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MRCP 1 > Gastro > Flashcards

Gastro Flashcards

1
Q

Stains for antral biopsies for h.pylori

A

Giesma
Haematoxylin
Eosin

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2
Q

Test for h pylori eradication

A

Urea breath test

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3
Q

Zollinger-Ellison - what is secreted?

A

Gastrin

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4
Q

Which MEN in ZE?

A

MEN1

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5
Q

Marker in GIST?

A

CD117 (C-KIT)

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6
Q

Staging for ZE?

A

Somatostatin receptor-scintigraphy

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7
Q

Insulinoma - which cells?

A

Islets of Langerhans

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8
Q

Glucagonoma - which cells?

A

Alpha cells

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9
Q

Triad of glucagonoma?

A

Diabetes
MNE
Weight loss

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10
Q

MNE?

A

Migratory Necrolytic Erythema

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11
Q

Massive diarrhoea and electrolyte deficiency?

A

VIPoma

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12
Q

HLA in coeliac?

A

HLA-BQ2, BQ8

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13
Q

Specific GI cancer risk increased in coeliac?

A

Small bowel lymphoma

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14
Q

Carcinoid - which cells?

A

Enterochromaffin cells

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15
Q

Carcinoid - what is secreted?

A

Serotonin

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16
Q

What does serotonin cause in carcinoid?

A

Bronchospasm and increased GI motility

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17
Q

SIgns of carcinoid?

A

Diarrhoea
Bronchospasm
Local effects of tumour
FLUSHING
RH disease

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18
Q

Treatment for diarrhoea in carcinoid?

A

Somatostatin analogue

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19
Q

Treatment of flushing in carcinoid?

A

Phenoxybenzamine

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20
Q

Phenoxybenzamine used for?

A

Flushing in carcinoid

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21
Q

GI bleeding, iron def., aortic stenosis?

A

Angiodysplasia

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22
Q

Test for bile salt malabsorption

A

SeHCAT

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23
Q

Risk factors for small bowel overgrowth?

A

Post-SB resection
Systemic sclerosis
Jejunal diverticulae

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24
Q

Where does Crohns affect

A

Particularly terminal ileum and colon but any part of the GI tract

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25
Q

Layers affected in CD?

A

Transmural (all layers)

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26
Q

Pathology findings in CD

A

Transmural inflammation
Mucosal/fissuring ulcers
Lymphoid aggregates
Neutrophil infiltrates

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27
Q

Clinical features of CD

A

Abdominal pain
Fever
Rectal bleeding
Anal/perianal/oral lesions
Obstructive symptoms

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28
Q

Associations of CD

A

Smoking
Skin - pyoderma, nodosum
Arthritis
Eye disease
Cholelithiasis

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29
Q

BMI cutoffs for weight loss surgery?

A

35 with complications
40 without

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30
Q

Most common cause of HCC in Europe, and worldwide?

A

Europe - Hep C
World - Hep B

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31
Q

Protein cutoff for Abx prophylaxis in ascites and what antibiotic?

A

Patients with ascites (and protein concentration <= 15 g/L) should be given oral ciprofloxacin or norfloxacin as prophylaxis against spontaneous bacterial peritonitis

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32
Q

Coeliac disease HLA?

A

HLA-DQ2

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33
Q

Chronic pancreatitis preferred imaging modality?

A

CT abdo

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34
Q

Strongest risk factor in CD?

A

Genetic

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35
Q

Which enzyme breaks starch into sugars?

A

Amylase

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36
Q

Arrhythmia from low magnesium in refeeding?

