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New Onset ascites, what to do next?
|
· Abdominal US (can be d/t acute obstruction by HCC)
· In pts w/ Ascites, routine US is recommened q 6 months
|
|
Does cirhosis cause hypogonadism?
|
Yes, by 3 mechanisms:
1. ❌ HPA axis
2. ❌ Testicles
3. ⤴️ Estriol
|
|
Lactose intolerance is characterized by?
|
· ⊕ Hydrogen breath test
· ⊕ STOOL test for reducing substance
· ⤵️ Stool PH
· ⤴️ Osmotic gap
|
|
What’s a vascular ring?
|
Vascular rings encompass congenital malformations of the
aortic arch system that encircle the trachea and/or
esophagus and cause compressive symptoms.
Vascular rings can also present with esophageal
compression symptoms, as in this patient with severe
solid-food dysphagia.
|
|
Upper GI bleeding and BUN:Cr?
|
BUN/Cr ⤴️
|
|
endoscopic findings in ischemic colitis?
|
pale mucosa / patechial bleeding / hemorrhagic nodules & ulcers / cyanotic mucosa
|
|
Shigella Abx choice?
|
· Ciprofloxacin
· Ceftriaxone
· Azithromycin
|
|
Splenic Abscess?
|
Post-cholecystectomy.
Sx: A (Fever, LUQ Pain, +1- Splenomegaly)
Dx: CT
Tx: Abx + Splenectomy (not drainage)
|
|
How to dx Acute liver failure?
|
These 3 things should be there:
1. ⤴️ LFTs >1000
2. Hepatic encephalopathy
3. Liver synthetic dysfunction (🆎 PT)
|
|
Tx of severe Alcoholic hepatitis?
|
Prednisone
(presents w/ ∆: Fever / Abd pain / Jaundice / ⊕ PMHx of Alcohol)
|
|
Tx of chronic Hep c?
|
1. Stop Alcohol
2. Vaccinate against Hep A + B
3. Anti-HCV 💊 (Sofosbuvir + Lamo)
|
|
HCV Dx
|
2 Step Process:
1˚ Serology → Confirm: Molecular (PCR)
After confirmation:
Liver Bx: check extent of fibrosis
Tx: ledipasvir-sofosbuvir
|
|
ERCP indications?
|
· Sphincterotomy
· Stone removal
· In pt w/ GS pancreatitis & cholangitis
|
|
Tx of Toxic Megacolon?
|
Bowel rest / NGT / Abx (Against C.diff: vancomycin + metronidazole)
|
|
Hypersplenism?
|
· Concequence of Cirrhosis
· portal HTN
· Splenomegaly
· leads to thrombocytopenia
|
|
Asx pt presents w/ ⤴️ LFT?
|
1˚ Take more hx
2˚ Rx tests w/i 6 months → if 🆎 → Keep investigations
3˚ Serology (viral hepatitis) / Hemochromatosis / fatty liver
4˚ TSH + Muscle do
|
|
Pt w/ UGIB, when to transfuse blood?
|
Hgb <7
|
|
Abdominal Succession splash?
|
Test for gastric outlet obsruction
|
|
Alcoholic liver dz dx?
|
Alcoholic liver disease is generally characterized by modest
elevations in aspartate aminotransferase (AST) and alanine
aminotransferase (ALT), usually <300 IU/L and almost always
<500 IU/L. A ratio of AST to ALT
⤴️ GGT | ⤴️ Ferritin
|
|
Conjugated bilirubinemia?
|
>2 direct bilirubin
>20% of total bilirubin is direct bilirubin
|
Review board materials extremely fast.
Fast HY Review 