Major Side Effect of Metoclopramidepromotility Agent EPS, Contraindicated in Parkinsons

HIGH YIELD

Major side effect of metoclopramidePromotility agent  EPS, contraindicated in Parkinsons

Meconium ileusSeen in cystic fibrosis, pancreatic probs start in utero vs lung probs after birth

5 signs of oral SCCPain, bleeding, non-healing sore, lump/mass, white/red patch

Lobular disarrayAcute hepatitis

Lobular collase Fulminant hepatitis

Only DNA hepatitis virusB, all others are RNA

Bile is conjugated withGlucoronide

Bilirubin is conjugated with Alanine/taurine

Oral white plaque that CAN be scraped offCandida, assoc w/ immunocomprimise, so look for underlying cause!

Oral white plaque that CANNOT be scraped offLeukoplakia, may be due to EBV (hairy), or precancerous lesion

Gray-Turner vs Cullen signFlank vs periumbilical discolor (retroperitoneal hemorrage), acute pancreatitis

Kayser-fleischer ringsDark rings that encircle the iris, due to Cu accum in Wilson’s dz

Bird beak on barium xrayAcalasia (no peristalsis in esophagus)

Shrunken liver Extreme, rapid necrosis (ex) fulminant hepatitis

Signet-ring cells, linitis plastica (leather bottle)Diffuse/infiltrating gastric adenocarcinoma

Athralgias, lymphadenopathy, malabsorption, PAS+Whipples disease, due to infxn by t whippelli

“Beaded” bile ducts Primary sclerosing cholangitis, assoc w/ IBD

Triple therapyFor H pylori, first line is omeprazole + clarithromycin + amoxicillin

PseudopolypsUlcerative colitis

PseudocystsPancreatitis

PseudoacalasiaAcalasia due to neoplasm

PseudomembranesC diff

PseudohypaheCandida

+ anti mitochondrial AbPrimary biliary cirrhosis, autoimmune destruction of intrahepatic ducts

Abd pain that radiates to back, worse w/ foodAcute pancreatitis

RUQ pain that radiates to shoulderAcute cholecystitis

Abd pain 30m post-prandial, worse by eatingGastric ulcer

Abd pain btw meals, relieved by eatingDuodenal ulcer

Most common oral cancerSquamous cell carcinoma (usually tongue), high risk if smoke/EtOH

Elevated alkaline phosphataseHallmark of cholestasis

Major cause of ACUTE pancreatitisGallstones  duct obstruction

Major cause of CHRONIC pancreatitisAlcoholism

Frond-like papilla, no goblet cellsVillous adenoma

CarcinoidTricuspid insuffiency, pulm stenosis, flushing, diarrhea, due to hi serotonin

Portal inflamm/fibrosisChronic hepatitis, cholestasis

Rose spots, CNS disturbances, high sustained feverEnteric fever due to salmonella typhi, get a BLOOD culture

Abx NOT indicated in which infectious diarrheas?EHEC (risk of HUS) or uncomplicated salmonella non-typhi (self-limiting)

NO risk of chronic hepatitisHep A/E

Onion skinning of bile ductsPrimary sclerosing cholangitis, assoc w/ IBD

Gingival hyperplasia + lymphadenopathyAssoc w/ myelogenous leukemias (hyperplasia alone assoc w/ dilantin)

Increase UNconjugated serum bilirubinHemolytic dz

Increase conjugated serum bilirubinLiver/biliary tract dz (can’t be excreted into bile ducts so spills into blood)

ONE test that proves a viral hepatitis infxnIgM anti-HBc

Location of esophageal cancersSCC affects proximal, adenocarcinoma affects distal (duh, assoc w/ Barretts)

Jaundice, dark urine, acholic stoolsCholestasis, due to hyperbilirubinemia

AsterixisFlapping tremor seen in hepatic encephalopathy

Necrotic bowel but duodenum/transverse sparedEMBOLUS that lodges in SMA distal to branching of middle colic a

Necrotic bowel w/ above NOT sparedTHROMBUS that forms @ branch point of SMA, thus MCA is also occluded

N-acetylcysteineAntidote to acetaminophen OD, as increases glutathione stores

Secretin effects on pancreasCauses HCO3 secretion from ductal cells

CCK effects on pancreasCauses enzyme secretion from acinar cells

Hepatic tumor + bile productionHCC, vs cholangiocarcinoma which does NOT produce bile

Murphys signPain upon inspiration when palpating under R rib, + in acute cholecystitis

Elevated gastrin, pernicious anemia, hypochlorhydriaDue to autoAb against parietal cells

Most common hepatic tumorMetastasis, esp from gut due to portal circulation

Most common primary hepatic tumorCavernous hemangioma, seen in young women

Most common primary hepatic malignancyHCC, assoc w/ hepB, hepC, cirrhosis, hemachromatosis

Fat, forty, female, fertile4 Fs assoc w/ cholesterol cholelithiasis

Free air under diaphragmGI perforation  escape of air, seen on xray

Zollinger Ellison syndromePUD + gastrinoma + gastric acid hypersecretion

Renal oxylate stonesSeen in fat malabsorption

APC tumor suppressor gene mutationFAP, 100% risk of colon adenocarcinoma

Most common small bowel obstructionIntra-abdominal adhesions, due to past surgery

Cons of H2 blockers (compared to PPIs)Less effective, adj in renal pts, tolerance, inhibits CYP450  many DDI

Focal nodular hyperplasiaBenign hepatic growth in young women NOT assoc w/ estrogen

Heptaocellular adenomaBenign hepatic growth in young women w/ STRONG assoc w/ estrogen