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PA YEAR 1 > CASE 9 & 10: GI > Flashcards

CASE 9 & 10: GI Flashcards

1
Q

What is the most common side effects of bisphonates (drug for osteoporosis)

A

dyspepsia (indigestion)

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2
Q

What is re-feeding syndrome?

A

electrolyte disturbance secondary to reintroduction of nutritions following a starved state, (eating after a period of starvation).

Hypophosphatemia (reduction in phosphates)

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3
Q

What is diverticulitis

A

inflammation of the diverticula that is caused by infection

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4
Q

what is diverticular disease?

A

herniation of the colonic wall (outpouching)

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5
Q

risk factors of pernicious anaemia

A

previous h.pylori infection and hypothyroidism

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6
Q

how do you diagnose pernicious anaemia (low vitamin b12)

A

test for serum intrinsic factor antibodies

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7
Q

treatment for acute gastroenteritis

A

advise monitor fluid intake and reassure self limiting

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8
Q

what is charcots triad and which condition has all 3

A

pain jaundice and fever, cholangitis

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9
Q

antibiotic choice for clostridium difficle

A

oral vanomycin

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10
Q

what are the consitipation NICE guidelines

A

1) self manage: fluids, high fibre, exercise etc
2) bulk forming laxative: ispaghula
3) osmotic laxative: macrogol
4) stimulant laxativie: senna

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11
Q

what common drugs can cause upper gi bleeds

A

NSAIDS

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12
Q

Presentation of mallory weiss tear

A

vomiting red blood (haematisis) and epigastric pain

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13
Q

which blood test would show acute pancreatitis

A

raised serum lipase (x3)

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14
Q

acute pancreatitis presentation

A 
G: gallstones
E: Ethanol
T:  trauma
S: steroids
M:mumps/malignancy
A: autoimmune
S:scorpion sting
H: hypocalcaemia or hyperlipidaemia
E: ERCP
D:drugs
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15
Q

management of acute pancreatits with no signs of sepsis

A

fluid resus
analgesia
antiemetics

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16
Q

management for acute pancreatitis with cholangitis

A

endoscopic retrograde cholangiopanreatography and/or cholecystectomy

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17
Q

35yr woman
abdo pain
whats the first investigation to do

A

urine dip to test for beta HCG, to check if she is preganant.
When womann presents with abdo pain at child bearing age , ectopic pregnancy must be ruled out first

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18
Q

painless blood in stool

A

haemorrohids

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19
Q

1st line meds for apthous ulcer

A

topical corticosteroid (hydrocortisone oro-mucosoal tablets)

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20
Q

test to diagnose h.pylori

A

carbon 13- urea breath test

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21
Q

what is sepsis 6

A 
give antibiotics
give iv fluids
give oxygen
take lactate
take urine output measurement
take blood clutures
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22
Q

abdo pain radiating to back

A

acute pancreatits

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23
Q

which peptic ulcer is worse after eating foods

A

gastric ulcer

24
Q

which peptic ulcer is better after eating food

A

duodenal ulcer

25
Q

anal fissure management (5 steps)

A

1) dietary advice
2) simple analgesia
3) advise shallow soaking in bath
4) topical anaesthetic
5) rectal GTN ointment

26
Q

management for paracetamol overdose

A

Acetylcystenine intravenously

27
Q

what must be done for coeliac testing?

A

reintroduce gluten at least once a day in diet for at least 6 weeks

28
Q

right upper quadrant pain radiating to back

A

acute cholecystitis

29
Q

4F’s of acute cholesystitis

A

female, forty, fat, fertile

30
Q

where is the pain felt for appendicitis

A

right illiac fossa (right lower quadrant)

31
Q

burning epigastric pain that occurs either after eating or with hunger

A

peptic ucler

32
Q

what is manometry

A

measurement of pressure within various parts of GI tract

33
Q

how do you differentiate between small and large bowel obstruction

A

small bowel obstructions: colicky pain with spasms lasting few mins. Visible valvulae (Kerkrig folds), central dilated bowel loops
large bowel obstructions: pain felt lower in abdomen and spasms last longer

34
Q

patient has acute pain, swelling of perianal area, unable to sit down, receptive anal sex

A

anorectal abscess (collection of pus)

35
Q

sudden onset of sever abdo pain, left illiac fossa, tachycardia, fever

A

perforated diverticulum

36
Q

recurrent non specific abdo pain, nausea, vomiting

A

intussusception

37
Q

moderate-mild severe colicky or constant pain.
early stages: minimal tenderness, no signs of peritonitis
later stages: pertionitis symptoms appear, reboung guarding and tenderness

AF in history

A

Bowel ischaemia

38
Q

sigmoid voluvulus

A 
coffee bean shape x-ray
sudden colicky lower abdo pain
sever abdo distension
unable to pass stool
vomiting in later stages
39
Q

what is Zenker’s diverticulum

A

diverticulum in the pharyngeal pouch, doesn’t present with abdo pain.

40
Q

what is rovsings sign

A

RLQ pain caused when pressure applied on LLQ

41
Q

Positive Rovsing’s sign

A

acute appendicitis

42
Q

laproscopic appendicetomy, which patient and when do they undergo treatment

A

young, male, fit: no ct, straight to theatre
young female: at least USS before theatre, to rule out gynae
>50yr: ct to look for cancer

43
Q

what is barrets oesophagus

A

when oesophagus becomes damaged by acid reflux causing lining to thicken and become red

44
Q

what is first line investigation if you suspect gallstones (billary colic, cholecystits)

A

US, but not if sepsis is suspected

CT of abdo if sepsis suspected

45
Q

direct inguinal hernia

A

passage of intestine through ecternal inguinal ring at Hesselbach triangle, rarelt enter scrotum

46
Q

indirect inguinal hernia

A
  • Most common
  • Involve the passage of intestine though internal inguinal ring, down inguinal canal and may pass into scrotum,
  • often congential
47
Q

femoral hernia

A

femoral canal most common in women

48
Q

ventral hernia

A

noted at site of previous surgery

49
Q

umbilical hernia

A

found at naval and are seen in babies

50
Q

investigation for biliary colic

A

abdo ultrasound

51
Q

acute mesenteric ischaemia: vbg and abg findings

A

VBG shows high lactate

ABG shows metabolic acidosis

52
Q

what is hiatus hernia

A

when part of your stomach moves up into your chest

53
Q

faelcal calprotectin test positive

A

IBD: Ulcerative colitis and Crohn’s Disease

54
Q

what test is used to test for coeliac disease

A

serum tissue transglutaminase antibodies (tTg-IgA)

55
Q

pyloric stenosis management

A

same day admission to hospital for surgery

56
Q

barrets oesphagus cell changes

A

squamous to columnar cells

PA YEAR 1 (10 decks)

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