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Gastrointestinal

RX Review Round 4

QuestionAnswer
What are to common expressions of Macrolide Toxicity? 1. Painful jaundice 2. Acute Cholestatic hepatitis
Macrolides are considered CYP450 system __________________. Inhibitors
Which macrolide has the least CYP450 inhibition features? Azithromycin
A patient with chronic and uncontrolled Ulcerative Colitis is at increase risk to develop? Colitis-associated Colorectal Cancer
Long-term inflammation in an uncontrolled UC patient, presents risk of developing what type of CRC? Colitis-associated Colorectal Cancer
What are the features of Colitis-associated Colorectal cancer? Frequently presents MULTIFOCAL, has high-grade histology, and present with Flat lesions in the PROXIMAL colon and occurs much earlier in life.
A young patient with long term colitis, is most likely to develop which kind of CRC? Colitis-associated Colorectal Cancer
Flat lesions in the proximal colon should raise suspicion of? Colitis-associated Colorectal Cancer
Coinsurance: Insurance plan in which patient pays for a portion util an an agreed deductible, which is then shared with the insurance company.
What are the potential factors for polyp malignancy? 1. Tubular adenocarcinoma < Villous adenocarcinoma 2. Larger polyps > Smaller polyps
Which metabolic imbalance is produced by excessive vomiting? Metabolic Alkalosis
What is implied in electrolytes balances in metabolic alkalosis? Loss of H+ , and Bicarbonate excess.
A value greater than _______ mEq/L in bicarbonate (HCO3) is considered excessively high. 28
What is another term used for Enterokinase? Enteropeptidase
Where is produced Enterokinase? Duodenum
What is the role of Enterokinase? Activates the conversion of Trypsinogen into TRYPSIN
Which is an essential duodenal enzyme in the digestion of complex lipids and proteins? Trypsin
What are the two most common causes of Gastric ulcers? H. pylori infection and NSAID overuse
What are red flags signaling non-ordinary gastric ulcers? Ulcers refractory to PPI use, and ulcers found DISTAL to duodenum with elevated gastrin levels
What syndrome is associated with many gastric ulcers distal to duodenum and with an elevated gastrin level? Zollinger-Ellison Syndrome
What is the MCC of Choledocholithiasis? Stone obstruction of the Common Bile Duct
What is the clinical presentation of Choledocholithiasis? Constant RUQ pain, jaundice, and cholestatic pattern of liver test results
What are the characteristic LFTs of cholelithiasis? Grossly elevated ALP, bilirubin, and mildly to normal levels of ALT/AST.
How does Giardia lamblia affect the intestinal tissue wall? Small bowel inflammation and villous atrophy, resulting in reduced absorptive capability and malabsorption.
What is the treatment of Giardiasis? Metronidazole
Which is the common type of protozoa that is ingested by drinking river (unfiltered) water? Entamoeba histolytica
What is a common hepatic consequence of amebiasis? Necrotic abscesses ascending from the Portal system
What is the treatment for amebiasis? Metronidazole
Yellow fever is caused by what type of viral family? Flavivirus
What is the clinical presentation of Yellow Fever? Headache, photophobia, musculoskeletal pain, and elevated transaminases with AST>ALT.
What is seen in liver bx of a Yellow Fever patient? Councilman bodies, eosinophilic degeneration and condensed nuclear chromatin.
What is the genomic description of Flaviviruses? Enveloped, (+) ssRNA virus
What mosquito transmits Yellow Fever? AEDES
What is the main characteristic/cause of Hirschsprung disease? Constricted colon that prevents the passage of stool into the anus
The "squirt sign" + first 24 hours of failed passed meconium. Dx? Hirschsprung disease
What is the classical sign seen in X-ray of a Hirschsprung disease patient? Dilated loops of Bowel and absence of gas in the rectum.
Double bubble sign in the abdominal x-ray. Dx? Duodenal atresia
What is the most common presentation of Squamous Cell Carcinoma of the larynx? HOARSENESS, but also with dysphagia dn weight loss.
