Welcome
dua_frank has joined the chat.
[erum] hi every one
[sara12] hi everyone
[sara12] is any one a student at AUC?
[blacktown] hi
[hamilton27] hi
[erum] hi room
[erum] hellooooooo
[hoor] hi usmleed how was your exam
[john002800] hi
[Jibbsie] Hi everyone. Is the step 1 chat session
Now entering USMLE_Step_2 subroom.
dua_frank has joined subroom: USMLE_Step_2
[fero] ok..thx lanny
[sanz] how r u?
[lanny] understand sanz you just need time to go over stuff yourself
[fero] hi dua
[dua_frank] hi all
[lanny] hi dua thx for the sched it looks good
[sanz] hi dua
[dua_frank] welcome lanny
[dua_frank] hi sanz, how are you?
[lanny] i see strug is organizing a step 3 chat!!!!!already
[sanz] dua, i'm getting the jitters... hehe
[sanz] i should relax but just cant
[dua_frank] wow really lanny? she must have done her exam well
[dua_frank] sanz jitters are goo
[dua_frank] good
[dua_frank] no jitters bad
[sanz] hehe
[sanz] too much jitters are not good i think
[lanny] she hasnt gone yet think whe going on the 7th
[sanz] hers is on the 7th
[sanz] mine is on the 9th
[lanny] good to see how much motivated she is after leaving our chat
[dua_frank] why is she on step 3 chat already then *)
[lanny] yes she is planning to start as soon as she is cone!!
[lanny] done
[dua_frank] oh ok, i guess sanz will be joining her
[lanny] yes sure
[dua_frank] we better teach them how to save their chats
[sanz] i'm not doing step 3 yet
[sanz] i think i'll do my MRCP part 2 first...
[sanz] dont know...
[lanny] ok
[dua_frank] oh sanz
[sanz] or maybe just not do exams anymore
[dua_frank] focus on usmle
[sanz] so sick of them
[dua_frank] lol
[dua_frank] i can understand your confusion but my advise stick to one country :P
[lanny] ok dua we can start
[sanz] dua yeah i guess
[dua_frank] don't try to put both your legs over the atlantic, know what i mean :P
[dua_frank] yes please lanny, i will be back in two minutes
[lanny] with usmle license can one practice in UK someone asked me
[sanz] just that i did part 1 already - just for completion sake, in case one day i go back
[lanny] sanz do you know
[sanz] yes lanny
[sanz] you can practice in the UK if you had done plab
[lanny] but not usmle
[sanz] but i graduated from there so i dont really know what's the deal
[lanny] yea
[lanny] dont think someone with american license need to go back to do plab
[fero] lanny u mean one can parctice in uk WITH USMLES?
[fero] Practice
[sanz] i dont think so...
[sanz] i'm not sure tho
[sanz] but i know ppl has to do PLAB... or MRCP
[lanny] i mean if you have license and have done residency do you have to do plab again
[sanz] dont know
[lanny] ok
[sanz] megs, thnx buddy!
[megs] HEY SANZ ANYTHING FOR U
[megs] ALL THE BEST...
[sanz] thnx
[sanz] i'll c ya all around
sanz has left the chat.
[megs] HI SAMMY
[megs] LETS START SHOOT DUA
[samantha] hi everyone
[lanny] dua will be back
[megs] OK
[lanny] hi sam we will be going together in april right
[lanny] i am just doing q now but my pace is slow
[Jee] hi everybody
[lanny] hi jee
[fero] hi
[samantha] yes lanny
[lanny] g luck to you
[megs] what are the risk factors for ca oesophagus???
[samantha] thank you same to u
[lanny] smoking alcohol
[fero] iron def, ryes exposure, smoking
[dua_frank] cramps lower abd, fever, pain, leukocytosis. dx?
[dua_frank] barrets
[dua_frank] plummer vinson
[megs] what do u mean by iron def fero
[fero] pulm vinson
[megs] ok
[lanny] dua we waited for you this is the first q so yo
[lanny] u missed nothing
[dua_frank] thanks lanny
[dua_frank] dx for my q?
[fero] specic risks for sq ca of esophagus?
[lanny] fero you mean lye exposure
[dua_frank] GERD
[lanny] smoking
[fero] rt... lanny mis type
[lanny] GERD is adeno i think
[fero] rt lanny..wat about pul vin?
[megs] barrets due to gerd=adeno ca
[dua_frank] oh
[lanny] plummer vinson is squamous
[dua_frank] plummer vinson?
[megs] plummer winson squamous
[fero] rt good
[fero] which one is more common in blacks?
