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51 Cards in this Set
- Front
- Back
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WHAT MEDICATIONS ARE RISK FACTORS FOR CHOLECYSTITIS?
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FIBRATES FOR DYSLIPIDEMIA (I.E. LOPID, TRICOR)THIAZIDE DIURETICS ESTROGEN, ORAL CONTRACEPTIVES |
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WHAT ARE CHOLECYSTITIS DIAGNOSTICS?
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**ULTRASOUND: HIGH SENSITIVITY FOR STONES 95%-- OKAY IN PREGNANCY** CBC, WITH DIFF LYTES, BUN, CR, UA LIVER FUNCTION TESTS: BILI, ALK, PHOS AMYLASE, LIPASE: R/O PANCREATITIS BETA HCG EKG, ABD XRAY, CXR (R/O RLL PNUEMONIA) BILIARY SCINTIGRAPHIC IMAGING |
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WHAT IS THE MANAGEMENT FOR ASYMPTOMATIC GALLSTONES IN CHOLECYSTITIS?
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ABOUTE 1 IN 5 WILL GO ON TO DEVELOP SYMPTOMS SURGICAL CONSULT GI CONSULT: MEDICAL DISSOLUTION (NOT EFFECTIVE - BILIARY LITHOTRIPSY) |
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WHAT IS THE MANAGEMENT FOR SYMPTOMATIC GALLSTONES IN CHOLECYSTITIS?
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DEHYDRATION: IVF, RE-ESTABLISH ELECTROLYTES VOMITING: NPO PAIN: ANALGESIA, MERPERIDINE / KETOROLAC (TORADOL) INFECTION: ANTIBIOTICS SURGERY: ERCP, LAPAROSCOPIC CHOLE |
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TAKING THESE MEDICATION PLACES A PERSON AT RISK FOR PANCREATITIS:
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ACE INHIBITORS THAZIDE DIURETICS, FUROSEMIDE CORTICOSTEROIDS NSAIDS ANTIFUNGAL -PENTAMIDINE STATINS |
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WHAT ARE PANCREATITIS BLOOD WORK DIAGNOSTICS?
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AMYLASE / LIPASE PANCREATIC ENZYME: TRYPSINOGEN-2 (SERUM & URINARY) TRYPSINOGEN ACTIVATION PEPTIDE GLUCOSE LEUKOCYTOSIS |
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WHAT ARE RESULTS OF PANCREATITIS BLOOD WORK DIAGNOSTICS?
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NON-SPECIFIC FOR CHRONIC PANCREATITIS, ETOH, ELEV. TRIGLY --> AMYLASE (RISES 6HR AFTER ONSET, RETURN TO NORMAL IN 3-5 DAYS)**LIPASE (MAY ELEVATE 3X NORMAL)** ELEVATED-TRYPSINOGEN-2 (SERUM & URINARY) ELEVATED-TRYPSINOGEN ACTIVATION PEPTIDE ELEVATED-GLUCOSE LEUKOCYTOSIS |
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WHAT ARE PANCREATITIS BLOOD WORK DIAGNOSTICS?
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TRIGYLCERIDES BILIRUBIN CALCIUM C- REACTIVE PROTEIN FECAL FAT - 72HR COLLECTION FOR MALABSORPTION |
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WHAT ARE RESULTS OF PANCREATITIS BLOOD WORK DIAGNOSTICS?
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ELEVATED - TRIGLYCERIDES ELEVATED - BILIRUBIN TRANSIENT- HYPOCALCEMIA ELEVATED - CRP |
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WHAT DIAGNOSITIC TESTS WILL BE DONE FOR PANCREATITIS?
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CT OF ABDOMEN MRCP -MAGNETIC RESONANCECHOLANGIOPANCREATOGRAPHY = MRI TECHNIQUE TO VIEW DUCTS |
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WHAT IS THE MANAGEMENT FOR ACUTE PANCREATITIS?
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ACUTE: HOSPITALIZE REHYDRATION: IV PAIN: OPIOIDS - DILAUDID N/V: RESTRICT ORAL INTAKE, NPO UNTIL PAIN IS RESOLVED |
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WHAT MEDICATIONS MUST BE AVOIDED IN THE MANAGEMENT OF ACUTE PANCREATITIS?
