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23 Cards in this Set
- Front
- Back
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284. Cholesterol stones (80%)?
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Radiolucent w/10-20% opaque due to calcification.
b. Associated w/obesity, Crohn’s disease, Cystic fibrosis, advanced age, clofibrate, oestrogens, multiparity, rapid weight loss. |
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285. What nationality is at high risk for Cholesterol gall stones?
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a. Native Americans.
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286. Pigment stones (radiopaque [not radiolucent] seen in pts w/:?
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a. Chronic hemolysis
b. Alcoholic cirrhosis c. Advanced age d. Biliary infection. |
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287. Complications of gallstones?
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1. Cholecystitis- (most commonly)
2. Ascending cholangitis 3. Acute pancreatitis 4. Bile stasis. b. Can also cause biliary colic- obstruction of common duct by gallstones causes bile duct contraction. c. May present without pain (e.g. diabetics). d. Can cause fistula between gallbladder and small intestine leading to air in the biliary tree. e. If gallstone obstructs ileocecal valve (gallstone ileus), air can be seen in biliary tree on imaging. |
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288. Charcot’s triad of cholangitis?
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1. Jaundice
2. Fever 3. RUQ pain. |
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289. Positive Murphy’s sign?
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a. Inspiratory arrest on deep palpation due to pain from GB region.
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290. Cholecystitis?
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a. Inflammation of gallbladder.
b. Usually from gallstones. c. Rarely ischaemia or infectious (CMV). d. ↑ Alkaline phosphatase if bile duct becomes involves (e.g., ascending cholangitis). |
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291. Acute pancreatitis Presentation?
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a. Autodigestion of pancreas by pancreatic enzymes.
b. Epigastric abdominal pain radiating to back c. Anorexia d. Nausea. |
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292. Causes of pancreatitis “GET SMASHED?a. Gallstones
b. Ethanol c. Trauma d. Steroids e. Mumps f. Autoimmune disease g. Scorpion Sting h. Hypercalcemia/Hyperlipidemia i. ERCP j. Drugs (e.g., sulfa drugs). |
a. Gallstones
b. Ethanol c. Trauma d. Steroids e. Mumps f. Autoimmune disease g. Scorpion Sting h. Hypercalcemia/Hyperlipidemia i. ERCP j. Drugs (e.g., sulfa drugs). |
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293. Labs for Acute pancreatitis?
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a. Elevated amylase
b. Elevated lipase (higher specificity) |
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294. Complications of acute pancreatitis?
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a. DIC
b. ARDS c. Diffuse fat necrosis d. Hypocalcemia (Ca2+ collects in pancreatic calcium soap deposits) e. Pseudocyst formation f. Hemorrhage g. Infection h. Multiorgan failure. |
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295. What can chronic pancreatitis lead to?
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a. Pancreatic insufficiency ->
1. Steatorrhea, fat soluble vitamin def. 2. DM. |
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296. What is chronic calcifying pancreatitis strongly associated w/?
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a. Alcoholism and smoking
b. ↑ risk of pancreatic cancer. |
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297. Pancreatic adenocarcinoma?
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a. Prognosis averages < 6 months.
b. Usually already metastasized at presentation. c. More common in pancreatic head (obstructive jaundice). |
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298. Who is at ↑ risk of pancreatic adenocarcinoma?
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a. Jews
b. Blacks. |
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299. Tumour markers for pancreatic carcinoma?
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a. CEA
b. CA-19-9. |
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300. Risk factors for pancreatic cancer?
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a. Cigarettes and chronic pancreatitis
b. Not Alcohol!!! |
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301. Presentation of pancreatic carcinoma?
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a. Abdominal pain radiating to back
b. Wt. loss (due to malabsorption and anorexia) c. Migratory thrombophlebitis- redness and tenderness on palpation of extremities (Trousseau’s syndrome). d. Obstructive jaundice w/palpable gallbladder (Courvoisier’s sign). |
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302. H2 blockers?
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a. Cimetidine
b. Ranitidine c. Famotidine d. Nizatidine |
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303. MOA of H2 blockers?
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a. Reversible block of histamine H2 receptors.
b. Cause ↓ H+ secretion by parietal cells. |
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304. Clinical use of H2 blockers?
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a. Peptic ulcers
b. Gastritis c. Mild esophageal reflux d. “Take h2 blockers before you DINE. Think “table for 2” to remember H2. |
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305. Toxicity of Cimetidine?
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a. Potent inhibitor of P-450
b. Also has antiandrogenic effects (prolactin release, gynecomastia, impotence, ↓ libido in males). c. Can cross BBB (confusion dizziness, HA) d. Can cross placenta. |
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306. Tox of both cimetidine and ranitidine?
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a. Both ↓ renal excretion of creatinine.
b. Other H2 blockers are relatively free of these effects. |
