dx of cirrhosis: labs
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, in early stages no diagnostic findings.
Low albumin
High serum protein
Hi bilirubin
High liver enzymes (AST, ALT)
Pltlts are often low
ANA high (inflammation)
can check hepatitis surface antigens
PT/PTT and albumin should be assessed to determine hepatic synthesis and
clotting function
these mean liver injury or inflammation, use these values to determine if
biopsy needed
management of hemorrhoids
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high fiber diet, increased fluid. fiber 20-30 g/day
sitz baths
stool softeners (not laxatives, can make it worse because of variable
consistency)
topical analgescis reduce inflammation.
vasoconstrictive preps cnan help too
can do rubber band ligation if still symptomatic after dietary/lifestyle
change
Hepatitis causes
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viral, alcohol, autoimmune, malnutrition, metabolic defects, meds, NAFLD.
If not halted it will result in chronic liver disease, cirrhosis, ESLD and
possibly cancer.
management of anal fissures
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usually resolve without tx.
Inc fiber, stool softeners, sitz baths, supps or foam antiinflammatory agents
lidocaine gel before BMs
topical nitrates or oral CCBs (diltiazem) helps healing of fissures
Markle sign
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stand on tip toes and drop down=severe pain=appendicitis
Cholangitis treatment
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, NPO
IV fluids
IV antibiotic (met + gent/amp or Ciprofloxacin)
ERCP (emergent)
Cholecystectomy (urgent)
Celiac Sprue Disease
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a reaction to gluten (found in wheat, rye, and barley) that causes damage
to the lining of the small intestine
early symtoms of primary biliary cirrhosis
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itching, weight loss, fatigue
What test to use if a patient has chronic hepatitis C and cirrhosis is suspected
Give this one a try later!
MRI (magnetic resonance elastography) measures liver stiffness
hematuria + pyuria means
Give this one a try later!
, in early stages no diagnostic findings.
Low albumin
High serum protein
Hi bilirubin
High liver enzymes (AST, ALT)
Pltlts are often low
ANA high (inflammation)
can check hepatitis surface antigens
PT/PTT and albumin should be assessed to determine hepatic synthesis and
clotting function
these mean liver injury or inflammation, use these values to determine if
biopsy needed
management of hemorrhoids
Give this one a try later!
high fiber diet, increased fluid. fiber 20-30 g/day
sitz baths
stool softeners (not laxatives, can make it worse because of variable
consistency)
topical analgescis reduce inflammation.
vasoconstrictive preps cnan help too
can do rubber band ligation if still symptomatic after dietary/lifestyle
change
Hepatitis causes
,Give this one a try later!
viral, alcohol, autoimmune, malnutrition, metabolic defects, meds, NAFLD.
If not halted it will result in chronic liver disease, cirrhosis, ESLD and
possibly cancer.
management of anal fissures
Give this one a try later!
usually resolve without tx.
Inc fiber, stool softeners, sitz baths, supps or foam antiinflammatory agents
lidocaine gel before BMs
topical nitrates or oral CCBs (diltiazem) helps healing of fissures
Markle sign
Give this one a try later!
stand on tip toes and drop down=severe pain=appendicitis
Cholangitis treatment
Give this one a try later!
, NPO
IV fluids
IV antibiotic (met + gent/amp or Ciprofloxacin)
ERCP (emergent)
Cholecystectomy (urgent)
Celiac Sprue Disease
Give this one a try later!
a reaction to gluten (found in wheat, rye, and barley) that causes damage
to the lining of the small intestine
early symtoms of primary biliary cirrhosis
Give this one a try later!
itching, weight loss, fatigue
What test to use if a patient has chronic hepatitis C and cirrhosis is suspected
Give this one a try later!
MRI (magnetic resonance elastography) measures liver stiffness
hematuria + pyuria means