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GI 9 Pancreatic D/O

Pancreatic disorders

What's the difference between Mallory Weiss and Boerhaave tears? Mallory Weiss is supf mucosal tears. Boerhaave is a full-thickness perforation.
What statistical calculation looks at true positives and divides them by the number of patients with the disease? Sensitivity
What are the HACEK bacteria? Culture negative endocarditis: Haemophilus, Actinobacillus, Cardiobacterium, Eikenella, and Kingella
What are the Ranson criteria in admission for acute pancreatitis? GA LAW: Glucose >200, AST >250, LDH >350, Age >55yo, Wt ct >16,000
What are the 48h Ranson criteria in acute pancreatitis? (don't need numbers) Hct dec >10%, Ca <8, arterial O2 <60, BUN inc >5, base deficit >4, fluid sequetration >6L
What is the most sensitive and specific lab test for the dx of chronic pancreatitis? Low fecal elastase level
What is the tx for chronic pancreatitis? Stop EtOH, opioid analgesia, pancreatic enzyme supplementation, and possible surgery
What are the MCC of acute pancreatitis in the US? Gallstones and alcohol
What is the tumor marker most useful in the dx of pancreatic cancer? CA 19-9
What procedure is performed to treat an isolated cancerous tumor in the head of the pancreas? Whipple
If pancreatitis is due to gallstone obstruction of pancreatic duct, what should be done after the pancreatitis has passed? Cholecystectomy
Can amylase and lipase be used to predict prognosis? Which one is more specific for pancreas? No; lipase is more specific for pancreas.
Name 6 drugs causing pancreatitis. Didanosine (HIV drug), sulfa drugs, HTZ, valproid acid, AZT, estrogens
What is Grey Turner's sign? What dz is it seen in? Hemorrhage into flank causing bluish discoloration. Acute pancreatitis
What is Cullen's sign Periumbilical hemorrhage seen in acute pancreatitis
Name 2 key radiographic findings in acute pancreatitis. Sentinel loop (dilated loops of bowel near pancreas on AXR). Colon cut-off sign (R colon distended until near pancreas)
Common cause of recurrent/chronic pancreatitis? Alcohol
What is Courvoisier's sign? Palpable, nontender gallbladder seen in exocrine pancreatic cancer (adenocarcinoma)
What does elevated alk phos suggest in a suspected pancreatic cancer case? BIle duct obstruction. Will also see increased T bili and D bili
What is Trousseau's syndrome? Migratory thrombophlebitis that is a complication of exocrine pancreatic cancer
Increased fasting insulin, spontaneous hypoglycemia, and positive C peptide. WHich tumor? Tx? Insulinoma. Tx is surgical resection. Diazoxide or ocretotide may relieve symptoms in non-resectable dz.
Alpha cell tumor causing hyperglycemia that may present as refractory DM. Tumor? Derm finding? Glucoagonoma. Exfoliating rash (migratory necrolytic erythema) may be found on exam.
Tx for glucagonoma? surgical resection if localized, octreotide, IFN-alpha, chemo, and embolization may be used in metastatic dz.
Tumor of non-beta islet cells causing watery diarrhea, weakness, nausea, vomiting, and abdominal pain. VIPoma
Multiple insulinomas are indicative of ___. MEN I
What type of diarrhea does a VIPoma cause? Secretory (check stool osmolality)
Tx for VIPoma? surgical resection if localized, corticosteroids, chemo, octreotide, and embolization may be used in metastatic dz.
Created by: sarah3148



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