[dua_frank] that was peritonitis, can you tell me all the possible causes?
[megs] sqaumous blck...
[megs] white=adenca
[fero] rt, adeno in whites
[lanny] agree
[lanny] dua dont u stand peritonitis?
[dua_frank] appendicitis, rupture peptic ulcer, cholecystitis, diverticulitis, strangulation of bowel, acute salpingitis, trauma and peritoneal dylasis
[dua_frank] stand lanny? sorry didn't get your q
[lanny] the list is lng
[lanny] long!!!
[lanny] dua i got it now
[dua_frank] i just gave you the long list :P
[lanny] i see...wow
[fero] epidodic dysphagia? cause?
[megs] oesophageal spasm fero
[lanny] zenkers?
[lanny] diffuse spasm
[dua_frank] ring
[lanny] nutcracker oeso
[lanny] schatzki ring
[dua_frank] yeah that ring
[fero] schiatzki ,i am aware of,,, zenkers cause diffic in initiating swallowing
[fero] foul smell associted finding with ?
[dua_frank] yeah zenker at upper EP
[lanny] i think zenkers is
[fero] rt lanny... how do u dx it?
[lanny] it is a transfer dysphagia but also episodix
[dua_frank] zenker?
[lanny] barum swallow
[fero] ya dx of zenkers
[dua_frank] barrium esophagogram
[fero] rt....
[fero] EGD AND N/G tube contraindicated
[dua_frank] low fibre intake, left lower quadrant pain, constipation and distension with pouches in colon, dx?
[fero] diverticolsis
[lanny] diverticulosis
[dua_frank] yeah
[megs] divericulitis
[dua_frank] how will you different right sided from left sided diverticulosis?
[lanny] no dua
[megs] dunno
[dua_frank] left sided is with pain, right sided with hemorrage
[dua_frank] do they predispose to colon ca?
[lanny] thx dua
[dua_frank] welcome
[lanny] no
[megs] i guess i know diff betn presentation in coloc ca...which sided
[fero] rt megs me too
[dua_frank] tell us megs
[megs] same u said like that only dua
[dua_frank] oh
[dua_frank] well that applies to diverticulosis too
[megs] its just rt sided colon ca and left sided colon ca
[dua_frank] except diverticulosis does not lead to colon ca
[lanny] rt side prst with constipation
[dua_frank] which type of polyps has high risk of cancer?
[lanny] villous
[dua_frank] and left sided lanny?
[megs] villous adenoma
[fero] regarding colon ca also,,,rt sides bleeds and lt sided obstrusts
[dua_frank] yes good
[fero] villios is the VILLAN
[dua_frank] nice fero
[megs] cool fero
[fero] lol
[dua_frank] can FAP lead to colon ca?
[fero] yes
[dua_frank] yes good
[megs] yeah can lead to
[lanny] yes
[megs] what is turcot synd???
[megs] what is gardners???
[dua_frank] whats FAP, multiple osteomas, epidermal cyts and fribromatoris dx?
[shreya] colonic polyp + cns tumor.
[fero] hypercalcemia is assoc finding of sq r adeno ca of esophagus?
[dua_frank] mine is gardners
[dua_frank] :P
[megs] dua
[lanny] gardners sd
[fero] gardners
[megs] yeah
[dua_frank] turcots with CNS tumours and FAP
[fero] cns tum is with turcuts
[megs] squamous ca fero
[shreya] bone with gardener
[fero] good megs
[dua_frank] so FAP and bone is basically gardners
[lanny] turcots (turban head)
[dua_frank] nice lanny
[lanny] dua its usu soft tissue tumors
[fero] nice
[dua_frank] oh
[lanny] bu t bone is poss too
[megs] which polyp is non malignant???
[dua_frank] tubular
[fero] biopsy of sq comnar juntion shows Goblet cells..dx?
[fero] hyperplastic?
[lanny] agree feror
[megs] juvenile polyp...dua...never malignant
[lanny] the most benign
[fero] junction> of eso
[dua_frank] oh thanks megs even tubular though
[dua_frank] barrets fero?
[fero] rt dua
[dua_frank] cutaneous flashes, wheezing, diarrhea, hepatomegaly. dx?
[lanny] carcinoid sd
[fero] carciniod
[megs] carsinoid
[dua_frank] yes
[shreya] carcinoid syndrome.
[dua_frank] which is the MC site for this?
[lanny] whats diff bet carc tumor and syndrome?
