Olestra
- what is it?
- indication
- non-caloric food additives that mimic taste/texture of triglyceride
- used for weight loss
Rifaximin
- MOA
- indication
- ANTIBIOTICS that kills gut flora which GENERATES ammonia
- hyperammonemia
How exactly lactulose works to treat hepatic encephalopathy? What is another indication of lactulose? how does it work?
ACIDIFY gut -> convert ammonia into NH4+
* gut flora degrades lactulose into lactic acid
Lactulose is also used as osmotic laxatives, dragging water into gut, inducing diarrhea to treat constipation
What treatment can improve dysphagia in achalasia?
CCB
-> reducing intracellular calcium -> dilation of esophageal smooth muscle
- remember:
- low 1/3 of esophagus: smooth muscle
- upper 1/3: striated muscle (dysphagia can happen from myasthenia gravis)
- middle 1/3: mixed
What are two physical exam findings for appendicitis? (not including Mcburney sign)
- psoas sign: pain during hip flexion against resistance
- obturator sign: pain during INTERNAL rotation in flexed hip
Is markedly elevated AST or ALT common in hepatocellular carcinoma?
NO.
true marker of HCC is alpha fetoprotein
What two abnormal electrolytes should I notice in VIPoma?
low potassium
high chloride: achlorhydia -> accumulation of chloride
Scleroderma affects which part of esophagus to result in aphasia? striated muscle? or smooth muscle
lower 2/3: smooth muscle (middle 1/3 is mixed striated and smooth)
- this is same for other conditions
: achlasia, plummer-vinson - upper 1/3: striated muscle -> aphasia in myasthenia gravis
Intussuseception may present as intermittent pain. Why?
partial reversal of obstruction
squamous cell carcinoma of esophagus vs. achalasia: how do they present differently in terms of symptom?
squamous cell carcinoma of esophagus
: dysphagia first solid and then progressively worse with liquid
achalasia
: dysphagia BOTH SIMULTANEOUSLY solid and liquid
Plummer Vinson syndrome: dysphagia due to esophageal web and iron deificiency anemia. What another condition is associated with it?
glossitis- beefy red tongue
palpable non-tender gallbladder: diagnosis?
pancreatic adenocarcinoma
- this physical exam finding is called Courvoisier sign
- PALPABLE, NONTENDER GALL BLADDERis keyword. Other gallbladder diseases (cholelithiasis, choledocholelithiasis) are generally not palpable gallbadder
What is choledocholelithiasis?
gallstone in common bile duct (out side of gallbladder)
Why misoprostol is contraindicated in pregnancy
uterine contraction, which induces labor
