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finals gastro Flashcards

1
Q

what sign is seen on imaging in pancreatic cancer?

A

double duct sign (CT, MRI, ERCP)
> dilatation of pancreatic and common bile duct

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2
Q

which tumour marker is associated with pancreatic cancer?

A

Ca 19-9 (think pancreas shaped like a 9)

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3
Q

what treatment is offered for dysplasia on biopsy in barrett’s oesophagus?

A

endoscopic mucosal therapy (radiofrequency ablation/endoscopic resection)

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4
Q

what is the management for wilson’s disease?

A

penicillamine (?tridentine now)
> chelates copper

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5
Q

anti-HBs -
anti-HBc +
HBs antigen +
IgM anti-HBc -

A

chronic hep B (prev acute infection still a carrier)

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6
Q

anti-HBs +
anti-HBc -
HBs antigen -
IgM anti-HBc -

A

prev immunisation

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7
Q

anti-HBs -
anti-HBc +
HBs antigen -
IgM anti-HBc -

A

prev hep B not a carrier

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8
Q

common side effect of metaclopramide?

A

diarrhoea (prokinetic)

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9
Q

what is the management for recurrence of c.diff within 12 weeks of symptom resolution?

A

oral fidaxomicin

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10
Q

what marker is positive in PSC?

A

pANCA

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11
Q

what bowel disease is PSC associated with?

A

ulcerative colitis

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12
Q

what is the management for life-threatening C-diff?

A
  • ORAL vancomycin
  • IV metronidazole
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13
Q

how is alcoholic ketoacidosis managed?

A

IV thiamine and saline

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14
Q

what is the mechanism of action of loperamide?

A

Reduction in gastric motility through stimulation of opioid receptors

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15
Q

what is the diagnostic investigation for PSC?

A

MRCP (sensitive and non-invasive)

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16
Q

what is grade I HE?

A

irritability

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17
Q

what is grade II HE?

A

confusion, inappropriate behaviour

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18
Q

what is grade III HE?

A

incoherent, restless

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19
Q

what is grade IV HE?

A

coma

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20
Q

what type of cancer is barrett’s oesophagus associated with?

A

oesophageal carcinoma

21
Q

what type of cancer is achalasia associated with?

A

squamous cell carcinoma of the oesophagus

22
Q

what score assesses risk of rebleeding after upper GI bleed (post endoscopy)?

A

rockall score

23
Q

what does the child-pugh score assess?

A

severity of liver cirrhosis

24
Q

what medication is given post-resuscitation for variceal haemorrhage?

A

terlipressin

25
Q

what is the triad of features in intestinal angina?

A
  1. severe colicky post-prandial abdo pain
  2. weight loss
  3. abdominal bruit
26
Q

what bloods are used to monitor treatment in haemochromatosis?

A

ferritin
transferrin

27
Q

how does PBC present?

A

may be asymptomatic, or fatigue, pruritus
cholestatic jaundice, hyperpigmentation
> raised ALP on routine LFTs

28
Q

how is PBC diagnosed?

A

AMA (highly specific)
raised serum IgM

29
Q

how do you treat PBC?

A

ursodeoxycholic acid

30
Q

which drugs should be stopped before 13C-urea breath test?

A

no abx last 4 weeks
no PPIs last 2 weeks

31
Q

what drugs are used first line in patients with ascites secondary to liver cirrhosis?

A

aldosterone antagonist - spironolactone

32
Q

what is carcinoid syndrome?

A

when metastases are present in the liver and release serotonin into the systemic circulation

33
Q

what are the features of carcinoid syndrome?

A
  • flushing
  • diarrhoea
  • bronchospasm
  • hypotension
  • RH valvular stenosis
34
Q

how is carcinoid syndrome investigated?

A

urinary 5-HIAA
plasma chromogranin A y

35
Q

how is carcinoid syndrome managed?

A

somatostatin analogues eg octreotide
for diarrhoea cyproheptadine may help

36
Q

what does metabolic alkalosis + hypokalaemia suggest?

A

? prolonged vomiting

37
Q

why do people with coeliac disease receive the pneumococcal vaccine?

A

hyposplenism

38
Q

what lifestyle factors are used in mgt of ascites?

A
  • reducing dietary sodium
  • fluid restriction is sodium is >125mmol/L
39
Q

what is a disadvantage of using a PPI long-term?

A

inc risk fractures + osteoporosis

40
Q

what type of cancer does pernicious anaemia predispose to?

A

gastric carcinoma

41
Q

what does dysphagia to both solids and liquids from the outset of symptoms suggest?

A

achalasia

42
Q

what is the AST/ALT ratio in alcoholic hepatitis?

A

AST:ALT 2:1
toAST

43
Q

which bowel condition is associated with gallstones?

A

crohn’s

44
Q

how does pharyngeal pouch present?

A
  • dysphagia
  • regurgitation
  • aspiration
  • neck swelling which gurgles on palpation
  • halitosis
45
Q

What is the management for C. difficile?

A

Oral vancomycin

46
Q

What are the key features of Peutz-Jeghers syndrome?

A
  • autosomal dominant
  • hamartomatous polyps in GI tract
    > small bowel obstruction, GI bleeding
  • pigmented lesions on lips, oral mucosa, face, palms and soles
47
Q

What is the most commonly affected part of the bowel in UC?

A

Rectum

48
Q

Which malignancy is associated with coeliac disease?

A

EATL (enteropathy-associated T cell lymphoma)

49
Q

What test is used for H.pylori post-eradication therapy?

A

Urea breath test

revision (11 decks)

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