezia, increased HR, light headed, hypotension |
|
|
Term
|
Definition
| bismuth, Fe, spinach, charcoal, licorice |
|
|
Term
|
Definition
bowel movements with increased liquid >200g/d stool
acute <2wk, chronic >2wk |
|
|
Term
| define and causes of secretory diarrhea |
|
Definition
osmotic gap <50
VIPoma, gastrinoma, medullary thyroid CA, enterotoxic bacteria, laxative, carcinoid tumor |
|
|
Term
| define and causes of osmotic diarrhea |
|
Definition
osmotic gap >50
malabsorption (celiac, whipple, pancreatic insufficiency, lactose), milk Mg |
|
|
Term
| define and causes of inflammatory diarrhea |
|
Definition
osmotic gap <50
autoimmune, immune suppression, chronic infection |
|
|
Term
| what acid base disorder does diarrhea cause |
|
Definition
| metabolic acidosis and hypokalemia |
|
|
Term
| #1 cause of chronic diarrhea in adults |
|
Definition
| lactose intolerance or IBS |
|
|
Term
| #1 cause of acute diarrhea in adults and kids |
|
Definition
adults norovirus
kids rotavirus |
|
|
Term
| what antacid causes diarrhea |
|
Definition
|
|
Term
| what virus causes diarrhea in the summer |
|
Definition
|
|
Term
| signs of adenovirus infection |
|
Definition
|
|
Term
| ETEC: diarrhea, fever, cause, length, leukocytosis, lactose, H2S, tx |
|
Definition
watery
fever
travelers (water, food)
lasts 2d
no leukocytosis
lactose positive
no H2S
tx hydration |
|
|
Term
| EHEC: diarrhea, fever, cause, leukocytosis, lactose, H2S, culture, tx, complications |
|
Definition
bloody diarrhea
fever
raw meat with poo
leukocytosis
lactose positive
no H2S
shiga like toxin
hydration (abx cause toxin release)
HUS, TTP |
|
|
Term
| salmonella: diarrhea, fever, cause, onset, length, leukocytosis, lactose, H2S, culture, tx |
|
Definition
watery or bloody
possible fever
poultry, milk, produce
24-48h onset
lasts 1wk
leukocytosis
no lactose
makes H2S
black growth
hydration, abx prolong carrier, fluoroquinolone if compormised |
|
|
Term
| shigella: diarrhea, fever, cause, length, leukocytosis, lactose, H2S, culture, tx, complications |
|
Definition
severe bloody
possible fever
food, water, crowding
lasts 1wk
leukocytes
no lactose
no H2S
actin polymerization and shiga toxin
cipro, TMP-SMX
HUS |
|
|
Term
| C. diff: diarrhea, fever, cause, onset, culture, tx, complications |
|
Definition
watery or bloody
fever
clindamycin, ampicillin, any abx
onset in 6wk
C.diff toxin, pseudomembranes
metronidazole or vancomycin
toxic megacolon, perforation |
|
|
Term
| S. aureus: diarrhea, fever, cause, onset, length, leukocytosis, culture, tx |
|
Definition
watery
no fever
mayo, meat
onset 1-6h
duration 24h
no leukocytes
preformed toxin
hydration |
|
|
Term
| C. perfringens: diarrhea, fever, cause, length, leukocytosis |
|
Definition
watery
no fever
food
onset 12-24h
lasts 24h
no leukocytes |
|
|
Term
| camplobacter: diarrhea, fever, cause, length, leukocytosis, culture, tx, complications |
|
Definition
bloody
fever
poultry, food
duration <1wk
leukocytes present
spirals in 3D (C/S in 2D)
erythromycin
guillian barre |
|
|
Term
| C. botulinium: diarrhea, fever, cause, culture, tx, complications |
|
Definition
watery
no fever
disseminated from wound, honey, home canned food
gastric toxin, spores
gastric lavage, antitoxin in adults
descendning flaccid paralysis |
|
|
Term
| Y. enterolytica: diarrhea, fever, cause, treatment |
|
Definition
bloody
fever
pork, puppy poo
hydration |
|
|
Term
| V. cholera: diarrhea, fever, cause, culture, treatment |
|
Definition
rice water
fever
seafood, water
slight curve, GNB, flagellum
tetracycline |
|
|
Term
| V. parahemolyticus: diarrhea, fever, cause, treatment |
|
Definition
watery
no fever
oysters
hydration |
|
|
Term
| giardia: diarrhea, fever, cause, culture, treatment |
|
Definition
greasy, smelly
no fever
water, forest
cysts and trophites
metronidazole |
|
|
Term
| bacillus cereus: diarrhea, fever, cause, treatment |
|
Definition
watery
no fever
rice
hydration |
|
|
Term
| E. histolytica: diarrhea, fever, cause, culture, treatment, other symptoms |
|
Definition
bloody
no fever
water, forest
cysts and trophoites
metronidazole
LIVER ABSCESS |
|
|
Term
| cyptosporidium: diarrhea, fever, cause, culture, treatment |
|
Definition
watery
no fever
food, water, AIDS
acid fast parasites
nitazoxanide |
|
|
Term
| trichhinella: diarrhea, fever, cause, culture, treatment, other symptoms |
|
Definition
watery
fever
pork
eosinophilia
albendazole/melbendazole
periorbital edema |
|
|
Term
| taniasis (tanea solium): diarrhea, fever, cause, culture, treatment |
|
Definition
watery
no fever
pork
tapeworm in gut
praziquantel, albendazole |
|
|
Term
|
Definition
T. soleum cyst/egg ingestion, causes cysts in brain and muscle
tx praziquantel, albendazole, steroid if CNS |
|
|
Term
| how does shiga toxin work |
|
Definition
| irreversibly nicks 60S ribosome inhibiting protein synthesis causing cell death |
|
|
Term
| how does salmonella cause toxicity |
|
Definition
| elicts immune response that increases intracellular cAMP |
|
|
Term
| how does cholera cause toxicity |
|
Definition
| toxin binds to stimulatory G proteins increasing intracellular cAMP |
|
|
Term
| complications of constipation |
|
Definition
| hemorrhoids, rectal prolapse, anal fissures, fecal impaction |
|
|
Term
|
Definition
| pain relieved by defecation, stool frequency increases after onset of pain, stool becomes looser following onset of pain, visible abdominal distension, passage of mucous with stool feeling of incomplete defecation |
|
|
Term
|
Definition
12wk symptoms + abdominal pain + 1 minimum from below...