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MEPERIDINE = METABOLITE CAN ACCUMULATE MORPHINE = INCREASED PRESSURE AT SPHINCTER OF ODI FENTANYL = RESPIRATORY DEPRESSION |
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WHAT IS THE NON-MEDICAL MANAGEMENT FOR CHRONIC PANCREATITIS?
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AVOID ALCOHOL DIETARY MANAGEMENT: FASTING, SMALL MEALS, DECREASE FAT CONTENT |
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WHAT IS THE MEDICAL MANAGEMENT FOR CHRONIC PANCREATITIS?
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PAIN CONTROL: SHORT COURSE OPIODS, AMITRIPTYLINE, NSAIDS SUPPLEMENT: INSULIN, PANCREATIC ENZYMES (DEC. STIMULATION TO RELEASE) OCTREOTIDE: INHIBIT PANCREATIC SECRETIONS |
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WHAT ARE DIAGNOSITICS FOR HEPATITIS A?
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ANTI-HEPATITIS A VIRUS IMMUNOGLOBULIN M (Anti-HAV IgM) ANTI-HEPATITIS A VIRUS IMMUNOGLOBULIN G (Anti-HAV IgG) |
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WHAT ARE THE RESULTS OF THE DIAGNOSITICS FOR HEPATITIS A?
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**Anti-HAV IgM = POSITIVE AT TIME OF ONSET OF SYMPTOMS GOES AWAY IN 4-6 MONTHS **Anti-HAV IgG= POSITIVE SOON AFTER IgM GENERALLY PERSIST FOR YEARS - SHOWS POST INFECTION IMMUNITY |
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DO HAV VACCINES CONTAIN LIVE VIRUS?
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NO 2 DOSES 6-12 MONTHS APART |
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THE HAV VACCINE IS RECOMMENED FOR:
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ALL CHILDREN 12-23 MONTHS TRAVELERS TO COUNTRIES W/ HIGH RATES MEN WHO HAVE SEX W/ MEN USERS OF ILLEGAL INJECTION AND NON-INJECTION DRUGS PRIMATE INFECTED LAB WORKERS CHRONIC LIVER DISEASE |
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HOW CAN HEPATITIS A VIRUS BE INACTIVATED?
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BOILING FOR 1 MINUTE
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HOW CAN PASSIVE IMMUNIZATION BE GIVEN TO A PERSON WITHIN 2 WEEKS AFTER EXPOSURE?
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IMMUNOGLOBULIN
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HEPATITIS B SEROLOGY: HBsAg WHAT IS IT? |
HEPATITIS B SURFACE ANTIGEN --------------------------------------------- DETECTED ~4 WEEKS AFTER EXPOSURE PERSON IS INFECTIOUS PROTEIN ON THE SURFACE OF HBV = DETECTED IN HIGH LEVELS (ACUTE/CHRONIC HBV INFECTION) |
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HEPATITIS B SEROLOGY: anti-HBs / HBsAb WHAT IS IT? |
HEPATITIS B SURFACE ANTIBODY ----------------------------------------------- INDICATES: IMMUNITY FROM HBV INFECTION, SUCCESSFUL VACCINATION OR RECOVERY ANTIBODIES PRODUCED AS PART OF THE NORMAL IMMUNE RESPONSE |
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HEPATITIS B SEROLOGY: anti-HBc / HbCAb WHAT IS IT? |
TOTAL HEPATITIS B CORE ANTIBODY ---------------------------------------------------- INDICATES: PREVOUS OR ONGOING INFECTION APPEARS AT THE ONSET OF SYMPTOMS IN ACUTE HEPATITIS B AND PERSISTS FOR LIFE |
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HEPATITIS B SEROLOGY: IgM anti-HBc WHAT IS IT? |
IgM ANTIBODY TO HEPATITIS B CORE ANTIGEN ------------------------------------------------------------------- INDICATES: ACUTE INFECTION OR RECENT INFECTION <6 MONTHS |
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HEPATITIS B SEROLOGY: HBeAg WHAT IS IT? |
HEPATITIS B e ANTIGEN ---------------------------------- INDICATES: VIRUS IS REPLICATION / HIGH LEVELS SECRETED PRODUCT OF THE HBV, FOUND IN SERUM |
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HEPATITIS B SEROLOGY: anti-Hbe or HBeAb WHAT IS IT? |
HEPATITIS Be ANTIBODY ----------------------------------- INICATES: PREDICTOR OF LONG TERM CLEARANCE IN PERSONS UNERGOING VIRAL THERAPY CONVERSION OF e ANTIGEN TO e ANTIBODY = SEROCONVERSION |
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WHEN EDUCATING A PATIENT ABOUT WHAT TO EXPECT FROM HEPATITIS B VACCINATION, WHAT SHOULD BE SAID?