[shreya] ileum
[lanny] small int
[fero] ileim colon
[lanny] lung
[dua_frank] appendix
[lanny] appendix
[lanny] fero they are not in colon
[dua_frank] HIV positive, vomiting, intestinal bleeding, weight loss, one month ago fungal pnemonia. dx?
[megs] syndrome is clinical scinario when it mets to lung..dua
[shreya] metastasis cause syndrome.
[lanny] crypto
[dua_frank] yes its carcinoid tumour not syndrome megs
[fero] candida esophgitis
[dua_frank] kaposi's sarcoma of stomach
[dua_frank] candida does not bleed fero
[fero] rt dua i did see the intes syp
[fero] did not
[dua_frank] very common to bleed in kaposis stomach
[fero] thx dua
[dua_frank] welcome
[lanny] thx megsdua is kaposis sarcoma seen in stomach
[lanny] ?
[megs] i dont know lanny
[dua_frank] 55 yr old japanese woman, migrates to us ten years ago, now weight loss and anorexia, dx?
[lanny] gastric cancer
[dua_frank] yes good
[dua_frank] linitis plastica
[dua_frank] histology shows?
[megs] signate ring cells
[dua_frank] yes
[dua_frank] what foods decrease incidene of gastric cas?
[megs] due to what ca stomach has decre incidence???
[megs] dua u read my mind
[dua_frank] lol
[dua_frank] telepathy megs
[megs] vit c
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[dua_frank] preservatives and refrigeration
[lanny] dua foods dont have nitrites
[dua_frank] yes lanny kaposis sarcoma in stomach bleeds
[lanny] non pickled and non salty
[lanny] thx dua wont forget
[lanny] i thought KS is on skin only
[dua_frank] stomach too
[megs] agree dua
[dua_frank] organs with white infarcts?
[dua_frank] usual cause?
[lanny] lung?
[dua_frank] nope
[fero] liver
[lanny] solild organs
[dua_frank] heart, kidney, spleen
[fero] solid organs
[lanny] yes thatw what i meant
[dua_frank] usually due to thrombus in heart or great arteries
[megs] organs with red infarct=lung , bowel...small and large
[dua_frank] cause of splenic abscess?
[lanny] ollow organs
[megs] septicemia dua
[lanny] hollow
[dua_frank] good megs, due to?
[megs] infective indocarditis...
[dua_frank] trauma, spread of infection and yes IE
[dua_frank] very good
[megs] or any septicemia
[dua_frank] just wanted to make a point about IE
[lanny] what is it dua
[dua_frank] that it can cause splenic abcess lanny
[megs] what is dumping syndrome???
[dua_frank] after gastrectomy
[fero] associ with gastric surgery
[megs] yeah..what r the symptoms
[dua_frank] diarrhea
[dua_frank] malabsoption
[lanny] sweating palpitations malabsorption
[megs] diaphoresis, palpitations nauses vomiting after 30 min of eati ng
[lanny] is this the same as short bowel sd.
[dua_frank] oh
[fero] yes lanny same
[megs] i dont think so lanny
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[fero] really megs?
[megs] short bowel when part of intestine is removed
[megs] and present with diarrhoea
[lanny] ok
[fero] thx
[dua_frank] right
[dua_frank] dumping synd is more like a pouch
[megs] they are different
[lanny] megs could you give me the web site again plz..thanks
[shreya] early dumping syndrome
[dua_frank] when it fills up you throw up
[dua_frank] right?
[megs] why lanny its not opening???
[lanny] because stuff cant be absorbed due to resect of duodenum
[fero] wats treatment?
[megs] frequent small meals
[lanny] fluuids??
[fero] rt,, and dec liq intake with meals
[dua_frank] who do people with hemachromatosis die of usually?
[lanny] cardiomyopathy
[fero] agree lanny
[megs] yup
[dua_frank] cardiac arrythmias
[dua_frank] people with CMP die of MI
[fero] ok wats treatment of primary hemochro verse sec hemochro e.g thalasemia?
[dua_frank] CMP itself does not kill
[dua_frank] its like angina
[megs] PRIMARY PHLEBOTOMY
[megs] SECONDERY IRON CHELATERS
[fero] good megs
[dua_frank] how will you differentiate the two on histology?
[fero] i will name term u tell me which its asoci with chrons r UC?
[dua_frank] ok
[fero] DUA THAS a hard one u tell
[fero] HISTo?
[dua_frank] iron in parenchymal cells is primary
[dua_frank] iron in kupfer cells seconday
[fero] thx..
