[cirrhosis complication]
four major -- portal hypertension
1. EV bleeding
2. hepati encephlopahty
3. hepatorenal syndrome
four major -- portal hypertension
1. EV bleeding
2. hepati encephlopahty
3. hepatorenal syndrome
- 3月 12 週三 200800:31
cirrhosis complication
- 3月 09 週日 200823:39
Tools for pancreas
ultrasound
[view]
-->pancreatic tumor, acute/chronic pancreatitis,
[pros]
1. GB stone!
2. initial investgation for most patients "suspected" pancreatitis
[cons]
1. bowel gas, fat, and ascites limitation
CT
[view]
1.
-->pancreatic tumor, abscess, pseudocyst, calcification
[pros]
1.
2. dynamic CT for CTSI
3. spiral CT for rapid, clear, and negate artifact image
[cons]
1. hard to distingquish between inflammation and nepplasm
EUS
- 3月 09 週日 200820:34
PPU
PPU
[highly suspected]
1. elderly, NSAID
2. history of peptic ulcer
L: epigastric pain
[highly suspected]
1. elderly, NSAID
2. history of peptic ulcer
L: epigastric pain
- 3月 09 週日 200820:08
Cholecystitis
cholecystitis
[cause]--inflammation
1. mechanical
2. chemical
3. bacterial
[cause]--inflammation
1. mechanical
2. chemical
3. bacterial
- 3月 07 週五 200800:04
SBP
PBP(SBP)
1. S: no apparent source.
B: >300 PMNs/mL
P: abdominal pain, fever, ileus, diarrhea, abd tenderness,
# alter MS
1. S: no apparent source.
B: >300 PMNs/mL
P: abdominal pain, fever, ileus, diarrhea, abd tenderness,
# alter MS
- 3月 04 週二 200823:30
Lower Gi bleeding
LGIB
[lower GI]
distal to lig. Treitz
[etuology]
1. diverticulosis 33%
[lower GI]
distal to lig. Treitz
[etuology]
1. diverticulosis 33%
- 3月 04 週二 200822:56
Colonic Polyps
Colonic Polyps
[classification]
1. non-neoplastic: hyperplastic, inflammatory, submucosal, mucosal polyps
2. neoplastic: adenomatous -> villous, tubular, mixed
3. hamatomatous: Peutz-Jegher syndrome, Juvenile polyps syndrome
- 3月 03 週一 200823:22
Acute Pancreatitis
Acute Pancreatitis
[etiology]
1. Alcohol
2. Gallstone
3. Hypertriglycemia
[PE]
Gereral appearance: ill-looking
T/P/R: increase ; BP: decrease
HEENT
Purtscher's retinopathy
pale face
diaphorsis
icteric sclera
Chest
basilar rale (left side)
Abdomen
Grey-Turner sign
Cullen sign
distension
rebounding pain
muscle rigidity
hypoactive bowel sound
Extremity
erythematous skin nodule
cold
[X-ray] --according to anatomical location
1. duodenal distension w/ A-F level
2. sentinel loop sign in jujeunum(most)
3. colon cut off sign
4. stomach displaced by pseudocyst
5. generalize ileus w/ A-F level
[Lab]
leukocytosis (15000~20000)
Hct >50% (plasma loss)
amylase increase
lipase increase
hypocalcemia
hyperglycemia
metabolic acidosis-- hyperkalemia
[Complication] -- local / systemic
[Prognisis]
1. Ranson's criteria
2. CTSI
[Tx]
1. self-limiting (3~7 days)
2. NPO + fluid + meperidine
[etiology]
1. Alcohol
2. Gallstone
3. Hypertriglycemia
[PE]
Gereral appearance: ill-looking
T/P/R: increase ; BP: decrease
HEENT
Purtscher's retinopathy
pale face
diaphorsis
icteric sclera
Chest
basilar rale (left side)
Abdomen
Grey-Turner sign
Cullen sign
distension
rebounding pain
muscle rigidity
hypoactive bowel sound
Extremity
erythematous skin nodule
cold
[X-ray] --according to anatomical location
1. duodenal distension w/ A-F level
2. sentinel loop sign in jujeunum(most)
3. colon cut off sign
4. stomach displaced by pseudocyst
5. generalize ileus w/ A-F level
[Lab]
leukocytosis (15000~20000)
Hct >50% (plasma loss)
amylase increase
lipase increase
hypocalcemia
hyperglycemia
metabolic acidosis-- hyperkalemia
[Complication] -- local / systemic
[Prognisis]
1. Ranson's criteria
2. CTSI
[Tx]
1. self-limiting (3~7 days)
2. NPO + fluid + meperidine
1
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