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53 Cards in this Set

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  • Back
What gene is deficient in hemochromatosis?
HFE
When can hemochromatosis be treated, and how?
Before cirrhosis: with phlebotomy (after cirrhosis, phlebotomy doesn’t decrease risk of HCC)
What does hemochromatosis cause? (5)
Bronze skin, diabetes, cirrhosis, arthritis, heart failure
What is the diagnostic test for hemochromatosis?
Liver biopsy
How to test for hep A?
Look for IgM against Hep A
What is the sensitivity of Hep C Ab?
Very poor (40% have negative results) ==> need to test for HCV RNA
How to test for hep C?
Hep C viral load -- look for HCV RNA (not Ab test b/c of poor sensitivity)
Classic demographics for PBC
middle-aged female
Screening test for PBC?
AMA (anti-mitochondrial antibody)
What does IgG to HAV suggest?
old infection / immunity
when does HELLP syndrome occur?
3rd trimester of pregnancy
TTP vs HUS
both have MAHA and thrombocytopenia; HUS has renal failure; TTP is +/- fever, MS changes, and renal failure
definition of fulminant hepatic failure
encephalopathy within 8 wks of liver injury
treatment of fulminant hepatic failure
transplant b/c of very high mortality rate
alcoholic hep vs acetaminophen tox (2)
EtOH: moderately elevated AST/ALT (<500), FEVER
what is gilbert's syndrome?
congenital unconjugated hyperbilirubinemia found in 5% of the population
lab findings in PBC
cholestatic picture -- elevated AlkPhos and maybe bili
how do you calculate globulin level?
total serum protein minus albumin
what liver dz a/w elevated globulins?
AIH
mgmt of NASH
wt loss
primary w/u of labs showing cholestatic picture?
RUQ u/s
secondary w/u of labs showing cholestatic picture?
depends on RUQ u/s findings: if biliary dilitation, ERCP/MRCP; if evidence of infiltrative liver dz, liver biopsy
Recommended kCal deficit for weight loss
-500 to -1000 kCal/day ==> 1-2lb loss/wk
what drugs for wt loss? When to use them?
orlistat and silbutramine: only used in pts refractory to diet/exercise, and only serve as temporary measure (wt comes back once drugs d/c'ed)
aphthous ulcers are a/w what GI pathology?
IBD
what is a major non-neoplastic cause of hyperprolcatinemia?
hypothyroidism (TRH stims both TSH and prolactin release)
lab findings in primary vs secondary hyperprolactinema
secondary has lower levels of prolactin production (<200ng/ml)
test to dx cushing's dz
24hr urinary free cortisol
risk factors for esophageal carcinoma
white male, long-standing GERD, barrett's esophagus
what condition generaly necessary for infectious esophagitis
immunocompromise (eg CMV esophagitis in AIDS)
MCC relapse of sx in mgmt of Celiac dz?
dietary incompliance with gluten-free diet
anti-tissue trasnglutaminase used to dx which dz?
celiac dz
villous blunting a/w? (3)
1) CELIAC SPRUE 2) TROPICAL SPRUE 3) BACTERIAL OVERGROWTH
tx of tropical sprue
folic acid + tetracycline
tests for bacterial overgrowth (2)
glucose hydrogen breath test, OR lactulose hydrogen breath test
IBS not a/w what common GI sx?
weight loss
usual location of primary anal fissure
posterior, midline; anything else suggestive of 2ndary cause, esp Crohn's (66% posterior midline, but 33% not)
Mechanism of hydroxyurea
ribonucleotide reductase inhibitor --> increased HbF
risks of hydroxyurea
mild! Can cause reversible myelosuppression, increased risk of AML in pts with polycythemia vera
lethal late complication seen in hodgkin's dz survivors treated with multimodal tx (pancytopenia): what is it and when does it occur?
secondary myelodysplastic syndrome, usually 3-11 yrs after tx
viral cause of anemia in immunocompromised pts?
parovirus b19 (reticulpenia)
dx of parvovirus anemia
parvovirus DNA in blood/marrow, detected via PCR
tx of parvovirus anemia
IV Ig containing anti-parvoviral IgG
Tx of choice for aplastic anemia? Which pts? Survival?
allogenic SCT; pts < 50yo with HLA-matched siblings; survival 75-90%
tx of chemo-induced anemia
weekly EPO
what does increased ferritin and decreased Fe levels in anemic pts with chronic inflam dz (eg RA) suggest?
Fe deficiency OR ACD: Although labs c/w ACD, could also be Fe deficiency since ferritin is an acute phase reactant
what does elevated HbA2 (alpha2delta2) suggest?
B-thal (trait)
lab findings in alpha-thal vs beta-thal
beta-thal: elevated HbA2 (alpha2delta2)
epi of myelodysplastic syndromes
>50yo
MCV in myelodysplastic syndromes
increased
increased total protein and decreased albumin levels suggests what with bone pathology?
elevated globulins -- multiple myeloma
hypercalcemia + anemia --> ?
?multiple myeloma (look for renal dysfunction)
nucleated RBCs seen when?
1) Hematologic causes (sickle cell, thal); 2) Marrow infiltrates (myelofibrosis, mets to bone)