GERD
- what
- tx
Gastric juice from stomach -> esophagus
PPIs = Nexium, Prilosec
“no protons”
Peptic ulcer dz (PUD)
- causes
- duodenal vs gastric ulcer
- tx
H pylori, NSAID use (destroy COX1)
D: pain worse with empty stomach, middle of night
G: pain soon after eating
PPIs = Nexium, Prilosec
(“no protons”)
Barrett’s esophagus
Metaplasia: squamous -> columnar cells
Tx: PPIs = Nexium, Prilosec
“no protons”
IBD: Crohn’s
- etiology
- location
- morphology
- complications
- ocular findings
Infectious Any portion (SKIP lesions) COBBLESTONE mucosa, CREEPING FAT, FISTULAS (punctures thru wall and connects to other organs) Strictures, malabsorption Uveitis, episcleritis
“Fat old crone skipping down a cobblestone road”
IBD: Ulcerative colitis
- etiology
- location
- morphology
- complications
- ocular findings
Autoimmune Colong/rectum Mucosal inflamm, friable pseudopolyps, crypt abscesses, ulcers CARCINOMA Uveitis, episcleritis
Wilson’s dz
aka hepatolenticular degeneration
Copper accumulation - esp liver, brain, cornea
- cirrhosis
- basal ganglia degen, dementia
- Kayser-Fleischer ring + sunflower cataract
Tx: cuprimine
-SE: ocular myasthenia, ocular pemphigoid, optic neuritis
Hepatitis
- fecal-oral
- chronic
- vaccines
- superinfection
A + E
C
A + B
D (always with B)
Hepatitis
- blood work
- tx for C
High ALT/AST (not dependent on etiology/strain)
Ribaviron + interferon
Cirrhosis
Fibrosis
Due to alcohol, viral hepatitis
Enlarges -> firm nodules -> shrinks
Cholecystitis
Gallbladder inflammation
-stones
Overweight females of child-bearing age
Pain URQ, esp after meals
(+) Murphy’s sign
Acute pancreatitis
80% due to alcohol abuse or gallstones
Pain around umbilicus radiating to back
HIGH SERUM AMYLASE + LIPASE
Hearing loss
-most common form
Loss of conduction
Vertigo
- true vertigo
- assoc dz
True always assoc with nystagmus
Meniere’s dz: vertigo, hearing loss, tinnitus
-improvement when cut tobacco/salt, sometimes with antihistamine use
Concern with salivary gland issues
Proximity to CN7
Temporomandibular disorder (TMJ)
Jaw pain (pops when eating), HA
Ocular assoc with sleep apnea
FES
NTG
NAION
COPD
- problem
- emphysema vs chronic bronchitis
Air trapped in lungs/can’t get out #1 cause smoking
E: pink puffers, barrel chest, enlarged air spaces
CB: blue bloaters, hypertrophy of mucus-secr glands in bronchioles
Pneumoconiosis
Restrictive lung dz
-e.g. coal worker’s, asbestos
Decr lung volumes and compliance
TB
- testing for active vs latent
- PPD results
Chest x-ray
(+) active, (-) latent
Healthy 15+mm
Healthcare 10+
Immunocomp 5+
TB
-ocular
Conj granulomas Phlyctenules (3rd world = TB, 1st = staph) Epi/scleritis Keratitis Bilateral chronic granulomatous uveitis CME - most visually significant Disc edema or papilledema
Bacterial pneumonia
-common cause
Strep pneumoniae (pneumococcus)
Less common: mycoplasma (“walking pneumonia”)