relief with defecation, change in frequency of stool, change in form of stool |
|
|
Term
| what do these types of vomiting indicate: bilious, feculent, undigested food, coffee ground or blood, with diarrhea, with headache or visual change, with abdominal pain |
|
Definition
bilious: obstruction distal to ampulla of vater
feculent: distal intestinal obstruction, bacterial overgrowth, gastrocolic fistula
undigested food: increased ICP, pyloric stenosis
coffee/blood: GI bleeding
diarrhea: gastroenteritis
abdominal pain: peritonitis, cholecystitis
headache/visual: increased ICP |
|
|
Term
|
Definition
| pleomorhic adenoma, benign |
|
|
Term
| define nonulcer dyspepsia |
|
Definition
| multiple epigastric symptoms (heartburn, indegestion, bloating, pain), diagnosis of exclusion after all testing including endoscopy without cause, present for minimum 4wk |
|
|
Term
|
Definition
1) avoid fatty foods, coffee, meals before bed, smoking, etc
2) antacids and meals and bed time
3) H2 blockers
4) SWITCH to PPI
5) add promotility agent (metocropramide, bethenchol)
6) add H2 blocker back on
6) nissen fundoplication |
|
|
Term
| pathogenesis of barretts esophagus, tx |
|
Definition
stratified squamous replaced with columnar, risk of turning into adenocarcinoma
caused by chronic GERD
tx PPI |
|
|
Term
| cause and location of esophageal SCC |
|
Definition
AA, male, alcohol, tobacco, nitrosamines, betel nuts, hot foods, plummer vinson, nasopharyngeal carcinoma
UPPER AND MID ESOPHAGUS |
|
|
Term
| cause and location of esophageal adenocarcinoma |
|
Definition
GERD, barretts, caucasian, male, alcohol, tobacco
DISTAL 1/3, GE JUNCTION |
|
|
Term
| what are good prognostic indicators for esophageal cancer |
|
Definition
| stages 0-2a (invading lamina propria, submucosa, muscularis, or adventitia without any node involvement) because it allows for total esophagectomy |
|
|
Term
| achlasia pathogenesis and signs |
|
Definition
motor disorder of esophageal smooth muscle, LES wont relax, no peristalsis
dysphagia of SOLIDS AND LIQUIDS, regurgitation, ASPIRATION, sitting up straight helps overcome it, twisting body or neck to air in peristalsis |
|
|
Term
|
Definition
| idiopathic #1, adenocarcinoma of proximal stomach, chagas, scleroderma |
|
|
Term
| test of choice for achlasia |
|
Definition
| manometry with increased LES pressure, secondary is barium swallow with birds beak sign and megaesophagus |
|
|
Term
|
Definition
| nitro, CCB, botulism, dilation, heller myotomy |
|
|
Term
| diffuse esophageal spasm cause, sx, tx |
|
Definition
non-peristaltic contraction, LES is normal
noncarciac CP, radiation to jaw, back, arm, dysphagia, NO REGURGITATION, manometrry with non-peristaltic contraction, barium with corkscrew pattern
nitrates, CCB, TCA |
|
|
Term
| explain two types of hiatial hernia |
|
Definition
sliding/1: GI junction and some stomach herniate through (assoc GERD)
paraesophageal/2: stomach herniates into thorax, GE stays below (assoc strangulation) |
|
|
Term
| treatment of mallory weiss syndrome |
|
Definition
90% stop on own, acid suppression promotes healing
can give epinepherine, vasopressin
severe electrocautery, laser procoagulation, angiographic embolization |
|
|
Term
| signs of borehaaves syndrome |
|
Definition
| CXR with pneumomediastinum initially, CT with contrast confirms, sternal pain, fever, leukoctosis |
|
|
Term
| complication of plummer vinson syndrome |
|
Definition
| SCC of oral cavity, hypopharynx, esophagus |
|
|
Term
| schatzki's ring cause and appearance |
|
Definition
circumfrential, thin, upper to mid esophagus
alkali/acid, bleach, deteegent ingestion |
|
|
Term
| zenker's diverticulum cause, sx, tx |
|
Definition
failure of crycopharyngeal muscle to relax increasing pressure and causing outpouching of UPPER 1/3 OF ESOPHAGUS
dysphagia, halatosis, regurgitation, change in voice, neck mass
CRYCOPHARYNGEAL MYOTOMY |
|
|
Term
| traction diverticulia cause, tx |
|
Definition
traction from mediastinal inflammation and adenopathy (pulmonary TB) at MIDESOPHAGUS NEAR TRACHEA BIFURCATION
no treatment, asymptomatic |
|
|
Term
| epiphrenic diverticulia cause, tx |
|
Definition
associated with spastic esophageal dismotility or achlasia
outpouch in LOWER 1/3 ESOPHAGUS ABOVE LES
esophagomyotomy |
|
|
Term
| treatment of esophageal perforation |
|
Definition
small/contained/draining into lumen: IVF, NPO, ABX, H2 blockers
large/pleura communication: open thoracotomy within 24h |
|
|
Term
| signs of esophageal perforation |
|
Definition
CP (retrosternal, chest, shoulder, neck), tachycardia, hypotension, dyspnea, fever, hamman's sign (mediastinal crepitus), pneumothorax, pleural effusion
dx contrast esophagram |
|
|
Term
| signs of candidia, drug, HSV, and CMV esophagitis |
|
Definition
candidia: white plaques
drug: erosion or shedding of lining
HSV: volcano lesion, well circumscribed
CMV: longitudinal ulcer, abdominal pain and distension, watery diarrhea, inclusion bodies |
|
|
Term
| cause of curling and cushing ulcers |
|
Definition
curling: severe burn
cushing: intracranial injury |
|
|
Term
| gastric ulcers: gastric acid, gastrin, eating, time after eating, nocturnal pain, blood type, malignancy risk, cause, age, prevalence |
|
Definition
gastric acid low normal
gastrin high normal
eating increases pain
soon after eating
nocturnal pain uncomon
blood type A
high risk malignancy
H. pylori #1, smoking, NSAIDs
>40yo
more common than duodenal |
|
|
Term
| duodenal ulcers: gastric acid, gastrin, eating, time after eating, nocturnal pain, blood type, malignancy risk, cause, age, prevalence, location |
|
Definition
gastric acid high
gastrin high
eating relieves pain