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COMES AS A SINGLE AND COMBINED VACCINATION CONVENTIONAL SERIES = 3 DOSES |
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WHO SHOULD BE VACCINATED WITH THE HEPATITIS B VACCINE?
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- ALL INFANTS - SEX & SUSCEPTIBLE HOUSEHOULD PARTNERS OF HEPATITIS B SURFACE ANTIGEN POSITIVE PERSONS - SEXUALLY ACTIVE, NOT MUTUALLY MONOGAMOUS RELATIONSHIP - PERSONS SEEKING EVAL OR TREATMENT FOR STD - MEN WHO HAVE SEX WITH MEN - INJECTION DRUG USERS - HEALTHCARE & SAFETY WORKERS AT RISK TO BLOOD EXPOSURE - DIALYSIS PT - PERSONS WITH HIV, CHRONIC LIVER DX |
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DOES HEPATITIS C (HCH) HAVE A VACCINE?
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NO , NO POST-EXPOSURE PROPHYLAXIS |
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WHAT IS THE MOST COMMON REASON FOR LIVER TRANSPLANT?
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HEPATITIS C (HCV)
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WHAT ARE BLOOD TEST THAT DETECT HCV INFECTION?
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SCREENING FOR ANTIBODY TO HCV (ANTI-HCV) -ENZYME IMMUNOASSAY (EIA) -CIA -RIBA HCV RNA POLYMERASE CHAIN REACTION (PCR) -QUALITATIVE - DETECT +/- VIRUS -QUANTITATIVE - DETECT VIRUS AMOUNT HCV VIRAL GENOTYPING: 6 KNOWN; 50 SUBTYPE |
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WHAT ARE THE DIFFERENTIAL DIAGNOSIS OF ELEVATED LFT?
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HEPATIC STEATOIS (FATTY LIVER DISEASE) HEPATITIS - VIRAL ALCOHOL LIVER DX DRUG OR TOXIN INDUCED HEPATITIS |
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WHAT ARE THE DRUG OR TOXIN INDUCED CAUSES OF HEPATITIS / ELEVATED LFT?
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ACETAMINOPHEN ISONIAZID MTHOTREXATE METHYLDOPA NITROFURANTOIN RIFAMPIN CHOLESTEROL LOWERING STATINS |
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WHAT LABWORK DIAGNOSTICS CAN BE DONE FOR HEPATITIS INFECTION?
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HEPATIC ENZYME: AST, ALT, ALKALINE PHOSPHATASE, TOTAL BILIRUBIN, PT/INR, WBC, LYMPHOCYTES, UA |
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WHAT LABWORK DIAGNOSTIC RESULTS CAN BE FOUND IN HEPATITIS INFECTION?
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ELEVATION - AST & ALT (AST HIGHER IN ALCOHOLIC) ELEVATION - ALKALINE PHOSPHATASE ELEVATED - TOTAL BILIRUBIN BILIRUBIN IN URINE LOW NORMAL WBC ATYPICAL LYMPHOCYTES |
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WHAT IS THE POST EXPOSURE MANAGEMENT OF HEPATITIS?
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HEPATITIS A: WITHIN 2 WK OF EXPOSURE - IMMUNE GLOBULIN 0.02ML/KG HAV VACCINE HEPATITIS B: HEPATITIS B IMMUNE GLOBULIN (HBIG) HBV VACCINE |
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WHAT IS THE THERAPY MANAGMENT FOR HEPATITIS A?
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NO ANTIVIRAL MEDICATION SUPPORTIVE CARE |
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WHAT IS THE THERAPY MANAGEMENT FOR CHRONIC HBV?
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BASED ON HBeAg STATUS GOAL: LOSE HBeAg / GAIN HBeAb INTERFERON (peg-IFN) FOR 48 WEEKS ANTIVIRALS 6-12 MONTHS DURATION AFTER LOSS OF HBeAg |
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WHAT ARE HBV ANTI-VIRAL MEDICATIONS?
