Internal MedicineˇGGastroenterology


ˇ@
ˇóRecovery of peristalsis small intestineˇ÷stomachˇ÷colon
ˇóVariceal bleeding risk factors: 1.size
2.red color sign
3.liver reserve
ˇóGround glass hepatocyte (GGH) represents a histological hallmark of chronic hepatitis B virus infection and contains surface antigens in the endoplasmic reticulum (ER)
ˇóexudate: Acites: > 3 g/dl (WBC> 250/mm3)
Pleural: protein> 0.5 Plasma, LDH> 0.6 Plasma
ˇ@
ˇóTx for hepatitis 1.alpha-interferon:
2.lamivudine: less side effects, but induce YMDD virus mutation
3.Ribavirin: for Hepatitis C, hemolysis
ˇ@
ˇóPancreatitis: "GET SMASHED"
pancreatic pseudocyst, abscess, fistula....
Ranson criteria:
On admission: Age(70y/o), WBC(18k), BS(>220), LDH(>400)
48 hrs: Hct(-10), BUN(+2), Ca(<8), PaO2, BE(>5), fluid sequestration(>4L)
ˇóreason for LDH elevation: First rule out:
L: lipid
D: Jaun-D-ice(icteric, hepatic injury)
H: hemolysis

Then, consider
1. rapid cell turn over: lymphoma, large tumor burden
2. pancreatits
3. AMI
ˇ@
ˇóIBD UC: rectum, continuously
CD: terminal ileum, skip areas, transmural, cobblestone patternˇ]§J¶©¸őĄŰˇ^
ˇ@
ˇóPeutz-Jeghers sundrome: perioral pigmentation, STK11 gene
ˇóHemangioma: peripheral nodular, centripedal pattern in triphasic CT
ˇóLiver abscess: ˇ÷indirect hemagglutination test for ameba: 90%
ˇ÷bil. usually not elevated in amebic!!
ˇóPseudomembranous Colitis: The antibiotic-induced change in the balance of normal gut flora allows overgrowth of C difficile (gram-positive, spore-forming, anaerobic bacillus). Colitis results from toxin A (enterotoxin) and toxin B (cytotoxin)....
ˇ@
ˇóGastric ca. ˇ÷Early stage: mucosa, submucosa/ Progressive: muscularis, serosa ˇ÷ˇ÷all not consider LN meta!!
ˇ÷Intestinal type: like colon ca., intestinal metaplasia, atrophic gastritis
ˇ÷Diffuse type: cirrhotic
ˇóColon ca ˇ÷prognosis: depth of invasion(Staging: A: mucosa B: serosa C: LN D: distal meta), META,atypia
ˇ÷Tx: 5FU + levamisoleˇ]Dukes A & D§K¤FˇIˇIˇ^
ˇ÷Stage D liver meta: surgery (no C/T)
ˇ@
ˇóMALToma: H.p related
ˇ@ ˇ@


Hosted by www.Geocities.ws

1