A

Torsades des Pointes

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37
Q

Pancreatitis causes

A

Popular mnemonic is GET SMASHED
Gallstones
Ethanol
Trauma
Steroids
Mumps (other viruses include Coxsackie B)
Autoimmune (e.g. polyarteritis nodosa), Ascaris infection
Scorpion venom
Hypertriglyceridaemia, Hyperchylomicronaemia, Hypercalcaemia, Hypothermia
ERCP
Drugs (azathioprine, mesalazine*, didanosine, bendroflumethiazide, furosemide, pentamidine, steroids, sodium valproate)

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38
Q

Hepatocelluar LFT injury

A

The following drugs tend to cause a hepatocellular picture:
paracetamol
sodium valproate, phenytoin
MAOIs
halothane
anti-tuberculosis: isoniazid, rifampicin, pyrazinamide
statins
alcohol
amiodarone
methyldopa
nitrofurantoin

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39
Q

Cholestatic LFT picture (drugs)

A

The following drugs tend to cause cholestasis (+/- hepatitis):
combined oral contraceptive pill
antibiotics: flucloxacillin, co-amoxiclav, erythromycin*
anabolic steroids, testosterones
phenothiazines: chlorpromazine, prochlorperazine
sulphonylureas
fibrates
rare reported causes: nifedipine

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40
Q

T2DM and abnormal LFTs?

A

NAFLD

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41
Q

First line treatment for NAFLD?

A

Weight loss

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42
Q

FAP gene?

A

APC

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43
Q

Small bowel overgrowth test?

A

Hydrogen breath test

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44
Q

Monoclonal antibody for c.diff?

A

bezlotoxumab

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45
Q

Life threatening c.diff?

A

Oral vanc + IV metro

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46
Q

Second line c.diff?

A

Oral fidaxomicin

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47
Q

AI hepatitis Ig?

A

IgG

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48
Q

Heart failure and significant skeletal muscle weakness in refeeding?

A

Hypophosphataemia

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49
Q

Hep B - anti-HBs positive, all other negative

A

Immunised

50
Q

Scoring system for LIKELIHOOD of acute pancreatitis?

A

Alvarado

51
Q

Scoring system for SEVERITY of acute pancreatitis?

A

Glasgow

52
Q

Most common extra-colonic manifestation of HNPCC in female patients?

A

Endometrial cancer

53
Q

First symptom of carcinoid?

A

Flushing

54
Q

Finding indicative of active (or chronic) hepatitis?

A

HsAg

55
Q

Treatment of small bowel overgrowth?

A

Rifaximin (co-amox and metro also used)

56
Q

Fulminant hepatitis pathological cellular mechanism?

A

Necrosis

57
Q

Gene implicated in CD?

A

NOD-2

58
Q

Biopsy findings in CD?

A

Cobblestone mucosa
String sign stricturing
Skip lesions
Rose-thorn ulcers

59
Q

1st line in CD?

A

Steroids, orally
Topically acting budesonide in terminal ileal disease

60
Q

Second line in CD? What should you check first?

A

Azathiaprine/mercaptopurine/MTX as alternative
TPMT activity

61
Q

Risks of azathiprine/mercaptopurine

A

Marrow suppression, hepatotoxicity

62
Q

Anti-TNF alpha in CD? Which is indicated for fistulating disease?

A

Infliximab - for fistulating also/adalibumab

63
Q

Treatment for perianal fistulae in CD?

A

Oral metronidazole

64
Q

FAP mode of inheritance?

A

AD

65
Q

Peutz-Jeghers clinical associations?

A

Mucocutaneous pigmentation, perioral freckles

66
Q

Classification system for colorectal Ca?

A

Duke’s

67
Q

Diagnostic criteria for IBS?

A

Rome III

68
Q

Skin finding in salmonella?

A

Rose Spots (chest)

69
Q

Unconjugated bilirubin inherited causes of jaundice?

A

Gilberts
Crigler-Najjar

70
Q

Conjugated bilirubin inherited causes of jaundice?

A

Rotor syndrome
Dubin-Johnson

71
Q

Gene in Dubin-Johnson

A

cMOAT

72
Q

Nasty drug in paracetamol OD?

A

Carbamazepine

73
Q

Terlipressin mechanism of action?

A

Constriction of the splanchnic vessels

74
Q

Prophylaxis of variceal bleeds?

A

Propranolol

75
Q

First line bariatric surgery?

A

Gastric sleeve

76
Q

H. pylori eradication?

A

PPI + amoxicillin + clarithromycin, or
PPI + metronidazole + clarithromycin

77
Q

Ongoing diarrhoea in Crohn’s patient post-resection with normal CRP - treatment?

A

Cholestyramine

78
Q

Test for Gilbert’s?