What are common and significant risk factors for Larynx Squamous Cell cancer? Smoking and alcohol use
Patient presents with dysphagia and regurgitation, but no weight loss or hoarseness. Dx? Achalasia
Achalasia is due to: Loss of Auerbach nerve plexus in the esophagus
Increased intracellular cAMP by exotoxins is seen with: V. cholerae and B. anthracis.
What is the name of the exotoxin released by B. anthracis? Edema factor.
What is a common medication used in the relief of symptoms in IBS? Loperamide
Loperamide is an _____________, used in _________________. Opioid; IBS
Abdominal pain relief with defecation? IBS
What is the MCC of LLQ pain in diverticulitis? Blockage of a Diverticulum
What is the histologic characteristics of the muscularis propria affected in diverticulosis? Areas of attenuated muscularis propria
What are manifestations of Acetaminophen toxicity? Nausea, vomiting, scleral icterus, RUQ pain, and elevations in the LFTs in the first 24 hours.
What is used to treat Acetaminophen overdose? N-acetylcysteine
What is N-acetylcysteine? A reducing agent, that regenerates Glutathione tatha binds to the NAPQI generated.
What is the optimal time frame to administer N-acetylcysteine in a Acetaminophen overdose patient? Within 8 hours from ingestion.
Patient with chronic, gnawing pain, and gastric ulcers due to H. pylori infection. Dx? PUD
What causes the gastric mucosa damage in a H. pylori induced PUD? Ammonia accumulation
What does ammonia in PUD causes to the gastric environment? Neutralization of the gastric environment
Important G-protein fro intracellular transmission of signals from Growth hormone? Ras
What is an important characteristic of Ras protein? Intrinsic GTPase activity which converts GTP ----> GDP inactivating the protein function.
Ras protein is associated with which cancers? Pancreatic, colon, and lung cancers
To which kind of receptors are G-proteins, such as Ras, linked to? Receptor Tyrosine Kinase
Where are the Paneth cells found? Crypts of Lieberkuhn in the Small intestine
What is the main function of Paneth Cells? Immunologic function in clearing pathogens
What cytokines/enzymes are released by Paneth cells? a-defensins, lysozymes, and TNF
What is the histologic resemblance of Paneth cells? Eosinophils
What common exotoxin infection is often associated with damage or involvement of Paneth cells? Cl. difficile infection
What is the cause of Hepatic encephalopathy? The buildup of AMMONIA in liver disease, resulting in the onset of neurologic dysfunction.
What is the ACUTE treatment choice for Hepatic encephalopathy? Lactulose
What is the mode of action of Lactulose? Acidifying colonic contents and reducing the absorption of ammonia from the bowel.
The Charcot triad is associated with which disease? Cholangitis
What is the Charcot triad composed of? 1. Fever 2. Jaundice 3. RUQ pain
Besides Charcot triad, what other associated symptoms of Cholangitis? 1. Leukocytosis with neutrophilia 2. Elevated band cell counts
What are the most common EXTRAINTESTINAL manifestations of Crohn's disease? Uveitis, migratory polyarthritis, Erythema nodosum, and Renal calculi
What are kind of renal stones are associated in Crohn's disease? Calcium - oxalate
"Skip lesions", granulomas, fistulas, and stenoses. These are often seen as? Intestinal manifestations of Crohn's disease.
What is the major component of Pigmented Gallstones? Unconjugated bilirubin
Which kind of bilirubin is water insoluble? Unconjugated bilirubin
Water soluble bilirubin is known as? Conjugated or Direct bilirubin
RadioPAQUE gallstone of X RAY appear? Bright White
RadioLUCENT gallstone on X-ray appear? "gray-black"
What are clinical findings of Toxic megacolon? Severe abdominal pain and visibly distended colon.
