Entameoba histolytica: disease caused, action
EntAmoeba causes Amoebic dysEntery.
Action: histo (cell) lytic (burst), so it bursts cells.
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---Robert O'Connor University College Dublin
Clostridium difficile: disease caused
"Difficult to be in a Closet with someone having explosive foul smelling diarrhea,
because it would smell and there would be no air in there.
Clostridium Difficile causes explosive foul smelling diarrhea and is an anaeorbe (no
air).
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---Robert O'Connor University College Dublin
Meckel's diverticulum details
2 inches long.
2 feet from end of ileum.
2 times more common in men.
2% occurrence in population.
2 types of tissues may be present.
· Note: "di-" means "two", so diverticulum is the thing with all the twos.
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---Robert O'Connor University College Dublin
Ulcerative colitis: definition of a severe attack
A STATE:
Anemia less than 10g/dl
Stool frequency greater than 6 stools/day with blood
Temperature greater than 37.5
Albumin less than 30g/L
Tachycardia greater than 90bpm
ESR greater than 30mm/hr
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---Anil Pandit Manipal College of Mecdical Sciences, Pokhara, Nepal
Pancreatitis (acute): causes
I GET SMASHED:
Idiopathitic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune (PAN)
Scorpion stings
Hyperlipidemia/ Hypercalcemia
ERCP
Drugs (including azathioprine and diuretics)
· Note: 'Get Smashed' is slang in some countries for drinking, and ethanol is an
important pancreatitis cause.
· Note: Shortest answer is gallstones for women, and ethanol for men. And scorpian
stings for people from Trinidad.
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---Chris Perry and RJP Edinburgh Medical School and University College Dublin
Hepatomegaly: 3 common causes, 3 rarer causes
Common are 3 C's:
Cirrhosis
Carcinoma
Cardiac failure
Rarer are 3 C's:
Cholestasis
Cysts
Cellular infiltration
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---Anonymous Contributor and Jamal Khan Not Specified and Birmingham University Medical Student
Hereditary Nonpolyposis Colorectal Cancer (HNPCC) cause is DNA
mismatch repair
DNA mismatch causes a bubble in the strand where the two nucleotides don't match.
This looks like the ensuing polyps that arise in the colon.
· See diagram.
Inflammatory Bowel Disease: which has cobblestones
Crohn's has Cobblestones on endoscopy.
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---Anonymous Contributor
Hepatic necrosis: drugs causing focal to massive necrosis
"Very Angry Hepatocytes":
Valproic acid
Acetaminophen
Halothane
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---Calvin Sy University of Pittsburgh School of Medicine
H. Pylori treatment regimen (rough guidelines)
"Please Make Tummy Better":
Proton pump inhibitor
Metronidazole
Tetracycline
Bismuth
· Alternatively: TOMB:
Tetracycline
Omeprazole
Metronidazole
Bismuth
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---Steven Holsenback and Leena Alexander COMP and Texas, USA
Van den Bergh reaction (Jaundice test)
"Indirect reacting bilirubin = Unconjugated bilirubin":
Both start with vowels, so they go together: Indirect & Unconjugated.
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---Dr. Waqas H. Sheikh BVI Co.
Bilirubin: common causes for increased levels
"HOT Liver":
Hemolysis
Obstruction
Tumor
Liver disease
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---Sung H. Kim
Ulcerative colitis: complications
"PAST Colitis":
Pyoderma gangrenosum
Ankylosing spondylitis
Sclerosing pericholangitis
Toxic megacolon
Colon carcinoma
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Cholangitis features
CHOLANGITITS:
Charcot's triad/ Conjugated bilirubin increase
Hepatic abscesses/ Hepatic (intra/extra) bile ducts/ HLA B8, DR3
Obstruction
Leukocytosis
Alkaline phosphatase increase
Neoplasms
Gallstones
Inflammatory bowel disease (ulcerative colitis)
Transaminase increase
Infection
Sclerosing
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---Rinku S. Uberoi UNIBE
Haemochromatosis definition, classic triad
"Iron man triathalon":
Iron man: deposition of iron in many body tissues.
· Triathalon has 3 components, which match triad:
Swimming: Skin pigmentation
Biking: Bronze diabetes
Marathon: Micronodular pigment cirrhosis
· See diagram for visual equivalent.
Gut intrinsic innervation: myenteric plexus vs. submucosal plexus
function
Myenteric: Motility.
Submucosal: Secretion and blood flow.
E. coli: diseases caused in presence of virulence factors
DUNG:
Diarrhea
UTI
Neonatal meningitis
Gram negative sepsis
· Dung, since contract E. coli from dung-contaminated water.