pain 2-4h after eating
nocturnal pain common
blood type O
low risk malignancy
#1 H. pylori
<40yo
less common than gastric
usually posterior wall |
|
|
Term
| locations of gastric ulcers |
|
Definition
1 (75%)) lesser curvature
2) gastric and duodenal ulcer
3) prepyloric
4) near GE junction
5) gastric body (NSAIDS) |
|
|
Term
| diagnosis of peptic ulcers |
|
Definition
| endoscopy is most accurate but isn't needed unless >55yo (required to RO malignancy) |
|
|
Term
| treatment of peptic ulcers |
|
Definition
NSAID: PPI or misprostol (COX2 inhibitor if must have NSAID)
1) PPI
2) H2 blocker
3) protect mucosa: sucralfate, bismuth, misoprostol
4) kill H. pylori
5) if symptoms >2mo get EGD to RO adenocarcinoma |
|
|
Term
|
Definition
PPI + clathromycin + amoxicillin x7-14d
alt metronidazole
if resistant add bismuth |
|
|
Term
| complications of duodenal ulcer |
|
Definition
hemorrhage: erosion of posterior duodenal ulcer into gastroduodenal artery
perforation: usually of anterior duodenal ulcer |
|
|
Term
| zollinger ellison syndrome location, dx, tx |
|
Definition
usually in DUODENUM, some in pancreas
serum gastrin, secretin stimulation test, localize with somatostatin scintigraphy or octreotide scan
resect, if not PPI THEN octreotide |
|
|
Term
| cause of acute gastritis, chronic gastritis 1, and chronic gastritis 2 |
|
Definition
acute: NSAID, H. pylori, alcohol, smoking, caffient, stress, shock, sepsis burns, toxin
1: anti-parietal or anti-intrinsic factor
2: H. pylori in antrum |
|
|
Term
| 4 types of gastric cancer, describe |
|
Definition
ulcerative: through all layers
polyploidy: soild, projects into lumen
superificial spreading: best prognosis, mucosa and submucosa only
linitis plastica: leather bottle like, thick, rigid, through all layers, decreased elasticity, poor prognosis |
|
|
Term
| risk factors for gastric cancer |
|
Definition
| H. PYLORI, pernicious anemia, preserved foods (nitrates, salt), BLOOD TYPE A, JAPANESE, tobacco, alcohol, vitamin C deficiency, male, family history |
|
|
Term
| tumor markers for gastric cancer |
|
Definition
|
|
Term
| treatment of gastric cancer |
|
Definition
distal 1/3 of stomach: subtotal gastrectomy and node dissection
middle or upper stomach or invasive: total gastrectomy |
|
|
Term
| 5 sites of gastric cancer metastasis |
|
Definition
kurnkenberg tumor: ovarian
blummer shelf: rectal pelvic cul de sac
sister mary joseph: periumbilica
virchow: supraclavicular
irish: left axillary |
|
|
Term
| complications of bariatric surgery |
|
Definition
depression, suicide
Fe, B12, folate, thiamine, vitamin D deficnecy
GERD
dumping syndrome: food inst processed by stomach, it dumps into intestine causing bloating and diarrhea |
|
|
Term
| causes of small bowel obstruction |
|
Definition
A- adhesions #1
B- bulge / incarcerated hernia (#1 in kids)
C- cancer usually colorectal |
|
|
Term
| define: partial, complete, closed loops, open loop, distal, proximal, and strangulated obstruction |
|
Definition
partial: able to pass gas or stool
complete: occasional gas only
closed: lumen occluded at 2 points by band/hernia ring
open: no bands or hernia
distal: distension of proximal segment, vomiting, pain, minimal distension
proximal: minimal vomiting, lots of distension
strangulated: compormised blood, fever, leukocytosis, pain, peritonitis |
|
|
Term
| signs of small bowel obstruction |
|
Definition
high pitched or no bowel sounds
visible peristaltic waves
colicly cramping
nausea and vomiting
dilated loops with lateral like air fluid levels and minimal gas in the colon |
|
|
Term
| treatment of small bowel obstruction |
|
Definition
| IVF, K, NG suction, NPO, monitor urine, surgery if no improvement in 12-24h or if complete or strangulated |
|
|
Term
|
Definition
abdominal pain, bloating
nausea and vomiting
no bowel movements and decreased sound
inability to tolerate meals
uniform gas distribution, air filled levels |
|
|
Term
| treatment of paralytic ileus |
|
Definition
IVF, NPO, stop opioids
erythromycin, neostigmine, or metoclopramide
NG suction if persists |
|
|
Term
| how long does post-op ileus typically last |
|
Definition
5d
SI 24h
stomach 48-72h
LI 3-5d |
|
|
Term
| what disease is celiac disease associated with |
|
Definition
|
|
Term
| what antibodies are used to diagnose celiac |
|
Definition
transglutaminanse and endomysium
glidian is less specific and no longer used |
|
|
Term
| what is seen on endoscopy in celiac |
|
Definition
| flattened villi, crypt hyperplasia |
|
|
Term
| treatment of tropical sprue |
|
Definition
folic acid
tetracycline or sulfa for 3-6mo |
|
|
Term
|
Definition
white european male, dementia, diarrhea, bloating, steatorrhea, vision abnormalities, new murmur, wasting, myoclonus, arthritis, hyperpigmentation, weight loss
foamy macrophages on PAS stain, villi atrophy, sudan positve for fat, abnormal d-xylose |
|
|
Term
| treatment of whipple disease |
|
Definition
| TMP-SMX or cephtriaxone 12mo |
|
|
Term
| treatment of appendicitis (infection) |
|
Definition
ampicillin/sublactam
piperacillin/tazobactam
tacaricillin/clavulanate
levofloxacin + metronidazole
metronidazole + cephalosporin
severe: ampicillin + levofloxacin + metronidazole OR imipenem/cliastatin OR mirapenem |
|
|
Term
| bugs causing infection in appendicitis |
|
Definition
| bacteroides, E. coli, pseudomonas |
|
|
Term
| signs of carcinoid syndrome |
|
Definition
flushing, diarrhea, sweating, bronchospasm, wheezing, abdominal pain, right heart dysfunction JVD, murmurs
urinary 5-HIAA, serum serotonin, octreotide sinctigraphy to localize |
|
|
Term
| treatment of carcinoid syndrome |
|
Definition
resection, if not..
