Goljan HY GI
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| Cleft lip/palate | show 🗑
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| Herpes labialis | show 🗑
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| Hairy leukoplakia | show 🗑
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| show | bilateral parotitis; unilateral orchitis; ↑ amylase
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| show | pseudomembrane pharynx and trachea with cervical lymphadenopathy
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| show | notched central incisors
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| Actinomycosis | show 🗑
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| S/S | show 🗑
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| show | majority are viral; 20% group A streptococcus
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| Oral thrush | show 🗑
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| Dental caries | show 🗑
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| Peutz-Jegher’s syndrome | show 🗑
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| show | biopsy to rule out squamous dysplasia or cancer
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| Squamous cell carcinoma | show 🗑
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| Smokeless tobacco | show 🗑
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| show | phenytoin, pregnancy, scurvy
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| Pleomorphic adenoma | show 🗑
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| Mucoepidermoid carcinoma | show 🗑
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| show | lesion obstructing esophagus; e.g., cancer, web
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| Plummer-Vinson syndrome | show 🗑
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| show | motor abnormality; e.g., achalasia MCC, PSS or CREST syndrome
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| TE fistula | show 🗑
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| show | vertebral abnormalities, anal atresia, TE fistula, renal disease/radius abnormality
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| Zenker’s diverticulum | show 🗑
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| show | relaxation of lower esophageal sphincter (LES) with acid reflux
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| show | MCC nocturnal cough and asthma
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| show | Candida MC, CMV, HSV
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| show | glandular metaplasia distal esophagus in GERD
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| Complications of Barrett’s | show 🗑
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| Esophageal varices | show 🗑
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| Mallory Weiss syndrome | show 🗑
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| show | rupture of distal esophagus from retching; pneumomediastinum
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| show | pneumomediastinum (air in subcutaneous tissue)
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| LES ganglion cells | show 🗑
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| show | failure of LES relaxation (no VIP); absent ganglion cells in the myenteric plexus
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| S/S | show 🗑
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| show | bird’s beak appearance
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| show | Chagas’ disease; leishmania destroy ganglion cells
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| Distal adenocarcinoma esophagus | show 🗑
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| show | smoking MCC; alcohol also causes
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| show | sign of upper GI bleed; acid changes Hb to hematin; peptic ulcer disease MCC
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| Hematemesis | show 🗑
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| show | hypertrophy pyloric muscle; vomiting non-bile stained fluid in 2-4 weeks
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| show | NSAIDs MCC
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| Mucous barrier stomach | show 🗑
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| show | due to PA; achlorhydria with ↑ serum gastrin
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| Type B chronic gastritis | show 🗑
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| H. pylori | show 🗑
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| show | lesser curvature pylorus and antrum; poor defense against acid; food aggravates pain
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| Duodenal ulcer | show 🗑
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| show | air under diaphragm causes pain in left shoulder
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| show | giant rugal hyperplasia; protein loss from increased mucus
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| Zollinger-Ellison syndrome | show 🗑
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| show | PUD in usual locations; sometimes multiple ulcers
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| show | ZE, achlorhydria, gastric distention, H2 or proton blockers; renal failure
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| show | MC benign tumor of stomach
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| Intestinal type adenocarcinoma | show 🗑
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| show | linitis plastica; signet ring cells; Krukenberg tumors ovaries
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| Gastric lymphoma | show 🗑
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| show | steatorrhea; chronic pancreatitis, bile salt deficiency, small bowel disease
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| Causes bile salt deficiency | show 🗑
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| D-xylose screen | show 🗑
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| Calcification of pancreas | show 🗑
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| show | autoimmune disease; antibodies against gliadin in gluten; flat villi
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| Celiac disease | show 🗑
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| show | systemic infection; foamy macrophages with bacteria (PAS+ inclusions) in small bowel submucosa
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| S/S | show 🗑
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| Invasive diarrhea | show 🗑
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| Secretory diarrhea | show 🗑
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| show | hypotonic loss fluid; laxatives, lactase deficiency
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| show | MCC diarrhea in children
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| show | MCC diarrhea in adults
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| show | common cause diarrhea in AIDS; MCC cholecystitis and pancreatitis in AIDS
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| show | preformed toxin causes food poisoning; culture food
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| show | preformed toxin in fried rice and tacos; gram positive rods in stool
