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Flashcards in Colon and Liver Deck (39)
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1
Q

Treatment for hepatic encephalopathy

A

Lactulose: prevents ammonia absorption by stimulating NH4+ formation
Neomycin: kills bacteria that produce ammonia in GI tract

2
Q

Medicine given to treat bleeding esophageal varices.

A

Octreotide: vasoconstrictor to prevent bleeding

3
Q

Way to classify liver cirrhosis.

A

Childs Classification

-based on ascites, nutrition, albumin, bilirubin, and encephalopathy

4
Q

Dx mode of choice for cirrhosis

A

Liver biopsy

5
Q

Most sensitive and specific test for colon cancer

A

Colonoscopy

6
Q

Riskiest type of colonic polyp

A
Villous type
(tubular lesions don't turn into cancer as often)
7
Q

What is FAP?

A

Familial Adenomatous Polyposis: autosomal dominant condition with lots of polyps in the colon and sometimes duodenum.
Colon cancer is 100% in 4th decade, colectomy recommended

8
Q

What is Peutz-Jeghers Syndrome?

A

Hamartomas scattered throughout the GI tract, pigmented spots seen on the lips.

9
Q

What are the Lynch Syndromes?

A

Hereditary Nonpolyposis CRC
Lynch 1: only one site
Lynch 2: multiple sites with other types of cancers

10
Q

Test of choice for diverticulosis

A

Barium Enema

11
Q

Test of choice for diverticulitis

A

CT scan

a barium enema would increase pressure too much and risk perforation

12
Q

What is Ogilvie Syndrome

A

Symptoms of a bowel obstruction without actual mechanical obstruction. Usually post trauma, surgery or some drug use.

13
Q

Treatment for pseudomembranous colitis.

A

Also called C. diff colitis, stop antibiotic and give metronidazole

14
Q

Treatment for hepatorenal failure and cirrhosis

A

Liver Transplant

15
Q

Treatment for Wilsons Disease

A

D-penicillamine

16
Q

Primary organ affected by hemochromatosis.

A

Liver
-cirrhosis is a common complication
(autosomal recessive disease)

17
Q

Requirement for diagnosis of hemochromatosis

A

Liver Biopsy to determine hepatic cellular iron concentration

18
Q

Board buzz word for hemochromatosis

A

Bronze Diabetic

  • iron deposits in the pancreas inhibiting insulin release causing diabetes
  • iron deposits in the skin causing a hyper-pigmentation appearance
19
Q

Treatment for hemochromatosis

A

Repeated phlebotomies

20
Q

Most common population to get hepatocellular adenomas and why?

A

Women age 15-40 because of oral contraceptive use

21
Q

Most common benign tumor of the liver and which population most commonly gets them?

A

Cavernous Hemangioma

  • vascular tumor in the liver vessels
  • oral contraceptive use causes them in menstruating women
22
Q

Two types of hepatocellular carcinoma and which is associated with Hep B and Hep C and cirrhosis?

A

Nonfibrolamellar: associated with cirrhosis and viruses
Fibrolamellar: not associated (better outcome because usually resectable)

23
Q

Biggest risk factor for hepatocellular carcinoma

A

Cirrhosis: especially due to Hep B, Hep C, or alcohol

24
Q

What is required for diagnosis of hepatocellular carcinoma?

A

Liver Biopsy

25
Q

Defect in Gilbert Syndrome

A

Autosomal dominant deficiency of diphosphate glucoronyl transferase. Elevation of unconjugated bilirubin

26
Q

Cause of hydatid cyst liver disease

A

Echinococcus granulosus

27
Q

Most common cause of pyogenic liver abscesses

A

Biliary duct obstruction, causes backup of bile flow allowing bacterial proliferation

28
Q

Main cause and prominent population to get amebic liver abscesses

A

Homosexual men, due to fecal oral route

Caused by Entamoeba histolytica

29
Q

What is Budd Chiari Syndrome?

A

Liver disease occludes hepatic venous flow causing portal congestion leading to ascites, RUQ pain, vatical bleeding, jaundice.

30
Q

When does jaundice clinically present?

A

When bilirubin levels are above 2mg/dl.

31
Q

Which bilirubin makes urine darker?

A

Conjugated (direct) because it is loosely bound to albumin and therefore more water soluble. Can be excreted easily by kidneys

32
Q

Name the two major inherited disorders that can cause direct hyperbilirubinemia

A

Dubin Johnson and Rotors

33
Q

What clinical signs on PE differentiate direct from indirect hyperbilirubinemia?

A

Direct: dark urine and pale stool
Indirect: neither of these

34
Q

Which aminotransferase is more specific for the liver?

A

ALT

ALT (a liver test)
AST (a systemic test)

35
Q

What change in LFT is expected with alcoholic liver disease

A

AST>ALT by about 2:1

36
Q

What is suspected with LFT where the AST and ALT are:

  1. Mildly elevated (low hundreds)
  2. Moderately elevated (high hundreds to thousands)
  3. Severely elevated (>10,000)
A

Mild: chronic viral hepatitis, acute alcoholic hepatitis
Moderate: acute viral hepatitis
Severe: ischemia, shock, bad viral hepatitis, acetaminophen toxicity

(Normal ALT: 10-35)
(Normal AST: less than 35)

37
Q

What does an elected alkaline phosphatase mean in regard to liver disease?

A

Cholestasis, if its very high (10x increase) think extra hepatic biliary tract obstruction.

38
Q

What can be measured to determine if an elevated alk phos is related to a hepatic disease?

A

Gamma-glutamyl-transferase activity. If it is also elevated it is probably a liver disease

39
Q

What is suspected if Alk phos is elevated but GGT is not?

A

Biliary obstruction, pregnancy, or bone disease