What are some common predisposing factors for Toxic Megacolon? 1. Cl. difficile infection 2. Loperamide use (especially in children) 3. Ulcerative colitis
At what level does IVC traverses the diaphragm? T8
The IVC travels directly through the _______________________ of the diaphragm. Central tendon
Which two main structures traverse the diaphragm at T10? Esophagus and Vagus nerve
Which two vessels traverse the diaphragm at T12? Aorta and the Azygos vein
The _______ and _______ ________ travel through the ________________, alongside the _____________, to traverse the diaphragm. Aorta; Azygos vein; Aortic hiatus; Thoracic duct
How does the toxin in V. cholerae cause diarrhea? Irreversibly activating Gs
Motile, comma-shaped organism that does not ferment lactose and is oxidase (+)? V. cholerae
What is the first line of treatment for chemotherapy-induced nausea and vomiting? Ondansetron
What is the mode of action of Ondansetron? Blocks the Serotonin 5-HT3 receptors and decreases vagal stimulation.
What is the strongest anti-emetic available? Ondansetron
Neonate with acute abdomen, abdominal distension, bilious vomiting, and failure to pass stool. Suspected diagnosis? Volvulus
Which cardiac abnormality is associated with Volvulus? Situs inversus
What are the imaging findings of volvulus? 1. "Bird beak" and/or "coffee bean" appearance 2. Multiple air fluid levels
What are the most common sites and their respective draining veins for the development of Volvulus? #1 ---> Sigmoid colon which drains by the sigmoid veins #2 ---> Ileocecal junction, which is drained by the Ileocecal veins
What arterial body irrigates the Jejunum? SMA
What are common predisposing factors for SMA ischemia? Atrial fibrillation and Atherosclerotic disease
What is the clinical profile of Midgut ischemia? Severe abdominal pain that is out of proportion to physical findings.
Acute Mesenteric events are due to ______________ events. Embolic
Chronic mesenteric events are due to ___________________ events. Thrombotic
What are the main 3 factors to develop edema? 1. Decrease in blood oncotic pressure 2. Increase in capillary hydrostatic pressure 3. Lymphatic blockage.
What are examples of edema causes in a decrease in blood oncotic pressure? Liver failure and/or Nephrotic syndrome
Congestive heart failure causes edema due to: Increase in capillary hydrostatic pressure
Description of structure of Campylobacter jejuni: gram negative, oxidase positive, comma-shaped organism
What are the most common forms of acquiring C. jejuni? Consumption of undercooked poultry or contact with infected animals
What is a common physical activity associated with C. jejuni infection? Camping
One is one of the MCC of bloody diarrhea? Campylobacter jejuni infection
What are the arterial irrigation of the esophagus? - Inferior Thyroid artery ---> proximal 1/3 - Bronchial artery and Thoracic Aorta ----> middle 1/3 - Left gastric artery ----> Distal 1/3
Diffuse Esophageal Spasms (DES) is: Periodic, uncoordinated, non-peristaltic contraction of the esophagus that lead of episodic substernal chest pain accompanied by dysphagia.
What is the common sign seen in Barium swallow in a DES patient? "Corkscrew" esophagus
What is the imaging characteristics of Eosinophilic esophagitis? Endoscopy shoes Esophageal rings and linear furrows
What esophageal disorder is suspected in a patient with chest pain, with normal EKG and normal upper endoscopy? Diffuse Esophageal Spasms
What are the common ways of Brucella transmission? Contaminated dairy products and livestock
What are is the common presentation of Brucellosis? Undulant fever, myalgia, and arthralgia
What are the most significant or characteristic findings of Brucellosis? 1. Undulant fever 2. Strong moldy odor 3. Myalgia and arthralgia
Brucell is an: Gram negative, aerobic, coccobacillus
In which structure provides survival of Brucella? Macrophages of the Reticuloendothelial system
What is the common treatment of Brucellosis? Doxycycline + rifampin (or streptomycin)
Bartonella Henselae causes: 1. Cat Scratch Disease (CSD) 2 .Bacillary Angiomatosis in those immunocompromised
What disease is suspected in a AIDS patient with a newly acquired cat as a pet? Bacillary angiomatosis
What is the difference in lymphadenopathy between Brucellosis and Bartonella infection? Brucellosis is seen with generalized lymphadenopathy and Bartonella henselae is seen with regional lymphadenopathy.