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ENTECAVIR (BARACLUDE) TENOFOVIR (VIREAD) ADEFOVIE (HEPSERA) - 2ND LINE TELBIVUDINE (TYZEKA) - 2ND LINE LAMIVUDINE (EPIVIR-HBV) - HIGH RATE OF RESISTANCE - 2ND LINE |
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WHAT ARE CHRONIC HCV MEDICATIONS?
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2013 FDA APPROVED = SOFOSBUVIR (SOVALDI) SIMEPREVIR (OLYSIO) CHRONIC HCV = COMBO- INTERFERON (peg-IFN) + RIBAVIRIN +PROTEASE INHIBITOR - BOCEPREVIR (VICTRELIS) / TELAPREVIR (INCIVEK) |
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WHAT ARE LABWORK DIAGNOSTICS FOR CIRRHOSIS?
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CBC W/ DIFF, LYTES, BUN/CR, GLUCOSE, ALBUMIN, GLOBIN, LFTS, BILIRUBIN HEP PANEL, FERRITIN, TRANSFERRIN SATURATION ANTIMITOCHONDRIAL ANTIBODIES |
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WHAT ARE DIAGNOSTIC TESTS FOR CIRRHOSIS?
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ULTRASOUND OR CT LIVER BIOPSY |
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WHAT IS THE GOAL OF CIRRHOSIS MANAGEMENT?
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PREVENT FURTHER LIVER DYSFUNCTION IMPROVE SURVIVAL PNEUMOCOCCAL & FLU VACCINE HEPATITIS A & B VACCINE |
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WHAT IS PART OF THE NONPHARMOCOLOGICAL MANAGEMENT OF CIRRHOSIS?
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STOP ETOH & HEPATOTOXIC DRUGS SCREEN FOR ESOPHAGEAL VARICES 2G NA DIET, FLUID RESTRICTION, PROTEIN RECOMMENDED (1-1.5 G/KG/D) TEACH FAMILY TO: REPORT WT GAIN, COGNITIVE CHANGES, DEPRESSION |
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WHAT IS PART OF THE PHARMOCOLOGICAL MANAGEMENT OF CIRRHOSIS?
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CORTICOSTEROIDS FOR AUTOIMMUNE HEPATITIS LIVER ULTRASOUND AFP TO SCREEN FOR CANCER PARACENTESIS HEPATIC ENCEPHALOPATHY - LACTULOSE & IDENTIFY THE CAUSE |
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WHAT IS THE MANAGEMENT OF BLEEDING VARICES IN CIRRHOSIS MANAGEMENT?
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BALLOON TAMPONADE INJECTION SCLEROTHERAPY TRANSJUGULAR INTERHEPATIC PORTOSYSTEMIC SHUNT ENDOSCOPIC VARCEAL BAND LIGATION |
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N/V MEDICATIONS: SUBSTANCE P / NEUROKININ ANTAGONIST |
APREPITANT (EMEND) FOR CHEMOTHERAPY INDUCED NAUSEA |
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N/V MEDICATIONS: CANNABINOIDS |
DRONABINOL (MARINOL)
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N/V MEDICATIONS: BENZODIAZEPINES |
ADJUNT FOR ANTICIPATORY EMESIS LORAZEPAM (ATIVAN) |
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N/V MEDICATIONS: ANTIHISTAMINE & ANTICHOLINERGIC |
FOR MOTION SICKNESS, VERTIGO & MIGRAINES DIMENHYDRINATE (DRAMAMINE) CYCLIZINE (MECLIZINE) SCOPALAMINE, TRANSDERMAL |
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WHAT ARE ANTIEMETIC MEDICATIONS?
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BISMUTH: N/V BENZAMIDES: PROMOTE GASTRIC EMPTYING METOCLOPRAMIDE FOR GASTROPARESIS PHENOTHIAZINE: ACT CENTRALLY PROCHLORPERAZINE (COMPAZINE) PROMETHIAZINE (PHENERGAN) TRIMETHOBENZAMIDE (TIGAN) 5-HT (SEROTONIN) RECEPTOR: POSTOP/ CHEMO INDUCED ONDANSETRON (ZOFRAN) GRANISETRON (KYTRIL) |
