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GI 4: Sm Intestine I
Small Intestines Part I: Malabsorption and Diarrheal Illnesses
Question | Answer |
---|---|
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 |