Podcast
Questions and Answers
What is the primary cause of liver cancer?
What is the primary cause of liver cancer?
Which of the following is a symptom of liver cancer?
Which of the following is a symptom of liver cancer?
What diagnostic test can be used for liver cancer?
What diagnostic test can be used for liver cancer?
What is the primary cause of cirrhosis?
What is the primary cause of cirrhosis?
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Which of the following is a symptom of cirrhosis?
Which of the following is a symptom of cirrhosis?
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What treatment may be considered for cirrhosis?
What treatment may be considered for cirrhosis?
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What does the MELD score calculate the probability of?
What does the MELD score calculate the probability of?
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What is a possible treatment for liver cancer?
What is a possible treatment for liver cancer?
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What are the symptoms of liver cancer?
What are the symptoms of liver cancer?
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Which test is used to diagnose liver cancer?
Which test is used to diagnose liver cancer?
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What might prolong survival for sclerosing cholangitis?
What might prolong survival for sclerosing cholangitis?
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Which condition causes scarring and fibrosis of the liver?
Which condition causes scarring and fibrosis of the liver?
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Which test is used to evaluate the portal venous system for collateral blood flow in patients with esophageal varices?
Which test is used to evaluate the portal venous system for collateral blood flow in patients with esophageal varices?
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Which condition is characterized by a thickened pyloric sphincter and narrow lumen causing projectile vomiting in infants?
Which condition is characterized by a thickened pyloric sphincter and narrow lumen causing projectile vomiting in infants?
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What is the rare condition caused by gastrin-secreting tumors resulting in high levels of gastric acid production?
What is the rare condition caused by gastrin-secreting tumors resulting in high levels of gastric acid production?
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What is the diagnostic test used for gallstone obstruction in the bile duct?
What is the diagnostic test used for gallstone obstruction in the bile duct?
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What is the condition that causes fibrosis of the common bile duct, leading to jaundice, weight loss, and malabsorption?
What is the condition that causes fibrosis of the common bile duct, leading to jaundice, weight loss, and malabsorption?
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What is the treatment for ascending cholangitis?
What is the treatment for ascending cholangitis?
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Which diagnostic test is used for definitive diagnosis of sclerosing cholangitis?
Which diagnostic test is used for definitive diagnosis of sclerosing cholangitis?
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What diagnostic test can be used to evaluate portal venous system for collateral blood flow?
What diagnostic test can be used to evaluate portal venous system for collateral blood flow?
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What condition is characterized by gallstone obstruction and secondary infection?
What condition is characterized by gallstone obstruction and secondary infection?
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Which disorder is caused by nerve damage resulting in decreased gastric emptying and gastroparesis symptoms?
Which disorder is caused by nerve damage resulting in decreased gastric emptying and gastroparesis symptoms?
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What is the most commonly diagnosed type of gastric cancer?
What is the most commonly diagnosed type of gastric cancer?
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Which organ is associated with disorders such as ruptured spleen, gastric ulcer, gastritis, and esophageal pain?
Which organ is associated with disorders such as ruptured spleen, gastric ulcer, gastritis, and esophageal pain?
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What is the cause of diffuse abdominal pain according to the discussion?
What is the cause of diffuse abdominal pain according to the discussion?
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Which quadrant of the abdomen is associated with diverticulitis?
Which quadrant of the abdomen is associated with diverticulitis?
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What happens to conjugated bilirubin in the body?
What happens to conjugated bilirubin in the body?
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Which tumor marker is associated with liver cancer?
Which tumor marker is associated with liver cancer?
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What do elevated unconjugated bilirubin levels indicate according to the discussion?
What do elevated unconjugated bilirubin levels indicate according to the discussion?
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Which part of the abdomen is associated with pain from appendicitis?
Which part of the abdomen is associated with pain from appendicitis?
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What disorder is linked to epigastric pain according to the discussion?
What disorder is linked to epigastric pain according to the discussion?
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Where is unconjugated bilirubin elevated in various disorders?
Where is unconjugated bilirubin elevated in various disorders?
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What does urobilinogen get converted to in the body according to the discussion?
What does urobilinogen get converted to in the body according to the discussion?
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What does conjugated bilirubin become in order to be recycled in the body?
What does conjugated bilirubin become in order to be recycled in the body?
