psoas abscess
etiology, symptomsprimary origin or a secondary origin from a contiguous infection such as osteomyelitis, ☆IBD (eg, Crohn disease), or pyelonephritis
diverticulosis and diverticulitis
symptoms, on imagingdiverticulosis→ painless hematochezia
many facse diverticula of the colon
diverticulitis→ several days of worsening LLQ pain(Japanese→RLQ pain is more common)
☆pericolic fat stranding gastrointestinal Nov 5, 2019, 3:01 AM HirotoShishido
treatment for Wilson disease, hemochromatosisWilson→ chelation with ☆penicillamine
metoclopramide clinical use☆diabetic and postsurgery gastroparesis(promote gastric emptying), antiemetic, persistent GERD(increase LES tone) pharmacologygastrointestinal Nov 5, 2019, 1:47 AM HirotoShishido
inguinal canal structureICE TIE
Internal spermatic fascia
Cremasteric muscle and fascia
External spermatic fascia
Clostridium difficile
two toxinsToxin A=enterotoxin→alters fluid secretion
Toxin B=cytotoxin(more potent than Toxin A)→cause ☆apoptosis in a variety of cell types via actin depolymerization
(Toxins inactivate Rho-regulatory proteins which is involved in actin cytoskeletal structure maintenance. The result is ☆loss of cytoskeleton integrity, leading to cell rounding/retraction, disruption of intercellular tight junctions, and increased paracellular intestinal fluid secretion (eg, watery diarrhea)) gastrointestinalmicrobiology Oct 8, 2019, 6:40 PM HirotoShishido
difference between
small and large intestinal folds on x-raykerckring's (circular) folds→obstruction can be found in small intestine
what urinary disease the patient with Crohn disease is predisposed to?urinary stone
Crohn disease can develop fat malabsorption, leading to the increased lipids in the large intestine. These lipids can compete with oxalate for calcium binding in the GI tract, thereby causing decreased formation of calcium-oxalate aggregates (which are eliminated) and increased amounts of free oxalate (which is reabsorbed). Oxalate then must be eliminated in the urine at high concentrations, which can lead to the formation of calcium oxalate kidney stones. gastrointestinal Oct 9, 2019, 1:26 AM HirotoShishido
giardia
etiologycolonization of the gut by Giardia trophozoites results in small bowel inflammation and villous atrophy, which reduces absorptive capability gastrointestinalmicrobiology Dec 3, 2019, 9:27 PM HirotoShishido
biological therapy for IBDanti TNF-α(infliximab)
anti IL-12/23(ustekinumab)
anti JAK(tofacitinib)
anti S1P(sphingosine 1 phospate)(ozanimod)→affect liver and heart
anti α4β7 integrin(vedolizumab) pharmacologygastrointestinal Dec 3, 2019, 3:59 PM HirotoShishido
Hirschsprung disease
findings“squirt sign.” In this condition, failure to pass stool results in increased pressure proximal to the obstruction which is relieved by rectal examination, leading to forceful evacuation of stool gastrointestinal Dec 3, 2019, 7:33 PM HirotoShishido
pathophysiology of duodenal atresia, jejunal and ileal atresiaduodenal→ failure to recanalize
