GI random

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Author:
fluidsmash
ID:
105583
Filename:
GI random
Updated:
2011-10-01 17:11:20
Tags:
COMLEX
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Description:
Random GI
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  1. H/P - refractory PUD, abdominal pain, nausea, vomiting, indigestion, diarrhea, steatorrhea, possible history of other endocrine abnormalities
    Zollinger-Ellison syndrome
  2. labs - increased fasting gastrin, positive secretin-stimulating test
    Zollinger-Ellison syndrome
  3. Treatment for Zollinger Ellison syndrome
    Surgical resection for nonmetastatic disease, PPI and H2 Blockers, octreotide may help reduce symptoms in metastatic disease
  4. Cancer resembling sulcers seen in PUD
    Ulcerating
  5. Cancer that are large intraluminal neuplasms
    Polyploid
  6. Cancers that involve the mucosa and submucosa
    • Superficial spreading
    • best prognosis
  7. all layers of stomach involved, decreased stomach elasticity
    • Linitis plastica
    • Poor prognosis
  8. Risk factors for stomach cancer
    H. Pylori, Family History, Japanese person living in Japan, tobacco, alcohol, vitamin C deficiency, high consumption of preserved food, male>females
  9. Antiendomysial and antigliadin antibodies
    Celiac Sprue
  10. Loss of duodenal and jejunal villi
    Celiac Sprue
  11. Acquired disorder in patient living in tropical areas
    without entiendomysial and antigliadin antibodies
    Tropical Sprue
  12. Treatment for tropical sprue
    • folic acid replacement, tetracycline or sulfa 3-6 months
    • removal of gluten from diet has no effect
  13. Testing for lactose intolerance
    • lactose tolerance test (minimal increase in serum glucose following ingestion of lactose)
    • lactose breath hydrgen test after lactose meal
  14. History of Weight loss, joint pain, abdominal pain, diarrhea, dementia, cough, bloating, steatorrhea, fever, vision abnormalities, lymphadenopathyy, new heart murmur
    Whipple disease
  15. Etiology of Whipple disease
    asociated with Tropheryma whippelii and immune deficiency
  16. Risk factors for Whipple disease
    males with European ancestry
  17. Treatment for Whipple disease
    TMP-SMX or ceftriaxone for 12 months
  18. CT showing air within bowel wall and bowel wall thickening
    Ischemic colitis
  19. Abdominal pain out of proportion to examination
    Small bowel ischemia
  20. Double bubble sign
    proximal or distal illeus
  21. Painful bleeding tears in posterior wall of anus secondary to trauma
    • Anal fissures
    • Treat with stool softeners, topical nitroglycerin to relieve spasm, partial sphinctertomy
  22. Inflammation of anal crypts, internal hemrrhids, or hair follicle leading

    Throbbing rectal pain, fever, tenderness on digital examination
    • Anorectal abscesses
    • treat with antibiotics and I&D
  23. Mild pain during defecatin, possible visible site of draining pus

    Formation of tract between rectum and adjacent structures from unknown cause, IBD, or abscess
    • Rectal fistula
    • treat with fistulotomy, treat IBD
  24. Presence of one or more cutaneous sinus tracts in the superior midline gluteal cleft, obsturction of the tact by hair or debris leading to cyst and abscess formation
    Usually asymptomatic, can be painful
    I&D with surgical closure of sinus tracts
  25. flushing, diarrhea, bronchoconstriction, tricuspid/pulmonary valvular disease
    carcinoid syndrome
  26. Abdminal pain, carcinoid syndrome
    Carcinoid tumor of GI tract, cna be asymptomatic
  27. Increased 5-hydroxy-indolacetic-acid (5-HIAA) in urine
    Carcinoid tumor
  28. Treatment for carcinoid tumor
    • Tumors <2 cm should be resected
    • Tumors >2 cm have a high risk of metastases and require extensive resection.
    • Metastatic disease treated with IFN-alpha, octreotide, and embolization
  29. Carcioembryonic Antigen (CEA)
    Increase in 70% of colorectal cancer

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