Goljan HY GI
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| Cleft lip/palate | show 🗑
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| Herpes labialis | show 🗑
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| show | EBV glossitis; pre-AIDS defining lesion; not precursor to cancer
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| Mumps | show 🗑
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| Diphtheria | show 🗑
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| show | notched central incisors
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| show | anaerobic gram + filamentous bacteria; complication extracted dental abscess
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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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| show | Streptococcus mutans
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| show | mucosal pigmentation; hamartomatous polyps
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| show | biopsy to rule out squamous dysplasia or cancer
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| show | smoking and alcohol association; lower lip MC site
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| Smokeless tobacco | show 🗑
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| show | phenytoin, pregnancy, scurvy
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| show | MC benign tumor of salivary glands; parotid MC site
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| Mucoepidermoid carcinoma | show 🗑
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| Dysphagia for solids only | show 🗑
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| show | iron deficiency anemia causes esophageal web, glossitis, achlorhydria (↓ HCl in gastric acid)
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| Dysphagia for solids and liquids | show 🗑
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| show | polyhydramnios; proximal esophagus ends blindly; distal esophagus derives from trachea
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| VATER syndrome | show 🗑
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| Zenker’s diverticulum | show 🗑
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| GERD | show 🗑
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| GERD | show 🗑
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| show | Candida MC, CMV, HSV
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| Barrett’s esophagus | show 🗑
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| Complications of Barrett’s | show 🗑
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| show | dilated left gastric vein; sign of portal hypertension due to cirrhosis
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| show | tear of distal esophagus from retching in alcoholic or bulimic
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| Boerhaave’s syndrome | show 🗑
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| Hamman’s mediastinal crunch | show 🗑
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| show | contain VIP - relaxes LES
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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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| show | MC primary cancer; due to Barrett’s esophagus
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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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| Congenital pyloric stenosis | show 🗑
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| show | NSAIDs MCC
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| show | maintained by PGE; misoprostol PGE analog
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| Type A chronic gastritis | show 🗑
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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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| show | never malignant; ↑ acid production; food relieves pain
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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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| show | malignant islet cell tumor secreting gastrin; part of MEN I syndrome
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| show | PUD in usual locations; sometimes multiple ulcers
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| Hypergastrinemia | show 🗑
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| show | MC benign tumor of stomach
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| show | H pylori related; ↓ incidence; lesser curvature pylorus/antrum
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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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| show | liver disease, bile salt resins, cholestasis, bacterial overgrowth, Crohn’s
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| show | failure to reabsorb xylose indicates small bowel disease
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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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| show | association with dermatitis herpetiformis
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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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| show | Campylobacter jejuni MCC; positive fecal smear for leukocytes
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| show | loss isotonic fluid; enterotoxins from E. coli and V. cholerae
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| Osmotic diarrhea | show 🗑
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| show | MCC diarrhea in children
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| Norwalk virus | show 🗑
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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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| show | colonization of bowel with release of neurotoxin; eating honey
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| Clostridium difficile | show 🗑
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| show | produces dysentery (bloody diarrhea); associated with HUS
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| show | gastroenteritis; animal reservoirs - poultry, turtles
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| show | sepsis; osteomyelitis in HbSS
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| Salmonella typhi | show 🗑
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| Carrier state site | show 🗑
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| M. tuberculosis | show 🗑
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| show | secretory diarrhea (traveler’s diarrhea); toxin stimulates guanylate cyclase
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| show | secretory diarrhea; toxin stimulates adenylate cyclase to produce cAMP
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| Oral Rx cholera | show 🗑
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| Yersinia enterocolitica | show 🗑
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| show | dysentery; trophozoites phagocytose RBCs; liver abscess; Rx metronidazole
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| show | MCC diarrhea in AIDS; acid-fast oocysts
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| show | MC protozoal cause of diarrhea; cause of malabsorption; Rx metronidazole
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| show | rectal prolapse in children
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| show | anal pruritus; urethritis in girls; no eosinophilia
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| Ascaris lumbricoides | show 🗑
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| Necator americanus | show 🗑
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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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| show | air-fluid levels on x-ray
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| MCC small bowel obstruction | show 🗑
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| show | vomiting bile-stained fluid at birth; double bubble sign; Down syndrome
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| Hirschsprung disease | show 🗑
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| show | proximal bowel dilated but peristalses; no stool in rectal vault
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| Hirschsprung association | show 🗑