octreotide: symptomatic relief
INFa: symptomatic relief alt
crytoheptadine: for diarrhea and anorexia
albuterol: for asthma
cholestyramine: for diarrhea
valve surgery |
|
|
Term
| causes of large bowel obstruction |
|
Definition
#1 cancer
#2 diverticulitis
#3 volvus |
|
|
Term
| signs of large bowel obstruciton |
|
Definition
feculent vomiting
high pitched bowel sounds or none
abdominal distension and pain |
|
|
Term
| treatment of constipation |
|
Definition
if >10cm decompress immediatly due to risk of rupture
if has HTN or tachycardia admit and give IVF, dont give motility or antinausea medications, make NPO |
|
|
Term
| FAP: gene, signs, when to get colonoscopy, tx |
|
Definition
| APC, hundreds of colon adenomas, begin colonoscopys at puberty, colectomy before 25yo |
|
|
Term
| gardner syndrome: gene, signs, when to get colonoscopy, tx |
|
Definition
APC
colon polyps, osteomas, dental abnormalities, benign soft tissue tumors, desmoid tumors, sebaceous cysts
begin colonoscopy at puberty
prophylactic colectomy before 25yo |
|
|
Term
| turcots syndrome: gene, signs, when to get colonoscopy, tx |
|
Definition
APC
colon polyps, medulloblastoma, glioblastoma multiform
begin colonoscopy at puberty
prophylectic colectomy before 25yo |
|
|
Term
| putz jeger syndrome signs |
|
Definition
benign harmatomas, pigmented spots around lips and oral mucosa, face, genitalia
cancer: stomach, ovary, breast, cervix, testicle, lung
risk of intussception |
|
|
Term
| familial juvenile polyposis coli signs |
|
Definition
10-100s harmatoms in colon, SI, stomach
GI bleeding
small risk of cancer |
|
|
Term
| hereditary nonpolyposis colorectal cancer - lynch 1 signs, tx |
|
Definition
early onset colorectal cancer, colon cancer forms from normal tissue not harmatomas
begnin colonoscopy q1-2y begining at 20yo or 5y before earliest family case |
|
|
Term
| hereditary nonpolyposis colorectal cancer - lynch 2 signs, tx |
|
Definition
lynch 1 plus other cancer (female genital, skin, stomach, pancreas, brain, breast, biliary tract)
begnin colonoscopy q1-2y begining at 20yo or 5y before earliest family case |
|
|
Term
| tumor marker for colon cancer |
|
Definition
|
|
Term
|
Definition
A/1: confined to bowel wall
B/II: penetrates into colonic serosa of perirectal fat
C/III: node involvement
D/IV: distant metastasis |
|
|
Term
| treatment of colon cancer |
|
Definition
right/left colon: right/left hemicolectomy
sigmoid/proximal rectum: anterior resection and anastomosis to rectal stump
within 5cm of anal verge: abdominal perianal resection and colostomy
dissect 12 regional nodes, if any are positive also gets chemo |
|
|
Term
| follow up for colon cancer |
|
Definition
| guiac yearly, CEA q3mo for 3y, CT body yearly, colonoscopy at 1, 3, and 5, years |
|
|
Term
| #1 location of mets for colon cancer |
|
Definition
| portal circulation to the liver |
|
|
Term
|
Definition
colonoscopy: 50yo or 10y before family case
FOBT: annual starting at 50yo
flexible sigmoid and double contrast barium enema: q5y
CT colonography: not recommended, better than nothing
screening stops: when life expectancy <5y or age 75 |
|
|
Term
| what type of adenomatous polyps are worrisome |
|
Definition
tubular have low risk, their usually pedunculated
villious have high risk and are sessile or flat |
|
|
Term
| treatment of diverticulitis |
|
Definition
PO abx and NPO for 3d, then PO abx 7-10d
fluoroquinolone + metronidazole
TMP-SMX + metronidazole
amoxicillin/clavulanate |
|
|
Term
| angiodysplasia: signs, risk factors, location, tx |
|
Definition
risk: aortic stenosis, vWD, ESRD
location: usually proximal wall
cherry radiating vessels on colonoscopy
tx none, observe, coagulation if hemorrhage |
|
|
Term
| causes/risks for acute mesenteric ischemia |
|
Definition
arterial emboli: AFib, MI,
arterial thrombi: PAD
hypoperfusion: shock
venous thrombosis: OC, portal HTN, malignancy, panmcreatitis
vasopressors in ill or hemo unstable |
|
|
Term
| signs of acute mesenteric ischemia |
|
Definition
| hypotension, lactic acidosis with anion gap metabolic acidosis, tachypnea, altered mental status, non overt bloody diarrhea, abdominal distension, absent bowel sounds, peritoneal signs, feculent breath, periumbilical pain out of proportion to exam, vomiting, thumbpringing of submucosa, pneumatosis of bowel wall |
|
|
Term
| risks/causes of ischemic colitis |
|
Definition
| aortic/cardiac bypass, prolonged physical activity, low CO, hypercoaguability, vasoconstrictors |
|
|
Term
| signs of ischemic colitis |
|
Definition
| >60yo, uregnt need to defecate, LLQ pain, overt rectal bleeding, tenderness without gaurding or rebound, segmental hemorrhagic nodules and ulcers in watershed regions on colonoscopy |
|
|
Term
| treatment of ischemic colitis |
|
Definition
| IVF, NPO, abx to cover anaerobes and gram negatives |
|
|
Term
| treatment of acute mesenteric ischemia |
|
Definition
IVF, NPO, abx to cover anaerobes and gram negatives
NG decompression
heparin and papavine
embolectomy or thrombectomy
removal of necrotic bowel |
|
|
Term
| signs of chronic mesenteric ischemia |
|
Definition
| abdominal angina post parandial subsiding in 2h, weight loss, nausea, vomiting, early satiety, ABDOMINAL BRUIT |
|
|
Term
| signs of oligive's syndrome |
|
Definition
radiologic LBO without mechanical obstruction
nausea, vomiting, distension, constipation, labored breathing, bowel sounds present, tympanic abdomen, EVEN GAS DISTRIBUTION |
|
|
Term
| treatment of colonic pseudo-obstruction |
|
Definition
| IVF, electrolytes, NG decompression, neostigmine |
|
|
Term
|
Definition
colicky abdominal pain, obstipation, abdominal distension, vomiting, palpable mass, omega loop (sigmoid), coffee bean (cecal), whril sign, double bubble sign, birds beak on barium, UNEVEN GAS DISTRIBUTION
sigmoidscopy prefered for diagnosis and treatmennt |
|
|
Term
|
Definition
| transmural, skip lesions, cobblestoning, noncaseating granulomas, apothus ulcers, watery diarrhea, anal fissures and fistulas, STRING SIGN ON BARIUM ENEMA, HLA-B27, ASCA |
|
|
Term