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Study Notes
- Katie Connor is a PA educator with experience in PA education and orthopedic surgery.
- She is discussing the gastrointestinal unit in a series aimed at helping students prepare for boards.
- Anatomy review: pain locations and associated organs in the abdomen.
- Right upper quadrant: gallbladder and liver disorders.
- Right lower quadrant: appendicitis.
- Left lower quadrant: diverticulitis.
- Diffuse abdominal pain: referred pain, small intestinal disorders, hernias, or inflammatory bowel disease.
- Left upper quadrant: stomach and spleen, disorders include ruptured spleen, gastric ulcer, gastritis, and esophageal pain.
- Epigastric pain: myocardial infarction, peptic ulcer, or esophageal rupture.
- Bilirubin: unconjugated and conjugated, unconjugated elevated in liver disease, conjugated elevated in gallbladder or pancreas issues.
- Conjugated bilirubin storage in the gallbladder and excreted in urobilinogen or urine.
- Urobilinogen converted to stercobilinin and creates dark stool.
- Conjugated bilirubin becomes urethrinogen and recycled to create new red blood cells.
- Lab review: bilirubin, tumor markers, and imaging tests.
- Bilirubin: unconjugated and conjugated, labs to identify liver or gallbladder problems.
- Tumor markers: alpha-fetoprotein for liver cancer, CA199 for pancreatic cancer, and CEA for colon cancer.
- Imaging tests: endoscopy, colonoscopy, and barium tests to examine anatomical structures or check for motility disorders.
- Pancreatic disorders: pancreatitis, elevated amylase and lipase levels, and imaging tests (ultrasound, hydroscan).
- Liver disorders: elevated liver function tests (AST, ALT), ggt and alkaline phosphatase.
- Elevated ALT specific to the liver, but alkaline phosphatase can also indicate bony disorders.
- Upper versus lower gi bleed: locations, symptoms, and management.
- Upper gi bleed: hematemesis, melena, and treatment with IVs, packed red blood cells, and endoscopy.
- Lower gi bleed: hematochezia, treatment with IVs, packed red blood cells, and colonoscopy.
- Esophageal disorders: esophagitis, esophageal tears (Mallory-Weiss, Boerhaave), Barrett's esophagus, and esophageal cancer.
- Esophagitis: acid reflux, candida, and therapies including proton pump inhibitors, H2 blockers, and steroids.
- Esophageal tears: Mallory-Weiss and Boerhaave, self-limiting for Mallory-Weiss, and emergent surgery for Boerhaave.
- Gastroparesis: slow motility, treatment with metoclopramide, cisapride, and domperidone.
- Esophageal cancer: solid food dysphagia, weight loss, and treatment with surgery, radiation, and chemotherapy.
- The text provides detailed information about various gastrointestinal disorders, including their symptoms, diagnosis, and treatment methods.- Esophageal disorders: Cherry red spots seen in endoscopy indicate active bleeding in patients with cirrhosis. Screen patients every two years to check for esophageal varices and bleeding. MRAs can evaluate portal venous system for collateral blood flow. Treatment includes controlling blood pressure with beta blockers, banding to cut off blood supply, and trans-jugular intra-hepatic porta-systemic shunts.
- Stomach disorders: GERD affects 40% of Americans and is caused by a weak lower esophageal sphincter. Risk factors include alcohol, hiatal hernias, obesity, pregnancy, and certain medications. Symptoms include burning chest pain, regurgitation, and hoarseness. Diagnostic tests include 24-hour pH probe monitoring and esophageal manometry. Treatment involves lifestyle modifications, medication, and surgery for severe cases.
- Peptic ulcer disease and acute gastritis share similarities in diagnosis and treatment. Ulcers can be caused by H. pylori infection or medications. Treatment includes proton pump inhibitors and antibiotics for H. pylori infection. Acute gastritis can be caused by alcohol, tobacco, cocaine, and food poisoning. Treatment includes proton pump inhibitors and addressing the underlying cause.
- Gastric cancer is most commonly adenocarcinoma and is associated with chronic autoimmune atrophic gastritis from Helicobacter pylori infection, pernicious anemia, and diets high in preserved foods. Symptoms include early satiety, weight loss, and abdominal pain. Diagnostic tests include endoscopy, biopsy, CT scans, and stool hemocult tests. Treatment includes excision, gastrectomy, and chemoradiation.
