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Gastro 11 (Hepatic)
Step-2
| Question | Answer |
|---|---|
| What is the mcc of "travelers' diarrhea"? | Enterotoxogenic ecoli |
| What is the initial treatment of localized non-small cell lung cancer? | surgical resection and chemo |
| What is the medical treatment of IBD? | 5-ASA, +/- sulfasalazine, steroids for acute exacerbation. |
| What is the tx for hepatic encephalopathy? | lactulose, neomycin & rifaximin, protein restriction |
| What antibiotics can be used to treat spontaneous bacterial peritonitis (SBP)? | Cefotaxime or other 3rd generation cephalosporin |
| What 2 diuretics are used in conjunction for the treatment of ascites/portal HTN? | Furosemide and spironolactone |
| What are the symptoms of Budd-Chiari syndrome? | Ascites, hepatomegaly, jaundice, RUQ pain |
| If you suspect AI hepatitis in a pt, what labs should be checked? | check anti-smooth muscles antibody |
| What are the risk factors for hepatic adenoma? | F>M age 20-44, OCP use, anabolic steroids (glycogen storage dz type 1 and 3) |
| What is the tx for hepatic adenoma? | discontinue OCP, serial imaging and AFP, +/- resection (esp if >5cm) |
| What is Budd-Chiari syndrome? | is thrombosis and occlusion of the hepatic vein or the intrahepatic/suprahepatic portion of the IVC |
| What is the equation for SAAG? | Serum-ascites albumin gradien= (serum albumin) - (ascites albumin) |
| What does SAAG >/= 1.1 indicate? | portal hypertension (low albumin in the ascites) |
| What causes a SAAG <1.1? | SAAG < 1.1 means that there is high albumin in the ascites, or low serum albumin. Caused by periotoneal carcinomatosis, peritoneal TB, pancreatitis, serositis, nephorotic syndrome |
| What is the tx for spontaneous bacterial peritonitis (SBP)? | cefotaxime, ceftriaxone or other 3rd gen cephalosporin for at least 5 days. Also give albumin IV to maintain plasma volume |
| What criteria compose the Child's classification of operative mortality in patient's with liver dz? | A BEAN: Ascites, Bilirubin, Encephalopathy, Albumin, INR |
| What is the most widely used screening test for hemochromatosis? | Ferritin |
| What copper-related lab value would you order in a pt suspected of having Wilson dz? | serum ceruloplasmin level |
| What is the tumor marker for HCC? | AFP |
| What is the tumor marker for Colon Ca? | CEA |
| What is the tumor marker for gastric CA? | CEA |
| What is the tumor marker for pancreatic CA? | CA 19-9 and CEA |
| What is the tumor marker for ovarian CA? | CA 125 |
| What is the tx for hemochromatosis? | phlebotomy, rarely deferoxamine |
| About 1/3 of patients with liver dz with have _______contracture. | Dupuytren's contracture |
| Hemochromatosis is an ______ ______ dz leading to excess ______absorption. | Autosomal recessive dz leading to excess iron absorption |
| Wilson's disease is a ________ _______ disorder causing impaired ________ secretion. | Audosomal-recessive d/o leading to impaired coper secretion |
| What is the treatment for Wilson's dz? | trientine or penicillamine for copper chelation, life-long zinc for maintenance therapy, diety copper restriction (no organ meats, shellfish, chocolate. etc), supplementary vit B6, and ultimately liver transplant for cases of liver failure. |
| PSC is a progressive destruction of ______ and ______bile ducts | intrahepatic and extrahepatic |
| What causes Gilbert's dz? | mild deficiency of glucuronosyltransferase |
| How is Crigler-Najjar syndrome different from Gilbet's dz? | Crigler is caused by severe deficiency of glucuronosyltransferase. Patient will have persistent jaundice and CNS symptoms (due to kernicterus). |
Created by:
shelybel
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