Viva la Liver
List 5 causes of cirrhosis
EtOH, MASH, Autoimmune hep, PBC, PSC, HFE, Wilsons, alpha 1 antitrypsin deficiency, HCV, HBV, MTX, Amio
Inflammation of the endocardium and heart valves
List 5 peripheral stigmata of chronic liver disease
spider nevi, caput medusa, clubbing, gynecomastia, palmar erythema, jaundice, petechia, dupuytrens, sarcopenia, cachexia
Which RTA is associated with hyperkalemia
IV
Who was the half blood prince in Harry Potter
Snape
What four things should we always send ascites for
cell count, culture, albumin, protein
How do we diagnose IE, and list the criteria
Duke's criteria 2 major, 1 major 3 minor or 5 minor. Major: Blood cx typical organisms >2 12h apart, evidence of vegetation abscess new valvular regurgitation
Minor: Immune phenomena (oilers, roth, GN), vascular phenomena (laneway lesions, mycotic aneurysm), risk factors (prev IE, prosthetic valve), Fever, micro evidence that doesn't meet major
Probe placement for Liver ultrasound (anatomical landmarks)
xyphoid and right mid axillary line
List 2 causes of osmolar gap with no metabolic acidosis
isopropyl alcohol, ethanol, early toxic alcohols,
Why did Dr Gregory House have a limp?
previous infarction in his right leg
How do we diagnose and treat SBP
PMN >250, culture pos, ceftriaxone and albumin
List three class A surgical indication for IE
Valve disease with signs/symptomatic HF, new heart block, abscess, persistent bacteria despite abx 5 days, prosthetic valve/pacemaker, left sided IE with resistant organisms or fungi,
What is virchows node, and what does it usually indicate
left supraclavicular lymphadenopathy (GI ca)
A patient with NAGMA, you do urine studies which shows Urine Na 100, K 30, Chloride 150. What is the likely etiology
GUT
What famous "wizard" from a famous fantasy book turned movie says "End? No, the journey doesn't end here. Death is just another path, one that we must all take."
Gandalf
4 Indications for albumin
SBP, HRS and large volume paracentesis
Usual duration of antibiotic therapy
4-6w
What is Leser-Trelat sign
sudden appearance and rapid increase in size and number of seborrheic keratoses, which can be a sign of internal malignancy.
If someone has chronic respiratory acidosis, what would we expect to see with their HCO3
For every rise of 10 CO2 the HCO3 will rise by 3-4
Who was 007 in greys anatomy
George Omalley
What is a common complication of TIPS, and if patients have a history of it can be a contraindication for having it done?
HE
Who gets IE prophylaxis and in what scenarios
if high risk (prosthetic valve, prev IE, some congenital heart disease, cardiac transplant)
When: dental procedures with gingival manipulation, resp procedures (lung biopsy, tonsillectomy), piercing of infected skin
Why do hands "flap" with hyperammonemia?
brief loss of muscle tone and the extensor muscles give out momentarily
What is the acid base disturbance? pH 7.25, Na 132, cl 105, bicarbonate 12, Co2 20.
Mixed high anion gap and non anion gap metabolic acidosis
Ph 7.25, bicarb 12, co2 20 = a metabolic acidosis is the driving force
Anion gap is 15.
Delta delta gap is 20-12/24-12 = 8/12 = 2/3 = 0.67 = high AG and NAGMA are both present
where was corner gas filmed
Rouleau, Saskatchewan