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| show | preformed neurotoxin (blocks acetylcholine release); paralysis and mydriasis
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| Clostridium botulinum (child) | show 🗑
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| Clostridium difficile | show 🗑
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| show | produces dysentery (bloody diarrhea); associated with HUS
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| Salmonella enteritidis | show 🗑
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| show | sepsis; osteomyelitis in HbSS
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| Salmonella typhi | show 🗑
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| show | gallbladder
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| M. tuberculosis | show 🗑
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| Enterotoxigenic E. coli | show 🗑
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| show | secretory diarrhea; toxin stimulates adenylate cyclase to produce cAMP
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| show | solution must contain glucose to reabsorb Na+ (co-transport)
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| show | mesenteric lymphadenitis; sepsis in iron overload states
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| Entamoeba histolytica | show 🗑
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| Cryptosporidium parvum | show 🗑
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| show | MC protozoal cause of diarrhea; cause of malabsorption; Rx metronidazole
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| Trichuris trichiura | show 🗑
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| Enterobius vermicularis | show 🗑
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| show | intestinal obstruction due to adult worms; no eosinophilia
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| show | hookworm; iron deficiency anemia
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| show | rhabditiform larvae in stool not eggs
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| show | fish tapeworm; vitamin B12 deficiency
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| show | colicky pain; constipation and obstipation
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| Radiograph small bowel obstruction | show 🗑
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| show | adhesions from previous surgery
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| show | vomiting bile-stained fluid at birth; double bubble sign; Down syndrome
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| show | absent ganglion cells in submucosal/myenteric plexus rectosigmoid
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| S/S | show 🗑
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| Hirschsprung association | show 🗑
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| Intussusception | show 🗑
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| Meconium ileus | show 🗑
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| Indirect inguinal hernia | show 🗑
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| show | obstruction of small bowel with gallstone + air in biliary tree
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| Volvulus | show 🗑
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| Direct inguinal hernia | show 🗑
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| show | common in black children; may entrap bowel in adults
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| show | MC site for polyps, cancer, diverticula
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| Small bowel infarction | show 🗑
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| show | embolism (atrial fibrillation), thrombosis SMA or SMV
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| show | splenic flexure pain with bloody diarrhea
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| show | pain in splenic flexure 30 minutes after eating
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| show | submucosal dilation of venules in cecum; cause of hematochezia
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| show | massive loss of blood per rectum; diverticulosis MCC
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| show | persistence omphalomesenteric duct
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| S/S | show 🗑
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| show | mimics acute appendicitis; cannot differentiate without radionuclide scan
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| show | diverticulitis MC complication; MCC hematochezia and fistula formation
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| Diverticulitis | show 🗑
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| Ulcerative colitis | show 🗑
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| show | left lower quadrant crampy pain with bloody diarrhea
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| show | primary sclerosing cholangitis, seronegative HLA B27 + spondyloarthropathy
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| show | transmural inflammation; terminal ileum involved 80%; granulomas; skip lesions
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| S/S | show 🗑
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| Carcinoid tumor | show 🗑
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| show | liver metastasis; flushing/diarrhea due to serotonin; increased urine 5-HIAA
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| Tubular adenomas | show 🗑
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| show | greatest risk for colon cancer (30%); secrete mucus rich in protein and potassium
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| show | AD with 100% penetrance for developing colon cancer
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| show | AD, polyposis plus osteomas and desmoid tumors
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| Turcot’s syndrome | show 🗑
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| show | second MC cancer and cancer killer in adults
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| show | obstruct; MC location rectosigmoid
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| show | bleed
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| Acute appendicitis | show 🗑
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| External hemorrhoids | show 🗑
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| Internal hemorrhoids | show 🗑
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| Urobilinogen (UBG) | show 🗑
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| UBG | show 🗑
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| Alcoholic liver disease | show 🗑
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| show | serum ALT>AST
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| show | serum AP and GGT
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| Unconjugated bilirubin | show 🗑
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| show | water soluble; never normal in urine
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| % CB <20% (unconjugated) | show 🗑
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| show | AD; ↓ uptake and conjugation; bilirubin increases with fasting
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| show | unconjugated hyperbilirubinemia; begins on day three
