Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSRA LS > gastro > Flashcards

gastro Flashcards

1
Q

Primary biliary cholangitis - the M rule

A

IgM
anti-Mitochondrial antibodies, M2 subtype
Middle aged females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Primary biliary cholangitis
presentation?
- tx

A

ALP/BILI high, associated with sjogens, thyroid disease

first-line: ursodeoxycholic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Urgent gastro referral

A

All patients who’ve got dysphagia

All patients who’ve got an upper abdominal mass consistent with stomach cancer

Patients aged >= 55 years who’ve got weight loss, AND any of the following:
upper abdominal pain
reflux
dyspepsia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Non-urgent referral

A

Patients with haematemesis

Patients aged >= 55 years who’ve got:
treatment-resistant dyspepsia or
upper abdominal pain with low haemoglobin levels or
raised platelet count with any of the following: nausea, vomiting, weight loss, reflux, dyspepsia, upper abdominal pain
nausea or vomiting with any of the following: weight loss, reflux, dyspepsia, upper abdominal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Acute cholecystitis

A

Pain similar to biliary colic but more severe and persistent. The pain may radiate to the back or right shoulder.

The patient may be pyrexial and Murphy’s sign positive (arrest of inspiration on palpation of the RUQ)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

in life-threatening C. difficile infection treatment is

first episode of c diff?

A

ORAL vancomycin and IV metronidazole

first-line therapy is oral vancomycin for 10 days
second-line therapy: oral fidaxomicin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

60 yo with unpleasant symptoms two months including frequent flushing
diarrhoea
tightness in his throat that sounds to the GP like bronchospasm
weight loss
hypotensive.

?, what is raised?

A

Carcinoid tumours release serotonin, so will cause a raised urinary 5-HIAA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

tx for carcinoid?

Diarrhoea?

A

somatostatin analogues e.g. octreotide
diarrhoea: cyproheptadine may help

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

alcoholic cirrhosis presents to the emergency department after 2 episodes of vomiting blood.
unstable
blood is given
going for endo
what else needs to be given before scope?

A

Both terlipressin and antibiotics should be given before endoscopy in patients with suspected variceal haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

key differences in crohns vs UC

features?
extra intestinal?
pathology?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

key differences in crohns vs UC
histology?
radiology?
endo?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hep serology
previous immunisation
previous hepatitis
previous hepatitis B, now a carrier

anti-HBc ?

A

previous immunisation: anti-HBs positive, all others negative

previous hepatitis B (> 6 months ago), not a carrier: anti-HBc positive, HBsAg negative

previous hepatitis B, now a carrier: anti-HBc positive, HBsAg positive

anti-HBc: caught, i.e. negative if immunized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Non-alcoholic fatty liver disease vs AFLD
AST/ALT?

A

Alcoholic liver disease is typically associated with an AST:ALT ratio >2 in contrast to non-alcoholic fatty liver disease which is associated with an ALT:AST ratio >2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what medication causes increase C. difficile infection risk?

A

PPIs are a risk factor for C. difficile infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What advice should you give a woman (who is NOT pregnant) if she asks what is the recommended amount of alcohol she can drink?

A

No more than 14 units of alcohol per week.

If you do drink as much as 14 units per week, it is best to spread this evenly over 3 days or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Achalasia

A

Dysphagia of both liquids and solids from the start
Heartburn
Regurgitation of food - may lead to cough, aspiration pneumonia etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Oesophageal candidiasis
whos at risk?

A

there may be a history of HIV or other risk factors such as steroid inhaler use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

coeliac serology?
dx?

A

tissue transglutaminase (TTG) antibodies (IgA) are first-choice according to NICE

Endoscopic intestinal biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

cholestasis.. what diabetic meds causing it?

A

Sulphonylureas: gliclazide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Peutz-Jeghers syndrome

A

hamartomatous polyps in the gastronintestinal tract (mainly small bowel)

pigmented lesions on lips, oral mucosa, face, palms and soles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

toxic megacolon features? dx?

A

uc complication
excessive stool bowel movemts
dx abdo x ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

severe flare of ulcerative colitis

mild-moderate flare?

A

severe: bowels more then x6, hr>90, CRP>30
IV corticosteroids
second line: IV ciclosporin

mild to moderate: just proctitis then rectal aminosalicylate, proctosigmoditis: rectal aminossylylates, extensive: rectal and oral aminosalicylates

23
Q

deranged LFTs combined with secondary amenorrhoea in a young female

A

autoimmune hepatitis

24
Q

Gastric cancer risk factors

A

Helicobacer pylori: triggers inflammation of the mucosa → atrophy and intestinal metaplasia

atrophic gastritis

diet: salt and salt-preserved foods, nitrates

smoking

blood group A

25
Q

Spontaneous bacterial peritonitis (SBP)

Antibiotic prophylaxis should be given to patients with ascites if?

A

Spontaneous bacterial peritonitis (SBP) is a form of peritonitis usually seen in patients with ascites secondary to liver cirrhosis.