What is the characteristic of fever of Borrelia recurrentis? Fever of 3-5 days with 7-9 days between relapses
What is the clinical features of Borrelia recurrentis? Jaundice, ecchymosis, petechiae, mental status changes, focal neurological findings, and respiratory distress
What are the liver test abnormalities in CHOLESTATIC conditions? 1. Grossly elevated ALP (>140) - Elevated Conjugated (direct) bilirubin - Mildly to normal AST and ALT
What are labs seen in Hepatocellular conditions? 1. Grossly elevated ALT/AST (compared to ALP) - Elevated bilirubin
Isolated hyperbilirubinemia is seen with: - Elevated bilirubin - Normal ALP, AST, and ALT
What is the normal levels of ALP? 20-140 IU/L
What are the normal range of AST and ALT? 8-20 IU/L
Which type of Crigler-Najjar Syndrome is the most severe? Type 1
What is the effective treatment for Type 1 Crigler-Najjar syndrome? Liver transplant
Crigler-Najjar is due to: Absence of Uridine diphosphate glucuronyl transferase
What is the treatment of Type 2 Crigler-Najjar syndrome? Phenobarbital, as it increases liver enzyme synthesis
Which two Hereditary Hyperbilirubinemias are seen with elevated Unconjugated Bilirubin? Gilbert syndrome and Crigler-Najjar syndrome
Elevated Conjugated bilirubin is seen in which hyperbilirubinemias? Dubin-Johnson syndrome and Rotor syndrome
Which hyperbilirubinemia condition is associated with "Dark liver"? Dubin-Johnson syndrome
What are the acute or first symptoms of Vitamin A deficiency? Night blindness and dry conjunctiva in malnourished and those with measles infection.
Which vaccine prevented condition is associated with Vitamin A deficiency? Measles
What is Keratoconjunctivitis sicca? Stinging, burning, and blurry vision seen with vitamin A deficiency.
Which are the two ocular late symptoms of vitamin A deficiency? Keratoconjunctivitis sicca and Keratomalacia
What is Keratomalacia? Corneal ulceration or melting
How is vitamin A absorbed in the GI tract? Micelle-mediated transport
Which type of bilirubin is bounded to Albumin? Unconjugated bilirubin
Bilirubin diglucuronide is seen with: Conjugated bilirubin
What structures drain lymph to the Superior Mesenteric lymph nodes? Lower duodenum, jejunum, ileum, and colon to splenic flexure
What are associated etiologies associated with affected Superior Mesenteric lymph node drainage? Mesenteric lymphadenitis, Typhoid fever, Ulcerative colitis, and Celiac Disease.
Sentinel lymph nodes are associated to with which main lymph drainage? Superior Mesenteric Lymph nodes
Milk-Alkali syndrome is due to: Chronic use of Calcium Carbonate
What are the clinical characteristics of Milk-Alkali syndrome? Hypercalcemia, metabolic alkalosis, and renal insufficiency.
What are characteristic of Hypercalcemia? Depression, constipation, weakness, fatigue
What are possible results of chronic use of Calcium Carbonate? 1. Milk-Alkali syndrome 2. Rebound Gastric acid hypersecretion
What is the clinical profile of Zollinger- Ellison Syndrome? Multiple gastric and duodenal ulcers, diarrhea, and epigastric pain
What kind of Pancreatic tumor is MOST associated with Zollinger-Ellison syndrome? Pancreatic Gastrinoma
Which cells in the stomach produce Gastrin? G-cells
Obstructing Gallstone produces what kind of bilirubinemia? Obstruction of Common bile duct can lead to Obstructive jaundice because of Conjugated bile cannot pass through the common bile duct.
