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GASTRO - RIA > d > Flashcards

d Flashcards

1
Q

INR in coagulopathy

A

> 1.5

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2
Q

how is the severity of Hepatic encephalopathy graded?

A

West haven criteria

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3
Q

criteria used to select patients to undergo liver transplantation

A

King’s college criteria

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4
Q

Risk assessment for patient presenting with paracetamol overdose

A
  • Date of ingestion
  • Timing of ingestion
  • Time since last ingestion (was it staggered)
  • Weight of patient
  • Pregnancy?
  • Total amount ingested
  • Current suicide risk
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5
Q

> 150 mg/kg in a 24 hour period, of paracetamol

A

serious toxicity

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6
Q

when does paracetamol reach peak concentration following ingestion?

A

@ 4 hours

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7
Q

possible treatment for paracetamol overdose as per graph

A

N-acetylcysteine (NAC)

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8
Q

what can be considered for acute ingestion of paracetamol < 8 hours

A

activated charcoal

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9
Q

when to take paracetamol levels

A

4 hours post ingestion

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10
Q

name of the chronic autoimmune condition whereby the interlobular bile ducts are damaged by inflammation causing cholestasis which may lead to fibrosis, cirrhosis and portal htn

A

primary biliary cirrhosis

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11
Q

antibodies present in primary biliary cirrhosis

A

AMA (antimitochondrial ab)

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12
Q

medication to lower cholesterol level in PBC

A

Ursodeoxycholic acid

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13
Q

pathophysiology of primary biliary cirrhosis

A

autoimmune inflammation of the intralobar ducts (canals of hering) causing obstruction of outflow of bile –> back pressure of bile obstruction leads to fibrosis, cirrhosis and liver failure

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14
Q

3 things that build up in the blood in primary biliary cirrhosis and associated symptoms

A
  • Bile acids: itching
  • Bilirubin: jaundice
  • Cholesterol: deposits such as xanthalasma
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15
Q

lack of bile in bowel causes?

A 
GI disturbance (malabsorption of fats and greasy stools) 
and pale stools due to lack of biliburuni
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16
Q

blood tests raised in Primary biliary cirrhosis (4)

A
  • ALP
  • AMA
  • IgM
  • ESR
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17
Q

Ursodeoxycholic acid mechanism

A

reduces intestinal absorption of cholesterol

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18
Q

Colestyramine role?

A

in PBC

is a bile acid sequestrate - binds to bile acids to prevent absorption in the gut & can help with pruritus due to raised bile acids

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19
Q

biliary condition with established association with Ulcerative colitis

A

Primary sclerosing cholangitis

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20
Q

4 risk factors for primary sclerosiing cholangitis

A
  • male
  • age 30-40
  • ulcerative colitis
  • family history
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21
Q

pathophysiology of primary sclerosing cholangitis

A

stricturing and fibrosing of intrahepatic & extrahepatic bile ducts (stiffening & hardening)

22
Q

antibodies in primary sclerosing cholangitis

A

p-ANCA
ANA
anticardiolipin

23
Q

gold standard diagnosis of primary sclerosing cholangitis

A

MRCP - showing bile duct lesions/strictures

24
Q

management of primary sclerosing cholangitis

A
  • ERCP: dilate & stent strictures
  • Ursodeoxycholic acid
  • Colestyramine
  • monitor for complication
25
Q

complications to be monitored for in prmary scleroising cholangitis

A
  • cholangiocarcinoma
  • cirrhosis
  • oesophageal varcies
26
Q

what is a positive murphys sign

A

hand placed at costal margin at RUQ & patient breathes in illiciting pain in the patient as gal bladder moves upwards

27
Q

name for when a gall stone in present in the common bile duct

A

choledocholithiasis

28
Q

charcots triad

A
  • fever
  • RUQ pain
  • jaundice
29
Q

what condition is charcots triad present in

A

Ascending cholangitis

30
Q

Reynolds pentad

A
  • hypotension
  • tachycardia
  • jaundice
  • RUQ pain
  • Jaundice
31
Q

features seen on abdominal ultrasound in Cholecystitis

A
  • thickening of gall bladder wall
  • pericholecystic fluid
  • ultrasonographic murphys sign
32
Q

how is acute pancreatitis diagnosed?

A

> 3 times normal amylase

CT scan

33
Q

3 most common causes of acute pancreatitis

A
  • gall stones
  • alcohhol
  • post ERCP
34
Q

score to assess severity of acute pancreatitis

A

glasgow score

35
Q

PANCREAS pneumonic for Glasgow score

A
  • P: PaO2 < 60
  • A: Age > 55 years
  • N: Neutrophils (WCC > 15)
  • C: Calcium <2
  • R: Urea > 16
  • Enzymes (LDH > 600 ro AST/ALT > 200)
  • A- Albumin < 32
  • S - Sugar: Glucose >10
36
Q

4 complications of acute pancreatitis

A
  • pancreatic necrosis
  • infection of necrotic areas
  • pseudocysts
  • chronic pancreatitis
37
Q

severe adverse effect of aminosalicylates e.g. mesalazine

A

agranulocytosis, presenting with sore throat

- check FBC

38
Q

biopsy finding that is diagnostic for Primary biliary cholangitis?

A

M2 anti-mitochondrial anitbodies

39
Q

3 M of primary biliary cholangitis

A
  • Middle aged females
  • IgM
  • anti-mitochondrial Ab M2 subtype
40
Q

AST/ALT ratio in alcoholic hepatitis

A

2:1

41
Q

(2) for secondary prophylaxis of hepatic encephalopathy

A

lactulose & rifaximin

42
Q

what is the double duct sign and when is it seen?

A

pancreatic cancer

the presence of simultaneous dilatation of the common bile ducts and pancreatic ducts

43
Q

side effects of mesalazine

A
  • GI upset
  • headache
  • agranulocytosis
  • pancreatitis
  • intersitial nephritis
44
Q

the only test that is recommended for H. Pylori post eradication therapy

A

Urea breath test

45
Q

plummer vinson syndorme triad

A
  • dysphagia
  • glossitis
  • iron deficiency anaemia
46
Q

grade 4 hepatic encephalopathy

A

coma

47
Q

deficiency in pellagra?

A

Vitamin B3 (niacin)

48
Q

type of rash seen in Pellagra?

A

sunburn-like dermatitis rash

49
Q

what is melanosis coli?

A

abnormal pigmentation of the large bowel due to presence of pigment laden macrophages

50
Q

causes of malenosis coli

A

laxative abuse

GASTRO - RIA (10 decks)

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