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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
Cystic fibrosis is associated with development of which endocrine disorder?
Diabetes mellitus
26
What is the most sensitive test for detecting pancreatic calcification?
CT
27
Faecal elastase can be used to assess what?
Pancreatic exocrine function
28
Supplementation of what is involved in chronic pancreatitis management?
Pancreatic enzymes
29
Acute epiglottitis is caused by what bacteria?
Haemophilus influenzae B
30
Stridor, drooling and tripod positioning is suggestive of what?
Acute epiglottitis
31
Steroid inhaler use increases the risk of what type of oesophageal infection?
Candida/thrush
32
Achalasia is due to loss of ganglia from which plexus?
Auerbach’s
33
Birds beak appearance on barium swallow is suggestive of what?
Achalasia
34
What is the first line treatment for achalasia?
Pneumatic balloon dilatation
35
Which complication are patients who undergo ERCP most at risk of?
Pancreatitis
36
High urea indicates GI bleeding originates from where?
Upper portion of GI tract
37
Which scoring system is used in upper GI bleeding at first assessment?
Glasgow-Blatchford
38
Which scoring system provides percentage risk of rebleeding and mortality in GI bleeding?
Rockall
39
Platelet count of below what in GI bleeding warrants a platelet transfusion?
Under 50
40
Patients with an upper GI bleed should have endoscopy within how long from presentation?
24 hours
41
Subcutaneous emphysema in the context of chest pain suggests what?
Boerhaave’s syndrome
42
History of what increases risk of acute mesenteric ischaemia?
Atrial fibrillation
43
What is the first line treatment for acute mesenteric ischaemia?
Urgent surgery
44
Ischaemic colitis is most likely to occur where?
Splenic flexure (watershed areas)
45
What is the most common cause of small bowel obstruction?
Adhesions following surgery
46
What kind of bowel sounds are heard in small bowel obstruction?
Tinkling bowel sounds
47
Which lab value may be raised in small bowel obstruction?
Amylase
48
What is the most common cause of large bowel obstruction?
Tumours
49
Peritonism can occur in bowel obstruction if what has occurred?
Perforation
50
Free intra-peritoneal gas on AXR is suggestive of what?
Colonic perforation
51
What is the main risk factor for developing cholangiocarcinoma?
Primary sclerosing cholangitis
52
Raised CA19-9 is possible in which 2 alimentary cancers?
Cholangiocarcinoma and pancreatic cancer
53
Barrett’s oesophagus increases the risk of which type of cancer?
Adenocarcinoma of the oesophagus
54
Which type of cancer is most common in the upper two thirds of the oesophagus?
Squamous
55
In Barrett’s oesophagus, squamous epithelium is replaced by what?
Columnar epithelium
56
What is the most significant risk factor for Barrett’s oesophagus?
GORD
57
What is the most significant risk factor for hepatocellular carcinoma?
Chronic hep B
58
Raised AFP is most commonly implicated in which alimentary cancer?
Hepatocellular
59
What is the investigation of choice for pancreatic cancer?
High resolution CT
60
The double duct sign is suggestive of what?
Pancreatic cancer
61
Which procedure can be used for resectable pancreatic head tumours?
Whipple’s
62
Amenorrhoea is a common manifestation of which liver disease?
Autoimmune hepatitis
63
Which immunoglobulin is raised in autoimmune hepatitis?
IgG
64
What are the 2 first line treatments for autoimmune hepatitis?
Steroids, immunosuppressants
65
Transient elastography is a test for what?
Liver cirrhosis
66
With regards to alcohol units, when should a male and female be offered transient elastography?
Male - over 50 units Female - over 35 units
67
Which medication is used for prophylaxis of variceal bleeding?
Propranolol
68
What should be administered pre endoscopy in suspected variceal bleeding?
Terlipressin + prophylactic abx
69
Uncontrolled haemorrhage of varices can be managed by what?
Insertion of Sengstaken-Blakemore tube
70
Name 4 drugs associated with developing acute pancreatitis
Any of: azathioprine, mesalazine, thiazides, furosemide, pentamidine, steroids, sodium valproate
71
What is the most common complication of ERCP?
Acute pancreatitis
72
Which anatomical landmark distinguishes upper from lower gastrointestinal tract?
Ligament of Treitz
73
Right sided abdominal tenderness on PR exam is suggestive of what?
Acute appendicitis
74
TIPS procedure connects what 2 structures?
Hepatic vein and portal vein
75
Name 2 conditions which are a risk factor for developing gallstones
Diabetes mellitus, Crohn’s disease
76
Carcinoembryonic antigen is a marker for what type of cancer?
Colorectal
77
Pregnancy can lead to an isolated rise in which liver function test, and why?
ALP, released by placenta

Year 4 Finals (15 decks)

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