| signs of ulcerative colitis |
|
Definition
| mucosa and submucosa, continous, crypt abscesses, pseudopolyps, friable mucosa, bloody diarrhea, weight loss, frequent small BM, tenesmus, LEAD PIPE SIGN DUE TO HASTURA LOSS, P-ANCA |
|
|
Term
| complications and associated conditions with chrons disease |
|
Definition
malabsorption: B12, bile acids
fistulae, fissures, abscesses, SBO
cholelithiasis
nephrolithiasis
erythrma nodosum |
|
|
Term
| complications and associated conditions with ulcerative colitis |
|
Definition
cholangiocarcinoma
colorectal cancer
malabsorption: Fe, electrolytes
TOXIC MEGACOLON #1 COD
LBO, hemorrhage, stricture
sclerosing cholangitis
ankylosing spondylitis
pyoderma gangrenosum |
|
|
Term
| signs and treatment of hemmhorids |
|
Definition
internal: painless
external: thrombosed painful and swollen, felling of incomplete defecation, painful BM, puritis |
|
|
Term
| anal cancer: risk factos, type, signs, complication |
|
Definition
HPV, anal intercourse, smoking, HIV
SCC
bleeding, pain, visual growth
mets to inguinal nodes |
|
|
Term
| where is the normal location of anal fissure, what does it mean if it isnt there |
|
Definition
usually posterior midline
if midline suggests chrons, infection, or chancer |
|
|
Term
| treatment of anal fissure |
|
Definition
stool softener, hydration
topical nitro
warm stiz bath
diltiazem, nifedipine, bethanechol cream
botox injection
partial sphincterotomy |
|
|
Term
| risk factor for ischiorectal abscess |
|
Definition
| HIV, necrotizing risk DM, internal hemorrhoids |
|
|
Term
| risk factors for fistula-in-ano |
|
Definition
| chrons, anorectal abscess, diverticulitis, foreign body reaction, infection, radiation, HIV |
|
|
Term
|
Definition
cutaneous sinus tract superior midline gluteal cleft due to obstruction of tracts by hair or debris leading to cysts and abscess
mild pain with drainage, small cysts and progress to abscess |
|
|
Term
| LFTs for alcoholic liver damage |
|
Definition
|
|
Term
| how can you make sure ALK-P is really talking about hepatobilliary |
|
Definition
|
|
Term
| if ALT/AST are super high and ALK-P isnt what should you suspect |
|
Definition
|
|
Term
| which hepatitis is a retrovirus |
|
Definition
|
|
Term
| which hepatitis causes hepatocellular carcinoma |
|
Definition
|
|
Term
| which hepatitis causes cirrhosis and hepatitis |
|
Definition
|
|
Term
| how does hepatitis C infect |
|
Definition
| coats itself with LDL to enter hepatocytes |
|
|
Term
| which diseases is hep B associated with |
|
Definition
| polyarteritis nodosa and membranous nephropathy |
|
|
Term
| which diseases is hep C associated with |
|
Definition
| cryglobinemia, membroproliferative GN, lymphoma, thyroiditis, prophyria cutanea tardia, lichen planus, DM |
|
|
Term
|
Definition
co infection: transmitted with B
superinfection: transmitted after B |
|
|
Term
| which hepatitis can be fulminent, what does that mean |
|
Definition
B, D, E
hepatic encephalopathy, hepatorenal syndrome, bleeding diathesis |
|
|
Term
| how is hep B diagnosed in the window period |
|
Definition
|
|
Term
|
Definition
| viral load, antibodies take a long time to see |
|
|
Term
| how is hepatitis B and C treated |
|
Definition
B: INFa or lamivudine
C: INFa and ribivarin, INFa alone in pregnancy |
|
|
Term
| how is fatty liver disease treated |
|
Definition
pioglitazone improves LFTs and inflammation
avoid alcohol, control glucose, loose weight
metformin |
|
|
Term
| what are the top causes of cirrhosis |
|
Definition
| alcohol #1, hep C #2, hep B, acetminophen, methotrexate, autoimmune hepatitis, PBC, wilsons, ATT, hematochromatosis |
|
|
Term
| how are esophageal varices treated |
|
Definition
| EGD and ligation or octreotide, prevent with BB |
|
|
Term
| bugs causing peritonitis in cirrhosis |
|
Definition
| #1 E. coli, #2 klebsiella, s. pneumo |
|
|
Term
| treatment of hepatic encephalopathy |
|
Definition
| laculose excretes ammonia in colon, rifamaxin/neomycin kills bowel flora making ammonia |
|
|
Term
| what is the #1 COD in cirrhosis |
|
Definition
|
|
Term
|
Definition
| nephrotic syndrome, pancreatitis, pseudomyxoitia peritonei (mucin producing tumor of appenxix), serositis, peritoneal carcinomatosis, peritoneal TB |
|
|
Term
|
Definition
| portal HTN: cirrhosis, hepatitis, heart failure, constrictive pericarditis, hepatic metastasis, budd-chiari |
|
|
Term
| when do you do a transjugular intrahepatic protosystemic shunt |
|
Definition
| patients with liver failure and bleeding that is continued despite medical and endoscopic treatment |
|
|
Term
| when do you do a decompressive surgical shunt in liver disease |
|
Definition
| end stage disease with surgical bleeding to prevent rebleeding, can cause hepatic encephalopathy |
|
|
Term
|
Definition
kayser fleischer rings, parkinsonian (resting tremor, rigidity, bradykinesia, dysphagia, drooling, incoordination), depression, personality change, psychosis, nephrocalcinosis
LOW CERULOPLASMIN, LOW/NORMAL TOTAL CU, HIGH FREE CU, HIGH URINARY CU, livery biopsy with copper |
|
|
Term
| treatment of wilsons disease |
|
Definition
d-penicillamine, zinc to prevent Cu uptake, B6, liver transplant
Cu restriction (organ meat, shellfish, chocolate, nuts, mushrooms) |
|
|
Term
| sighs of hematochromatosis |
|
Definition
restrictive cardiomyopathy, hepatomeagly, INCREASED RISK HEPATOCELLULAR CARCINOMA X200, DIABETES, HYPERPIGMENTATION, impotence, testicular atrophy, arthritis
HIGH FE, FERRITIN, TRANSFERIN SATURATION, LOW TBIC, biopsy of liver with high Fe in hepatocytes |
|
|
Term
| treatment hematochromatosis |
|
Definition
| phlebotamines, avoid alcohol, deferoxamine |
|
|
Term
| cause of autoimmune hepatitis |
|
Definition
type 1: anti-smooth muscle ab
type 2: anti-LKM (liver, kidney, microsome), anti-liver cytosol |
|
|
Term
| risk and appearance for hepatocellular adenoma |
|
Definition
OC, female, steroids, glycogen storage disease
incidental small mass, remove if >5cm |
|
|
Term
| risk and appearance of cavernuous hemangioma |
|
Definition
OC, pregnancy, estrogen, female
