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Yr 5 - GI > Corrections > Flashcards

Corrections Flashcards

1
Q

Can a brisk upper GI bleed present with fresh blood PR rather than malaena?

A

Yes

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2
Q

If constipation doesn’t respond to a bulk-forming laxative such as isphagula husk, what should you try next?

A

Osmotic laxative e.g. macrogol

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3
Q

What triad of features is seen in liver failure?

A

1) encephalopathy
2) jaundice
3) coagulopathy

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4
Q

Triad of symptoms in Budd-Chiari syndrome?

A

1) sudden onset abdo pain
2) ascites
3) tender hepatomegaly

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5
Q

What is Budd-Chiari syndrome?

A

Hepatic vein thrombosis - usually seen in the context of underlying haematological disease or another procoagulant condition.

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6
Q

Transferrin saturation in haemochromatosis?

A

Raised

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7
Q

What is required during large-volume paracentesis for the treatment of ascites?

A

IV human albumin solution to avoid avoid paracentesis-induced circulatory dysfunction (PICD).

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8
Q

Mx of bile acid malabsorption causing diarrhoea?

A

Cholestyramine (bile acid sequestrant)

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9
Q

What liver disease is sudden weight loss associatged with?

A

NAFLD

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10
Q

What is the investigation of choice for suspected carcinoid tumours?

A

Urinary 5-HIAA

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11
Q

1st line mx for NAFLD?

A

Weight loss

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12
Q

What cancer does achalasia increase the risk of ?

A

Squamous cell carcinoma of the oesophagus

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13
Q

What is Plummer-Vinson syndrome?

A

Triad of:

1) iron def anaemia

2) dysphagia

3) atrophic glossitis

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14
Q

What type of duodenal ulcers are most likely to cause major upper GI haemorrhage?

A

Posteriorly sited ulcers –> gastroduodenal artery

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15
Q

What is used to monitor treatment in haemochromatosis?

A

Ferritin + transferrin saturation

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16
Q

1st line mx for achalasia?

A

Pneumatic (balloon) dilatation

17
Q

Mx of achalasia if recurrent or persistent symptoms?

A

surgical intervention with a Heller cardiomyotomy should be considered

18
Q

What is primary sclerosing cholangitis?

A

A biliary disease characterised by inflammation and fibrosis of intra and extra-hepatic bile ducts.

19
Q

Most common association of PSC?

A

UC

20
Q

Features of PSC?

A

1) cholestasis
- jaundice, pruritus
- raised bilirubin + ALP

2) RUQ pain

3) fatigue

21
Q

Investigations of choice in PSC?

A

ERCP/MRCP

22
Q

What are the 3 characteristic electrolyte disturbances seen in patients with refeeding syndrome?

A

1) Hypophosphataemia

2) Hypokalaemia

3) Hypomagnesaemia

23
Q

What does an ‘apple core’ sign on barium swallow indicate?

A

Oesophageal carcinoma

24
Q

What is primary biliary cholangitis (PBC)?

A

A chronic liver disorder, thought to be an autoimmune condition.

Interlobular bile ducts become damaged by a chronic inflammatory process causing progressive cholestasis which may eventually progress to cirrhosis.

25
Q

Classic presentation of PBC?

A

Itching in a middle-aged woman

26
Q

Give 4 associations with PBC

A

1) Sjogren’s (seen in up to 80%)

2) RA

3) Systemic sclerosis

4) Thyroid disease

27
Q

What antibdies are present in PBC?

A

AMA M2 subtype

28
Q

Mx of PBC?

A

first-line: ursodeoxycholic acid

29
Q

Mx of pruritus in PBC?

A

cholestyramine

30
Q

Complications of PBC?

A

1) Cirrhosis –> portal HTN –> ascites, variceal haemorrhage

2) Osteomalacia & osteoporosis

3) significantly increased risk of HCC

31
Q

What cancer are those with PBC at an increased risk of?

A

HCC

32
Q

What is Sister Mary Joseph node?

A

A palpable nodule in the umbilicus due to metastasis of malignant cancer within the pelvis or abdomen

33
Q

What are the investigations of choice in primary sclerosing cholangitis? (PSC)

A

ERCP/MRCP

34
Q

What do patients who have had an episode of SBP require?

A

Antibiotic prophylaxis (e.g. ciprofloxacin)

35
Q

Mx of pharyngeal pouch?

A

Surgical repair

36
Q
A

Yr 5 - GI (5 decks)

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