Vomiting: extra GI differential VOMITING:

Vestibular disturbance/ Vagal (reflex pain)

Opiates
Migrane/ Metabolic (DKA, gastroparesis, hypercalcemia)
Infections
Toxicity (cytotoxic, digitalis toxicity)
Increased ICP, Ingested alcohol
Neurogenic, psychogenic
Gestation

Pancreatitis: Ranson criteria for pancreatitis at admission LEGAL:

Leukocytes > 16.000
Enzyme AST > 250
Glucose > 200
Age > 55
LDH > 350

Whipple's disease: clinical manifestations SHELDA:

Serositis
Hyperpigmentation of skin
Eating less (weight loss)
Lymphadenopathy
Diarrhea
Arthritis

Haemachromatosis complications "HaemoChromatosis Can Cause Deposits

Anywhere":
Hypogonadism
Cancer (hepatocellular)
Cirrhosis
Cardiomyopathy
Diabetes mellitus
Arthropathy

GIT symptoms BAD ANAL S#!T:

Bleeding
Abdominal pain
Dysphagia
Abdominal bloating
Nausea & vomiting
Anorexia/ Appetite changes
Lethargy
S#!ts (diarrhea)
Heartburn
Increased bilirubin (jaundice)
Temperature (fever)
Pancreatitis: criteria
PANCREAS:
PaO2 below 8
Age >55
Neutrophils: WCC >15
Calcium below 2
Renal: Urea >16
Enzymes: LDH >600; AST >200
Albumin below 32
Sugar: Glucose >10 (unless diabetic patient)

Cholangitis features CHOLANGITITS:

Charcot's triad/ Conjugated bilirubin increase
Hepatic abscesses/ Hepatic (intra/extra) bile ducts/ HLA B8, DR3
Obstruction
Leukocytosis
Alkaline phosphatase increase
Neoplasms
Gallstones
Inflammatory bowel disease (ulcerative colitis)
Transaminase increase
Infection
Sclerosing

IBD: extraintestinal manifestations A PIE SAC:

Aphthous ulcers
Pyoderma gangrenosum
Iritis
Erythema nodosum
Sclerosing cholangitis
Arthritis
Clubbing of fingertips

Digestive disorders: pH level With vomiting both the pH and food come up.
With diarrhea both the pH and food go down.

Bilirubin: common causes for increased levels "HOT Liver":

Hemolysis
Obstruction
Tumor
Liver disease

IBD: surgery indications "I CHOP":

Infection
Carcinoma
Haemorrhage
Obstruction
Perforation
· "Chop" convenient since surgery chops them open.

H. Pylori treatment regimen (rough guidelines) "Please Make Tummy Better":

Proton pump inhibitor
Metronidazole
Tetracycline
Bismuth
· Alternatively: TOMB:
Tetracycline
Omeprazole
Metronidazole
Bismuth

Hereditary Nonpolyposis Colorectal Cancer (HNPCC) cause is DNA mismatch

repair DNA mismatch causes a bubble in the strand where the two nucleotides don't
match.
This looks like the ensuing polyps that arise in the colon.
· See diagram.

Pancreatitis (acute): causes GET SMASHED:

Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune (PAN)
Scorpion stings
Hyperlipidemia/ Hypercalcemia
ERCP
Drugs (including azathioprine and diuretics)
· Note: 'Get Smashed' is slang in some countries for drinking, and ethanol is an important
pancreatitis cause.

Charcot's triad (gallstones) "Charcot's Triad is 3 C's":

Color change (jaundice)
Colic (biliary) pain, aka RUQ pain
Chills and fever

Charcot's triad (gallstones) "Charge a FEE":

Charcot's triad is:
Fever
Epigastric & RUQ pain
Emesis & nausea
Ulcerative colitis: complications "PAST Colitis":
Pyoderma gangrenosum
Ankylosing spondylitis
Sclerosing pericholangitis
Toxic megacolon
Colon carcinoma

Crohn's disease: morphology, symptoms CHRISTMAS:

Cobblestones
High temperature
Reduced lumen
Intestinal fistulae
Skip lesions
Transmural (all layers, may ulcerate)
Malabsorption
Abdominal pain
Submucosal fibrosis
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---Samuel Atom Baek-Kim

Celiac sprue gluten sensitive enteropathy: gluten-containing grains BROW:

Barley
Rye
Oats
Wheat
· Flattened intestinal villi of celiac sprue are smooth, like an eyebrow.
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---Jack A. Pasquale, MD St. George's University, School of Medicine

Diabetic ketoacidosis: precipitating factors · 5 I's:

Infection
Ischaemia (cardiac, mesenteric)
Infarction
Ignorance (poor control)
Intoxication (alcohol)
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---James Thomas

Liver failure (chronic): signs found on the arms CLAPS:

Clubbing
Leukonychia
Asterixis
Palmar erythema
Scratch marks
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---Jason
Pancreatitis: Ranson criteria for pancreatitis: at admission "GA LAW" (GA is
abbreviation for the U.S. state of Georgia):
Glucose >200
AST >250
LDH >350
Age >55 y.o.
WBC >16000
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---Anonymous Contributor

Pancreatitis: Ranson criteria for pancreatitis: initial 48 hours "C & HOBBS"
(Calvin and Hobbes):
Calcium < 8
Hct drop > 10%
Oxygen < 60 mm
BUN > 5
Base deficit > 4
Sequestration of fluid > 6L
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---Anonymous Contributor

Hepatic encephalopathy: precipitating factors HEPATICS:

Hemorrhage in GIT/ Hyperkalemia
Excess protein in diet
Paracentesis
Acidosis/ Anemia
Trauma
Infection
Colon surgery
Sedatives
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---Dr. Chetan Wasekar

Cirrhosis: causes of hepatic cirrhosis HEPATIC:

Hemochromatosis (primary)
Enzyme deficiency (alpha-1-anti-trypsin)
Post hepatic (infection + drug induced)
Alcoholic
Tyrosinosis
Indian childhood (galactosemia)
Cardiac/ Cholestatic (biliary)/ Cancer/ Copper (Wilson's)