Gastroenterology - Revision history

Aesetholephews at 04:26, 15 January 2023

2023-01-15T04:26:34Z

2023-01-15T03:21:24Z

Gallstone Disease

2023-01-15T03:19:10Z

Approach to LFTs

2023-01-15T03:18:49Z

Approach to LFTs

2023-01-15T03:14:15Z

Heredity Hemochromatosis

2023-01-15T03:13:19Z

Esophageal Pathology

2023-01-15T03:12:32Z

LGIB

2023-01-15T03:11:51Z

Approach to LFTs

2023-01-15T03:09:47Z

PSC

2023-01-15T03:09:21Z

PBC

@@ Line 1: / Line 1: @@
 =Esophageal Pathology=
 *H&P:
@@ Line 116: / Line 121: @@
 *Dx: Elevated ALK + bili; '''ANA, anti smooth muscle, and anti pANCA''' antibodies; bile duct dilation on imaging
 *Tx: Ursodeoxycholic acid, cholestyramine, fat-soluble vitamins; transplant '''frequently''' required

@@ Line 68: / Line 68: @@
 ==Gallstone Disease==
-*H&P:
+*H&P: Female, Fat, Forty, Fair, Fertile
 *Dx: Cholestatic pattern of '''elevated bilirubin and alk phos''', Charcot triad for '''ascending cholangitis includes RUQ pain, fever, jaundice'''. When clinical suspicion for acute cholecystitis is high, but US is negative or inconclusive, '''get HIDA scan.'''
 *Tx: For acute/ascending cholangitis, treat with '''ERCP within 24-48 hrs'''

@@ Line 54: / Line 54: @@
 {| class="wikitable"
 |-
-| rowspan="3" | Cholestasis (ALK + TBili) || rowspan="2" | No Obstruction || Indirect bili: Hepatitis, Cirrhosis
+| rowspan="3" | Cholestasis (ALK + TBili) || rowspan="2" | No Obstruction || '''Indirect''' bili: Hepatitis, Cirrhosis
 |-
-|| Direct bili: PBC, Drug-induced, Post-op, Sepsis
+|| '''Direct''' bili: PBC, Drug-induced, Post-op, Sepsis
 |-
 || Obstruction || PSC, Choledocholithiasis, Cholangiocarcinoma, Pancreatic cancer, Pancreatitis

@@ Line 54: / Line 54: @@
 {| class="wikitable"
 |-
-| rowspan="3" | Cholestasis (ALK + TBili) || rowspan="2" | No Obstruction || Hepatitis, Cirrhosis
+| rowspan="3" | Cholestasis (ALK + TBili) || rowspan="2" | No Obstruction || Indirect bili: Hepatitis, Cirrhosis
 |-
-|| PBC, Drug-induced, Post-op, Sepsis
+|| Direct bili: PBC, Drug-induced, Post-op, Sepsis
 |-
 || Obstruction || PSC, Choledocholithiasis, Cholangiocarcinoma, Pancreatic cancer, Pancreatitis

@@ Line 88: / Line 88: @@
 ==Heredity Hemochromatosis==
-*H&P: Males present young (30s), Females present late (60s), '''hyperpigmentation''', arthritis, cardiomyopathy, diabetes
+*H&P: Males present young (30s), Females present late (60s); '''hyperpigmentation''', arthritis, cardiomyopathy, diabetes
 *Dx: Elevated AST and ALT; increased serum ferritin and transferrin saturation; HFE gene mutation
 *Tx: Therapeutic phlebotomy

@@ Line 41: / Line 41: @@
 =LGIB=
 *H&P:
-*Dx: Angiodysplasias (e.g. AVMs) are associated with '''AS, vWD, and ESRD'''. Workup for hematochezia is '''colonoscopy''' if HDS, '''resuscitate, ± surgery/IR consult, EGD''' if HDUS.
+*Dx: Workup for hematochezia is '''colonoscopy''' if HDS, '''resuscitate, ± surgery/IR consult, EGD''' if HDUS. Angiodysplasias (e.g. AVMs) are associated with '''AS, vWD, and ESRD'''.
 *Tx:

@@ Line 56: / Line 56: @@
 | rowspan="3" | Cholestasis (ALK + TBili) || rowspan="2" | No Obstruction || Hepatitis, Cirrhosis
 |-
-|| PBC, PSC, Drug-induced, Post-op, Sepsis
+|| PBC, Drug-induced, Post-op, Sepsis
 |-
-|| Obstruction || Choledocholithiasis, Cholangiocarcinoma, Pancreatic cancer, Sclerosing cholangitis, Pancreatitis
+|| Obstruction || PSC, Choledocholithiasis, Cholangiocarcinoma, Pancreatic cancer, Pancreatitis
 |-
 | rowspan="3" | Hepatocellular Injury (AST + ALT) || Viral || Hepatitis Virus (A-E), EBV, CMV, HSV, VZV

@@ Line 114: / Line 114: @@
 ==PSC==
 *H&P: '''Intra and extra hepatic''' bile duct '''fibrosis'''; Age 30-40; M>F; associated with IBD (UC>Crohn's); asymptomatic or presenting with fatigue, pruritic, RUQ pain
-*Dx: Elevated ALK + bili; '''ANA, anti smooth muscle, and anti pANCA''' antibodies.
+*Dx: Elevated ALK + bili; '''ANA, anti smooth muscle, and anti pANCA''' antibodies; bile duct dilation on imaging
 *Tx: Ursodeoxycholic acid, cholestyramine, fat-soluble vitamins; transplant '''frequently''' required

@@ Line 109: / Line 109: @@
 ==PBC==
 *H&P: '''Intrahepatic''' bile duct '''destruction'''; Age 30-65; F>M; Fatigue and jaundice; pruritis and osteoporosis; associated with hypothyroid and arthritis
-*Dx: Elevated ALK + bili; '''positive AMA'''
+*Dx: Elevated ALK + bili; '''positive AMA'''; no bile duct dilation on imaging
 *Tx: Ursodeoxycholic acid, cholestyramine, fat-soluble vitamins; transplant in rare cases