very vascular, dont biopsy can cause hemorrhage, remove if >5cm |
|
|
Term
| risk and appearance of focular nodular liver hyperplasia |
|
Definition
female, reproductive age
CT shows mass with central scar |
|
|
Term
| risk factors for hepatocellular carcinoma |
|
Definition
| hep B, hep C, vinyl chloride, thorotrast, ATT deficiency, hematochromatosis, wileons, schistosomiasis, hepatic adenoma, smoking, glycogen storage disease 1, alfatoxin from aspergillus infected food |
|
|
Term
| signs of hepatocellular carcinoma |
|
Definition
| weight loss, fever, malaise, diarrhea, BRUIT OVER LIVER, hepatomeagly, abd pain, jaundice, ERYTHROCYTOSIS, HYPERCALCEMIA, CARCINOID SYNDROME, HYPOGLYCEMIA, thrombosis, high cholesterol |
|
|
Term
| tumor marker for hepatocellular carcinoma |
|
Definition
|
|
Term
| most common metastasis to the liver |
|
Definition
|
|
Term
|
Definition
| blood draining into duodenum bia common bile duct due to bleeding along biliary tract, liver or ampullary region |
|
|
Term
| cause of polycystic liver cysts |
|
Definition
| AD, associated with polycystic kidney disease |
|
|
Term
| cause of hydatid liver cysts |
|
Definition
| Echinococcus granulosus or multilocularis tapeworm in right upper lobe (DONT BREAK IT CAUSES ANAPHYLAXIS) |
|
|
Term
| cause, sx, tx of pyogenic liver abscess |
|
Definition
bile flow obstruction, E. coli, klebsiella, proteus, enterococcus, anaerobes
foul smelling aspirate, RUQ pain, fever, malaise, jaundice, vomiting
need to drain it |
|
|
Term
| amebic liver abscess cause, risks, sx, tx |
|
Definition
E. histolytica
risk: male, homosexual, mexico
RUQ pain, vomiting, hepatomeagly, diarrhea, ANCHOVY PASTE ODORLESS ASPIRATE
metronidazole |
|
|
Term
|
Definition
| hypercoaguability, polycythemia, pregnancy, OC, infection, cancer, trauma, hepatocellular carcinoma |
|
|
Term
|
Definition
best initial: US shows inability to visualize junction of major hepatic veins with IVC, thick hepatic veins and abnormal flow
gold standard: hepatic venography |
|
|
Term
|
Definition
anticoagulation, thrombolytics, and diuretics
shunt if refractory |
|
|
Term
| signs of unconjugated hyperbilirubinemia |
|
Definition
indirect
tight on albumin
toxic
can cross BBB |
|
|
Term
| signs of conjugated hyperbilirubinemia |
|
Definition
direct
loose on albumin
water soluble
non toxic
makes urine dark and poo pale |
|
|
Term
| causes of unconjugated hyperbilirubminemia |
|
Definition
hemolysis
erythropoesis
internal hemorrhage reabsorption
physiologic of newborn
gilberts
crigler-nijjar |
|
|
Term
| causes of conjugated hyperbilirubinemia |
|
Definition
dubin johnson
rotor
hepatocellular disease
drug (OC)
intrahepatic bile duct (PCS, PSC)
gallstone obstruction
pancreatic or biliary cancer
biliary atresia |
|
|
Term
|
Definition
mild glucuronosyl-transferase deficiency, mild jaundice after fast, exercise, stress
no treatment |
|
|
Term
| crigler-najjar 1 cause, sx, tx |
|
Definition
AR severe deficiency in glucuronosyl transferase
persistent jaundice, kinicterus
phototherapy, plasmophoresis, transplant |
|
|
Term
| crigler-najjar 2 cause, sx, tx |
|
Definition
AR mild glucuronosyl transferase deficiency
mild jaundice after fast, exercise, stress
phenobarbital induces hepatic synthesis of enzyme |
|
|
Term
|
Definition
abdomin pain, fatigue, jaundice, scleral icterus, black liver
INCREASED CORPOPRPHYRIN I BY 80% AND III BY 20% IN URINE
CANNOT SEE GALLBLADDER ORAL CHOLECYSTOGRAM |
|
|
Term
|
Definition
| INCREASED COROPORPHYRN III BY 80% AND I BY 2-% IN URINE |
|
|
Term
| cause and signs cholestasis |
|
Definition
blockage of bile flow increases bilirubin levels causing malabsorption of fat and fat soluble vitimins
puritis, xanthomas, dark urine, pale stool, jaundice |
|
|
Term
| cause and signs, tx of cholelithiasis |
|
Definition
stone in gallbladder
biliary colic, RUQ pain, boas sign (Refered to R scapula), vomiting, indigestion, flatulence
diet modification, bile salts, cholecystectomy if recurrent |
|
|
Term
| gallstone ileus sx, cause, dx |
|
Definition
gallstone enters bowel lumen via cholecystoenteric fistula and gets stuck in termina ileum causing obstruction
episodic obstruction, old woman, vague recurrent abdominal pain, vomiting
CT with pneumobilia, visualized stone in bowel, dilated loops proximal to obstruction |
|
|
Term
| acute cholecystitis cause, sx, tx |
|
Definition
obstruction of cystic duct causes inflammation of gallbladder wall
RUQ pain, radiation to scapula, nausea, murphys sign, palpable gallbladder, low fever, leukocytosis, US showing thick gallbladder and sludge, HIDA positive
ECRP to remove any stones, cholecystectomy within 48h, IVF, NPO, ABX |
|
|
Term
| choledocholithiasis cause, sx, tx |
|
Definition
gallstone in common bile duct
jaundice, courvoisiers sign, NO FEVER OR LEUKOCYTOSIS
ERCP AND SPHINCTEROTOMY WITH STONE EXTRACTION AND STENTING |
|
|
Term
|
Definition
infection of biliary tract secondary to obstruction
RQU pain, jaundice, fever, septic shock, altered mental status, hyperbilirubinemia, leukocytosis, high amylase |
|
|
Term
|
Definition
HIDA is most sensitive
US detects obstruction
ERCP is best to confirm |
|
|
Term
|
Definition
IV ABX
ERCO and drain ducts
cholecystectomy follows |
|
|
Term
| signs of adenocarcinoma of gallbladder |
|
Definition
| gallstones, gallbladder infections, CALCIFIED PORCELAIN GLALLBLADDER, jaundice, biliary colic, RUQ mass, pain radiating to back, AMPILLARY CANCER CAN BLEED INTO GI TRACT, hyperbilirubinemia |
|
|
Term
| signs primary sclerosing cholangitis |
|
Definition
p-ANCA, associated with uc
string of pearls on ERCP
jaundice, puritis, fatigue, xanthomas, portal HTN, liver failure, cirrhosis |
|
|
Term
| signs primary biliary cirrhosis |
|
Definition
ANTI-MITOCHONDRIAL AB
HYPERCHOLESTEROLEMIA
associated with autoimmune diseases
fatigue, puritis
HYPERPIGMENTATION
ZANTHELASMA/XANTHOMAS
dermatographism
RUQ PAIN
steatorrhea, malabsorption, hepatomeagly |
|
|
Term
| causes of secondary sclerosing cholangiits |
|
Definition
| intraductal stones, trauma, chemotherapy, AIDS, autoimmune pancreatitis |