- Zollinger Ellison syndrome is a rare condition caused by gastrin-secreting tumors that result in high levels of gastric acid production. Diagnostic tests include somatostatin receptor scintigraphy and serum fasting gastrin levels. Treatment includes surgery to remove the tumor and proton pump inhibitors to manage symptoms.
- Pyloric stenosis is a condition affecting infants characterized by a thickened pyloric sphincter and a narrow lumen, causing projectile vomiting. Diagnosis is made by ultrasound and treatment is surgical pylorotomy.
- Diabetic gastroparesis is a functional disorder caused by nerve damage, resulting in decreased gastric emptying and gastroparesis symptoms. Diagnosis is made by gastric emptying scans. Treatment includes maintaining strict glycemic control and medications to stimulate peristalsis.
- Cholethiasis and choledocolithiasis are conditions characterized by gallstone obstruction, most commonly caused by cholesterol stones in the bile duct. Symptoms include right upper quadrant pain, jaundice, and a positive Murphy sign. Diagnostic tests include ultrasound, ERCP, and HIDA scan. Treatment includes oral dissolving agents, laparoscopic cholecystectomy, or robotic cholecystectomy.
- Cholecystitis is an inflammatory process caused by gallstone obstruction and secondary infection. Symptoms include right upper quadrant pain, fever, and guarding. Diagnostic tests include ultrasound and blood tests. Treatment includes fluids, antibiotics, and surgery to remove the stones.
- Pregnancy increases the risk of gallbladder disorders due to decreased gallbladder contraction. Females, those over 40, and certain ethnic groups are also at higher risk. Symptoms include sharp right upper quadrant pain, jaundice, and a positive Murphy sign. Diagnostic tests include ultrasound and ERCP. Treatment includes antibiotics, fluid replacement, and surgery to remove the stones.- Galstone obstruction in the common bile duct can lead to ascending cholangitis, a serious infection with a high mortality rate if not treated promptly.
- Shocko's triad (fever, jaundice, and abdominal pain) and Reynold's pentad (same symptoms plus hypotension and altered mental status) are indicative of ascending cholangitis.
- Diagnostic tests for ascending cholangitis include CBC (elevated leukocytes), ultrasound or CT scan, and MRCP (magnetic resonance cholangiopancreatography) for definitive diagnosis.
- Treatment for ascending cholangitis includes endoscopic or percutaneous biliary drainage and IV antibiotics.
- Sclerosing cholangitis is a chronic condition that causes fibrosis of the common bile duct, leading to jaundice, weight loss, and malabsorption.
- Sclerosing cholangitis is associated with comorbid ulcerative colitis in 90% of cases.
- Diagnostic tests for sclerosing cholangitis include elevated GGT, ALT, AST, ALP, and conjugated bilirubin, as well as MRCP for definitive diagnosis.
- There is no cure for sclerosing cholangitis, but transplant may prolong survival.
- Primary liver cancer can be caused by cirrhosis, hepatitis B or C, or hemochromatosis.
- Symptoms of liver cancer include right upper quadrant pain, easy bleeding, and bruising, jaundice, and hepatomegaly.
- Diagnostic tests for liver cancer include elevated AST, ALT, and unconjugated bilirubin, as well as ultrasound, CT, or MRI.
- Treatment for liver cancer depends on the stage and may include transplant, excision, or chemotherapy.
- Cirrhosis is a chronic condition that causes scarring and fibrosis of the liver, and can lead to various complications such as hepatomegaly, ascites, and encephalopathy.
- Cirrhosis can be caused by chronic alcoholism, hepatitis C, or other factors.
- Symptoms of cirrhosis include impotence, hematemesis, dementia, gynecomastia, asterixis, xanthomas, and jaundice.
- Treatment for cirrhosis may include avoiding alcohol, managing ascites and encephalopathy, and considering a transplant.
- The transplant probability for cirrhosis depends on the MELD score, which calculates the probability of survival beyond the transplant list based on various factors.
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Description
Prepare for board exams with detailed information about gastrointestinal disorders, including symptoms, diagnosis, and treatment methods. Learn about anatomy, lab reviews, pancreatic and liver disorders, upper and lower GI bleeds, esophageal disorders, stomach disorders, gallbladder disorders, and liver conditions.