Increased ALP and Increased direct bilirubin levels. Suspect diagnosis? Cholestasis
Metoclopramide is a: Prokinetic medication as an D-2 antagonist
What are the common uses of? 1. Antiemetic 2. Tx of Diabetic gastroparesis
What are some SE of metoclopramide? - EPS (tremor, akathisia, dystonia, and tardive dyskinesia)
Hyperplasia of Brunner glands is associated with which kind of ulcers? Duodenal
Which times at day (periods of day) do Duodenal ulcers cause the most pain? Nighttime and/or upon waking up in the morning
What kind of tissue is seen hyperplastic in duodenal ulcers? Brunner glands
What is Brunner glands function? Bicarbonate (HCO3-) secreting cells of submucosa of duodenum
What are Crypts of Lieberkuhn? Contain stem cells that replace enterocytes/Goblet cells and Paneth cells that secrete a-defensins, lysozymes, and TNF.
What is secreted by Paneth cells? a-defensins, lysozymes, and TNF
Where are Peyer Patches found? Lymphoid tissue found in the last segment (ileum) of small intestine
Peyer Patcher hyperplasia is an common cause of? Intussusception in pediatric patients
A GI infection of the ileum is often accompanied of __________________. Peyer patches hyperplasia
How is Pancreatic adenocarcinoma presented? 1. Painless jaundice 2. Weight loss 3. Palpable, NON-tender gallbladder (Coursevoir sign)
Positive Coursevoir sign is associated with: Pancreatic adenocarcinoma
What is the most important risk factor of Pancreatic adenocarcinoma? Smoking
What kinds of Jaundice is seen with Pancreatic adenocarcinoma? Obstructive (post-hepatic) jaundice
Conjugated bilirubin is: - Water soluble - Detectable in Urine
How do Opioids cause constipation? Activating mu-receptors in the gut, which slows peristalsis
How is opioid-induced constipation prevented? Use of Senna
What is the mode of action of Senna? Stimulates peristaltic activity in the intestine
Describe the rate-limiting step of Fatty Acid synthesis? Involves carboxylation of Acetyl-CoA to Malonyl-CoA
What is the substrate of the rate limiting step in fatty acid synthesis? Malonyl-CoA
What is inhibited by Malonyl-CoA? CAT I, in the fatty acid degradation, preventing mitochondrial entry of Fatty acids
What is the main cause of Renal calculi in Crohn's Disease? Excess of lipid in the large intestine
Which two substances compete for calcium binding in the large intestine in Crohn's disease? Oxalate and lipids
Crohn's disease is seen with __________________ in the urine. Hypercalciuria
The elevated levels of oxalate in urine in Crohn's disease lead to the development of? Calcium-Oxalate kidney stones
What are hepatic adverse effects seen with Antifungal azoles? Impaired liver function -----> hepatotoxicity
Antifungal azoles ____________________ CYP450 system. Inhibit
Propionyl-CoA carboxylase deficiency causes ______________. Propionic Acidemia
What is the clinical profile of Propionic Acidemia? Neonatal hepatomegaly, seizures, hypotonia, vomiting, poor feeding, and metabolic acidosis with increased anion gap.
What are the main lab results seen in Propionic acidemia? 1. Elevated Propionyl-CoA 2. Decreased Methylmalonic acid
What is the Charcot triad? Fever, RUQ pain, and Jaundice
What is the most common treatment of Cholangitis? IV fluids and antibiotics
What is a common cause of Cholangitis? Common bile duct stones
What are the main signs of VIPoma? - Watery diarrhea - Hypokalemia - Achlorhydria
What levels of Potassium are seen in VIPoma? Hypokalemia
What are the functions of VIP? 1. Increase secretion of water and electrolytes into GI lumen 2. Relaxation of smooth muscle and sphincters.
