Basics Flashcards
PPIs before endoscopy?
Stop 2-weeks before
Gold standard for coeliac
Duodenal biopsy
Anti-emetics
Cyclizine - GI cause, H1
Metoclopramide, domperidone - prokinetic (D2 NOT PARK)
Ondansetron - chemotherapy
Duodenal ulcers
Relieved by eating
Upper GI Bleed score
Rockall: Pre-endoscopy re-bleeding & death risk
Age 60 - 80 [2 points]
BP & Pulse (<100HR, >100BP –> >100HR, >100BP –> >100HR, <100BP) [2 points]
Comorbidity [2 or 3 points –> 3 for failure]
Age BP & HR Comorbid Diagnosis Endoscopy
Upper GI Intervention score
Blatchford: is the intervention necessary
NICE first assessment
Urea, Hb, BP, pulse, melena, syncope, hepatic, cardiac
Buddi Chiari
Thrombus in hepatic portal vein
Abdo pain, ascites, hepatomegaly
Can cause post-hepatic varices
Long term varices prevention
Propranolol, banding, gastric sclerotherapy
Varices emergency drug
Terlipressin
Chronic Pancreatitis Stool
Faecal elastase
Diarrhoea w/ Polymorphs
Shigella, Campylobacter, E.coli (is both)
Diarrhoea w/o Polymorphs
Salmonella, E.coli (is both), C.diff, Norovirus (culture negative)
C diff
Colic, diarrhoea, temp, dec. albumin
Colitis - yellow plaques, inflamed non-ulcerated mucosa
Spreads well
Can progress to toxic megacolon & organ failure
There is asymptomatic carriage in some adults
Patient: >70yrs, Hx, anti-peristaltic drugs, specific smell
Test: C.diff protein & ELISA for toxins, AXR for TMC
Stop Abx –> Start Metronidazole/Vancomycin
TMC –> urgent colectomy in deterioration
Acute UC Investigation
Limited flexible sigmoidoscopy
UC Mx
Mild maintenance –> Mesalazine [ASA]
PR hydrocortisone/pred for flare
Moderate –> 4-6 motions, oral pred 40mg for 1 wk
then Mesalazine
Severe –> 6 motions, admit, IV fluid & steroid
Rescue therapy –> azathiprine, infliximab
Failure to improve by D7/toxic dilation 6cm –> colectomy
Immune therapy for >2 steroids per year –> azathioprine