[fero] good one
[dua_frank] welcome
[megs] YEAH DUA
[lanny] ok fero shoot
[fero] ok,,non caseating granolumas
[lanny] chrons
[dua_frank] c
[fero] fistulas
[fero] rt
[dua_frank] c
[megs] WHAT IS BRONZ DIABETIS
[fero] skip lesions
[megs] OK OK LETS DO IT LATER
[dua_frank] skin pigmentation with hemachomatosis
[dua_frank] c
[lanny] chrons
[megs] YEAH DUA
[fero] psudo polys
[megs] UC
[lanny] uC
[dua_frank] uc
[fero] sunmusal inflamm
[fero] sub
[dua_frank] uc
[lanny] uc
[megs] UC
[fero] transmural
[dua_frank] c
[megs] CHR
[fero] associa with PSC
[lanny] chrons
[megs] UC
[lanny] UC
[fero] rt..
[fero] surgery as treatment
[megs] UC
[fero] apthtous ulcers..
[dua_frank] 52 yr old woman, high bilirubinemia who died of metastatic bile duct adenoca dx?
[fero] rt
[fero] ok thas about it all the main ones
[lanny] thx fero
[megs] DIDNT GET U DUA
[dua_frank] cholestasis
[lanny] more info dua
[megs] OK
[dua_frank] people with bile duct adenoca block their bile ducts
[dua_frank] have cholestasis
[dua_frank] thus jaundice
[megs] WHAT IS CHARCOTS TRIAD???
[fero] jandice, RUQP AND ....HMMM
[fero] lol
[dua_frank] fever
[shreya] jaundica, pain fever.
[fero] fever
[megs] PAIN FEVER AND JAUNDICE...IN PT OF CHOLECYSTITIS
[megs] YUP ALL CORRECT
[lanny] fever fero
[dua_frank] antimitochondrial antibodies seen in
[dua_frank] ?
[lanny] PBC
[shreya] pbc
[dua_frank] yes
[megs] agree
[dua_frank] drugs causing cholestasis?
[megs] estrogens
[fero] beading on ERCP? DX?
[fero] OCP
[megs] and anobolic steroids too
[shreya] chronic pancreatitis?? fero
[dua_frank] yes and erythromycin and phenothiazines
[dua_frank] PSC?
[fero] rt dua,,,ant body associated?
[dua_frank] microsomal?
[dua_frank] dunno
[fero] anca BUT NOT SPECIFIC
[dua_frank] ah yes thanks
[dua_frank] p anca and c anca
[dua_frank] c anca with this one i guess
[fero] treatment of both PBC, AND PSC
[fero] not sure dua
[dua_frank] p anca with PAN
[lanny] dua i think its P anca
[megs] urodeoxycholic acid fero
[fero] agree megs,,,
[dua_frank] not sure lanny
[fero] both treated same,, only onon confusing part about these 2
[fero] non
[megs] which one fero
[fero] megs i meant both have same treatment
[megs] ok
[megs] why is the beaded apperance seen??
[megs] on ERCP??
[fero] psc
[dua_frank] fibrosis or scaring in the portal tract
[megs] STRICTERS AND DILATATION OF BILE DUCTS DYA
[fero] dilattaions
[lanny] what is ERCP good for versus HIDA scan?
[dua_frank] first fibrosis that causes strictures
[dua_frank] then dilatations
[megs] ERCP FOR PANCREAS...HIDA FOR GALL BLADDER
[megs] YEAH DUA
[dua_frank] common site for adeno ca duadenum?
[megs] 2nd part dua...????
[dua_frank] ampula of vater
[fero] ahh
[dua_frank] its seen with FAP in garners syndrome
[fero] best initial test to screen for H pylori?
[dua_frank] infection causing GB ca?
[megs] urea breath test??
[dua_frank] yeah breath test
[fero] megs thats to know the effectivenes of treatment...
[fero] seriology should always b done first
[dua_frank] clo test?
[fero] IgG
[lanny] is there a screening test?
[dua_frank] but thats less accurate
[megs] yeah fero u r right
[fero] BEST INITIAL TEST DUA,,NOT MOST ACCURATE
[dua_frank] ok
[dua_frank] so ig g then breath test
shreya has left the chat.
[megs] what is clo test fer??/
[dua_frank] then clo or endo with biopsy
[dua_frank] camp like organism
[lanny] whats this clo test?
[fero] cambylo bacter like org
[dua_frank] yellow to pinkn gel
[dua_frank] detects h py lanny
[fero] clo is usualy done with urease test
[dua_frank] clonorchis sinensis
[lanny] still asking is there a screening test??
[megs] ok thanx fero
[dua_frank] mc site for GB ca?
