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Primary Biliary Cholangitis (Primary Biliary Cirrhosis) Diagnosis and Treatment
Diagnosis
Positive Antimitochondrial Antibodies
Increased Alkaline Phosphatase (ALK-P)
Increased Cholesterol
Treatment
Ursodiol
Liver Transplant
2 mins
Cholecystitis Assessment
RUQ Pain
Referred Shoulder Pain
Clay Colored Stools
Jaundice
Nausea and Vomiting
Dyspepsia (Indigestion)
Fever
Considerations
Increased WBCs
Fatty or Spicy Foods
Ultrasound
2 mins
Cholecystitis Causes
Gallbladder Inflammation
6 Fs
Female
Fair (Caucasian)
Fat (Obese)
Fertile (Pregnant)
Forty (Advanced Age Over 40)
Flatulence
2 mins
Cholecystitis Interventions
Supportive Therapy
Antibiotics
Low Fat Diet
NG Tube
Analgesics
Lithotripsy
Cholecystectomy
T Tube
2 mins
Acute Pancreatitis Assessment
Mechanism
Heavy Alcohol Use and Gallstones
Signs and Symptoms
Abdominal Pain
Nausea/Vomiting/Anorexia
Abdominal Rigidity/Guarding
Decreased or Absent Bowel Sounds
Hypotension and Tachycardia
Jaundice
Increased White Blood Cells
2 mins
Acute Pancreatitis Disease
Autodigestion of Pancreas by Pancreatic Enzymes
Symptoms
Epigastric Abdominal Pain Radiating to Back
Anorexia
Nausea
Labs
Increased Amylase and Lipase
Complications
Disseminated Intravascular Coagulation (DIC)
Infection
Hypocalcemia
Systemic Inflammatory Response Syndrome (SIRS)
Acute Respiratory Distress Syndrome (ARDS)
Pancreatic Pseudocyst
Hemorrhage
3 mins
Acute Pancreatitis Causes
"GET SMASHHED" Mnemonic
Gallstones
(Ethanol) Alcohol
Trauma
Steroids
Mumps
Autoimmune
Scorpion Sting
Hypercalcemia
Hypertriglyceridemia > 1000
ERCP
Drugs
1 min
Acute Pancreatitis Interventions
NPO with NG Tube to Suction
Pain Management
Albumin
Lactated Ringers Solution
Proton Pump Inhibitor (PPI)
Antibiotics
Surgery
Nutrition
2 mins
Ranson's Criteria on Admission
Use
Mortality Predictor for Acute Pancreatitis
Criteria on Admission
GA LAW (Each is +1)
Glucose > 200 mg/dL
Age > 55 Years
LDH > 350 U/L
AST > 250 U/L
WBC Count > 16,000/mm3
2 mins
Ransons Criteria During First 48 Hours
Use
Mortality Predictor for Acute Pancreatitis
Criteria Present at 48 Hours
C HOBBS (Each is +1)
Calcium < 8.0 mg/dL
Hematocrit Decreased by > 10%
Oxygen (PO2) < 60 mmHg
BUN Increased by Greater or Equal to 5 mg/dL
Base Deficit > 4 mEq/L
Sequestered Fluid > 6 L
3 mins
Zollinger-Ellison Syndrome Disease
Pathophysiology
Gastrin-Secreting Tumor
Increased Gastric Acid
Recurrent Peptic Ulcers
MEN Type 1
Symptoms
Abdominal Pain
Heartburn (Pyrosis)
Diarrhea
3 mins
Zollinger-Ellison Syndrome Diagnosis and Treatment
Diagnosis
Gastrin > 1000 pg/mL
Positive Secretin Stimulation Test
Treatment
High-Dose PPI
Octreotide
Surgical Resection
3 mins
Achalasia
Pathophysiology
Failure to Relax Lower Esophageal Sphincter
Malignancies
Chagas Disease
Loss of Auerbach Plexus
Symptoms
Dysphagia to Solids & Liquids
Diagnosis
Barium Swallow
Bird's Beak Appearance
Manometry
Risk Factors
Increased Risk Squamous Cell Carcinoma
2 mins
Gastroesophageal Reflux Disease (GERD) Assessment
Pathophysiology
Relaxed Lower Esophageal Sphincter
Signs and Symptoms
Dyspepsia (Indigestion)
Belching
Nighttime Coughing
Dysphagia
Epigastric Pain
Regurgitation
Heartburn (Pyrosis)
Globus
2 mins
Barrett's Esophagus
Histological findings
Metaplasia in Lower Esophagus
Columnar Epithelium
Associated Pathologies
Gastroesophageal Reflux Disease (GERD)
Esophagitis
Esophageal Ulcers
Increased Risk of Esophageal Adenocarcinoma
1 min
Mallory-Weiss
Characteristics
Bleeding From Tears in Mucosa
Forceful Vomiting
Alcoholism
Eating Disorders (Bulimia)
Painful Hematemesis
Diagnosis
Endoscopy
Management
Observation
2 mins
Boerhaave Syndrome
Pathophysiology
Esophageal Rupture
Increased Esophageal Pressure while Vomiting
Lower 1/3 of Esophagus
Signs and Symptoms
Chest Pain
Odynophagia
Subcutaneous Emphysema
Management
Shock
Surgical Emergency
2 mins
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