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Year 4 Finals > Alimentary > Flashcards

Alimentary Flashcards

1
Q

What is the diuretic of choice in cases of ascites?

A

Spironolactone

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2
Q

An SAAG level of over what indicates portal hypertension?

A

Over 11g/L

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3
Q

Migration of abdominal pain to the right iliac fossa is highly suggestive of what?

A

Appendicitis

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4
Q

What is the classical clinical sign for appendicitis?

A

Rovsing’s sign - pain in right iliac fossa on palpation of left iliac fossa

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5
Q

Maddrey’s discriminant function is often used to determine what?

A

Which acute alcoholic hepatitis patients would benefit from glucocorticoids (prednisolone)

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6
Q

Acute pancreatitis can be caused by which electrolyte abnormality?

A

Hypercalcaemia

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7
Q

Which antibodies are useful for diagnosing pernicious anaemia?

A

Intrinsic factor antibodies

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8
Q

What is the first line medication for primary biliary cholangitis to slow disease progression?

A

Ursodeoxycholic acid

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9
Q

What can be used for control of pruritus in primary biliary cholangitis?

A

Cholestyramine

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10
Q

A mildly elevated amylase plus fluid in the abdomen 6 weeks post acute pancreatitis is suggestive of what?

A

Pancreatic pseudocyst

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11
Q

Acute respiratory distress syndrome is associated with which alimentary pathology?

A

Acute pancreatitis

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12
Q

Albumin cover during paracentesis for large volume ascites reduces risk of what?

A

Post paracentesis circulatory dysfunction

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13
Q

What is the first line treatment for acute pancreatitis?

A

Fluid rescusitation

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14
Q

HbA1c can be falsely lowered under what conditions?

A

Increased red cell turnover

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15
Q

Which 3 bacterial infections are most common post splenectomy?

A

Strep pneumoniae
Haemophilus influenza
Meningococcus

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16
Q

Which immunoglobulin is elevated in primary biliary cholangitis?

A

IgM

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17
Q

What is the surgical treatment of choice for acute cholecystitis? Within how long from diagnosis should this be performed?

A

Laparoscopic cholecystectomy within 1 week of diagnosis

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18
Q

State the three elements Charcot’s triad. What is this useful for diagnosing?

A

Fever, RUQ pain, jaundice
Useful for diagnosing ascending cholangitis

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19
Q

What treatment may be used for acute alcoholic hepatitis?

A

Prednisolone

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20
Q

What conditions may over estimate HbA1c?

A

Vit B12/folate/iron deficiency, splenectomy

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21
Q

Name 3 conditions which may underestimate HbA1c

A

Sickle cell anaemia
G6PD deficiency
Hereditary spherocytosis

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22
Q

Haemodialysis may cause what estimation error in HbA1c?

A

Under estimation

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23
Q

What should be given to patients prior to appendectomy?

A

Prophylactic antibiotics

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24
Q

Which electrolyte abnormality is associated with a more severe pancreatitis?

A

Hypocalcaemia
Note that hypercalcaemia can cause pancreatitis

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25
Q

Cystic fibrosis is associated with development of which endocrine disorder?

A

Diabetes mellitus

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26
Q

What is the most sensitive test for detecting pancreatic calcification?

A

CT

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27
Q

Faecal elastase can be used to assess what?

A

Pancreatic exocrine function

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28
Q

Supplementation of what is involved in chronic pancreatitis management?

A

Pancreatic enzymes

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29
Q

Acute epiglottitis is caused by what bacteria?

A

Haemophilus influenzae B

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30
Q

Stridor, drooling and tripod positioning is suggestive of what?

A

Acute epiglottitis

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31
Q

Steroid inhaler use increases the risk of what type of oesophageal infection?

A

Candida/thrush

32
Q

Achalasia is due to loss of ganglia from which plexus?

A

Auerbach’s

33
Q

Birds beak appearance on barium swallow is suggestive of what?

34
Q

What is the first line treatment for achalasia?

A

Pneumatic balloon dilatation

35
Q

Which complication are patients who undergo ERCP most at risk of?

A

Pancreatitis

36
Q

High urea indicates GI bleeding originates from where?