[dua_frank] i would go for breath test in that case lanny
[dua_frank] actually even ig G can be screening sorry
[lanny] I DONT THINK THERE IS A SCREENING TEST GUYS
[megs] agree lanny
[fero] ENZYME LINED IMMUNO ESSAY( IGG)
[dua_frank] fundus and neck
[dua_frank] easy lanny and fero, lets not shout here now :P
[fero] duodenal ulcer r gastric is BAD?
[lanny] dont u.stand fero?
[megs] GASTRIC BAD
[shreya] gastric
[dua_frank] gastric
[fero] wat lanny??
[lanny] oh gastric is
[fero] stand?
[megs] duodenal never turn malignant
[lanny] understand
[fero] rt..gastric
[lanny] but i got it now
[megs] which ulcer hels fast..gasric or duodenal???
[lanny] duodenal
[megs] yup lanny
[fero] pt on PPI...u suspect ZE SYN , next step to dx?
[dua_frank] drugs that can cause incompetant LES?
[fero] nitrates CCB
[lanny] whats ppI
[dua_frank] barium swollow?
[megs] which one is associated with incr acid???
[fero] PROTON pump inhib
[dua_frank] oh
[lanny] calcium blockers
[dua_frank] surgery
[lanny] nitrates
[dua_frank] yeah also theophylline, demerol, morphine
[fero] dua,,u sure sound like a surgeon
[shreya] nitrates,ca channel blockers,b agonists.
[fero] next step buddy to dx
[dua_frank] i said barium first :P
[lanny] dont we use PPI to trt?
[dua_frank] you didn't accept my answer so i threw surgery at you :P
[fero] barium for ZE?
[dua_frank] was worth a shot :P
[lanny] secretin test
[lanny] to see gastrin secretion
[megs] iv secretin test???
[shreya] gastirn test.
[megs] secretin test is most confermatory
[dua_frank] gastrin levels
[fero] good lanny..but b careful...do stop his omemprazole,,that too cause inc in gastrin
[dua_frank] oh yeah
[megs] good point fero???
[lanny] i was just typing that
[lanny] good
[fero] gastrin cause inc in gastrin but not in thousands as in ZE
[dua_frank] how will you different inc gastrin from ZE syndrome to gastrinomas?
[fero] in ZE ,,its like > 1000ng/dl
[lanny] well PPI can add to the gastrin secretion
[lanny] dua thats why you stop it
[dua_frank] same in gastrinomas fero
shreya has left the chat.
[dua_frank] stop what lanny?
[fero] proton pump inhib dua
[lanny] PPI
[lanny] dua
[dua_frank] i'm lost
[dua_frank] isn't gastrinoma like a tumour that produces excess gastrin
[lanny] to make sure its a gastrinoma before measure gastrin levels stop PPI cause thry too can inc gastrin
[megs] isnt zes ia A GASTRINIMA???
[fero] ya megs i was just about to say this too
[dua_frank] oh man
[lanny] ZES is a gastrin prod tumour
[dua_frank] uh oh
[dua_frank] ok then i got it
[megs] OHH FERO
[dua_frank] confused myself silly over nothing
[megs] GOOD
[lanny] you o k now dua?
[dua_frank] ok now thanks lanny
[fero] i just came across a ques,,, in which the doc had to stop PPI to a patient suspic of ZE,,,,, before doing a iv sec test
[megs] WHICH MEN SYNDROME ASSOCIATED WITH GASTRINOMA
[fero] men 1
[megs] YUP FERO
[lanny] pit pancreas parathy
[dua_frank] thanks fero and megs
[megs] WHAT IS THE COMMONEST SITE OF GASTRINOMA???
[dua_frank] pancreas
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[lanny] pancreas
[lanny] head
[megs] HEAD OF THE PANCREAS IS MOST COMMON FOLLOOWED BY DUODENUM AND STOMACH
[fero] treat of fistuals in CD?
[lanny] antibiotics
[megs] with antibiotics and fistulectomy fero
[fero] WHICH
[lanny] forgot which one
[shreya] metronid +mercaptopurinne,
[lanny] maybe metro
[fero] metronidazole
[megs] metro agree
[fero] rt
[lanny] oh boy a complete guess
[lanny] how do we follow colonoscopy in UC
[lanny] if pt has UC how often do we do colono?
[dua_frank] every 2 yrs
[megs] 8 yrs after...if age is less than 55
shreya has left the chat.
[fero] dunno
[megs] if history of pancolitis then after 8 yrs
[megs] as 5% have risk of ca colon
[lanny] what s after 8 yrs?