|
|
Term
| treatment of primary biliary cirrhosis |
|
Definition
| ursodeoxycholic acid: delays progression and enhances survival |
|
|
Term
| cholangiocarcinoma: 3 types |
|
Definition
bile duct adenocarcinoma
klatiskin tumor when in proximal 1/3 of CBD and causing confluence of hepatic ducts
distal extrahepatic: best for resection
intrahepatic: least common |
|
|
Term
| cholangiocarcinoma: risk factors |
|
Definition
| 70s, primary sclerosing cholangitis, UC, choledochal cysts, chloronichis sinenisis, opisthorchis viverrini, cholelithiasis |
|
|
Term
| cholangiocarcinoma signs and diagnostic method |
|
Definition
obstructive jaundice, weight loss, RUQ pain, CEA, CA 19-9
PCT/ERCP to determine resectability
usually found on US |
|
|
Term
| choledocal cysts cause and tx |
|
Definition
cystic dilation of biliary tree due to duct obstruction
resect and restore proper connections |
|
|
Term
| bile duct stricture cause and tx |
|
Definition
iratogenic injury leading to recurring choledocholithiasis, chronic pancreatitis, and PSC
treat with stenting or bypass |
|
|
Term
| biliary dyskinesia cause, dx, tx |
|
Definition
motor dysfunction of sphincter of oddi causes biliary coli without gallstones
diagnosis with HIDA
tx cholecystectomy or sphincterotomy |
|
|
Term
| causes of acute pancreatitis |
|
Definition
#1 gallstones
#2 alcohol
#3 post-ERCP
#1 kids abdominal trauma
other: didanisine, furosemide, hcTZ, valproic acid, azathioprine, estrogens, sulfa, hypercalcemia, hyperTG, cosackie B, mumps, scoroion bite, pancreatic divisium, pancreatic cancer, uremia |
|
|
Term
|
Definition
epigastirc and midabdominal pain after meal, constant, radiating to back, nausea, vomiting, rebound tenderness of epigastrum
elevated amalyase and lipase (more specific), LFTs
sintenial loop (air filled bowel), colon cut off sign (Air filled transverse colon), pleural effusions, hemidiaphragm elevation, thoracentesis with high amalyase |
|
|
Term
| most accurate imaging for pancreatitis |
|
Definition
|
|
Term
| treatment of acute pancreatitis |
|
Definition
| NPO, IVF, NG suction, pain control with fentanul/meperidine because morphine increases oddi pressure |
|
|
Term
| signs of hemorrhagic pancreatitis |
|
Definition
rapid onset epigastric pain, radiating to back, worse supine and after meals, paralytic ileus, vomiting, abdominal distension
low grade fever, tachycardia, hypotension, shock
GRAY TURRNER SIGN: flank ecchymosis
CULLENS SIGN: periumbilical echymosis
FOXS SIGN: inguinal lig ecchymosis
LOW HEMATOCRIT
high amalyase and lipase
metabolic acidosis |
|
|
Term
| what is ransons criteria on admission |
|
Definition
| on admission with pancreatitis if glucose >200, >55yo, LDH >350, AST >250, WBC >16 then prognosis is bad |
|
|
Term
| treatment of hemorrhagic pancreatitis |
|
Definition
NPO, IVF, electrolytes, NG suction, fentanyl/mepiridine
ICU with TPN
prophylactic antibiotics (imipenem)
daily CT scans |
|
|
Term
| signs tx of suppurlative pancreatitis |
|
Definition
acute or hemorrhagic pancreatitis with a CT showing collection of puss and leukocytes
abscess drainage, daily CT scans |
|
|
Term
| what is ransons criteria in 48h |
|
Definition
Ca <8, HCT >10% decrease, PaO2 <60, BUN >5 increase, base deficit >4mL, fluid sequestration >6L
3+ indicates poor prognosis |
|
|
Term
| treatment of pancreatic necrosis |
|
Definition
sterile: resolves spontaneously, prophylactic antibiotics to avoid infection
infected: surgical debridement and abx |
|
|
Term
| pancreatic pseudocyst cause, sx, tx |
|
Definition
encapsulated ensyme rich fluid 2-5wk post pancreatitis without epithelial lining
usually asymptomatic, epigastric pain, fever, palpable, increased amylase, aspirate with high amylase, leukocytosis
<6cm <6wk observe, >6cm >6wk drain percutaneous or surgically int GI or stomach |
|
|
Term
| pancreatic pseudo aneurysm cause |
|
Definition
| digestion of adjacent tissue and blood vessel and bleeding into pancreatic pseudocyst |
|
|
Term
| causes of chronic pancreatitis |
|
Definition
| #1 alcoholis, narcotics, DM, hereditary, tropical pancreatitis, idiopathic |
|
|
Term
| signs of chronic pancreatitis |
|
Definition
fibrosis, epigastric pain worse with food, radiating into back, nausea, vomiting, malabsorption, steatorrhea, cosntipation, recurring acute pancreatitis
calcifications of pancreas, enlargement, pseudocysts, LOW FECAL ELASTASE IS MOST SPECIFIC AND SENSITIVE |
|
|
Term
| pancreatic cancer location, risk factors |
|
Definition
usually on head
tobacco, DM, family history, chronic pancreatitis, high fat diet, male, bese, sedentary, AA, >60, alcoholism, b-naphthylamine, bzidine |
|
|
Term
|
Definition
abdominal pain radiating to back, anorexia, nausea, vomiting, weight loss, courvoisers sign if at head, splenomeagly if at tail, painless jaundice early then painful later
MIGRATORY THROMBOPHLEBITIS (TROSSEAU SYNDROME) |
|
|
Term
| pancreatic cancer tumor marker |
|
Definition
|
|
Term
| most specific and sensitive test for pancreatic cancer diagnosis |
|
Definition
ERCP specific
CT most sensitive |
|
|
Term
| treatment of pancreatic cancer |
|
Definition
| whipple: removal of pancreatic head, duodenum, proximal jejunum, common bile duct, gallbladder, distal stomach |
|
|
Term
| most common type of tracheoesophageal fistula |
|
Definition
| esophageal atresia with distal esophageal fistula: blind pouch in upper esophagus and fistula between lower esophagus and tracheobronchial tree |
|
|
Term
| signs of tracheoesophageal fistula |
|
Definition
| associated with VATER, salivation, choking at first feed, coughing, cyanosis, abdominal distension with air, aspiration pneumonia, malnutrition. NG tube curls in upper chest, imperforate anus, drooling (when esophageal atresia) |
|
|
Term
| how is imperforate anus treated |
|
Definition
| repair delayed to any time before toilet training if fistula, if no fistula colostomy done for high rectal pouches then later repair, primary repair if blind pouch is almost at anus |
|
|
Term
| congenital diaphragmatic hernia signs |