What is achlorhydria? Absence of hydrochloric acid in gastric secretion
The lack of HCL in gastric content is named _______________. Achlorhydria
What are the two MC population/activities that predispose for Giardiasis? Immunocompromised and Exposure to UNFILTERED water
What are the most common treatments for Giardia lamblia infection? Tinidazole, Nitazoxanide, and Metronidazole
What are the most characteristic symptom of Giardiasis? Chronic and acute diarrhea with bulky fatty stools, as well as nausea and vomiting
What is a common connective tissue disease affecting African-American women? Scleroderma
How is the dysphagia in Scleroderma described? Difficulty to swallow solids and liquids
Why does dysphagia occur in Scleroderma patients? Secondary to atrophy of smooth muscle of the lower 2/3 of the Esophagus and incompetence of the lower esophageal sphincter, leading to reflux
Which third(s) of the the esophagus are involved in dysphagia development in Scleroderma patients? Lower 2/3
Why is there reflux in Scleroderma patients? Incompetency of the lower esophageal sphincter (LES)
What is the MCC of HCC? HBV infection
Which continents are endemic of HBV infection? Asia and Africa
What are some relevant distingctions between HCC caused by HBV and HCV? HBV-associated HCC occurs in the absence of cirrhosis and at an earlier age than HCV-associated HCC
Which type of HCC is associated at a younger age? HBV-associated HCC
Why is HBV - associated hepatocellular carcinoma associated without liver dysfunction and at an earlier age? HBV DNA directly integrate into the host genome predisposing hepatocytes to neoplastic changes.
To which specific condition is Hepatic Encephalopathy most likely due to? Hyperammonemia
What are the clinical signs seen in a patient with Cirrhosis? Altered metal statues, hepatic encephalopathy (secondary to hyperammonemia).
Which biochemical cycle is involved in the conversion of ammonia into urea? Urea cycle
Which organ harbors the metabolism of Ammonia during the Urea cycle? Liver
Which amino acid is responsible to transfer ammonia into the liver? Alanine
Ammonia's amino group is transferred to _____________ in order to form ________________, a precursor in the Urea cycle. a-Ketoglutarate; GLUTAMATE
Common precursor in Urea cycle that involves the transfer of Ammonia amino group to a-KG? Glutamate
Excess ammonia, as seen in Hepatic Encephalopathy, will deplete with amino acid? a-Ketoglutarate
What is the cause of Duodenal atresia? Failure of recanalization of the GI tract during embryogenesis
What word is used to describe the emesis produced by Duodenal atresia? Intractable
Which trisomy is often associated with Duodenal atresia? 21
Lynch Syndrome is also known as? HNPCC
What is the cause of Lynch syndrome? Mutation in DNA mismatch repair genes
What are other cancers, besides colon carcinoma, associated with Lynch syndrome? Endometrial, urinary, GI, and female reproductive tract cancers.
What is the most common Female reproductive tract cancer associated with Lynch syndrome? Endometrial carcinoma
What is Celiac Sprue disease? Autoimmune disorder with intolerance to gluten.
Clinical picture of Celiac sprue disease patient: Foul-smelling diarrhea, steatorrhea, decrease weight, fatigue, and abdominal pain, and cutaneous rash
What is the skin involvement characteric of Celiac disease? Dermatitis herpetiformis
What is Dermatitis herpetiformis? Skin disorder with clustered vesicles that often appear in a SYMMETRIC pattern in Celiac sprue patients.