A

Upper portion of GI tract

37
Q

Which scoring system is used in upper GI bleeding at first assessment?

A

Glasgow-Blatchford

38
Q

Which scoring system provides percentage risk of rebleeding and mortality in GI bleeding?

39
Q

Platelet count of below what in GI bleeding warrants a platelet transfusion?

40
Q

Patients with an upper GI bleed should have endoscopy within how long from presentation?

41
Q

Subcutaneous emphysema in the context of chest pain suggests what?

A

Boerhaave’s syndrome

42
Q

History of what increases risk of acute mesenteric ischaemia?

A

Atrial fibrillation

43
Q

What is the first line treatment for acute mesenteric ischaemia?

A

Urgent surgery

44
Q

Ischaemic colitis is most likely to occur where?

A

Splenic flexure (watershed areas)

45
Q

What is the most common cause of small bowel obstruction?

A

Adhesions following surgery

46
Q

What kind of bowel sounds are heard in small bowel obstruction?

A

Tinkling bowel sounds

47
Q

Which lab value may be raised in small bowel obstruction?

48
Q

What is the most common cause of large bowel obstruction?

49
Q

Peritonism can occur in bowel obstruction if what has occurred?

A

Perforation

50
Q

Free intra-peritoneal gas on AXR is suggestive of what?

A

Colonic perforation

51
Q

What is the main risk factor for developing cholangiocarcinoma?

A

Primary sclerosing cholangitis

52
Q

Raised CA19-9 is possible in which 2 alimentary cancers?

A

Cholangiocarcinoma and pancreatic cancer

53
Q

Barrett’s oesophagus increases the risk of which type of cancer?

A

Adenocarcinoma of the oesophagus

54
Q

Which type of cancer is most common in the upper two thirds of the oesophagus?

55
Q

In Barrett’s oesophagus, squamous epithelium is replaced by what?

A

Columnar epithelium

56
Q

What is the most significant risk factor for Barrett’s oesophagus?

57
Q

What is the most significant risk factor for hepatocellular carcinoma?

A

Chronic hep B

58
Q

Raised AFP is most commonly implicated in which alimentary cancer?

A

Hepatocellular

59
Q

What is the investigation of choice for pancreatic cancer?

A

High resolution CT

60
Q

The double duct sign is suggestive of what?

A

Pancreatic cancer

61
Q

Which procedure can be used for resectable pancreatic head tumours?

A

Whipple’s

62
Q

Amenorrhoea is a common manifestation of which liver disease?

A

Autoimmune hepatitis

63
Q

Which immunoglobulin is raised in autoimmune hepatitis?

64
Q

What are the 2 first line treatments for autoimmune hepatitis?

A

Steroids, immunosuppressants

65
Q

Transient elastography is a test for what?

A

Liver cirrhosis

66
Q

With regards to alcohol units, when should a male and female be offered transient elastography?

A

Male - over 50 units
Female - over 35 units

67
Q

Which medication is used for prophylaxis of variceal bleeding?

A

Propranolol

68
Q

What should be administered pre endoscopy in suspected variceal bleeding?

A

Terlipressin + prophylactic abx

69
Q

Uncontrolled haemorrhage of varices can be managed by what?

A

Insertion of Sengstaken-Blakemore tube

70
Q

Name 4 drugs associated with developing acute pancreatitis

A

Any of:

azathioprine, mesalazine, thiazides, furosemide, pentamidine, steroids, sodium valproate

71
Q

What is the most common complication of ERCP?

A

Acute pancreatitis

72
Q

Which anatomical landmark distinguishes upper from lower gastrointestinal tract?

A

Ligament of Treitz

73
Q

Right sided abdominal tenderness on PR exam is suggestive of what?

A

Acute appendicitis

74
Q

TIPS procedure connects what 2 structures?

A

Hepatic vein and portal vein

75
Q

Name 2 conditions which are a risk factor for developing gallstones

A

Diabetes mellitus, Crohn’s disease

76
Q

Carcinoembryonic antigen is a marker for what type of cancer?

A

Colorectal

77
Q

Pregnancy can lead to an isolated rise in which liver function test, and why?

A

ALP, released by placenta

Year 4 Finals (15 decks)

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