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---Robert O'Connor University College Dublin
Ulcerative colitis: features
ULCERATIONS:
Ulcers
Large intestine
Carcinoma [risk]
Extraintestinal manifestations
Remnants of old ulcers [pseudopolyps]
Abscesses in crypts
Toxic megacolon [risk]
Inflamed, red, granular mucosa
Originates at rectum
Neutrophil invasion
Stools bloody
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---Samuel Atom Baek-Kim
Esophageal cancer: risk factors
ABCDEF:
Achalasia
Barret's esophagus
Corrosive esophagitis
Diverticuliis
Esophageal web
Familial
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---Lau Yue Young Geoffrey HKU
Peptic ulcer: associated causative factors
SHAZAM:
Smoking
Hypercalcemia
Aspirin
Zollinger-Ellison
Acidity
MEN type I
· These may work with H. pylori to promote ulceration, or may act alone.
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---Robert O'Connor University College Dublin
Carcinoid syndrome: components
CARCinoid:
Cutaneous flushing
Asthmatic wheezing
Right sided valvular heart lesions
Cramping and diarrhea
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---Robert O'Connor University College Dublin
Gallstones/cholecystitis: risk factors
5 F's:
Fat
Female
Family history
Fertile
Forty
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---Saif Nasafi
Crohn's disease: morphology, symptoms
CHRISTMAS:
Cobblestones
High temperature
Reduced lumen
Intestinal fistulae
Skip lesions
Transmural (all layers, may ulcerate)
Malabsorption
Abdominal pain
Submucosal fibrosis
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---Samuel Atom Baek-Kim
Dysphagia: differential
DISPHAGIA:
Disease of mouth and tonsils/ Diffuse oesophageal spasm/ Diabetes mellitus
Intrinsic lesion
Scleroderma
Pharyngeal disorders/ Palsy-bulbar-MND
Achalasia
Heart: eft atrium enlargement
Goitre/ myesthenia Gravis/ mediastinal Glands
Infections
American trypanosomiasis (chagas disease)
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---Anil Pandit, Manipal College of Medical Sciences, Pokhara, Nepalmanipal
Nematodes: ones spreading by egg ingestion
"ATE eggs":
Ascaris Lumbricoides
Trichuris trichuira
Enterobius vermicularis
spread by ingestion of eggs (vs skin invasion or insect bite)
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---Leena Alexander Texas, USA
Food poisoning: bugs inducing
"Eating Contaminated Stuff Causes Very Big Smelly Vomit":
E. coli O157-H7 [undercooked meat, esp. hamburgers]
Clostridium botulinum [canned foods]
Salmonella [poultry, meat, eggs]
Vibrio parahaemolyticus [seafood]
Bacillus cereus [reheated rice]
Staphylococcus aureus [meats, mayo, custard]
Clostridium perfringens [reheated meat]
Vibrio vulnificus [seafood]
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---Joel Camilo Universidad Iberoamericana (UNIBE), Santo Domingo, Dominican Republic
Pepsin-producing cells
"Chief of Pepsi-Cola":
· Chief cells of stomach produce Pepsin.
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---Dr. Atif Farooq Khawaja Rawalpindi Medical College, Horizon Medical Institute, Pakistan
Duodenal atresia vs. Pyloric stenosis: site of obstruction
Duodenal Atresia: Distal to Ampulla of vater.
Pyloric stenosis: Proximal to it.
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---Rinku Uberoi
Folate deficiency: causes
A FOLIC DROP:
Alcoholism
Folic acid antagonists
Oral contraceptives
Low dietary intake
Infection with Giardia
Celiac sprue
Dilatin
Relative folate deficiency
Old
Pregnant
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---Robert O'Connor University College Dublin
Pancreatitis: causes
PANCREATITIS:
Posterior
Alcohol
Neoplasm
Cholelithiasis
Rx (lasix, AZT)
ERCP
Abdominal surgery
Trauma
Infection (mumps)
Triglycerides elevated
Idiopathic
Scorpion bite
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---Anonymous Contributor
Bilirubin: phototherapy
BiLirUbin absorbs light maximally in the
BLUe range.