|
Definition
hernia on left and bowel in chest leads to hypoplastic lung with fetal type circulation
respiratory distress in 1st 24h, circulatory insufficiency, bowel sounds in anterior thorax, scaphoid abdomen, shift cardiac sounds to right, lung hypoplasia, air filled bowel loops in left chest, mediastinum shift left |
|
|
Term
| treatment of congenital diaphragmatic hernia |
|
Definition
1) NG decompression
2) intubation and ventilation
3) surgical correction |
|
|
Term
|
Definition
gastric contents pushed out, no protective membrane, angry matted bowel
obtain vascular access for parenteral nutrition, immediate surgical repair, bowel will work within 1mo |
|
|
Term
|
Definition
bowel sticking out, cord goes to defect that has thin membrane with normal bowel
small defects close paimairly, large require constriction of stiastic silo to protect bowel and push it in a bit every day for a week |
|
|
Term
| risk factors for gastroschisis |
|
Definition
| cocaine, meth, aspirin, ibprofen, young mother |
|
|
Term
| extrophy of bladder cause, sx, tx |
|
Definition
abdominal wall defect over non fused pubis
medallion of red bladder mucosa, wet shining urine
transfer for repair within 1-2d of life |
|
|
Term
|
Definition
assoc down syndrome
green vomit, <1mo (usually within first few hours), double bubble, duodenal stenosis, midgut bolbus |
|
|
Term
|
Definition
<1MO, green vomit, BLOOD PER RECTUM, abdominal pain, obstruction
barium swallow with CORKSCREW coiled
double bubble at duodenum due to obstruction |
|
|
Term
|
Definition
| green vomit, associated with genital abnormalities, multiple air filled fluid levels in abdomen |
|
|
Term
| necrotizing enterocolitis signs |
|
Definition
mucosal necrosis and epithelial sloughing in preme
feeding intolerance, distension, low platelets, bilious vomit, lethargy, poor feeding, diarrhea, hematoschezia, shock, metabolic acidosis, air in bowel wall, portal vein gas or free air |
|
|
Term
| treatment necrotizing enterocolitis |
|
Definition
| TPN, NG suction, ABX, IVF, surgical intervention if wall erythema, air in portal vein, intestinal pneumatosis, pneumoperitoneum |
|
|
Term
| signs of meconium ileus and tx |
|
Definition
feeding intolerance, vilious vomiting
dilated loops of small bowel, ground glass lower abdomen, gastrografin enema with microcolon, pelets in terminal ileum
gastrografin dissolves it |
|
|
Term
| risk factors for intussception |
|
Definition
| meckel diverticulum, henoch scholein purpura, adenovirus, peyers patch inflammation, CF, adults cancer |
|
|
Term
| diagnosis of intussception and tx |
|
Definition
| barium or air enema is diagnostic and theraputic |
|
|
Term
| signs neonatal jaundice is pathological |
|
Definition
in 1st 24h
rise in bili >0.5 mg/dL/h
rise in bili >5mg/dL/d
direct >20% of total or >1.5
total >13 if term
jaundice after 2-3wk old |
|
|
Term
| physological jaundice of the newborn cause, sx |
|
Definition
does not have enough udgt enzyme yet
starts day 2-3, peaks at <10 dL on day 3-5, resolves in 2wk, jaundice should not pass nipple line |
|
|
Term
| exaggerated pysiologic jaundice of newborn cause, sx, tx |
|
Definition
has physiological jaundice and is drink breast milk that isnt ready yet and is dehydrated
starts 1wk, peaks 12-15mg/dL due to dehydration
make sure >10 feeds/d, phototherapy |
|
|
Term
| breast milk jaundice cause, signs |
|
Definition
due to substances in the milk
starts days 4-14, continues for wks-mos while breastfeeding, improves with formula for 48-72h (diagnostic) |
|
|
Term
| biliary atresia cause signs |
|
Definition
biliary tract fails to canalize
jaundice 2wk after birth, pale stools
direct >20% of total which is 6-12 |
|
|
Term
|
Definition
| deposition of bilirubin in basal ganglia and hippocampus that may cause permanent damage due to high bilirubin in infants |
|
|
Term
|
Definition
weight <3rd percentile or >1 occasion
weight <80% ideal for age
crosses 2 major percentiles on growth chart
weight to length <10th percentile
rate daily weight gain less than expected for age |
|
|
Term
|
Definition
epidermis and dermis
SC/hypodermis
campers fascia
scarpas fascia
external oblique
inernal oblizue
rectus abdominus
transverse abdominus
pyrmidalis
fascia transversalis
peritoneum |
|
|
Term
|
Definition
linea semicircularis, douglas liine
superior to it: internal oblique aponeurosis splits to envelop rectus abdominus
inferior to it: internal oblique and transverse abdominus aponeurosis merge anterior to rectus abdominus |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| contains meckels diverticulum |
|
|
Term
|
Definition
| only has portion of bowel circumference, high strangulation risk |
|
|
Term
|
Definition
| through deep inguinal ring, lateral to inferior epigastrics, due to congenital defect to processus vaginalis or lifting |
|
|
Term
|
Definition
through hesselbachs (lateral rectus abdominus, inferior epigastric latera, inguinal lig)
acquired in old men |
|
|
Term
| umbilical hernia treatment |
|
Definition
| if not closed before 8yo then close surgically (usually 4-8yo) |
|
|
Term
|
Definition
semilunar line lateral to rectus at junction of douglas due to fascial deficit
high incidence incarceration |
|
|
Term
| complications of obturator hernia |
|
Definition
| intermittent bowel obstruction, paresthesias of anterior medial thich (howship rhomberg sign) |
|
|
Term
|
Definition
wide mouth at superior lumbar triangle
low risk incarceration |
|
|
Term
|
Definition
wide mouth at inferior lumbar triangle
low risk of incarceration |
|
|
Term
| treatment of asymptomatic hernia |
|
Definition
| decrease intrabdominal pressure before elective surgery (BMI <35, decrease COPD, no ocnstipation, pregnancy, ascites, urinary obstruction) |
|
|
Term
| cholanal atresia cause, signs |
|
Definition
blockage of nasal passage
unable to pass NG tube, no gastric distension, respiratory distress if bilateral, discharge if unilateral |
|
|
Term
| electrolyte changes in pyloric stenosis |
|
Definition
| hypochloremic, hypokalemic, metabolic acidosis |
|
|