[megs] ulcerative colitis attack lanny
[fero] salfasalazine should not b given to men with infertilty dec sperm count
[lanny] gotta wait 8 yrs before doing colon?
[megs] yeah
[lanny] well if they are in their say sixties?
[megs] if u have attack of uc at the age 30 yrs do colonoscopy at 38 yrs
[megs] then follow routine for oldies lanny
[lanny] thx megs i raised cause kap says 10 but UW sys 8
[dua_frank] what is oldies routine?
[megs] yeah lanny
[lanny] start at 50
[fero] kaplan hasnt mention doing a colonscopy for UC,, it says just do surgery its curative
[megs] 5 yrly after 50 dua
[dua_frank] thanks
[lanny] every 5 yrs after
[megs] what are the comlications of UC??
[fero] megacolon
[dua_frank] colon ca
[lanny] tox megacolon
[fero] ca
[megs] WHAT IS MEGACOLON DUE TO FERO???
[megs] YUP
[fero] donno megs
[lanny] chagas dz
[fero] org?
[lanny] in south americans
[lanny] trypanosoma cruzi
[fero] good lanny
[fero] megs megacolon due to wat?
[megs] YUP BUT THE ONE ASSOCIATED WITH uc???
[fero] submus inflamm
[lanny] clsotridium diffficile?
[lanny] colitis
[megs] its a type of fulminent colitis..associated with pain fever...and shock
[fero] megs is infec assoc with megacolon?
[lanny] pseudomembreae colitis
[fero] never heard that
[lanny] hear now
[lanny] so megs whats the answer
[megs] i already given it
[megs] fulminent colitis associated with fever pain and shock
[lanny] ok thx.
[fero] treatment of psudo men colitis?
[shreya] metro
[shreya] or vancomycin
[megs] oral vanco too
[fero] rt,,,oral vanco and metro
[fero] iv vanco wont work
[megs] never answet iv vanco for pseudome,mb colitis
[dua_frank] MC cuase of pyloric stenosis these days?
[megs] duaodenal ulcer
[dua_frank] caner megs
[megs] ???really dua
[dua_frank] incidence due to DU coming down due to medicines
[megs] ok
[megs] thanx
[dua_frank] welcome
[megs] what to add toxic megacolon guys
[megs] due to fulminent colitis there us neuromascular degeneration hense dilatation pf colon
[dua_frank] what are cushings and curlings ulcers?
[megs] got a good point just now
[dua_frank] thanks megs that explains it well
[lanny] whats this megs?
[fero] cushing is stress
[dua_frank] also burns fero
[megs] cushing is stress
[megs] curlings burn
[fero] curling is crainial
[dua_frank] good fero
[lanny] megs could you do it again dont get you
[dua_frank] CVA is curlings
[lanny] ok megs got it
[dua_frank] how do you treat h pylori infection?
[megs] lanny inmegacolon...dilatation is due to fulminent colitis wich causes neuromascular degeneration
[fero] guys,,,just checked,,, correction curling is stress...cushing is due to intra crainal inj
[lanny] thanks
[megs] hense mega colon
[lanny] right fero i thought so too
[fero] confusing
[lanny] curling is stress
[dua_frank] fero
[megs] i learnt curlings in burns fero
[megs] in my undergrad
[megs] cushings are due to stress
[fero] rt megs any cond with mucosal inj and ishemia
[megs] agree
[fero] curling also called stress ulcers,,just checked megs
[dua_frank] 2 antibiotics with bismiuth or MOC
[megs] ok fero
[dua_frank] metro omepra clarythro
[megs] this is for irradication of h pylori dua
[dua_frank] what cant you treat with one antibiotic?
[lanny] fero i go with you curling is stress
[dua_frank] yeah megs
[lanny] cushing is intra cranial injuries
[fero] h pylori
[fero] rt lanny
[dua_frank] might have resistance
[dua_frank] hypercalcemia, hypergastranimia and gynecomastia, dx?
[fero] ze
[dua_frank] MEN 1
[megs] men!???
[dua_frank] good megs
[fero] y gynecomastia?
[lanny] which men
[dua_frank] rx?
[dua_frank] pituatary tumoir fero
[lanny] never heard gyneco in MEN
[megs] what is common cause for appendicitis/??
[fero] ya..
[lanny] ok dua
[dua_frank] infection
[lanny] inflammation
[megs] impacted ficolith
[dua_frank] omeprazole for ZE rx
[dua_frank] ewww megs :P
[megs] thats true for diverticulitis too
[dua_frank] yeah
[fero] which drug gives gynecomastia( used as anti ulcer)
[megs] cimitidine fero
[fero] rt
[shreya] cimetidine
[lanny] agree
[megs] what is gastroparesis???
