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23 Cards in this Set
- Front
- Back
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MCC of travelers diarrhea
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ETEC
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initial Rx for localized non small cell lung cancer
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surgical resection + chemo
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Rx for IBD
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SMALL BOWEL ONLY:
mesalemine (5-ASA) LARGE BOWEL INVOLVED: sulfasalazine (SSZ) ACUTE EXACERBATIONS: steroids |
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S/Sx's of Cirrhosis
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PORTAL HTN:
varices (esophageal & caput medusa) hepatosplenomegaly ascites LIVER FAILURE: decr'd conjugation (jaundice) decr'd proteins (coagulopathy & peripheral edema) incr'd toxins (encephalopathy/asterixis) incr'd estrogen (testicular atrophy, gynecomastia, spider angioma, & palmer erythema) OTHER: weakness wt loss digital clubbing dupuytren's contractures |
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what is NASH stand for & what are the MCC's
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NASH = NonAlcoholic SteatoHepatitis
MCC's (think metabolic syndrome): obesity DM hyperlipidemia insulin resistance |
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what is rx for NASH
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avoidance of alcohol
wt loss aggressive control of DM TZDs (eg. pioglitazone) improve LFTs |
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What is Budd-Chiari Syndrome
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thrombosis & occlusion of hepatic vein or intrahepatic/suprahepatic portion of IVC
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S/Sx's of Budd-Chiari Syndrome
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ascites (84%)
hepatomegaly (76%) jaundice RUQ pain (if acute) eventual liver failure --> hepatic encephalopathy (no fever, t/f no cholangitis; no JVD, t/f no rt-side HF) |
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Dx'c tests & Rx for Budd-Chiari Syndrome
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Initial Dx'c test: ultrasound
Gold Standard: hepatic venography Tx: thrombolytics anticoagulation angioplasty diuretics |
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diuretics used to Rx ascites/portal HTN
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furosemide
spironolactone |
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Rx for hepatic encephalopathy
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lactulose
rifaximin decreased protein intake |
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antibiotics used in spontaneous bacterial peritonitis
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cefotaxime
ceftriaxone other 3rd Gen Ceph's |
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screening test for hemochromatosis
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ferritin levels
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Rx for hemochromatosis
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phlebotomy
deferoxamine (rarely) |
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lab value a/w wilson disease
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serum cerruloplasmin levels (low)
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tumor marker for hepatocellular carcinoma
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AFP
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tumor marker a/w colon cancer
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CEA
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tumor marker a/w gastric cancer
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CEA
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tumor marker a/w pancreatic cancer
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CA 19-9
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tumor marker a/w ovarian cancer
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CA 125
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what is SAAG & how is it calculated
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SAAG = serum-ascites albumin gradient
SAAG = [serum albumin] - [ascites albumin] |
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What does SAAG indicate & what are the possible etiologies
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SAAG >/= 1.1 --> portal HTN
(low albumin in ascites relative to serum) cirrhosis alcoholic hepatitis HF/constrictive pericarditis massive hepatic metastases Budd-Chiari syndrome SAAG < 1.1 --> NOT due to portal HTN (high albumin in ascites relative to serum) Nephrotic Syndrome (2nd/2 decr'd serum albumin) Infection (2nd/2 incr'd ascites albumin) Neoplasm (2nd/2 incr'd ascites albumin) |
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What labs are concerning for neoplastic cause of ascites
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SAAG > 1.1
+ high ascites LDH (i.e. > 60% of serum LDH) |