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| show | terminal ileum telescopes into cecum; obstruction plus bloody diarrhea
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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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| show | MC due to sigmoid colon twisting around mesentery
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| show | protrudes through center of triangle of Hesselbach; no obstruction
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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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| Causes small bowel infarction | show 🗑
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| Ischemic colitis | show 🗑
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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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| Hematochezia | show 🗑
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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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| show | “left-sided acute appendicitis”
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| show | mucosal/submucosal ulceration; starts in rectum; crypt abscess; ↑ risk adenocarcinoma
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| S/S | show 🗑
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| UC associations | show 🗑
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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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| Carcinoid syndrome | show 🗑
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| show | precursor lesion colon cancer; size and number determine risk of malignancy
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| Villous adenoma | show 🗑
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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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| show | AD, polyposis plus brain tumors
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| show | second MC cancer and cancer killer in adults
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| Left-sided colorectal cancer | show 🗑
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| Right-sided colorectal cancer | show 🗑
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| show | due to lymphoid hyperplasia in children and obstruction by fecalith in adults
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| show | thrombose
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| show | bleed; prolapse out of rectum
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| Urobilinogen (UBG) | show 🗑
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| UBG | show 🗑
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| show | serum AST>ALT; ↑ serum GGT
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| show | serum ALT>AST
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| Cholestasis markers | show 🗑
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| show | macrophage degradation of heme; lipid soluble; never in urine
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| Conjugated bilirubin (CB) | show 🗑
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| show | Gilberts, spherocytosis, physiologic jaundice newborn, ABO/Rh HDN
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| Gilbert’s disease | show 🗑
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| Physiologic jaundice newborn | show 🗑
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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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| Negative urine bilirubin + trace urobilinogen | show 🗑
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| Positive urine bilirubin, absent urobilinogen | show 🗑
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| Positive urine bilirubin + increased urobilinogen | show 🗑
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| show | extravascular hemolytic anemia
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| Markers of severity of liver disease | show 🗑
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| Hepatitis A | show 🗑
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| Hepatitis B | show 🗑
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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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| Anti-HBs + anti-HBc-IgG | show 🗑
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| HBsAg + HBeAg + HBVDNA + anti-HBc-IgM | show 🗑
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| Anti HBc-IgM alone | show 🗑
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| show | chronic HBV healthy carrier
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| show | viral hepatitis and acetaminophen MCCs
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| show | E. coli in adults; S. pneumoniae in children; complication of ascites
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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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| show | Clonorchis sinensis; ingesting encysted larvae in fish; cholangiocarcinoma
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| Congestive hepatomegaly (centrilobular necrosis) | show 🗑
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| show | Budd-Chiari syndrome; painful hepatomegaly; ascites; portal hypertension
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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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| Hypoglycemia in alcoholics | show 🗑
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| show | ↑ lactate, ↑ ßOHB (acetyl CoA converted to AcAc and then ßOHB)
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| show | granulomatous destruction triad bile ducts; anti-mitochondrial antibody
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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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| Anabolic steroids | show 🗑
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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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| show | AR; increased iron reabsorption; liver target organ
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| S/S | show 🗑
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| show | ↑ serum ferritin, iron, % saturation; ↓ TIBC
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| Wilson’s disease | show 🗑
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| S/S | show 🗑
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| show | ↓ ceruloplasmin (causes ↓ total copper); ↑ serum/urine free copper
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| HELLP syndrome | show 🗑
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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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| Cirrhosis | show 🗑
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| Causes cirrhosis | show 🗑
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| show | mental status changes; ↑ serum ammonia
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| Portal hypertension | show 🗑
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| show | portal hypertension; hypoalbuminemia; secondary aldosteronism
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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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| Liver cell adenoma | show 🗑
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| Liver cancer | show 🗑
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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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| Acute pancreatitis | show 🗑
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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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| Chronic pancreatitis | show 🗑
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| show | smoking MCC
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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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| show | normal urine
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| Positive urine bilirubin, absent urobilinogen | show 🗑
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| show | hepatitis
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| show | extravascular hemolytic anemia
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