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FINALS - GI > gastric: coeliac, malapsorption, bariatric surgery > Flashcards

gastric: coeliac, malapsorption, bariatric surgery Flashcards

1
Q

what autoimmune disorders is coeliac associated with

A

T1dm, hepatitis, thyroid

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2
Q

what genes is coliac assoc with

A

HLA DQ2/8

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3
Q

what skin condition is coaliac assoc with

A

dermatitis herpetiformis (purple, itchy(

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4
Q

symptoms coeliac

A

diarrhoea/ persistant GI symptoms / abdo pain and cramp

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5
Q

what anaemia is most common in coeliac

A

folate > B12

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6
Q

what complications are seen in coeliac (6)

A

anaemia // hypospleen // osteoporosis // lactose // T cell lymphoma // subfertile

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7
Q

what cancer can be assoc with coeliac

A

T cell lymphoma

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8
Q

when should a gluten diet be recommenced when testing coeliac

A

for 6 weeks prior

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9
Q

what serology tests can be done for coeliac and what is first line

A

TTG antibodies are first line WITH IgA // antigialidin can also be done

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10
Q

what is gold standard for coeliac

A

biopsy

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11
Q

what is seen of biopsy on coeliac

A

villous atrophy / crypt hyperplasia

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12
Q

what vaccine should coeliac patients get and why

A

pneumococcal with booster every 5 years // hyposplenism

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13
Q

what are secondary causes of bile acid malabsorptions (3)

A

cholecystectomy // coeliac // small intestine bacteria overhrowth

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14
Q

what is the main symptom of ile acid malabsorptions and wat deficiencies does it cause

A

steathorrhea // ADEK vitamins

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15
Q

invx for bile acid malabsorptions

A

SeHCAT

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16
Q

mx bile acid malabsorptions

A

bile acid sequestrate eg cholestryamine

17
Q

what is pernicious anaemia

A

autoimmune damage of gastric mucosa –> vit B12 deficiency

18
Q

what antibodies are produced in pernicious anaemia

A

antibodies to IF which blocks vit B12 binding sites

19
Q

who is pernicious anaemia most common in

A

middle aged/ elderly females/ group A

20
Q

what are symptoms of pernicious anaemia

A

anaemia features // neurological: pins and needles, weakness, ataxia, memory // glossitis

21
Q

what bloods are seen with pernicious anaemia

A

macrocytic anaemia // low WCC and platelets // hypersegmented on blood film

22
Q

what antibodies can be screened for in pernicious anaemia

A

intrinsic factor antibodies

23
Q

mx pernicious anaemia

A

B12 injection 3x for 2 weeks –> every 3 months // +/- folic acid

24
Q

what cancer does pernicious anaemia increase risk of

A

gastric

25
Q

what BMI tends to be referred for bariatric surgery

A

40-50

26
Q

at what stage of obesity is bariatric surgery reccommended

A

early - to prevent disease progression

27
Q

what are 3 restrictive bariatric surgeries

A

lap gastric band (LAGB) // sleeve gastrectomy // intragastric balloon

28
Q

what is a primary malabsorpative bariatric surgery

A

bilopancreativ diversion with duodenal switch

29
Q

what is a mixed bariatric surgery

A

rout en Y bypass

30
Q

what bariatric surgery is first line for 30-39 BMI

A

LABG

31
Q

what bariatric surgery is first line for BMI >60

A

bilopancreatic diversion

32
Q

what bariatric surgery gives best functional outcomes

A

rout en Y

33
Q

when would a duodenal or jejunal tube be favoured over gastric feeding

A

if there is upper GI dysfunction

34
Q

what defines a malnourished patient (3)

A

BMI <18,5 // weight loss of >10% // BMI <20 and weight loss >5%

35
Q

what are common complications of enteral feeding (4)

A

diarrhoea, aspiration, hyperglycaemia, refeeding

36
Q

when can a PEG be used / removed

A

use 4 hours after // must be in for 2 weeks

37
Q

when is parenternal feeding used

A

nutritionally compromised surgical patients

38
Q

how is parental food given

A

IV - usually through a central vein eg (PICC)

FINALS - GI (18 decks)

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