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| % CB 20-50% | show 🗑
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| show | bile duct obstruction (intra or extrahepatic); carcinoma head of pancreas
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| show | normal urine
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| show | obstructive jaundice
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| show | hepatitis
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| Negative urine bilirubin + increased urobilinogen | show 🗑
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| show | albumin, PT
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| Hepatitis A | show 🗑
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| show | protective antibodies; accidental needle stick, IVDA; hepatocellular carcinoma
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| Hepatitis C | show 🗑
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| show | no protective antibodies; requires HBsAg to replicate
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| show | vaccination
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| show | recovered from HBV
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| show | acute HBV/chronic HBV infective carrier if >6 months
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| Anti HBc-IgM alone | show 🗑
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| show | chronic HBV healthy carrier
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| Fulminant hepatic failure | show 🗑
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| Spontaneous peritonitis | show 🗑
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| show | TB MC bacteria
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| Amebiasis | show 🗑
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| show | Echinococcus granulosis; sheep dog definitive host; man intermediate host
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| Schistosomiasis | show 🗑
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| Clonorchiasis | show 🗑
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| show | “nutmeg” liver; RHF MCC
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| Hepatic vein thrombosis | show 🗑
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| show | ascites, portal hypertension, no hepatomegaly
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| show | fatty change; alcoholic hepatitis; cirrhosis
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| show | ↑ synthesis of glycerol 3P (substrate for TG synthesis)
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| show | ↓ gluconeogenesis (↑ NADH causes pyruvate to convert to lactate)
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| Ketoacidosis in alcoholics | show 🗑
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| Primary biliary cirrhosis | show 🗑
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| Primary sclerosing cholangitis | show 🗑
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| Extrahepatic biliary atresia | show 🗑
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| show | acetaminophen, isoniazid, halothane
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| show | intrahepatic cholestasis
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| Estrogen/oral contraceptives | show 🗑
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| Methotrexate | show 🗑
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| show | vinyl chloride
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| Hemochromatosis | show 🗑
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| show | cirrhosis; “bronze diabetes” - skin pigmentation + destruction of islet cells; malabsorption
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| show | ↑ serum ferritin, iron, % saturation; ↓ TIBC
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| Wilson’s disease | show 🗑
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| show | cirrhosis, movement disorder (necrosis in putamen), Kayser Fleisher ring (Descemet’s membrane)
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| Lab | show 🗑
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| show | pre-eclampsia; Hemolytic anemia, ELevated transaminases, Low Platelets
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| AAT deficiency in child | show 🗑
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| show | coma and microvesicular fatty change post viral infection; increased ammonia
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| show | irreversible fibrosis; regenerative nodules; portal hypertension
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| show | alcohol (MC), HBV/HCV, hemochromatosis, Wilson’s, AAT deficiency, 1° biliary
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| Hepatic encephalopathy | show 🗑
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| show | ascites; varices; splenomegaly; hemorrhoids; caput medusae
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| Cause of ascites | show 🗑
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| Rx | show 🗑
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| show | gynecomastia; spider angiomas; female hair distribution
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| Lab findings cirrhosis | show 🗑
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| show | estrogen related (steroids, oral contraceptives); intraperitoneal hemorrhage
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| show | metastasis MC cancer; lung cancer MC primary site
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| Hepatocellular carcinoma | show 🗑
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| show | primary sclerosing cholangitis MCC, C.C sinensis
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| Pathogenesis of cholesterol stones | show 🗑
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| Black pigment stones | show 🗑
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| Acute cholecystitis | show 🗑
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| Chronic cholecystitis | show 🗑
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| show | risk factors - cholelithiasis and porcelain gallbladder
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| show | causes - alcohol and gallstones; ↑ amylase and lipase (more specific)
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| S/S | show 🗑
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| show | localized ileus of duodenum due to acute pancreatitis
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| Pancreatic pseudocyst | show 🗑
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| show | alcohol abuse, CF; malabsorption, pain, type I diabetes
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| Pancreatic cancer | show 🗑
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| show | jaundice/acholic (gray/pale) stools; palpable gallbladder; superficial migratory thrombophlebitis (Trousseau's sign); ↑ CA 19-9
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| Negative urine bilirubin + trace urobilinogen | show 🗑
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| show | obstructive jaundice
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| Positive urine bilirubin + increased urobilinogen | show 🗑
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| Negative urine bilirubin + increased urobilinogen | show 🗑
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