Exam Flashcards
Gastroenteritis- bacteria with short incubation?
Staph aureus
Bacillus cereus
Clostridium perfringens
Norovirus- how long after symptoms pass are patients still infective for?
48 hours
Risk factors for C diff? (5)
Age Prolonged hospital stay PPI use Recent surgery particularly bowel Immunosuppression
Motile, flagellated trophozoites in the stool?
Giardiasis
Transient episode of diarrhoea followed fever, sweats and rose spot rash?
Typhoid fever
C difficile treatment? (2)
Non severe- metronidazole
Severe- metronidazole + vancomycin
Investigation of coeliac disease? (3)
Unexplained IDA/B12/folate deficiency
Tissue TTG
Jejunal biopsy
Non-pharmacological treatment of IBS? (3)
Low FODMAP diet
Peppermint oil
Probiotic yoghurts
Investigations to rule other causes in IBS?
TTG
ESR and CRP
Faecal calprotectin
Chronic granulomatous inflammation of interlobular bile ducts
Primary biliary cirrhosis
Antibody association in PBC?
anti-mitochondrial Ab M2
Treatment of itch in PBC?
Cholestyramine, ursodeoxycholic acid
Inflammation, fibrosis and stricture of the extra and intra-hepatic bile ducts
Primary sclerosing cholangitis
Classical skin sign of PBC?
Xanthelasma of eyelid
Risk factors for peptic ulcer? (3)
H. pylori infection
NSAIDs
Smoking
ALARMS in dyspepsia?
Anaemia Loss of weight Anorexia Recent onset and progressive Malaena Swallowing difficulty
Management of dyspepsia?
a) ALARMS or older than 55
b) no alarms
a) upper GI endoscopy
b) stop exacerbating drugs, encourage lifestyle changes, OTC antacids
What is the indication for H pylori breath testing?
Failure of symptoms to respond to conservative management
Treatment of
a) H pylori -ve dyspepsia
b) H pylori +ve dyspepsia
a) PPI/H2 blocker for 4 weeks
b) Eradication therapy- PPI + amox + erythro
Multiple gastric ulcers, diarrhoea, refractory o treatment?
? possible gastrinoma
Peptic ulcer disease + gastrinoma….syndrome name?
Zollinger Ellison
Underlying cause of most gastric MALT?
H pylori infection
Main risk factor for the development of HCC?
Liver cirrhosis secondary to hepatitis, alcohol
Screening for HCC in at risk patients? (2)
Liver USS and alpha fetoprotein
Jaundice is an early feature in ….cancer and a late feature in….
Cholangiocarcinoma
HCC
Triad of symptoms in HCC?
Hepatomegaly + ascites + jaundice
Tumours which commonly metastazise to liver? (3)
Breast, bronchus, colorectal
Young/middle aged woman with acute hepatitis + amenorrhoea?
Autoimmune hepatitis
Antibodies implicated in autoimmune hepatitis? (4)
ANA, anti-smooth muscle, LKM1, soluble liver-kidney antigen
Management of autoimmune hepatitis? (3)
Steroids to induce and maintain remission
AZT as steroid-sparing agent
Liver transplantation
Toxic accumulation of copper in the liver and CNS>
Wilson’s disease
Pathognomonic sign in Wilson’s disease?
Kayser-Fleischer rings
Diagnostic tests for Wilson’s disease? (2)
High 24hr urinary copper excretion
Low serum copper and ceruloplasmin
Management of Wilson’s disease? (3)
Avoidance of foods with high copper content
Lifelong penicallamine
Liver transplantation
Commonest cause of an acute hepatitis, spread by the faecal-oral route?
Hepatitis A
Complications of hepatitis B and C? (2)
Chronic carrier state in 85% for HCV, 10% for HBV
Hepatocellular carcinoma
Hepatitis B serology:
a) Anti-HBS
b) implies high infectivity
c) defines chronic infection
a) recovery/vaccinated
b) HBeAg
c) persistence of HBsAg for 6 months
Treatment of HCV? (2)
Ribavarin + PEGinterferon alpha
Spread of HBV and HCV? (3)
Sexually, IVDU, blood transfusions
In chronic liver disease, symptoms resulting from:
a) reduced synthetic function
b) reduced detox
c) portal hypertension
a) ascites, bruising, peripheral oedema (3)
b) jaundice, encephalopathy, amenorrhoea (3)
c) ascites, haematemesis, PR bleeding/melaena (3)
Stigmata of chronic liver disease? (8)
Asterixis Bruising Dupuytren's contracture Palmar eyrthema Jaundice Spider naevi Caput medusae Splenomegaly
Accounts for 50% of liver failure in the UK?
Paracetamol overdose
Definition of liver failure?
Severe liver dysfunction leading to jaundice, encephalopathy and coagulopathy
Liver failure management of:
a) ascites
b) hepatic encephalopathy
c) cerebral oedema
d) hepatorenal syndrome
a) salt and fluid restriction, spironolactone, furosemide, parecentesis, IV albumin
b) lactulose
c) mannitol
d) IV albumin + terlipressin
Jaundice + diabetes + arthritis
Hereditary haemochromatosis
Tests for hereditary haemochromatosis? (2)
Increased serum ferritin
HFE genotyping
Management of hereditary haemochromatosis?
Venesection
