Conditions Flashcards
diet in coeliac disease
gluten free
s/o to Matt xo
which scoring system is used for malnutrition
MUST score
complication of feeding someone that was previously malnutritioned
what is it
what can it result in
refeeding syndrome
when electrolyte levels shift fatally
arrhythmias, hypokalaemia, hypomagnesaemia
is oesophagitis reversible
what does oesophagitis progress to if untreated, is this reversible
yes
barretts oesophagus - no its irreversible
what can barretts oesophagus predispose
oesophageal adenocarcinoma
treatment of GORD (2)
PPI eg omeprazole to decrease gastric acid secretion
antacids OTC for symptomatic relief
what does GORD predispose
oesophagitis (then barretts oesophagus then oesophageal adenocarcinoma)
what is the cell change form oesophagitis to barretts oesophagus
stratified squamous epithelium to columnar epithelium with goblet cells
prognosis of oesophageal cancer (good or bad)
v bad
10% 5 year survival
where does barretts oesophagus occur
lower 1/3 of oesophagus
which type of oesophageal cancer arises in the upper oesophagus
which virus is it associated with
squamous cell carcinoma
HPV
curative treatment of oesophageal adenocarcinoma
surgery
palliative treatment of oesophageal adenocarcinoma(what most people get) (3)
stent to open tube
chemo
radio
bacterial cause of peptic ulcers
h pylori
drug cause of peptic ulcers
NSAIDs
treatment of peptic ulcer
PPI (eg omeprazole) to decrease acid secretion
is coeliac disease an allergy or autoimmune condition
autoimmune condition against IgA antibody
what do the villi (finger like projections) look like in coeliac disease
flattened = reduces absorption
which antibody is present in coeliac disease
anti-TTG
where is the meckels diverticulum (if you have one)
2 inches long, 2 feet above the iliocaecal valve, in 2% of people (rule of 2s)
where does UC start/go to
rectum (to ileocaecal valve)
is UC a thinning or thickening of mucosa
thinning (ulceration)
IBD
crypt abscesses
continuous inflammation (not patchy)
bloody diarrhoea
neutrophils
ulcerative colitis
IBD
patchy inflammation knife like fissures cobblestoning of mucosa granulomas weight loss, anaemia, mouth ulcers
crohns
where does crohns occur
is the inflammation patchy or continuous
anywhere between mouth and anus
patchy inflammation
is crohns a thinning or thickening of mucosa
thickening (UC is ulceration = thinning)
first line treatment of UC
mesalazine
first line treatment of crohns (2)
steroids
stop smoking
what is IBS
GI upset with no pathological problem
treatment of IBS (4)
exercise
reduce stress (it aggravates it)
diet
psych help
risk of untreated appendicitis
peritonitis
bowel cancer screening
qFIT (used to be FOB)
colonoscopy if positive
3 sites of varices caused by portal hypertension in areas of venous/portal anastomosis
oesophagus, umbilicus, rectum
PR bleeding - fresh blood
chronic constipation
haemorrhoids (piles)
diarrhoea treatment (class and example)
antimotility drugs eg loperamide
constipation treatment (2)
lifestyle - exercise, fluids, fibre, fruit
laxatives
what stage of liver pathology from alcohol is irreversible
fibrosis (months-years of drinking)
in alcoholic hepatitis which is raised more ALT or AST
AST (bc they wASTed)
IgM positive biliary duct condition
primary sclerosing cholangitis (autoimmune destruction)
IgM and AMA (antimitochondrial antibody) positive biliary duct condition
primary biliary cholangitis/cirrhosis (autoimmune granulomatous inflammation)
antim i tochondrial antibody = pr i mary, b i liary c i rrhosis
painless jaundice
viral hepatitis
which autoimmune condition is associated with ulcerative colitis
primary sclerosing cholangitis
which viral hep is associated with gaymen
hep A
viral hep associated with deers, pigs and rabbits
hep E
which viral hep causes a super infection if occurring alongside hep B
hep D
most common viral hep in UK
can be transmitted from mother to baby, tattoos or blood transfusions
hep C
where does bilirubin come from
break down product of RBC (can be conjugated or unconjugated depending on it its been through the liver or not)
sudden onset epigastric pain that radiates through to back
cullens sign/grey turners sign
high serum amylase
pancreatitis
what causes inflammation of the pancreas
bile reflux eg gallstones, alcohol (I GET SMASHED)
weight loss and jaundice
pancreatic cancer (causing obstructive jaundice)
treatment of ascites (2)
spironolactone
paracentesis
aetiology of c diff infection
inappropriate antibiotic use (4C antibiotics - coamoxiclav, clindamycin, ciprofloxacin, cephalosporins)
treatment of c diff infection (2)
metronidazole PO if moderate
vancomycin PO if severe
(when its DIFFICULT TO SEE you should take the METRO bc if you use the VAN it might be SEVERE, lol u crash)
PO bc it goes straight to the gut = where the infection is
gastroenteritis; reheated rice, profuse vomiting, 6 hours
bacillus cereus
gastroenteritis; under cooked chicken, 48 hours, green diarrhoea
salmonella
gastroenteritis; raw poultry/milk, 5 days, severe abdo pain
campylobacter
gastroenteritis; animal contact, 2 days, bloody diarrhoea, stool culture
enterohaemorrhagic E.coli (ecoli 0157)
gastroenteritis; watery/profuse diarrhoea, kids under 3, outbreaks, PCR on stool (bc its viral)
rotavirus
gastroenteritis; explosive vomiting and diarrhoea, 2 days, highly infectious, do a PCR on stool
norovirus
investigation for ?bacterial gastroenteritis
stool culture
investigation for ?viral gastroenteritis
stool PCR
investigation for ?parasitic gastroenteritis
stool microscopy (can actually see them)
treatment of peritonitis (3)
amoxicillin IV, metronidazole IV and gentamicin IV
what is satiey
the period between meals
what is grehlin
hunger signal
drug treatment of obesity
orlistat
in a direct hernia, will it reappear once you have coughed after being occluded
which ring does it travel through/come out of
yes
directly out of the superficial ring
in an indirect hernia, will it reappear once you have cough after being occluded
which rings does it travel through/come out of
no
through the deep then superficial ring
how do you occlude a hernia to test whether its direct or indirect
occlude through the superficial ring then put pressure on the deep ring (direct comes through deep ring so it will not reappear on coughing)
gastroenteritis; traveller, watery profuse diarrhoea
cholera