A

Nicotinic acid test

79
Q

Treatment of eosinophillic oesophagitis?

A

Dietary modification and TOPICAL steroids

80
Q

Severe hepatitis in pregnant woman?

A

Hep E

81
Q

Unwell sewage worker, renal impairment?

A

Leptospirosis

82
Q

Class of virus - hep C?

A

RNA flavavirus

83
Q

Vertical transmission rate from mother to child in Hep C?

A

6%

84
Q

Can mothers with Hep C breatfeed?

A

Yes

85
Q

Proportion of Hep C which becomes chronic?

A

50-80%

86
Q

Treatment of Hep C?

A

Currently a combination of protease inhibitors (e.g. daclatasvir + sofosbuvir or sofosbuvir + simeprevir) with or without ribavirin are used

87
Q

Infection in recent solid organ transplant?

A

CMV

88
Q

Typically presents with flu like illness → brief remission→ followed by jaundice and haematemesis

A

Yellow fever

89
Q

Which hepatitis C test first?

A

Antibodies, then RNA if positive

90
Q

Telbivudine mechanism of action?

A

Synthetic thymidine nucleoside analogue

91
Q

Cut-off for prophylactic Abx in ascites in cirrhosis?

A

15g/L or less

92
Q

Most commom SBP isolate

A

Cefotaxime

93
Q

Treatment of type 2 Crigler-Najjar?

A

Phenobarbitol

94
Q

Treatment of hepatorenal syndrome?

A

Terlipressin
HAS
TIPS

95
Q

Most commonly affected site in ischaemic colitis?

A

Splenic flexure

96
Q

What to D cells produce?

A

Somatostatin

97
Q

What do G cells produce?

A

Gastrin

98
Q

What do I cells produce?

A

CCK

99
Q

What do S cells produce?

A

Secretin

100
Q

Treatment for Wilson’s disease?

A

Penicillamine

101
Q

Drug induced dyspepsia?

A

NSAIDs
Bisphosphonates
Steroids

102
Q

Serum finding in Wilson’s disease

A

LOW serum caeruloplasmin

103
Q

Wilson’s gene

A

ATP7B

104
Q

Wilson’s chromosome

A

13

105
Q

Double duct sign?

A

Panc Ca

106
Q

Ix of choice in PSC?

A

MRCP/ERCP

107
Q

Drug-induced cholestasis?

A

combined oral contraceptive pill
antibiotics: flucloxacillin, co-amoxiclav, erythromycin*
anabolic steroids, testosterones
phenothiazines: chlorpromazine, prochlorperazine
sulphonylureas
fibrates
rare reported causes: nifedipine

108
Q

Drug-induced hepatitis?

A

paracetamol
sodium valproate, phenytoin
MAOIs
halothane
anti-tuberculosis: isoniazid, rifampicin, pyrazinamide
statins
alcohol
amiodarone
methyldopa
nitrofurantoin

109
Q

What are two reversible complications in Haemachromatosis?

A

Cardiomyopathy
Skin pigmentation

110
Q

Inheritance in Wilson’s?

A

AR

111
Q

Major ribavarin side effect?

A

Haemolytic anaemia

112
Q

First line Ix for PSC?

A

MRCP

113
Q

Malabsorptive symptoms with prev GI surgery and oxalate stones?

A

Short bowel syndrome

114
Q

H pylori cancer association?

A

MALT (B-cell lymphoma)

115
Q

Food poisoning 2-4 hours of ingestion?

A

S aureus

116
Q

Best dietary source of vitamin D?

A

Oily fish

117
Q

Meckel’s congenital association?

A

Downs

118
Q

Homozygosity for HLA-DQ2 in coelic - assoc with what malignancy?

A

Small bowel lymphoma

119
Q

Young woman, headache, vertigo, weak/absent pulses, vasculitis-sounding question?

A

Takayasu’s

120
Q

Strongest influencer on peak bone mass attainment?

A

Genetic factors

121
Q

Bowing of the tibia

A

Paget’s

122
Q

Typical age of onset in Wilson’s disease?

A

!0 to 25 years

MRCP 1 (24 decks)

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