General GI 4

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  1. the most common infectious agents in the U.S. for diarrhea.
    Salmonella, Campylobacter, Shigella, Shigatoxin E. coli, Cryptosporidia.
  2. Fever, rose spots, ileitis
    s. typhi

    achlorrhydria and sickle cell disease pre dispose
  3. diarrhea that causes ileitis/ileocolitis. usually not bloody, carried by reptiles.
    non typhoidal gastroenteritis.
  4. low inoculum.
    bacterial cause of dysentery
    treat all cases
    shigella
  5. In contaminated poultry
    associated with Gullian Barre
    bloody
    Camphylobacter
  6. E.coli- multiple types of e. coli diarrhea
    most importantly
    • STEC (shiga toxin e coli)
    • common cause of HUS

    avoid antibiotics and antidiarrheals
  7. S. boulardii has been shown to be effective in treatment of this bad daddy
    C.diff
  8. Non C.diff cause of antibiotic associated diarrhea.
    gram negative bug
    klebsiella oxytoca
  9. often confused with acute appendicitis
    pork intestines
    Terminal ileitis and mesenteric adenitis
    Yersinia
  10. 2 species that can cause chronic colonic infections
    can be found in shellfish
    Teddy has never heard of these
    Aeromonas and Plesiomonas
  11. high mortality in cirrhotics
    on spp can be associated with a giant rash.
    non-cholera vibrios
  12. lunch meat
    high fetal loss
    lysteria

    think cantolupo
  13. Gastric biopsies with > 25 lymphocytes/high power field
    CD8 T lymphocyte expansion
    • Lymphocytic gastritis.
    • treat H pylori
  14. significant abdominal pain followed by bloody significnat bloody diarrhea in a patient with a vascular history
    Acute mesenteric ischemia
  15. abdominal pain
    RUQ mass
    jaundice
    choledochal cyst
  16. portal hypertension, eosinophilia, normal lft large spleen
    • Schistosomiasis
    • treat with praziquantal
  17. Bleeding after liver biopsy
    • hemobilia
    • treat with angoigraphy
  18. neutropenia , and imaging showing inflammaiton in the ileum and cecum.
    neutorpenic enterocolitis or more commonly typhlitis.

    tx is supportive, emperic abx and avoid scoping because of the risk of perforation.
  19. HCV, + RA, renal insuff, low C4, rash, paresthesias
    mixed cryoglobulinemia
  20. cobblestone appearance of tongue,
    papillary thyroid cancer
    breast Ca
    gi hammartomas
    • Cowden's syndrome
    • PTEN
  21. fever, microscopic hematuria, elevated alk phos but normal GGT, flank pain
    renal cell carcinoma
  22. headache, elevated alk phos and elevated gtt. with normal other lft and no history of liver disease +/_ visual changes
    temporal arteritis
  23. Type I achalasia
    incomplete les relaxation and minimal esophageal pressurization
  24. Type II achalasia
    incomplete les relaxation with esophageal pressurization

    This is the subtype that responds best to treatment
  25. Type III achalasia
    • spastic achalasia - lumen obliterating spasm
    • failure of les to relax

    Worst subtype
  26. etiology of achalasia
    unknown. tissue lacks nitric oxide synthase.

    chagas disease- secondary achalasia

    tumor- pseudoachalasia
  27. This cancer is increased in achalasia
    squmous cell carcnoma.
  28. Diffuse esophageal spasm
    simultaneous contrctions in more than 30% of swallows, prolonged duration of the wave, and normal LES relaxation.
  29. Nutcracker esophagus
    wave amplitude greator than 220mmHG and normal propagation and LES relaxation.
  30. Familial visceral neuropathy vs. myopathy
    • in the neuropathy the muscle contractions are normal but not co-ordinated
    • type I (autosomal dominant)
    • type II (autosomal recessive)
  31. type 2 FVM (familial visceral myopathy)
    under the microscope
    this is a mitochondrial disorder

    • bx shows "ragged red fibers"
    • this condition has multiple extraintestinal manifestations
  32. What drug given to patients with pseudo-obstruction can lower SIBO if given in low doses at night
    octreotide

    if given at meals, this can prolong gastric emptying and exacerbate symptoms.
  33. Trypanosoma cruzi
    • chagas diseas
    • Reduviid bug. 10-30 % of infected people will develop chronic disease
  34. Middle aged smoker with sudden onset nausea, vomiting and/or feeding intollerance
    paraneoplastic visceral neuropathy
  35. This catagory of cancer is often associated with a paraneoplastic disorder that causes CIPO
    small cell lung cancer
  36. state the Rome III criteria for IBS
    • Recurrent ab pain for at least 3 days in past 3 months with 2 or more of:
    • -improvement with defecation
    • -onset associted wth change in stool frequency
    • -onset associated with change in stool form
  37. occularmasticory and oculofacial myorhythmia
    whipple disease
  38. recurrent pain, fever and sx precipitated by estrogens and etoh
    • AIP
    • auto autosoma dominant diseae.
    • Inappropriate ADH- hyponatremia
  39. Treatment of AIP
    oral glucose
  40. location of vascular lesions in HHT
    stomach . bleeding is in upper GI tract.
  41. the mutation that leeds to multiple colon polyps in patients with HHT
    SMAD4
  42. papules on hands with marked umbilication, that show angiomatosis on bx
    • bacillary angiomatosis,
    • found on skin and liver in peliosis hepatitis
  43. Peliosis hepatis
    what is it
    what are most common causes
    MULTIPLE BLOOD FILLED CYSTIC SPACES IN THE LIVER PARENCHYMA.

    • hiv
    • BARTONELLA HENSELAE INFECTION,
  44. active metabolite of aza
    6-TG
  45. hepatotoxic product of 6mp affected by tpmt enzyme
    6mmp
  46. villous blunting in small bowel
    oatmeal like stool
    travel to puerto Rico, Cuba, or the Hati/DR. also middle east or india
    Tropical sprue.

    treat with tetracycline and folate for 6-12 months.
  47. heart failure and malabsorption
    • intestinal lymphangiectasia.
    • white spots on endoscopy, show dilated lacteals.
  48. anti-diarrheal that causes sevear peumonitis
    mineral oit
  49. drug causes of macrovesicular steatosis
    tylenol, cisplatin, steroids and tamoxifen
  50. drugs that cause ischemic colitis
    • alosetron
    • carboplatinin
    • docaine
    • digitalis
    • diuretics
    • estrogen
    • nsaids
    • tegaserod
    • paclitaxel
  51. what is the thereshold for treatment of colonic pseudoobstruction
    cecal diameter of 12cm. or flailure of condition to resolve ater 24-48 hrs with conservative therapy
  52. diarrhea and saddle paresthesias
    HSV proctitis-
  53. flask shaped ulcers
    etamoeba histolytica colitis.
  54. charcot-leyden crystals
    isospora -
  55. treatment for familial editerranean fever.
    colchicine

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Author:
 jonpnass
ID:
 114519
Filename:
 General GI 4
Updated:
2011-11-07 21:10:31
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General GI
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General GI 4
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