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GI 4: Sm Intestine I

Small Intestines Part I: Malabsorption and Diarrheal Illnesses

QuestionAnswer
What radiographic study is used to dx injury to the urethra? retrograde cystourethrogram
What are the SE of corticosteroids? Acne, Osteoporosis, immunosuppression, thin skin, mania/psychosis, insominia, moon face, buffalo hump, abd striae, cataracts, incr glucose
What type of oral infection has branching rods when examined microscopically? Actinomyces israelii
A recent Cuban immigrant with symptoms of malabsorption is found to also have megaloblastic anemia. What is the dz and tx? Tropical sprue. Abx (tetracyclines or sulfas) + folic acid supplementation x3-6mos
What is the most likely cuase of malabsorption in a pt with a + Sudan stain in the stool sample and a normal D-xylose test? Pancreatic insufficiency
What is the tx for Whipple dz? Bactrim or ceftriaxone x12mos
What tumors can cause a secretory diarrhea? Carcinoid tumor wiht serotonin excess, VIPoma, gastrinoma, medullary thyroid CA
WHat labs should be ordered to identify the pathogen in a pt with an acute diarrheal illness? If pt has sx >5d, fever, or bloody diarrha: OxP, fecal leukocytes, stool guaiac, stool cx, and stool acid fast stain. Otherwise the dz is prob self limited.
What is the MCC of adult chronic diarrhea? Lactose intolerance
What skin condition is associated with Celiac's disease? Dermatitis herpetiformis
How can you differentiate between Celiac sprue and tropical sprue? Celiac will have antiendomysial and antigliadan Ab whereas tropical won't.
What will you find on biopsy in a pt with Whipple dz? Jejunal biopsy shows foamy macrophages on PAS stain and villous atrophy
What causes Whipple disease? Infection with tropheryma whippelii likely leading to immune deficiency. High mortality if untreated with 1 yr of abx
Which chronic diarrhea am I?: usually hormone mediated or caused by enterotoxic bacteria secretory
Which chronic diarrhea am I?: caused by solute collecting in bowel lumen; occurs after eating, lessens with fasting osmotic
Which chronic diarrhea am I?: results from autoimmune or chronic infection process inflammatory
Created by: sarah3148