[fero] DM neuropathy
[lanny] which drug causes sperm hypomotility given in inflammm bowel dz?
[fero] SALFASALAZINE
[megs] agree fero
[lanny] right fero
[megs] yup fero
[shreya] whts ur ans megs
[lanny] which drug causes lupus like sd used in inflamm bowel dz?
[megs] diabetic neuropathy shreya
[shreya] ok thanks.
[fero] salfasalazine?
[fero] hydralazine, isoniazid, procianamide r rthe others,,so wats your ans lanny?
[dua_frank] where is iron absorbed?
[lanny] immunosuppresive agents
[fero] duodenum dua?
[fero] ok thx lanny
[lanny] right fero
[dua_frank] proximal jejanum
[dua_frank] what all get absorped in terminal ileum?
[lanny] B12
[fero] jeju also absorn B 12
[dua_frank] b 12 vit adek bile salts
[lanny] agree
[megs] agree
[lanny] guys are we staying
[lanny] till?
[dua_frank] 30 more minutes perhaps lanny?
[dua_frank] lymphedenitis in UC or chrons?
[lanny] ok just need to go for few mins...
[megs] most common cause of lower GI BLEEDING
[megs] IN OLDIES
[lanny] upper GI bleed
[dua_frank] divericulosis
[fero] HEMMOR IN YOUNG AND DIVERTI IN OLD
[dua_frank] ca
[megs] DIVERICULOSIS
[lanny] oh diverticul
[megs] YEAH
[dua_frank] upper gi bleed
[dua_frank] ulcers i guess
[fero] ulcer
[lanny] megs whos right
[megs] AGREE FERO
[dua_frank] diseases ashkenazi jews can have?
[megs] TAY SACH GUACHERS
[fero] CD , UC
[dua_frank] goog goog goog
[dua_frank] erythema nodosum in?
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[fero] uc?
[dua_frank] crhs
[fero] dua wat?
[dua_frank] crohns
[fero] ok thx..
[fero] drug for prevention of NSAID induced ulcers?
[megs] MISOPROST
[shreya] misoprostol
[dua_frank] stop nsaid
[fero] rt.. rt....
[dua_frank] cox 2 inhibitors
[fero] celocox, refocoxib
[dua_frank] miso does not prevent necessarily, more like fights hcl high
[dua_frank] i'm afraid to write cox 2 as answer now that its banned
[fero] i read for treatment u still have to give h2 bloc r PPI
[dua_frank] well yes you still have to give them fero
[fero] for NSAID induced ulcers,,just for prevention misopros
[fero] k.
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[fero] steps in diagnosing...LOW gi BLEED?
[dua_frank] complications of UC?
[fero] malgnancy..toxic megacolon
[fero] pericholangitis
[dua_frank] rectal prolapse and abscesses
[dua_frank] how about cx of chrons?
[fero] uvietis, iritis, oxalate stones, fistulas
[dua_frank] fistulas, intestinal obstruction and performation
[dua_frank] good fero
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[dua_frank] how will you rx toxic megacolon?
[shreya] surgery dua
[fero] colectomy
[dua_frank] antimicrobials
[lanny] protocolectomy
[dua_frank] surgery is always curative and last resort
[fero] ok dua
[fero] low GI BLEED.? initial test?
[dua_frank] hamartomas in intestine and stomach, melanin pigmentation over lips and buccal mucosa, dx?
[fero] putz jeg
[dua_frank] rectal exam?
[dua_frank] yes fero
[shreya] whts the ans fero
[fero] test dua?
[dua_frank] dunno
[fero] flex sigmoidoscopy always first, followed by colonosopy
[dua_frank] ok
[dua_frank] i would just do rectal exam first to see if he has hemorrhoids :P
[dua_frank] but whatever the book says :P
[shreya] thanks fero
[fero] rt dua
[megs] agree dua
[dua_frank] what does carcinoid syndrome cause in heart?
[shreya] ok
[fero] cardiomeg...tachy
[megs] yeah dua
[dua_frank] it destroys right sided valves
[megs] cardiomegaly too
[dua_frank] ok
[shreya] rt side hear valve lesions
[lanny] valve dz
[fero] ok
[lanny] what vitamin def is seen in carcinoid sd?
[fero] niacin
[dua_frank] celiac sprue skin manifestatioN?
[dua_frank] why niacin?
[lanny] dermatitis herpertiformis
[fero] dermititis herpet
[dua_frank] yes
[fero] trptophan def?
