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64 Cards in this Set
- Front
- Back
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When you say pernicious anemia is an 'autoimmune disease', what is the autoimmunity to? What is the result?
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Autoimmune attack is on gastric PARIETAL Cells - there is gastric atrophy and loss of parietal cells
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What happens to the intestinal epithelium in atrophic gastritis?
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It undergoes metaplasia to GOBLET CELLS in place of CHIEF CELLS and PARIETAL CELLS
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So what is the autoimmunity NOT in pernicious anemia?
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It's not against intrinsic factor itself; its against the parietal cells that make IF.
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What is Angiodysplasia?
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Rupture of mucosal and submucosal vessels causing Intermittent lower intestine bleeding
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Can Angiodysplasia cause anemia?
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yes but it would be iron deficiency due to blood loss
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Can duodenal ulcers cause anemia?
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Yes - they can cause chronic blood loss
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What is menetrier disease?
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Hypertrophic gastropathy
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What happens in Menetrier disease?
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The gastric wall gets thick and HCL fails to be secreted
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What does lack of HCl cause?
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Protein losing enteropathy
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Can Ulcerative colitis cause vit B12 deficiency?
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Yes, by causing malabsorption; but not by changing Intrinsic factor.
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50 yr old patient presents with several-month history of Fatigue, Vague Abdominal pain, and dark-colored urine.. he has slight jaundice, Gbladder is palpable but not painful.
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Pancreatic cancer
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Why does pancreatic carcinoma cause jaundice?
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Most are in the pancreatic HEAD which compresses the bile duct
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What is an enlarged palpable gallbladder?
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Courvoisier's sign
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What would tenderness on gb palpation indicate?
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ACUTE cholecystitis
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35-yr old Female, Diarrhea, Abdominal pain, Flushing, elevated 5-HIAA in urine:
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Carcinoid syndrome - tumor secreting gi hormones
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What hormone INHIBITS GI hormone secretions?
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Somatostatin
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So what is used for treating Carcinoid syndrome?
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Octreotide - SST analog
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What is Alosetron?
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5-HT3 antagonist for IBS that is Diarrhea predominant
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What is Domperidone?
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D2 antagonist Prokinetic drug
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What is Dronabinol?
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Orally active Cannabinoid for nausea/vomiting control post chemo
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What is Famotidine?
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H2antagonist to inhibit gastric acid secretion
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What is Lactase?
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Replacement enzyme for Lactose intolerant people
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What is Lansoprazole?
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PPI inhibitor for gastric acid secretion
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What is Phentermine?
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Amphetamine derivative - decreases appetite
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What is Sulfasalazine used for?
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Mild-to-mod UC
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What is Ursodiol?
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Dissolves Cholesterol gallstones
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What are the cells that undergo hyperplasia in Menetrier disease?
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Mucus-producing cells proliferate
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Does Menetrier disease affect carbohydrate absorption?
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No just protein
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Does Menetrier disease affect acid secretion?
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YES it inhibits it
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So would menetrier disease cause hypochloremia?
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no you're NOT losing Cl
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What portion of the GI system is ALWAYS involved in Hirschsprung?
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The RECTUM
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What portion is commonly involved in MALE patients with Hirschsprung?
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A SHORT segment of involvement, with MEGAcolon PROXIMAL TO IT
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How is Hirschprung treated?
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Surgical removal of the affected segment
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What sex would be more likely to have a longer portion of involvement?
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Females
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What is Small left colon syndrome associated with?
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Neonates born to diabetic mothers
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What is the outcome of Small left colon syndrome?
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Self-limiting
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What is Docusate?
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A stool softener
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What is the mechanism of Docusate?
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Detergent
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What is Docusate used for?
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Preventing constipation
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What are psyllium and methylcellulose?
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Bulk-forming laxatives that cause bowel lumen water retention
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What is an irritant laxative?
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BISACODYL
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What are Loperamide and Diphenoxylate?
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Opioid receptor agonists
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What are Loperamide and Diphenoxylate used for treating?
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Diarrhea
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And what is the stool softerner to think of?
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Docusate - it mixeses up the stools and softens them up
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What prokinetic drug will exacerbate Parkinson's disease?
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Metoclopramide
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Why does Metoclopramide exacerbate PD?
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It is an ANTAGONIST of D2 receptors
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What is Granisetron's mechanism?
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5HT3 antagonist
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Clinical use of Granisetron
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Anti-nausea/vomiting post chemo and general anesthesia
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what is Alosetron?
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Happy bellies - for diarrhea predominant IBS
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What are side effects of Granisetron?
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HA/constipation
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What is Sucralfate?
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Aluminum salt - adheres to bases of ulcers and allows healing
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Most common side effect of Sucralfate:
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Constipation
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You know that Pancreatic adenocarcinoma has a very poor prognosis - like 3.5% 5-yr survival rate; what other cancer has a similarly low prognosis?
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Esophageal adenocarcinoma - 10% 5-yr survival!
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What is the mechanism of Aprepitant?
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NK1 antagonist
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What is the clinical use of Aprepitant?
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Chemo-induced n/v
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What is the mechanism of Prochlorperazine? Clinical use?
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Dopamine antagonist - n/v
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What benzos can be used for treating vomiting?
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Lorazepam and Diazepam
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What KIND of vomiting do Lorazepam/Diazepam treat?
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Anticipatory and Vertigo
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What is Scopolamine used for?
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Motion sickness and PREop nausea
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What is Scopolamine NOT used for?
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NOT for post-chemo n/v
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What are the 2 5-HT3 antagonists that are used for treating chemo-induced n/v?
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-Ondansetron
-Granisetron |
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What is the classic Apple core lesion on radiographic imaging pathognomonic for?
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Colon cancer - a CIRCUMFERENTIAL lesion around the sigmoid colon with narrowing of the lumen.
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What cancer marker will be elevated in this case?
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CEA
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What is CEA used FOR? What NOT FOR?
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For: guiding treatment
NOT for: screening - too many false pos |