Punched-out lesions in the gastric mucosa, should raise suspicion of? Chronic H. pylori-associated gastric ulcers
What organism produces urease that hydrolyse urea to ammonia and carbonate? H. pylori
MC organism involved in presence of gastric ulcers, especially in the antrum of stomach? H. pylori
What is the role of ammonia in H. pylori-associated gastric ulcer? Acts as an "cloud" to buffer the H. pylori from the acidic environment of the stomach lumen
Breath test result Urease +, and patient complains of intermittent postprandial abdominal pain. Suspected diagnosis? Chronic H. pylori-associated gastric ulcers
Severe cases of B-Thalassemia may result in the development of which iron disorder? Secondary Hemochromatosis
What is the main imbalance of Hemochromatosis? Iron overload
Iron overload, often refers to which iron imbalance disease? Hemochromatosis
What is an common therapeutic action of a severe B-Thalassemia patient that develops secondary Hemochromatosis? Recurrent blood transfusions
Which ulcer is associated with increased ICP and parasympathetic activity from trauma or illness? Cushing ulcer
What does the elevated ICP produced by a Cushing ulcer also causes? Increased stimulation of Vagus nerve
Most cases of HCV infected patients are untreated because it goes mostly _________________. Undetected
Over 60-85% of HCV untreated patients will manifest _____________________ hepatitis. Chronic
How is HCV infection defined clinically? Presence of viral RNA and the absence of antiviral antibodies
Which kind of antifungals are often used in local or less severe systemic mycoses? Azoles
Antifungal azoles are CYP450 system ______________________. Inhibitors
Itraconazole is often used in treatment of the following fungal infections: Blastomyces, Coccidioides, Histoplasma, and Sporothrix schenckii
Approximately 70% of Ulcerative colitis patients also present with? Primary Sclerosing Cholangitis
PSC causes: Periportal fibrosis and ALTERNATING stenosis (and dilations) of hepatic bile ducts
PSC is positive for? p-ANCA
Cholecystitis is MCC to? Obstruction of biliary duct system at the level of the Cystic duct
At what is most commonly found the obstruction of Biliary duct system in a cholecystitis patient? Cystic duct
How are the liver function test levels in a patient with Cholecystitis? Normal to mildly elevated
What are the 4 virulence factors seen in Neisseria species? IgA protease, pilli, endotoxin, and capsule
Which virulence factors of Neisseria species cause Nasopharynx colonization possible? IgA protease and pilli
What does the IgA and pili of Neisseria work in causing infectinction? Via cleavage of immunoglobulin into Fab and Fc fragments
Which parasitic infection presents with chronic rash, cough, and eosinophilia? Strongyloidiasis
What is the most commonly used form of diagnosing or identifying a Strongyloides infection? Microscopic examination of stool for RHABDITIFORM larvae
What is larva currens? Associated rash seen in Strongyloidiasis infection
How is pattern of larva currens distinctive? It reflects the mobilization of the parasite along the affected areas, leaving a serpentine-like pattern of the rash, easy to distinguish.
Which part of the colon is always involved in Lynch syndrome? Proximal colon
Microsatellite instability due to mutation of DNA mismatch repair genes is seen in? Lynch syndrome
What is the cause of Kernicterus? Increased unconjugated bilirubin crossing the Blood-Brain Barrier.
To which protein is unconjugated bilirubin bounded in serum? Albumin
Conditions that decrease the amount of Albumin in serum, will indirectly increase the risk of developing which bilirubin related neurological condition? Kernicterus
How does decreased levels of serum Albumin lead to prompt development of Kernicterus? Less Albumin in blood leads to minimal Albumin-Indirect bilirubin complexes, leading to increase unconjugated bilirubin to cross the BBB.
What are two conditions that often lead to Kernicterus? Serious neonatal illness and preterm baby
What is an important risk factor to the development of Duodenal ulcers, not associated with H. pylori and/or NSAID use? Smoking
What is Linezolid? antibiotic and MAO-Inhibitor used in the treatment of Gram positive species
What is the clinical presentation of Serotonin Syndrome? Autonomic instability, altered mental status, and neuromuscular hyperactivity
Which antibiotic is often associated with development of Serotonin syndrome? Linezolid
Esophageal Squamous Cell Carcinoma is most often seen in the ---> Upper 2/3 of the Esophagus
Which kind of Esophageal cancer is associated with the lower third of the esophagus? Adenocarcinoma
Is Squamous cell or Adenocarcinoma, most likely seen in the distal part of the Esophagus? Adenocarcinoma
Esophageal adenocarcinoma stains positive for? Cytokeratin
How is Acute Bowel ischemia often presented? Acute-onset of abdominal pain out of proportion in physical examination, and with rebound tenderness
What is the MCC of acute bowel ischemia? Thrombotic arterial occlusion
Created by: rakomi