[lanny] dua tryptophan is the prec for niacin and in carc trypto is used to make more sero so niacin is not synthez as much
[dua_frank] how do you dx celiac sprue?
[dua_frank] oh thanks lanny
[fero] biopsy
[dua_frank] whats D xylose test?
[lanny] stool studies
[lanny] test for intest mucosal damage
[lanny] d xylose is abs in the intestine
[shreya] d-xylose abn for bowel diseases.
[dua_frank] so why not do that first?
[fero] dx of celiac dua wats the ans
[dua_frank] i dunno fero, either two i think
[dua_frank] but definitive would be biopsy ofcourse
[lanny] agree dua
[lanny] biopsy is def
[fero] ok thx
[lanny] sreening is stool studies for steatorrhoea
[dua_frank] how will you differentiate celiac sprue from tropical spre ?
[fero] hx of travel
[dua_frank] oh yes lanny
[dua_frank] yes fero, more?
[shreya] gets better with gluten free diet. in c.s
[dua_frank] yes more
[lanny] tropical seen in the tropics or recent immigrant or traveller
[fero] distal small bowel effec
[fero] in tropical
[shreya] torpical needs antibiotics
[dua_frank] no tetany, osteomalaciaa or coagulopathy either
[dua_frank] more?
[lanny] gluten free diet gets better absorption
[fero] dunno
[dua_frank] biopsy staining in oil
[dua_frank] red o stain
[dua_frank] and the antigliadin antibodies
[lanny] dua you know why tetany
[dua_frank] you have to give tetracyclins
[fero] ca def
[dua_frank] vit d def
[fero] in celiac..abs effected
[lanny] yes but why not in tropical too?
[dua_frank] dunno lanny
[fero] prox small bowel resp for ca absor
[shreya] tet, osteomal, coagulopathy seen in celiac sprue ??dua
[dua_frank] yes shreya
[fero] in tropical distal part is effected
[shreya] oh thanks.
[dua_frank] ah
[dua_frank] thanks
[dua_frank] PAS positive dx?
[fero] whipples dis
[dua_frank] rx?
[shreya] agree
[fero] bactrim
[lanny] where does vit D work what part?
[dua_frank] terminal ileum lanny
[lanny] celiac sprue ?
[dua_frank] penicilin and streptomycin for ten days and then bactrim for one year
[dua_frank] didn't get you lanny
[lanny] what part of SI is celiac sprue most affected?
[dua_frank] abd pain due to psychological stress dx?
[fero] antiendomysial AB, new name is Transglutaminase Ab
[megs] bile is req for absorption of vit d
[fero] proximal lanny
[lanny] thanks
[dua_frank] i didn't know it was proximal
[dua_frank] thanks fero
[dua_frank] iritable bowel syndrome
[dua_frank] rx?
[megs] isnt it PUD TOO DUA???
[fero] u suspect laxative abuse in a diarehe pat( phenophtalene use) which test for Dx?
[shreya] naoh
[fero] good sherya
[dua_frank] PUD due to psychological stress megs?
[megs] PEPTIC ULCER DISEASE DUA...
[megs] ARNT THEY???
[dua_frank] its not that dramatic a pain as IBS
[fero] got to cook..lol
[dua_frank] peptic ulcer develops over time due to stress
[dua_frank] like stress ulcers
[dua_frank] IBS treated by psychothreapy, antidepressants, anticholinergics and increase fibre diet
[megs] OK
[dua_frank] we can stop now if you want
[dua_frank] i see its getting late
[dua_frank] or continue?
[megs] KAPLAN SAYS ONLY REASSURANCE AND DIETERY FIBRES DUA
[fero] ask everyone else
[dua_frank] same thing megs
[fero] stay r lev?
[shreya] bye
[megs] ok
[dua_frank] boy shreya, that was a quick decision
[megs] whats tomorrow guys/??
[lanny] fero in laxative use whats the diag?
[fero] lol .....agree dua
[fero] u do NAOH TEST....
[lanny] what will it show you know
[fero] turns stool red in pphen use
[shreya] its morning time for me..i have no problem to saty
[lanny] ok i think i am done for today
[dua_frank] shreya is in india
[shreya] s.
[dua_frank] where in india shreya?
[megs] ok...i am also leaving
[shreya] andhra.
[dua_frank] ok bye guys
[shreya] bye
[megs] bye all
[lanny] good night all
[fero] ok bye everyone
[dua_frank] good night
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[fero] good nite to u 2
[fero] uni was missing today
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[fero] bye
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