Antibiotic prophylaxis should be given to patients with ascites if:
patients who have had an episode of SBP
patients with fluid protein <15 g/l and either Child-Pugh score of at least 9 or hepatorenal syndrome
NICE recommend: ‘Offer prophylactic oral ciprofloxacin or norfloxacin for people with cirrhosis and ascites with an ascitic protein of 15 g/litre or less until the ascites has resolved’

26
Q

Management of non-variceal bleeding i.e due to NSADS, patient on warfarin

A

IV prothrombin complex concentrate to reverse warfain

PPI only AFTER endoscopy if non-variceal bleed

27
Q

recurrent episode of C. difficile within 12 weeks of symptom resolution

A

oral fidaxomicin

28
Q

Proton pump inhibitors should be stopped …….. before an upper GI endoscopy

A

Proton pump inhibitors should be stopped 2 weeks before an upper GI endoscopy

29
Q

Melanosis coli: pigment-laden macrophages, associated with

A

laxative abuse

30
Q

what does it suggest when there is high ferritin level with either with vs without iron overload?

A

best test to see whether iron overload is present is transferrin saturation.

31
Q

medical treatment to maintain remission for UC

maintain remission in left-sided or extensive ulcerative colitis?

patients who have had a severe relapse or 2 or more exacerbations in the past year?

A

oral aminosalicylate

Oral azathioprine

32
Q

What cancer associated with GORD /Barrett’s?

A

Oesophageal adenocarcinoma is associated with GORD or Barrett’s

33
Q

Urea breath test : what to stop for accurate test and for how long?

A

no antibiotics in past 4 weeks, no antisecretory drugs (e.g. PPI) in past 2 weeks

34
Q

Iron defiency anaemia vs. anaemia of chronic disease:

A

TIBC is high in IDA, and low/normal in anaemia of chronic disease

35
Q

paracetamol OD, levels of ALT, ALP and ALT/ALP ratio?

A

Think T for trauma…. increased ALT

36
Q

Wilson’s disease
presentation?
Ix?
Mx?

A

neuropsychiatric symptoms, Kayser-Fleischer rings and family history of liver disease.

37
Q

most common cause of hepatocellular carcinoma in the United Kingdom vs worldwide?

A

hepatitis B most common cause worldwide
hepatitis C most common cause in Europe

38
Q

A sigmoidoscopy demonstrates localised proctitis, with no inflammation more proximally in the gastrointestinal tract. A new diagnosis of ulcerative colitis

tx?

A

In a mild-moderate flare of distal ulcerative colitis, the first-line treatment is topical (rectal) aminosalicylates i.e mesalazine

39
Q

Acute pancreatitis

A

Severe epigastric pain

Vomiting is common

Examination may reveal tenderness, ileus and low-grade fever

Periumbilical discolouration (Cullen’s sign) and flank discolouration (Grey-Turner’s sign) is described but rare

40
Q

Ix for vitamin B12 deficiency,

A

intrinsic factor antibodies

41
Q

many units of alcohol are in a 750ml bottle of red wine with an alcohol by volume of 12%?

A

Alcohol units = volume (ml) * ABV / 1,000

9units

42
Q

Cyclical Vomiting Syndrome

A

main symptoms are severe nausea and vomiting which can last from a few hours to a few days, occurring in discrete episodes.

43
Q

Achalasia- physiology
ix
tx

A

Failure of oesophageal peristalsis and of relaxation of the lower oesophageal sphincter (LOS) due to degenerative loss of ganglia from Auerbach’s plexus

44
Q

very common complication of scleroderma (systemic sclerosis).

A

Malabsorption syndrome is a very common complication of scleroderma (systemic sclerosis). The bloods show evidence of impaired absorption of some vitamins (B12, folate), nutrients (iron) and protein (low albumin).

45
Q

prophylaxis of oesophageal bleeding

A

non-cardioselective B-blocker (NSBB) : propranolol

46
Q

typical presenting features of coeliac disease in children.

A

chronic diarrhoea, abdominal bloating and failure to thrive.

47
Q

most common extra-intestinal feature in both Crohn’s and UC

A

Arthritis

48
Q

Bile-acid malabsorption may be treated with

A

cholestyramine

49
Q

Metoclopramide can cause extrapyramidal side effects….?

A

acute dystonia: eyes are trapped in strange position

50
Q

patients with non-alcoholic fatty liver disease, what test should be performed next to identify extent of damage?

A

enhanced liver fibrosis (ELF) testing is recommended to aid diagnosis of liver fibrosis

51
Q

investigation of choice for suspected perianal fistulae in patients with Crohn’s

A

mri pelvis

52
Q

Endoscopic intestinal biopsy is the gold standard for diagnosis of coeliac disease.. what area of intestine?

A

jejunal

june has coeliacs

53
Q

Isoniazid therapy can cause

what is the vitamin deficiency?

A

vitamin B6 deficiency causing peripheral neuropathy
‘burning sensation’ sole foot

Like Ice giving me pins and needles

54
Q

Fisherman, with AkI, feeling jaundice, reports feeling unwell, cold, cough flu like symptoms?

A

MSRA LS (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions