Gi Path And Pharm

Front 1

hepatocellular jaundice

Back 1

cong/uncong
increased urine br
nl/decr urine urobilinogen

Front 2

obstructive jaundice

Back 2

cong
increased urine br
decr unine urobilinogen

Front 3

hemolytic jaundice

Back 3

uncong
absent urine bilirubin
increased urine urobilinogen

Front 4

Gilberts

Back 4

mildy decreased UGT
incr uncong br without hemolysis, assoc with stress

Front 5

Crigler Najjar I

Back 5

absent UGT
die within a few years

Front 6

Crigler Najjar II

Back 6

less severe, responds to PHB which increases liver enzyme synthesis

Front 7

Dubin Johnson

Back 7

conjug hyperbr due to defective liver excretion
grossly black liver
benign

Front 8

Rotors

Back 8

similar to dubin johnson but milder and does not cause black liver

Front 9

Primary sclerosing cholangitis

Back 9

intra/extra hepatic; inflammation and fibrosis of bile ducts-->alternating strictures and dialtion with beading
assoc with UC; can lead to 2ndary biliary cirrhosis
triad: fever, jaundice, RUQ pain
tx: ersodiol, weight loss
men, 40 y/o

Front 10

Primary biliary cirrhosis

Back 10

intrahep, AI; severe obstructive jaundice, steatorrhea, pruritis, hypercholesterolemia, increased alk phos, increased AMA, assoc with scleroderma, CREST

Front 11

secondary biliary cirrhosis

Back 11

due to extrahep biliary obstruction; increased pressure in intrahep ducts-->injury-->fibrosis
often complicated by asc cholangitis, bile stasis, bile lakes
increased alk phos, increased cong br

Front 12

HCC

Back 12

increased risk with hep B/C, wilsons, hemochromatosis, alpha AT def, alcoholic cirrhosis, carcinogens (aflatoxin B1- asp fungus)
heme spread
sxs: hepatomegaly, ascites, polycythemia, hypoglycemia
increased AFP

Front 13

cholesterol stones

Back 13

radiolucent; assoc with obesity, Crohns, CF, advanced age, clofibrate, estrogens, multiparity, rapid weight loss, NA origin

Front 14

Mixed stones

Back 14

radiolucent both cholesterol and pigment components; most common

Front 15

Pigment stones

Back 15

radioopaque seen in pts with chronic RBC hemolysis, alcoholic cirrhosis, advanced age, biliary infection

Front 16

tx of gallstones

Back 16

estradiol

Front 17

acute pancreatitis cauces

Back 17

gallstones, ethanol, trauma, steroids, mumps, AI dz, scorpion sting, hyperCa/hyperlipidemia, drugs (sulfas, propofol, didanosine)

Front 18

acute pancr

Back 18

presents with epigastric ab pain radiating to back, anorexia, nausea
elevated amylase, lipase
can lead to DIC, ARDs, diffuse fat necrosis, hypoca, pseudocyst formation, hemorrhage, infection

Front 19

panc adenocarc

Back 19

prognosis 6 mos or less; very aggressive; usually already mets at presentation; tumors more common in pancr head (obstructive jaundice) painless
often presents with: ab pain radiating to back, weight loss, migratory thrombophlebitis, obstructive jaundice with palpable GB

Front 20

carcinoid

Back 20

tumor of endocrine cells; dense core bodies seen on EM; often produce 5HT; classic sxs: wheezing, right sided heart lesions, diarrhea, flushing
serotonin excess

Front 21

hepatic angiosarcoma

Back 21

vinyl chloride and arsenic

Front 22

OCP, anabolic steroids

Back 22

hepatic adenoma (benign)

Front 23

H2 blockers

Back 23

cimetidine, ranitidine, famotidine, nizatidine
block H secretion by parietal cells
used in peptic ulcer, mild GERD
can cause TCP

Front 24

cimetidine

Back 24

inhibits P450, antiandrogenic effects
can cross BBB

Front 25

PPI

Back 25

omeprazole, lansoprazole, pantroprazole
irreversibly inhibit H/K ATPase in stomach parietal cells
use: peptic ulcer, gastritis, eso reflux, ZES

Front 26

bismuth, sucralfate

Back 26

bind to ulcer base proving physical protection and allow bicarb secretion to reestablish pH
require acidic environment to work
used in ulcer healing, travellers diarrhea

Front 27

misoprostol

Back 27

PGE analog; increases production and secretion of gastric mucous barrier, decreases acid production
prevention of NSAID induced peptic ulcers; maintenance of PDA, induce labor
diarrhea, abortifactant

Front 28

muscarinic antag

Back 28

pirenzepine, propantheline
block MI receptors on ECL cells (decrease histamine secretion) and M3 receptors on parietal cells (decrease H secretion)
used for peptic ulcer
tox: tachycardia, dry mouth, difficulty focusing eyes

Front 29

aluminum hydroxide overusse

Back 29

constipation and hypophosphatemia, prox muscle weakness, osteodystrophy, seizures

Front 30

mg OH

Back 30

diarrhea, hyporeflexia, hypotenion, cardiac arrest
do not use with renal disease

Front 31

calcium carbonate overuse

Back 31

hypercalcemia, rebound acid increase (increases gastrin release)

Front 32

infliximab

Back 32

antibody to TNF-alpha; proinflammatory cytokine (must test for tb!)
use: crohns, RA
tox: resp infection, fever, hypotension

Front 33

sulfasalazine

Back 33

sulfa (AB) and mesalamine (antiinflam)(
activated by colonic bacteria
use: UC, Crohns
tox: malaise, nausea, sulfa tox, reversible oligospermia

Front 34

ondansetron

Back 34

5HT3 antag; powerful centrally acting antiemetic
control vomiting postop and in pts undergoing cancer chemo
tox: HA (vasodil), constipation

Front 35

octreotide

Back 35

decreases hormones, splanchnic circulation
PUD, eso varices, pancreatitis

Front 36

cisapride

Back 36

acts through serotonin receptors to increase Ach release at myenteric plexus
increases eso tone
increases contractility, improving transit time
NOT USED

Front 37

metoclopramide

Back 37

D2 antag; increases resting tone, contractility, LES tone, motility; does not increase transit time through colon
use: diabetic and post surgery gastroparesis
tox: increases parkinsonian effects, restlessness, drowsiness, fatigue, depression, nausea, constipation
DI: digoxin, diabetic agents
CI: SI obstruction
safe in preg

Front 38

increase ACh, increase 5HT, decrease D2

Back 38

chol ag, ACHE-I (neostigmine), metoclopramide, domperidone (decreases DA), cispride (increases 5HT), macrolides (stim SM motilin receptors), EES