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29 Cards in this Set
- Front
- Back
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What is macroamylasemia?
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Presence of macroamylase in the blood, which is abnormal. It consists of amylase attached to a protein.
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Conditions associated with macroamylsemia?
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1. Celiac disease
2. Lymphoma 3. HIV 4. Monoclonal gammopathy 5. RA 6. Ulcerative Collitis |
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In what way does lipase differ from other pancreatic enzymes?
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Pancreatic lipase is secreted in its final form but only becomes effective in the presence of colipase in the duodenum.
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Serum levels of lipase are raised in which conditions?
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1. Pancreatitis (used to diagnose acute pancreatitis)
2. Pancreatic adenocarcinoma |
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Drugs that may increase lipase levels include
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1. Codeine
2. Indomethacin 3. Morphine |
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Elastase 1 is a useful marker of
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Pancreatic exocrine function
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What is the fecal elastase test?
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1. Used to assess pancreatic exocrine function
2. Preferred over secretin stimulation test. However, it may have problems detecting mild exocrine pancreatic insufficiency |
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Reason for a blood elastase test?
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Differentiate between acute and chronic pancreatitis
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Most common causes of pancreatic insufficiency?
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1. Cystic Fibrosis
2. Shwachman-Diamond Syndrome (SDS) 3. Type 1 DM |
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Symptoms of pancreatic insufficiency?
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1. Malabsorption and malnutrition
2. Vitamin deficiencies 3. Weight loss (failure to thrive) 4. Steatorrhea |
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Acute pancreatitis mnemonic
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I GET SMASHED
I - Idiopathic G - Gall stones E - Ethanol T - Traumas S - Steroids M - Mumps, Malignancy A - Auto-immune S - Scorpion sting H - Hypercalcemia, Hyperlipidemia E - ERCP D - Drugs |
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Gold standard for diagnosing pancreatitis?
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CT (and abdominal USG).
Note: XR is not recommended |
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Which scoring system is the most predictive of adverse outcomes in acute pancreatitis?
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- CT Severity Index.
- A CT score >5 is associated with a 15x mortality rate |
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Which H.pylori strains are more dangerous?
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Strains producing both VacA and CagA cause more intense tissue inflammation and induction of cytokine production. In addition, CagA strains may be associated with a higher frequency of precancerous lesions.
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Non-invasive tests for H.pylori?
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1. Urease Breath Test
2. Serological tests - IgG, IgA, IgM 3. PCR (salive or feces) 4. 13C-Bicarbonate in serum 5. 15-NH4 in urine |
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H.pylori test results may be influenced by
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1. PPIs
2. H2-blockers 3. Antibiotics |
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Diagnostic tests for celiac disease includes
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1. IgA-tTGA
2. EMA 3. HLA typing 4. Small bowel histology (most specific and sensitive) |
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Role of Peptide YY?
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Suppress appetite
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Hormones that may suppress appetite?
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1. GLP-1
2. Oxyntomodulin 3. Pancreatic polypeptide |
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Role of CCK?
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1. Stimulate the pancreas to produce the enzymes of pancreatic juice
2. Causes the gallbladder to empty. It also promotes normal cell growth of the pancreas. |
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Most common diagnostic tool for gastritis?
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Endoscopy with biopsy
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Other than [the most common diagnostic test for gastritis] the following tests may be ordered
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1. Contrast XR
2. Hemofec 3. CBC (anemia) 4. H.pylori tests (RUT, Urea breath test) |
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Complications of chronic gastritis?
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1. Peptid ulcer disease
2. Gastric polyps 3. Tumors (benign and malignant) 4. Atrophic gastritis |
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Most common causes of cirrhosis?
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1. HepC
2. Alcohol abuse 3. Obesity |
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Test to assess severity of cirrhosis?
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MELD. Predicts 90-day survival. Scores 6-40; lower is better.
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MELD measures which three units?
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1. INR
2. Bilirubin 3. Creatinine |
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What is Alagille syndrome?
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AD inherited disease: reduced number of bile ducts-->hepatic insufficiency-->necessitates liver transplant
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Unique symptoms of Alagille syndrome?
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Other than liver failure:
1. Heart murmur 2. Deep set eyes, small and pointed chin 3. Opaque ring on the eyes 4. Kidney problems (various) 5. Splenomegaly 6. Abnormal carotid arteries |
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To make a diagnosis of Alagille syndrome, a positive liver biopsy and the presence of three of the following symptoms are usually required:
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1. liver symptoms
2. heart abnormalities or murmurs 3. skeletal abnormalities 4. posterior embryotoxon 5. facial features typical of Alagille syndrome (6. JAG1/2 mutation) |