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---Rinku Uberoi New York Hospital
Hepatocellular carcinoma: aetiology, features
ABC:
Aetiology:
Aflatoxins
Hep B
Cirrhosis
· Features:
AFP increased (classic marker)
Bile-producing (DDx from cholangiocarcinoma)
Commonest primary liver tumor
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---Robert O'Connor University College Dublin
Cirrhosis: causes of hepatic cirrhosis
HEPATIC:
Hemochromatosis (primary)
Enzyme deficiency (alpha-1-anti-trypsin)
Post hepatic (infection + drug induced)
Alcoholic
Tyrosinosis
Indian childhood (galactosemia)
Cardiac/ Cholestatic (biliary)/ Cancer/ Copper (Wilson's)
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---Dr. Chetan Wasekar
Pancreatitis: causes
BAD S#!T:
Biliary: gallstones, 1% of ERCP patients
Alcoholism/ Azotemia
Drugs
Scorpion bite/ Sea anenome/ SLE
Hyperlipidemia/ Hypercalcemia
Idiopathic/ Infectious (mumps, coxsackie, salmonella, ascariasis)
Tumor/ Trauma
· The drugs are: penacillamine, furosemide, thiazides, ethacrynic acid, steroids, sulfas,
ace inhibitors, N-SAIDs, erythromycin, estrogen.
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---Anonymous Contributor
IBD: extraintestinal manifestations
"Left intestine to sail the SEAS of the rest of the body":
Skin manifestations: erythema nodosum, pyoderma gangrenosum
Eye inflammation: iritis, episcleritis
Arthritis
Sclerosing cholangitis
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---Anonymous Contributor
Pyloric stenosis (congential): presentation
Pyloric stenosis is 3 P's:
Palpable mass
Paristalsis visible
Projectile vomiting (2-4 weeks after birth)
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---Dr. Atif Farooq Khawaja Rawalpindi Medical College, Pakistan
Ileus: causes
MD SPUGERS:
Mesenteric ischemia
Drugs (see below)
Surgical (post-op)
Peritonitis/ Pancreatitis (sentinnel loop)
Unresolved mechanical obstruction (eg mass, intussusception, blockage)
Gram negative sepsis
Electrolyte imbalance (eg hypokalemia)
Retroperitoneal bleed or hematoma
Spinal or pelvic fracture
· Drugs are Aluminum hydroxide, Ba++, Ca carbonate, opiates, TCA, verapamil.
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---Hugo M. Rodriguez, MD University of Virginia Roanoke-Salem Program
Oesophageal cancer risk factors
PC BASTARDS:
Plummer-Vinson syndrome
Coeliac disease
Barrett's
Alcohol
Smoking
Tylosis
Achalasia
Russia (geographical distribution)
Diet
Stricture
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---Dr. John Holme
Achalasia: 1 possible cause, 1 treatment
aCHAlasia:
1 possible cause: CHAgas' disease
1 treatment: Ca++ CHAnnel blockers
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---Anonymous Contributor
E. coli: major subtypes, key point of each
"HIT by E. coli outbreak":
EnteroHemorrhagic:
· HUS from Hamburgers
EnteroInvasive:
· Immune-mediated Inflammation
EnteroToxigenic:
· Traveller's diarrhea
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---Robert O'Connor University College Dublin
Celiac sprue gluten sensitive enteropathy: gluten-containing grains
BROW:
Barley
Rye
Oats
Wheat
· Flattened intestinal villi of celiac sprue are smooth, like an eyebrow.
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---Jack A. Pasquale, MD St. George's University, School of Medicine
Colon cancer: risk factors
HULA:
Heridity/ Heriditary diseases
Ulcerative colitis
Low fibre, high fat diet
Adenomatous polyps
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---Anonymous Contributor
Dysphagia: causes
MOON:
Mouth lesions
Obstruction
Oesophageal stricture
Neurological (eg stroke, Guillain-Barre, achalasia)
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---Jamal Khan Birmingham University Medical Student
Cirrhosis: differential: common and rarer
· Common causes are ABC:
Alcohol
B (Hepatitis)
C (Hepatitis)
· Rarer are also ABC:
Autoimmune
Biliary cirrhosis
Copper (Wilson's)
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---Jamal Khan Birmingham University Medical Student
Hepatitis: transmission routes
"Vowels are bowels":
Hepatitis A and E transmitted by fecal-oral route.
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---F.G. Madbak University of Kentucky College of Medicine
Pancreatitis: treatment
MACHINES:
Monitor vital signs
Analgesia/ Antibiotics
Calcium gluconate (if deemed necessary)
H2 receptor antagonist
IV access/ IV fluids
Nil by mouth
Empty gastric contents
Surgery if required/ Senior review
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---Sushant Varma Junior Doctor
Colon carcinoma: aeitiology
CRAPS:
Chronic ulcerative colitis
Ratio of animal fat:fibre diet
Adenomatous polyps
Familial Polyposis
Strong family history of colon cancer.
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---C.A. Whelan 4th year Medical Student, Liverpool University